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  • 1.
    Axelsson, Lena
    et al.
    Sophiahemmet Högskola.
    Klang, Birgitta
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Jacobson, Stefan H
    Andreassen Gleissman, Sissel
    Sophiahemmet Högskola.
    End of life of patients treated with haemodialysis as narrated by their close relatives2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, 776-784 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The study aimed to describe end of life for patients treated with maintenance haemodialysis as narrated by their close relatives.

    INTRODUCTION: Many patients undergoing haemodialysis are older, have several comorbidities and underestimated symptoms and are in their last year of life. To improve care, we need to know more about their end-of-life situation.

    DESIGN: Qualitative and descriptive.

    METHODS: Qualitative retrospective interviews were conducted with 14 close relatives of deceased haemodialysis patients (3-13 months after death). Data were analysed using qualitative content analysis. The study is ethically approved.

    FINDINGS: In the last months, a gradual deterioration in health with acute episodes necessitating hospital admissions was described. This involved diminishing living space and expressions of dejection, but also of joy. Three patterns emerged in the last weeks: uncertain anticipation of death as life fades away; awaiting death after haemodialysis withdrawal; and sudden but not unexpected death following intensive care. Findings show complexities of decisions on haemodialysis withdrawal.

    CONCLUSIONS: Different end-of-life patterns all involved increasingly complex care needs and existential issues. Findings show a need for earlier care planning. The identification of organisational factors to facilitate continuity and whole person care to meet these patients' specific care needs with their complex symptom burdens and comorbidities is needed. Findings indicate the need for integration of a palliative care approach in the treatment of patients in haemodialysis care.

  • 2.
    Axelsson, Lena
    et al.
    Sophiahemmet Högskola.
    Klang, Birgitta
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Jacobson, Stefan H
    Andreassen Gleissman, Sissel
    Sophiahemmet Högskola.
    Meanings of being a close relative of a family member treated with haemodialysis2015Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 3/4, 447-456 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To describe and elucidate the meanings of being a close relative of a severely ill family member treated with maintenance haemodialysis approaching the end of life.

    BACKGROUND:

    End-stage renal disease together with comorbidities, haemodialysis treatment and high mortality rates also affects the lives of close relatives, who report burdens and impaired quality of life. To improve care, more understanding is needed of close relatives' experiences during these patients' end of life.

    DESIGN:

    This study has a qualitative interpretative design.

    METHODS:

    Fourteen retrospective qualitative interviews were conducted with close relatives (aged 48-93 years) of deceased patients who had been treated with haemodialysis. The interview text was interpreted using a phenomenological hermeneutical method in three phases.

    RESULTS:

    The findings of the structural analysis were formulated as six themes: Striving to be supportive and helpful without doing harm to the ill person's self; Needing increasing strength and support; Balancing the will to help with one's own ongoing life; Increasing responsibility involving dilemmas; Striving for a good life together in the present and Living with awareness of death.

    CONCLUSIONS:

    Close relatives strive for balance and well-being accompanying their ill family member through the end of life. They are facing moral dilemmas and growing demands as their responsibility increases with the deterioration of their family member. Support from and interaction with the healthcare professionals is then of significance.

    RELEVANCE TO CLINICAL PRACTICE:

    Findings challenge healthcare professionals in haemodialysis settings to identify close relatives' individual resources and needs towards the patients' end of life. Healthcare professionals in haemodialysis settings need to offer close relatives opportunities to talk about the future and what may be expected at end of life, with or without haemodialysis. They should also contact the closest relative after the death as they may need confirmation and closure.

  • 3.
    Axelsson, Lena
    et al.
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Jacobson, Stefan H
    Klang, Birgitta
    Thoughts on death and dying when living with haemodialysis approaching end of life2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 15-16, 2149-59 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe inner thoughts and feelings relating to death and dying when living with haemodialysis approaching end of life.

    BACKGROUND: Patients who undergo maintenance haemodialysis suffer a significant symptom burden and an impaired quality of life. The high mortality rate in these patients indicates that about one-fourth of them are in their last year of life, suggesting the presence of death and dying in the haemodialysis unit.

    DESIGN: A qualitative descriptive design was used. Methods.  A total of 31 qualitative interviews were conducted with eight patients (aged 66-87) over a period of 12 months. Qualitative content analysis was used to analyse data.

    RESULTS: The analysis revealed 10 subthemes that were sorted into three main themes. Being aware that death may be near comprises being reminded of death and dying by the deteriorating body, by the worsening conditions and deaths of fellow patients, and by knowing haemodialysis treatment as a border to death. Adapting to approaching death comprises looking upon death as natural, preparing to face death, hoping for a quick death and repressing thoughts of death and dying. Being alone with existential thoughts comprises a wish to avoid burdening family, lack of communication with healthcare professionals and reflections on haemodialysis withdrawal as an hypothetic option.

    CONCLUSIONS: Living with haemodialysis approaching, the end of life involves significant and complex existential issues and suffering, and patients are often alone with their existential thoughts.

    RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals in haemodialysis settings need to combine technical and medical abilities with committed listening and communication skills and be open to talking about death and dying, with sensitivity to individual and changeable needs.

  • 4. Beck, Ingela
    et al.
    Olsson Möller, Ulrika
    Malmström, Marlene
    Klarare, Anna
    Samuelsson, Henrik
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Rasmussen, Birgit
    Fürst, Carl Johan
    Translation and cultural adaptation of the Integrated Palliative care Outcome Scale including cognitive interviewing with patients and staff2017Inngår i: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 16, nr 1, 49Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: To expand our clinical and scientific knowledge about holistic outcomes within palliative care, there is a need for agreed-upon patient-reported outcome measures. These patient-reported outcome measures then require translation and cultural adaptation, either from country-specific languages to English, or the other way around. The aim of this study was to translate and cross-culturally adapt the Integrated Palliative care Outcome Scale (IPOS) to the Swedish care context.

    METHODS: Swedish versions of IPOS Patient and IPOS Staff were developed and culturally adapted using recommended guidelines including cognitive interviews with patients (n = 13) and staff (n = 15) from different care contexts including general and specialised palliative care.

    RESULTS: The comprehension and judgement difficulties identified in the pre-final patient and staff versions were successfully solved during the cognitive interviewing process. IPOS was well accepted by both patients and staff, none of the questions were experienced as inappropriate, and all questions were judged important.

    CONCLUSIONS: In this study, we translated and culturally adapted the patient and staff versions of IPOS, and demonstrated face and content validity and acceptability of the scale through cognitive interviewing with patients and staff within residential care facility, surgical and specialised palliative home care units. Cognitive interviewing in parallel with patients and staff in rounds, with tentative analysis in between, was a suitable method for identifying and solving challenges with comprehension and evaluation in the pre-final version of IPOS. The Swedish IPOS is now available for use in a variety of clinical care settings.

  • 5. Broberger, Eva
    et al.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Symtomskattningsinstrument minskar patientens besvär2011Inngår i: Onkologi i Sverige, ISSN 1653-1582, Vol. 7, nr 3, 42-46 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 6. Domeisen Benedetti, Franzisca
    et al.
    Raijmakers, Natasja JH
    Bragg, Colin
    Galushko, Maren
    Jorge, Margarita
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Popa Velea, Ovidiu
    Romotzky, Vanessa
    Schuler, Stefanie
    Mason, Stephen
    Lindqvist, Olav
    OPCARE9: how to develop junior researchers in palliative care projects2012Inngår i: European Journal of Palliative Care, ISSN 1352-2779, E-ISSN 1479-0793, Vol. 19, nr 3, 127-130 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 7. Henoch, Ingela
    et al.
    Carlander, Ida
    Holm, Maja
    James, Inger
    Kenne Sarenmalm, Elisabeth
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Lind, Susanne
    Sandgren, Anna
    Öhlén, Joakim
    Palliative Care Research - A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 20122016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 1, 5-25 s.Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: In 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci.

    METHODS: A literature review was undertaken. The databases Academic search elite, Age line, Ahmed, Cinahl, PsychInfo, PubMed, Scopus, Soc abstracts, Web of science and Libris were reviewed for Swedish palliative care research studies published from 2007 to 2012, applying the search criteria 'palliative care OR palliative medicine OR end-of-life care OR terminal care OR hospice care OR dying OR death'.

    RESULTS: A total of 263 papers met the inclusion criteria, indicating an increased volume of research compared to the 133 articles identified in the previous review. Common study foci were symptom assessment and management, experiences of illness and care planning. Targeting non-cancer-specific populations and utilisation of population-based register studies were identified as new features. There was continued domination of cross-sectional, qualitative and mono-disciplinary studies, not including ethnic minority groups, nonverbally communicable people or children <18 years of age.

    CONCLUSIONS: The trend is that Swedish palliative care research has expanded in volume from 2007 to 2012 compared to during the 1970s to 2006, with increasing participation of non-cancer-specific populations. A domination of qualitative approaches and small, cross-sectional studies with few interventions is still characteristic. Still more strategies are needed to expand the knowledge development of palliative care to respond to demographical, epidemiological, therapeutic and healthcare structure changes.

  • 8. Henoch, Ingela
    et al.
    Melin-Johansson, Christina
    Bergh, Ingrid
    Strang, Susann
    Ek, Kristina
    Hammarlund, Kina
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Westin, Lars
    Österlind, Jane
    Browall, Maria
    Undergraduate nursing students' attitudes and preparedness toward caring for dying persons - A longitudinal study2017Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 26, 12-20 s., S1471-5953(17)30384-0Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives.

  • 9. Henriksson, H
    et al.
    Bengtsson, J
    Bolin, S
    Jonsson, A
    Selesi, E
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Vårdtyngdsmätning av patient och närstående på palliativ slutenvårdsavdelning2016Konferansepaper (Annet vitenskapelig)
  • 10.
    Holmberg, Katarina
    et al.
    Sophiahemmet Högskola.
    Bergkvist, Karin
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    ESAS as a teaching tool for self-care in allogeneic stem cell transplantation2016Konferansepaper (Annet vitenskapelig)
  • 11. Imoni, Rose-Marie
    et al.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Handledning för personal inom palliativ vård: en webbaserad svensk kartläggning2016Konferansepaper (Annet vitenskapelig)
  • 12.
    Klarare, Anna
    et al.
    Sophiahemmet Högskola.
    Hansson, Johan
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Fürst, Carl Johan
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Team type, team maturity and team effectiveness in specialized palliative home care: An exploratory questionnaire studyManuskript (preprint) (Annet vitenskapelig)
  • 13.
    Klarare, Anna
    et al.
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fürst, Carl Johan
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Team interactions in specialized palliative care teams: a qualitative study2013Inngår i: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 16, nr 9, 1062-9 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Teamwork is a standard of care in palliative care and that is emphasized by leading organizations. When interdisciplinary teams communicate their varied assessments, outcomes may be more than additive due to the synthesis of information. Interprofessionality does not guarantee multidimensionality in health care interventions, however, and that interprofessional teams promote collaboration may be questioned.

    AIM: The aim was to explore team interaction among team members in specialized palliative care teams.

    DESIGN: Semistructured interviews were conducted with health professionals working in specialized palliative home care teams. The interviews were analyzed by content analysis.

    SETTING/PARTICIPANTS: Participants were recruited from specialized palliative care units in Sweden. The 15 interviewees included 4 men and 11 women. Physcians, nurses, paramedical staff, and social workers were included.

    RESULTS: Organizational issues like resources and leadership have a great impact on delivery of care. Competence was mirrored in education, collaboration, approach, and support within the team; while communication was described as key to being a team, resolving conflict, and executing palliative care.

    CONCLUSION: Communication and communication patterns within the team create the feeling of being a team. Team climate and team performance are significantly impacted by knowledge and trust of competence in colleagues, with other professions, and by the available leadership. Proportions of different health professionals in the team have an impact on the focus and delivery of care. Interprofessional education giving clarity on one's own professional role and knowledge of other professions would most likely benefit patients and family caregivers.

  • 14.
    Klarare, Anna
    et al.
    Sophiahemmet Högskola.
    Rasmussen, Birgit
    Fürst, Carl Johan
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Hansson, Johan
    Experiences of security and continuity of care: patients' and families' narratives about the work of specialized palliative home care teams2017Inngår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 15, nr 2, 181-189 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Those who are seriously ill and facing death are often li ing with physical, emotional, social, and spiritual suffering. Teamwork is considered to be necessary to holistically meet the diverse needs of patients in palliative care. Reviews of studies regarding palliative care team outcomes have concluded that teams provide benefits, especially regarding pain and symptom management. Much of the research concerning palliative care teams has been performed from the perspective of the service providers and has less often focused on patients' and families' experiences of care.

    OBJECTIVE: Our aim was to investigate how the team's work is manifested in care episodes narrated by patients and families in specialized palliative home care (SPHC).

    METHOD: A total of 13 interviews were conducted with patients and families receiving specialized home care. Six patients and seven family members were recruited through SPHC team leaders. Interviews were transcribed verbatim and the transcripts qualitatively analyzed into themes.

    RESULTS: Two themes were constructed through thematic analysis: (1) security ("They are always available," "I get the help I need quickly"); and (2) continuity of care ("They know me/us, our whole situation and they really care"). Of the 74 care episodes, 50 were descriptions of regularly scheduled visits, while 24 related to acute care visits and/or interventions.

    SIGNIFICANCE OF RESULTS: Patients' and family members' descriptions of the work of SPHC teams are conceptualized through experiences of security and continuity of care. Experiences of security are fostered through the 24/7 availability of the team, sensitivity and flexibility in meeting patients' and families' needs, and practical adjustments to enable care at home. Experiences of continuity of care are fostered through the team's collective approach, where the individual team member knows the patients and family members, including their whole situation, and cares about the little things in life as well as caring for the family unit.

  • 15.
    Klarare Ljungberg, Anna
    et al.
    Sophiahemmet Högskola.
    Fossum, Bjöörn
    Sophiahemmet Högskola.
    Fürst, Carl Johan
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Translation and cultural adaptation of research instruments - guidelines and challenges: an example in FAMCARE-2 for use in Sweden2015Inngår i: Informatics for health & social care, ISSN 1753-8165, Vol. 40, nr 1, 67-78 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Assessing and evaluating health care is important, and an abundance of instruments are developed in different languages. Translating existing, validated instruments is demanding and calls for adherence to protocol. Purpose: The purpose of this study was to translate and culturally adapt the FAMCARE-2 scale for use in Sweden. Methods: Traditional back-translation and the decentering stance were utilized and assessed. Experts in palliative care clinic and research were involved; the FAMCARE-2 instrument was discussed with family caregivers and content validity was assessed by experienced health professionals. Results: Significant discrepancies were not revealed by back-translation. Using the decentering stance gave reliable structure and opportunities for reflection throughout the translation process. Discussion: Translating an existing instrument into a second language requires interpretation and adaptation more than a naive translation. The back-translation process may be enhanced if the decentering stance is adopted.

  • 16.
    Klarare Ljungberg, Anna
    et al.
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Teamarbete inom palliativ vård - möjligheter och utmaningar?2013Inngår i: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, Vol. 30, nr 2, 47-50 s.Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 17. Lindqvist, Olav
    et al.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Lundquist, Gunilla
    Sauter, Sylvia
    Lunder, Urska
    Rasmussen, Birgit
    Tishelman, Carol
    Fürst, Carl Johan
    OPCARE9 work package 3: complementary comfort care at the end of life2012Inngår i: European Journal of Palliative Care, ISSN 1352-2779, E-ISSN 1479-0793, Vol. 19, nr 2, 69-72 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 18. Lindqvist, Olav
    et al.
    Lundquist, Gunilla
    Dickman, Andrew
    Bükki, Johannes
    Lunder, Urska
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Rasmussen, Birgit H
    Sauter, Sylvia
    Tishelman, Carol
    Fürst, Carl Johan
    Four essential drugs needed for quality care of the dying: a Delphi-study based international expert consensus opinion2013Inngår i: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 16, nr 1, 38-43 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract Purpose: The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among physicians working in specialist palliative care. Material and methods: Within OPCARE9, a European Union seventh framework project aiming to optimize end-of-life cancer care, we conducted a Delphi survey among 135 palliative care clinicians in nine countries. Physicians were initially asked about first and second choice of drugs to alleviate anxiety, dyspnea, nausea and vomiting, pain, respiratory tract secretions (RTS), as well as terminal restlessness. Results: Based on a list of 35 drugs mentioned at least twice in the first round (n=93), a second Delphi round was performed to determine ≤5 essential drugs for symptom alleviation in the last 48 hours of life that should be available even outside specialist palliative care. There was ≥80% consensus among the participants (n=90) regarding morphine, midazolam, and haloperidol as essential drugs. For RTS, there was consensus about use of an antimuscarinic drug, with 9%-27% of the physicians each choosing one of four different drugs. Conclusion: Based on this consensus opinion and other literature, we suggest four drugs that should be made available in all settings caring for dying patients with cancer, to decrease the gap between knowledge and practice: morphine (i.e., an opioid), midazolam (a benzodiazepine), haloperidol (a neuroleptic), and an antimuscarinic.

  • 19. Lindqvist, Olav
    et al.
    Tishelman, Carol
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Clark, Jean B
    Daud, Maria L
    Dickman, Andrew
    Domeisen Benedetti, Franzisca
    Galushko, Maren
    Lunder, Urska
    Lundquist, Gunilla
    Miccinesi, Guido
    Sauter, Sylvia B
    Fürst, Carl Johan
    Rasmussen, Birgit H
    Complexity in non-pharmacological care-giving activities at the end of life: an international qualitative study2012Inngår i: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 9, nr 2, 1-10 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 20.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Ett livslångt lärande: ökade möjligheter för utbildning inom palliativ vård och medicin: Erfarenheter från att starta specialistsjuksköterskeprogram inriktning palliativ vård2016Konferansepaper (Annet vitenskapelig)
  • 21.
    Lundh Hagelin, Carina
    et al.
    Sophiahemmet Högskola.
    Imoni, Rose-Marie
    Vem får handledning i den palliativa vården?2016Inngår i: Palliativ vård: tidskriften för palliativ vård i Sverige, ISSN 2001-841X, nr 1, 30-31 s.Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 22.
    Lundh Hagelin, Carina
    et al.
    Sophiahemmet Högskola.
    Klarare, Anna
    Fürst, Carl Johan
    The applicability of the translated Edmonton Symptom Assessment System: revised [ESAS-r] in Swedish palliative care2017Inngår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, 1-2 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 23.
    Lundh Hagelin, Carina
    et al.
    Sophiahemmet Högskola.
    Melin-Johansson, C
    Henoch, I
    Bergh, I
    Ek, K
    Hammarlund, K
    Strang, S
    Westin, L
    Österlind, J
    Browall, M
    Studenters attityder till att vårda döende patienter vid start av sjuksköterskeutbildning2016Konferansepaper (Annet vitenskapelig)
  • 24.
    Lundh Hagelin, Carina
    et al.
    Sophiahemmet Högskola.
    Melin-Johansson, Christina
    Henoch, Ingela
    Bergh, Ingrid
    Ek, Kristina
    Hammarlund, Kina
    Prahl, Charlotte
    Strang, Susann
    Westin, Lars
    Österlind, Jane
    Browall, Maria
    Factors influencing attitude toward care of dying patients in first-year nursing students2016Inngår i: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 22, nr 1, 28-36 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract

    Aim: To describe Swedish first-year undergraduate nursing students’ attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated. Method: The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) was used in six universities. Descriptive statistics and regression analysis were used. Results: Some 371 students (67.3%) reported overall positive attitude toward caring for dying patients (total mean FATCOD 119.5, SD 10.6) early in their first semester. Older students, students with both earlier care experience and earlier education, those with experience of meeting a dying person, and students born in Sweden reported the highest scores, a more positive attitude. Conclusion: Age, earlier care experience and education, experiences of meeting a dying person and place of birth seems to affect students’ attitudes toward care of the dying and need to be considered among nursing educators.

  • 25.
    Lundh Hagelin, Carina
    et al.
    Sophiahemmet Högskola.
    Tishelman, Carol
    Rasmussen, Birgit H
    Lindqvist, Olav
    Den komplexa vården under livets sista dagar - det räcker inte med fyra hörnstenar2013Inngår i: Palliativ vård: begrepp & perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkanson, Lund: Studentlitteratur, 2013, 1, 395-403 s.Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 26. Melin-Johansson, Christina
    et al.
    Henoch, Ingela
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Österlind, Jane
    Browall, M
    Vård i livets slutskede: specialistsjuksköterskors attityder - en longitudinell multicenterstudie2016Konferansepaper (Annet vitenskapelig)
  • 27. Piper, Barbara F
    et al.
    Olson, Karin
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Cancer-related fatigue2011Inngår i: The MASCC textbook of cancer supportive care and survivorship / [ed] Olver, Ian N., New York: Springer , 2011, 23-32 s.Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [en]

    This chapter describes what is currently known about cancer-related fatigue (CRF) in cancer survivors. Significance and prevalence rates are reviewed and definitions are discussed within the context of the need to develop case definitions and phenotypes to advance the science and practice of CRF. Two conceptual frameworks/models for CRF are identified based on emerging evidence that unify the seemingly disparate underlying mechanisms proposed in the literature. While further testing of these models and their propositions are needed, these models can be used to guide future studies investigating CRF and its underlying relationships with other symptoms such as pain, depression, and insomnia. The National Comprehensive Cancer Network (NCCN) guidelines for the assessment and management of CRF are reviewed. Particular emphasis is given to the assessment and management of the common contributing and treatable factors associated with CRF (i.e., anemia, comorbidities, deconditioning, emotional distress, nutrition, pain, sleep disturbance/insomnia, symptom clusters, and cognitive impairment). Barriers to guideline adherence and exercise prescription are discussed, and patient and provider education is emphasized.

  • 28. Raijmakers, Natasja
    et al.
    Galushko, Maren
    Domeisen, Franzisca
    Beccaro, Monica
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Lindqvist, Olav
    Popa-Velea, Ovidiu
    Romotzky, Vanessa
    Schuler, Stefanie
    Ellershaw, John
    Ostgathe, Christoph
    Quality indicators for care of cancer patients in their last days of life: literature update and experts' evaluation2012Inngår i: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 15, nr 3, 308-316 s.Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Quality indicators (QIs) are needed to monitor and to improve palliative care. Care of patients in the last days of life is a discrete phase of palliative care and therefore specific QIs are needed. This study aimed to identify and evaluate current QIs against which to measure future care of patients in the last days of life. Methods: To identify QIs for patients in the last days of life an update of the literature and national guidelines was conducted. Subsequently, an international panel of palliative care experts was asked to evaluate the identified QIs: how well they describe care and how applicable they are for care in the last days of life. Also additional QIs were asked. Results: In total, 34 QIs for care in the last days were identified in the literature and guidelines. The experts (response rate 58%) agreed with seven QIs as being good descriptors and applicable: concerning a home visit for the family following a patient's death, the presence of a dedicated family room, limited patients receiving chemotherapy, limited need for pain control, gastrointestinal symptoms, and communication from professional to patient and family. The experts also suggested 18 additional topics for QIs for the last days of life. Conclusion: Currently no definite set of QIs exist to describe quality of care of patients in their last days of life. New QIs that are focused on care for patients in their last days of life, their relatives, as well as their professional caregivers are needed

  • 29.
    Swall, Anna
    et al.
    Sophiahemmet Högskola.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    'Bringing respite in the burden of illness': dog handlers experience of visiting older persons with dementia together with a therapy dog2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 15-16, 2223-31 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To illuminate meanings of the lived experiences of dog handlers' when visiting older persons with dementia with their therapy dog.

    BACKGROUND:

    Studies indicate that care of persons with dementia should focus on a person-centred approach with the person's interests in the centre. Animal-assisted therapy using a therapy dog in the care of persons with dementia has been shown to increase well-being and decrease problematic behaviours associated with the illness.

    DESIGN:

    A qualitative lifeworld approach was adopted for this study.

    METHODS:

    Data were collected from open-ended interviews with nine dog handlers, and the analysis conducted using the phenomenological hermeneutical method.

    RESULTS:

    The structural analysis resulted in one theme, 'Respite from the burden of illness for persons with dementia'.

    CONCLUSIONS:

    Visiting a person with dementia can be seen as an act of caring, providing temporary respite from their illness, and creating a special relationship between handler and patient. A therapy dog visit can represent a moment of communion between the handler and the person with dementia.

    IMPLICATION FOR CLINICAL PRACTICE:

    Dog handlers use their skills and knowledge to promote a situation that reduces symptoms of illness and encourages healthier behaviour. The results of this study may be of interest to researchers, clinical practitioners, caregivers and dog handlers who care for persons with dementia using therapy dog teams on prescription as an alternative method to minimise behavioural and psychological symptoms of dementia.

  • 30.
    Swall, Anna
    et al.
    Sophiahemmet Högskola.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?2015Inngår i: International journal of older people nursing, ISSN 1748-3743, Vol. 10, nr 2, 84-93 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose.

    AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease.

    METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach.

    RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level.

    CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia.

    IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.

  • 31. Swall, Anna
    et al.
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    Stepping out of the shadows of Alzheimer's disease: a phenomenological hermeneutic study of older people with Alzheimer's disease caring for a therapy dog2017Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, nr 1, 1347013Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Living with Alzheimer's disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog.

    METHOD: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method.

    RESULTS: The main theme was "Using one's own resources and abilities as a human being", which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog.

    CONCLUSIONS: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.

  • 32.
    Swall, Anna
    et al.
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    Ebbeskog, Britt
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease: a case study2014Inngår i: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 2, nr 4, 80-93 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Animal-Assisted Therapy using dogs have been described as having a calming effect, decrease sundowning and blood-pressure in persons with Alzheimer’s disease. The aim was to investigate how continuous and scheduled visits by a prescribed therapy dog affected daytime and night-time sleep for persons with Alzheimer’s disease.

    Methods: In this case study, registration of activity and sleep curves was conducted from five persons with moderate to severe Alzheimer’s disease living at a nursing home, over a period of 16 weeks using an Actiwatch. Data was analysed with descriptive statistics.

    Result: The study shows no clear pattern of effect on individual persons daytime activity and sleep when encounter with a therapy dog, but instead points to a great variety of possible different effects that brings an increased activity at different time points, for example during night-time sleep.

    Conclusions: Effects from the use of a Animal-Assisted Therapy with a dog in the care of persons with Alzheimer’s disease needs to be further investigated and analysed from a personcentred view including both daytime and nightime activities.

  • 33.
    Swall, Anna
    et al.
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Fagerberg, Ingegerd
    'Stepping out of the shadows of Alzheimer's disease': a phenomenological hermeneutic study of older persons with Alzheimer's disease caring for a therapy dogArtikkel i tidsskrift (Fagfellevurdert)
  • 34. Söderström, J
    et al.
    Hakola, P
    Henriksson, H
    Samuelsson, M
    Strang, P
    Lundström,
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Patienters upplevelse av sömn och vad som påverkar sömn inom specialiserad palliativ slutenvård2016Konferansepaper (Annet vitenskapelig)
  • 35.
    Tunedal, Ulla
    et al.
    Sophiahemmet Högskola.
    Hansson, Anna
    Sophiahemmet Högskola.
    Rydell Karlsson, Monica
    Sophiahemmet Högskola.
    Lundh Hagelin, Carina
    Sophiahemmet Högskola.
    Distance only separates the bodies - four years of experiences from an online distance learning programKonferansepaper (Annet vitenskapelig)
1 - 35 of 35
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