Sanne Angel

Psychiatric Hospital Nursing Staff's Experiences of Participating in Group-Based Clinical Supervision: An Interview Study

Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses’ experiences of participating in group-based supervision and identifying psychosocial reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses.

Nursing roles and functions in the inpatient neurorehabilitation of stroke patients: a literature review.

ABSTRACTStroke is a major cause of morbidity and mortality in the world. In the United States, it was estimated that approximately 750,000 patients had a stroke annually. Denmark, with a population of 5.5 million, had about 12,500 cases of hospitalizations from stroke in 2009. Despite the patient’s obvious need for complex nursing care and a common recognition of the nurse’s central role in rehabilitation after a stroke, a description of their specific contributions appeared sparse. Therefore, a literature review was conducted using the matrix method. The purpose was to explore the nursing roles and functions identified in empirical research and to discern any possible evolution in the nursing roles and functions during a span of years. The rehabilitation literature related to inpatient rehabilitation after stroke during the period from 1997 to 2010 was reviewed. The total number of identified citations was 1,529. After screening for relevancy, 134 eligible articles remained. Of these, 30 articles were extracted into a table and formed the basis for the conclusion. We found that four nursing roles and functions described in 1997 still accommodated central aspects of the current nursing practice but also emerging changes reflecting a development in the nurses’ responsibilities and contributions in conducting rehabilitation after a stroke. These changes seemed mainly to be shaped instigated by changes in the (1) patient role, (2) increasing interdisciplinary teamwork, and (3) focus on rehabilitation efforts conducted in the patient’s environment.

Relatives perception of writing diaries for critically ill. A phenomenological hermeneutical study.

BACKGROUND Diaries written by nurses for the critically ill patient help the relatives cope and support the patient. Relatives may participate in writing a diary for the critically ill and when they do this is appreciated by the patients. However, the relatives perception of writing a diary has not previously been explored. AIM To explore how relatives perceive writing a diary for the critically ill patient. METHOD In a phenomenological-hermeneutic study building on the theory of Ricoeur interviews with seven relatives were conducted and interpreted. FINDINGS When relatives wrote a diary for the critically patients, they experienced that writing and reading the diary allowed for the unloading of emotions and expression of feelings. Writing a diary was a meaningful activity while enduring a situation of uncertainty and furthermore it created a distance that allowed understanding of the critical situation. CONCLUSION Involving relatives in writing a diary may support relatives and help them cope with the critical situation. RELEVANCE TO CLINICAL PRACTICE Relatives are distressed and struggle to understand what is happening during the patients course of illness. Involving relatives in writing a diary for the critically ill could be one way to meet their needs in the critical situation.

The experience of being a partner to a spinal cord injured person: A phenomenological-hermeneutic study

This qualitative focuses on the personal experiences of partners to a spinal cord injured person. Using a Ricoeurian phenomenological-hermeneutic approach, we analysed seven partners’ narratives 1 and 2 years after their partners injury. The study revealed how the injury was experienced from the partners’ perspective through the aftermath. In the acute phase after the injury, partners also felt harmed, and support was needed in relation to their own daily activities, eating, resting, and managing distress. During the institutionalized rehabilitation, partners felt torn between supporting the injured partner and the demanding tasks of everyday life outside the institution. After discharge, partners struggled for the injured partner to regain a well-functioning everyday life and for reestablishing life as a couple. The partner struggled to manage the overwhelming amount of everyday tasks. Some sought to reestablish their usual functions outside the family, whereas others focused on establishing a new life together. The partners experienced much distress and appreciated the support they got, but felt that they were mainly left to manage the difficult process on their own.

Vulnerable, but strong: The spinal cord-injured patient during rehabilitation

A traumatic spinal cord injury affects the body to an extent that the patient requires the assistance of others to survive and recover. The rehabilitation phase puts the patient in a vulnerable position and involves a considerable amount of strength on the patients part. The aim of this paper is to explore the vulnerability of the spinal cord patient and how this vulnerability connects to the necessary strength, as the patient struggles to survive the injury and get through the rehabilitation. The circumstances of 12 traumatic spinal cord-injured patients were observed in the rehabilitation unit and after discharge. A phenomenological–hermeneutic narrative approach applying Ricoeurs theory was used. Data were collected by field observation and interviews during the first 2 years after the spinal cord injury. The patients strength during the rehabilitation was portrayed by their endurance and from their narratives of how they handled difficult situations. The patients perception of vulnerability varied, and strength was mobilised as a response to the vulnerability to overcome the imbalance between demands and resources. Vulnerability should therefore refer to a persons experience of the situation rather than the person, as it may hinder the professionals’ open, explorative approach towards the person.

How diaries written for critically ill influence the relatives: a systematic review of the literature?

Background Diaries written by nurses for the critically ill patient helps relatives cope and support the patient. When relatives participate in writing a diary for the critically ill, patients appreciate it. Furthermore, the diary may reduce post-traumatic stress disorder, anxiety and depression in patients and relatives. Aim To explore how relatives perceive reading and writing in the diary and how it affects their well-being. Search strategies A systematic search was carried out in the databases PubMed, Embase, CiNAHL and PsycINFO and supplemented by a citation search in Scopus on four-selected articles. Finally, 10 articles were included in this review structured by the Matrix method. Inclusion criteria (a) Original scientific work, (b) relatives participation and experience of the diary as subject and (c) diaries studied in an intensive care unit setting. Findings Relatives were given instructions on how to write in the diary. They expressed strong feelings in the diary in a very different way than health care staff. The relatives used the diary themselves to gain understanding and to cope. The diary has been shown to prevent post-traumatic stress symptoms. Conclusion The relatives express their love for the patient, when they author the diary and this may be beneficial to the relatives as it helps them cope and support the patient. The organized account of the time in the intensive care unit in the diary may explain the diarys ability to reduce the occurrence of post-traumatic stress disorder; however, further research is needed to confirm this. How relatives interact through writing and reading a diary, originally intended for the patient, is unclear. Relevance to clinical practice Providing relatives with a diary may help them cope. However, caution should be taken as possible adverse effects related to the interaction between relatives in the diary may not yet be known.BACKGROUND Diaries written by nurses for the critically ill patient helps relatives cope and support the patient. When relatives participate in writing a diary for the critically ill, patients appreciate it. Furthermore, the diary may reduce post-traumatic stress disorder, anxiety and depression in patients and relatives. AIM To explore how relatives perceive reading and writing in the diary and how it affects their well-being. SEARCH STRATEGIES A systematic search was carried out in the databases PubMed, Embase, CiNAHL and PsycINFO and supplemented by a citation search in Scopus on four-selected articles. Finally, 10 articles were included in this review structured by the Matrix method. INCLUSION CRITERIA (a) Original scientific work, (b) relatives participation and experience of the diary as subject and (c) diaries studied in an intensive care unit setting. FINDINGS Relatives were given instructions on how to write in the diary. They expressed strong feelings in the diary in a very different way than health care staff. The relatives used the diary themselves to gain understanding and to cope. The diary has been shown to prevent post-traumatic stress symptoms. CONCLUSION The relatives express their love for the patient, when they author the diary and this may be beneficial to the relatives as it helps them cope and support the patient. The organized account of the time in the intensive care unit in the diary may explain the diarys ability to reduce the occurrence of post-traumatic stress disorder; however, further research is needed to confirm this. How relatives interact through writing and reading a diary, originally intended for the patient, is unclear. RELEVANCE TO CLINICAL PRACTICE Providing relatives with a diary may help them cope. However, caution should be taken as possible adverse effects related to the interaction between relatives in the diary may not yet be known.

Grasping the experience of the other from an interview: Self-transposition in use

This article describes a part of the interview process that is never usually reported. Listening to what people say is the key to increasing our knowledge of human existences. Procuring knowledge about human experience is much more challenging. Although good sources on how to prepare and conduct an interview exist, the process of the interviewers perception of the interviewees message and meaning is less examined. Beyond the role of eliciting the data, the researcher endeavours to reproduce the interviewees narration and not the voice of the researcher. By illustrating the process during the interview, further transparency and thereby validity may be achieved. To exemplify this, the perception of the interviewer is explored, and here Heideggers work on self-transposition has proved to be helpful.This article describes a part of the interview process that is never usually reported. Listening to what people say is the key to increasing our knowledge of human existences. Procuring knowledge about human experience is much more challenging. Although good sources on how to prepare and conduct an interview exist, the process of the interviewers perception of the interviewees message and meaning is less examined. Beyond the role of eliciting the data, the researcher endeavours to reproduce the interviewees narration and not the voice of the researcher. By illustrating the process during the interview, further transparency and thereby validity may be achieved. To exemplify this, the perception of the interviewer is explored, and here Heideggers work on self-transposition has proved to be helpful.

Nursing Roles and Functions in the Acute and Subacute Rehabilitation of Patients With Stroke: Going All In for the Patient.

ABSTRACT Background: The description of nursing roles and functions in rehabilitation of patients with stroke remains sparse. Aim: The aim of this study was to describe the experienced roles and functions of nurses during in-hospital rehabilitation of patients with stroke. Methods: Within a phenomenological hermeneutic approach, 19 nurses working with in-hospital rehabilitation of patients with stroke participated in three focus group interviews during 2013. Findings: The nurses’ experiences were described in two themes: (a) the nurse’s role and function in relation to the patient’s needs 24/7 and (b) the nurse’s role and function in the interdisciplinary team. Getting to know the patient as a person was essential to the nurses to care for the patient’s basic needs; these must come first working with rehabilitation and always include the relatives. Recognition of the team members’ individual skills with focus on the patient’s needs must be the center of attention. Conclusion: An interdisciplinary rehabilitation program actively needs to include the patient by integrating the patient’s perspective in the goals as well as in daily rehabilitation. In the team, nurses had the role of coordinator and the patient’s voice.

Expectations, Worries and Wishes: The Challenges of Returning to Home after Initial Hospital Rehabilitation for Traumatic Spinal Cord Injury

Literature highlights the barriers and problems that individuals who sustain traumatic spinal cord injury (TSCI) meet when they attempt to resume everyday life after hospital rehabilitation. However, what do patients think about before returning home, and what should professionals encourage patients to address while the patient is hospitalized in order to balance the patient’s expectations and to reveal what is of importance to the patient. This qualitative study explores the expectations, wishes and worries patients have before they return home after hospital rehabilitation due to TSCI. Eight Danish residents aged 25-75 years, admitted for initial rehabilitation at the Spinal Cord Injury Center of Western Denmark, participated in an individual interview before returning home. The transcribed interviews were analyzed according to inductive content analysis. Transversal analyses revealed four categories of barriers and problems: “facing uncertainty when leaving the rehabilitation center and peers”, “hoping to get back to work and safe economy”, “needing understanding from the community”, and “relying on resilience of significant others”. These categories were combined into one major theme: “relations”. The findings indicate that there is a need for professionals to address patients´ close relations and to initiate dialog with patients and their families on how SCI may impact close relations in order to promote a good life on new terms.

Placing rehabilitation and recovery after spinal cord injury into a biographical context: a U.S. versus Danish case comparison.

ABSTRACT Although medical and technological advances have extended survival rates through ever more effective acute clinical management for people with spinal cord injuries, the links between rehabilitation and recovery are less well understood. With ever shorter length of stays in inpatient rehabilitation, the focus of support has been shifting toward outpatient support pathways. In this article, the narrated rehabilitation experiences of two young men with comparable spinal cord injuries in the United States and Denmark are contrasted. From their biographical narratives, we examine the sociocontextual factors that underpin the rehabilitation pathways in two quite distinctive social and healthcare environments. Our analysis raises questions about the importance of factors such as readiness, timeliness, duration, and appropriateness of rehabilitation to facilitate independent living, achieve meaningful recovery, and provide equitable access to the goods and services afforded by society.