Kristiina Heikkilä

Problems and consequences in the use of professional interpreters : qualitative analysis of incidents from primary healthcare.

The aim of this study was to explore what problems are reported by healthcare professionals in primary healthcare concerning the use of interpreters and what the problems lead to. The study involved a single case in a real-life situation with qualitative content analysis of 60 incident reports written by different healthcare professionals. The main problems documented were related to language, such as lack of the interpreters with proficiency in a particular language, and to organisational routines, with difficulties in the availability of interpreters and access to the interpreter agency. The problems reported led to incorrect use of time and resources, which increased the workload and thus delayed treatment. Other consequences were limited possibilities to communicate and thus consultation was carried out without a professional interpreter, using family members instead. The results highlight the importance of developing good co-operation between the interpreter agency and the primary healthcare centre in order to fulfil the existing policy of using professional interpreters to provide the right interpreter at the right time and guarantee high-quality care.

Life experiences after stroke among Iranian stroke survivors

BACKGROUND Stroke is a major cause of disability worldwide. It is a life-threatening and life-altering event, which leaves many physical and mental disabilities, thus creating major social and economic burdens. Experiencing a stroke and its aftermath can be devastating for patients and their families. In Iran, many services are not available for those who lack property; this may result in many difficulties and long-term problems for stroke survivors and their family members who are usually the main caregivers in Iranian cultural. Despite its effect on their lives, little is known about how the survivors perceive stroke in the Iranian context, therefore, knowing more about this process may enhance problem identification and problem solving. AIM To illuminate how stroke survivors experience and perceive life after stroke. METHOD A grounded theory approach was recruited using semi-structured interviews with 10 stroke survivors. FINDINGS The survivors perceived that inadequate social and financial support, lack of an educational plan, lack of access to rehabilitative services, physical and psychological problems led them to functional disturbances, poor socio-economical situation and life disintegration. The core concept of life after stroke was functional disturbances. CONCLUSIONS The study shows the need to support the stroke survivors in their coping process with their new situation by providing appropriate discharge plans, social and financial support, social insurances and training programmes for the stroke survivors and their families.

Health Care Experiences and Beliefs of Elderly Finnish Immigrants in Sweden

Purpose: To elucidate the experiences and beliefs of care of elderly Finnish immigrants living in Sweden (Sweden-Finns) in order to gain an understanding of the role ethnic back-ground plays in these experiences and beliefs. Design: 39 elderly Sweden-Finns living in Stockholm were interviewed. The data were analysed hermeneutically. Results: On a surface level, the care in Sweden was culturally congruent to elderly Sweden-Finns’ experiences and beliefs of care. However, care in Finland and the care providers with Finnish background were regarded as superior to Swedish caregivers, giving a deeper sense of familiarity and trust in anticipation of good care. Implications for practice: Culturally appropriate care with care providers sharing the same ethnic background is important for ethnic elderly persons in enabling familiarity and trust between staff and patients.

Healthcare staffs perceptions of using interpreters: a qualitative study

Aim: To describe how healthcare professionals experience and perceive the use of interpreters in their contacts with patients with whom they do not share a common language. Methods: An explorative ...

Gardening activities for nursing home residents with dementia

Activity is recommended for persons with dementia based on the assumption that human abilities and functions must be exercised in order to be retained. The aim of the study is to describe and evaluate gardening activities for persons with dementia. Eight nursing home residents with a diagnosis of dementia were selected. The participants were activated in an outdoor environment three times a week during an intervention period of 6 weeks. The activities used were gardening activities (i.e. watering, weeding, raking, and planting), walks, and social activities. The ability to carry out activities independently was assessed with an independence scale devised for this study. All residents were able to participate, but the degree of independence varied. Factors such as impaired balance and falls risk seemed to be more important than degree of dementia. Activation and rehabilitation in outdoor environments are suitable in the care for demented persons but should be seen as an individual treatment.

Barriers and opportunities in assessing calls to emergency medical communication centre - a qualitative study

IntroductionPrevious studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher’s (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC).AimThe aim of the study was to identify overall factors influencing the registered nurses’ (RNs) assessment of calls to the EMCC.MethodA qualitative study design was used; a purposeful selection of calls to the EMCC was analysed by content analysis.ResultsOne hundred calls to the EMCC were analysed. Barriers and opportunities related to the RN or the caller were identified as the main factors influencing the RN’s assessment of calls to the EMCC. The opportunities appeared in the callers’ symptom description and the communication strategies used by the RN. The barriers appeared in callers’ descriptions of unclear symptoms, paradoxes and the RN’s lack of communication strategies during the call.ConclusionBarriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN’s use of different communication strategies such as closed loop communication.

Experiences of dementia in a foreign country: qualitative content analysis of interviews with people with dementia

BackgroundDementia is a worldwide health concern of epidemic proportions. Research in the field of subjective experience of dementia suffers from a lack of diversity of their participants including immigrants. Different portraits of life with dementia could help us understand how people with dementia conceptualise their experiences of dementia and how they live. Our study aimed to explore the subjective experiences of living with dementia among Iranian immigrants in Sweden.MethodsQualitative content analysis of interviews with fifteen people with dementia from Iranian immigrant backgrounds were conducted (8 females and 7 males).ResultsThree themes and seven associated sub-themes were revealed. The themes included: Being a person with dementia means living with forgetfulness (personal sphere), living with forgetfulness in the private sphere means feeling incompetent but still loved, living with forgetfulness in the public sphere means feeling confident and secure but also isolated.ConclusionsLiving with dementia for the participants meant living with forgetfulness. They experienced feeling incompetent but still loved within their families and feeling confident and secure but also isolated in the society. Educating people with dementia and their families about the course and process of dementia may help them understand the changes better and adjust their expectations. Our study can provide a basis for healthcare workers to understand the experiences of living with dementia from this specific perspective.

What is the reward? Medical students' learning and personal development during a research project course.

Background Until recently, the outcome of medical students’ research projects has mainly been assessed in terms of scientific publications, whereas other results important for students’ development have been less studied. The aim of this study was to investigate medical students’ experiences of learning as an outcome of the research project course. Method Written reflections of 50 students were analyzed by manifest inductive content analysis. Results Three categories emerged: ‘thinking as a scientist’, ‘working as a scientist’, and ‘personal development’. Students became more aware about the nature of knowledge, how to generate new knowledge, and developed skills in scientific thinking and critical appraisal. Unexpectedly, effects on personal characteristics, such as self-confidence, self-discipline, independence, and time management skills were also acknowledged. Conclusions We conclude that individual research projects enhance research-specific skills and competencies needed in evidence-based clinical work and are beneficial for personal and professional development.

Rehabilitation Experts' Experience of Community Rehabilitation Services for Stroke Survivors in Iran

Abstract Purpose: Successful stroke rehabilitation is a complex process involving teamwork by members of several professions. The aims of this study were to explore the experiences of Iranian rehabilitation experts concerning community rehabilitation services for stroke survivors and obtain their opinions on how to further develop and improve these services. Method: A qualitative research method with grounded theory was used, including purposive and theoretical sampling. A constant comparative analysis was conducted. Data were gathered from 2 focus group discussions including 10 Iranian rehabilitation experts and 4 in-depth individual interviews. Results: Nonintegrated rehabilitation services emerged as the core concept of the study. The explored concepts were identified as deficiently allocated budget, inadequate public insurance, lack of availability of rehabilitative care, negative public opinion, lack of consistency in care, and split services and professional separation. Areas identified for potential improvement included need to change policymakers’ attitudes, need to refine rehabilitation in the health care system, need to establish a registration system, need to provide information and skills, and need to see the family as a whole. Conclusion: Experts should participate in educational rehabilitation programs to become more aware of current rehabilitation services within the community. Stroke survivors and their families should also participate in the rehabilitation programs as this would allow them to gain knowledge and skills for dealing with stroke management. This can help reduce problems, change public opinion, and eliminate mistrust between health care providers and families.

The relationship between geographical and social space and approaches to care among rural and urban caregivers caring for a family member with Dementia: a qualitative study

ABSTRACT Knowledge about family caregivers in rural areas remains sparse. No studies to date have addressed the sociocultural aspects in caregiving, thus neglecting potentially significant data. This study aimed to explore and better understand family caregivers’ experiences in rural and urban areas and the sociocultural spheres that these two areas represent. How do family caregivers approach their caregiving situation? A hermeneutical approach was chosen to uncover the underlying meanings of experiences. Open-ended in-depth interviews were conducted. The ontological and epistemological roots are based on hermeneutic philosophy, where a human being’s existence is viewed as socially constructed. The study followed a purposeful sampling. Semi-structured in-depth interviews were conducted with 12 rural and 11 urban family caregivers to persons with dementia. These were then analyzed in accordance with the hermeneutical process. The findings provide insight into the variations of family caregiver approaches to caregiving in rural and urban areas of Sweden. There seemed to be a prevalence of a more accepting and maintaining approach in the rural areas as compared to the urban areas, where caregiving was more often viewed as an obligation and something that limited one’s space. Differences in the construction of family identity seemed to influence the participants approach to family caregiving. Therefore, community-based caregiving for the elderly needs to become aware of how living within a family differs and how this affects their views on being a caregiver. Thus, support systems must be individually adjusted to each family’s lifestyles so that this is more in tune with their everyday lives.