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Search Results: 1 - 10 of 81 matches for " Annica Kihlgren "
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A Meaningful Life for Older Persons Receiving Municipal Care—Unit Leaders’ Perspectives  [PDF]
Annica Kihlgren
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.511110
Abstract: Introduction: In Sweden, new national guidelines for elderly care have been introduced containing core values and local guarantees of dignity that highlight the need for dignity, well-being and the organisation of the older person’s daily life, so it is perceived as meaningful. Unit leaders play a crucial role in health care organisations when guidelines are to be implemented. Aim: The aim was therefore to describe unit leaders’ experiences about what constituted a meaningful daily life for older persons receiving municipal care and the opportunities and obstacles that might exist. Method: Repeated interviews using reflective conversations with nine leaders were performed and analysed with qualitative content analysis. Results: Unit leaders felt a shared vision regarding a meaningful life was needed. Daily routines and habits that promoted independence, a feeling of community together with familiarity with the job, and got the little extra from knowledgeable staff were important. The historical collective paradigm in elderly care needed to be abandoned in favour of one promoting more individualism. Fundamental was the courage to ask the older person what was important and dared to follow through to “Give power to the older person to decide what care to be given”. Conclusion: Organisational conditions affect unit leaders’ ability to succeed in the implementation of the work. Further studies are required regarding the nature of the support that the unit leaders need to succeed in their work.
Experiencing Participation in Health Care: “Through the Eyes of Older Adults”  [PDF]
Samal Algilani, Inger James, Annica Kihlgren
Open Journal of Nursing (OJN) , 2016, DOI: 10.4236/ojn.2016.61007
Abstract: Background: Patient participation is well understood by health care professionals but not many studies have focused on the older adults and their perceptions of patient participation. Aim and Objectives: To report an analysis of the concept of participation from the perspective of the older adult. Design: Concept analysis. Methods: An integrative review approach was undertaken and the searches were limited from January 2003 to December 2014, guiding question was; “what constitutes patient participation according to the older adult?” Results: Through the eyes of the older adults, a two-way communication should be initiated by the staff. Equality and sharing power between older adults and staffs was perceived as a precondition. Been given time was an essential issue, implying that older adults wished to have enough time from staffs and be in the right context surrounded by the appropriate environment in order to experience participation. Conclusion: In order to experience participation for older adults, it is important that the health care professionals are aware of how and in what ways they can contribute to participation among older adults. The need or wish to create participation is not enough; the health care professional needs to see and understand participation through the older adult’s eyes. Thus, a person-centered nursing approach is relevant for the health care professional in order to both give and maintain the experience of participation to the older adult.
Being a Next of Kin—Experiences of Burden and Quality of Life  [PDF]
Elisabeth Liedstr?m, Annica Kihlgren, Kirsti Skovdahl, Jenny Windahl
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.44032

Aim and Objectives: To increase the understanding of next of kin’s life situation in the context of supporting persons who are long term ill, disabled and/or older by describing their experienced burden and quality of life and also the relationship between QoL, burden and socioeconomic variables. Methods: Cross-sectional, descriptive and correlative design. Eighty-four next of kin answered two questionnaires: the Caregiver Burden Scale and the Subjective Quality of Life. Results: Next of kin experienced a high burden in their life situation although they, at the same time, experienced a good quality of life. In the results gender differences were found. Females next of kin to a higher extent were disappointed, more emotionally involved, and they also estimated their economic situation as more unsatisfactory than the males next of kin. Conclusion: Healthcare personnel meet next of kin, persons in need of care, within all healthcare and social care in society. Therefore it is important to have a general knowledge and ability to understand the next of kin’s life situation, thus making it possible to focus the nursing interventions on individual support regardless of the care receiver’s diagnosis.

Referrals to Emergency Departments— The Processes and Factors That Influence Decision-Making among Community Nurses  [PDF]
Annica Kihlgren, Helena Sunvisson, Kristina Ziegert, Anna-Greta Mamhidir
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.45042

The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNs in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme “Shared responsibilities in the best interests of the older person reduce feelings of insufficiency”. The content was formulated, which revealed the RNs’ feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person’s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the “inner circle” were crucial for the nurses’ confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the “outer circle”, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs’ and staff members’ competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons’ health.

Consequences of Working in Eldercare during Organizational Changes and Cut Backs While Education and Clinical Supervision Was Provided: A Mixed Methods Study  [PDF]
Birgitta Fl?ckman, Kirsti Skovdahl, Ingegerd Fagerberg, Mona Kihlgren, Annica Kihlgren
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.59086
Abstract: Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.
Dealing with daily emotions—supportive activities for the elderly in a municipal care setting
Margaretha Norell,Kristina Ziegert,Annica Kihlgren
International Journal of Qualitative Studies on Health & Well-Being , 2012, DOI: 10.3402/qhw.v7i0.9510
Abstract: There are diverse descriptions of supportive activities in nursing to be found in the literature. What they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting, registered nurses (RN) work in a consultative way and they describe a part of their tasks as comprising supportive activities without specifying what kind of supportive activities they mean. The aim of the study was to explore the main concern of the support given by RN to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory. Data were collected using nonparticipant observations regarding the supportive activities of 12 RN at the home of 36 patients between the ages of 80 and 102. Most of the home visit lasted about 40 min but some lasted for 90 min. The central category was about dealing with daily emotions. This was done by encouraging the situation and reducing the patient's limitations, but situations also occurred in which there was a gap of support. Support was about capturing the emotions that the patient expressed for a particular moment, but there were also situations in which RN chose not to give support. To develop a holistic eldercare, more knowledge is needed about the factors causing the RN to choose not to provide support on some occasions.
Trying to cope with everyday life—Emotional support in municipal elderly care setting
Margaretha Norell Pejner,Kristina Ziegert,Annica Kihlgren
International Journal of Qualitative Studies on Health & Well-Being , 2012, DOI: 10.3402/qhw.v7i0.19613
Abstract: Emotional support is considered to be important to older patients because it is a contributing factor to experiencing good health and it has been shown that it can prevent depression after a hip fracture. Opinions differ on whether emotional support falls within the field of nursing, and studies also show that nurses in an elderly home care setting fail when it comes to giving emotional support. The aim of this study was to explore reasons for registered nurses to give emotional support to older patients in a municipal home care setting. The study was conducted using Grounded Theory. Data collection was carried out through interviews with 16 registered nurses. The inclusion criteria were emotional support given to patients aged 80 years and above living in ordinary or sheltered housing and who were in need of help from both the home help service and registered nurses. The results show that the main concern of emotional support was “Trying to relieve the patient from their emotions so they are able to cope with everyday life.” This core category illustrates how registered nurses tried to support the patients’ own strength, so that they were able to move forward. Registered nurses consider that they could support the patients because they give them access to, or could create access to, their emotions, but there were also times when they felt helplessness and as a result, consciously opted out. The results also indicate that registered nurses were keen to give emotional support. To develop patient-centered elderly care, more knowledge of emotional support and the elderly's need for this support is required.
Communication patterns in coordinated care planning conferences with older patients
Tyra Graaf,Annica Kihlgren,Margareta Ehnfors,Karin Blomberg
Journal of Nursing Education and Practice , 2013, DOI: 10.5430/jnep.v3n10p35
Abstract: Background: When an older patient is discharged from a hospital in Sweden, a care plan in cooperation with the patient should be made through coordinated care planning (COCP). Previous research has described difficulties in the discharge process; consequently, it is important to develop additional knowledge and investigate both whether and how patients are given the opportunity to participate in COCP. The aim of the present study was to determine if older patients are given the opportunity to participate in COCP meetings, and if so, what characterizes these meetings. Method: This qualitative, descriptive study is based on non-participant observation of interactions between older patients and care staff at six COCP meetings. The data collected were analyzed using directed content analysis and critical discourse analysis (CDA). Results: The main findings indicate a lack of patient participation in all the COCP meetings held at the hospital. The dialogues in that context were less information intensive, and a professional perspective dominated. The situation in advanced home care (AHC) was the opposite; already from the outset, it was evident that the patient was the chief informant and that the patient’s perspective predominated during the dialogues. Conclusions: General differences in the way the dialogues were initiated and in how they progressed were observed between the hospital and AHC. Due to both shortage of time in health care today and financial issues, it is important to find solutions that incorporate the older patient’s experiences as well as professional knowledge.
Adaptive Co-management Networks: a Comparative Analysis of Two Fishery Conservation Areas in Sweden
Annica Sandstr?m,Carl Rova
Ecology and Society , 2010,
Abstract: Co-management constitutes a certain type of institutional arrangement that has gained increased attention among both policy makers and researchers involved in the field of natural resource management. Yet the concept of co-management is broad, and our knowledge about how different kinds of management structures affect the ability to deal with challenges pertinent to the commons is limited. One of these challenges is to foster an adaptive management process, i.e., a process in which rules are continuously revised and changed according to what is known about the ecological system. We aim to address the relationship between different kinds of co-management structures and adaptive management. To this end, we conducted a comparative case study of two Fishery Conservation Areas in Sweden. The concept of networks and the formal method of social network analysis are applied as theoretical and methodological devices. Building on previous research, we propose that adaptive management processes occur in co-management networks consisting of a heterogeneous set of actors that are centrally and densely integrated. Networks of this kind are believed to promote a management process in which actors with disparate perspectives and resources formulate a common view regarding the condition of the ecosystem, the basic problem to be solved, and what measures to adopt. The empirical findings support the existence of such a relationship. Nonetheless, the restricted empirical material, an inability to control for hidden variables, and a lack of success in determining causality among variables are all factors that call for more research.
The importance of electron-electron interactions in the RKKY coupling in graphene
Annica M. Black-Schaffer
Physics , 2010, DOI: 10.1103/PhysRevB.82.073409
Abstract: We show that the carrier-mediated exchange interaction, the so-called RKKY coupling, between two magnetic impurity moments in graphene is significantly modified in the presence of electron-electron interactions. Using the mean-field approximation of the Hubbard-$U$ model we show that the $(1+\cos(2{\bf k}_D\cdot {\bf R})$-oscillations present in the bulk for non-interacting electrons disappear and the power-law decay becomes more long ranged with increasing electron interactions. In zigzag graphene nanoribbons the effects are even larger with any finite $U$ rendering the long-distance RKKY coupling distance independent. Comparing our mean-field results with first-principles results we also extract a surprisingly large value of $U$ indicating that graphene is very close to an antiferromagnetic instability.
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