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  • 1.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Editorial, SJCS September 2017 issue: NCCS in the past and for the future2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 3, p. 425-426Article in journal (Refereed)
  • 2.
    Craftman, Asa Gransjon
    et al.
    Sophiahemmet Univ, Sweden.
    Westerbotn, Margareta
    Sophiahemmet Univ, Sweden.
    von Strauss, Eva
    Stockholm Univ, Sweden.
    Hilleras, Pernilla
    Sophiahemmet Univ, Sweden.
    Marmstal Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Older people's experience of utilisation and administration of medicines in a health- and social care context2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 760-768Article in journal (Refereed)
    Abstract [en]

    Background: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care. Aim: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care. Design: A qualitative descriptive study. Methods: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used. Findings: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process. Conclusions: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine. Relevance to Clinical Practice: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health-and social care delivery is efficient and improve outcome for the recipient of care.

  • 3.
    Dellve, Lotta
    et al.
    Nordic School of Public Health, Gothenburg, Sweden.
    CERNERUD, LARS
    Nordic School of Public Health, Gothenburg, Sweden.
    Hallberg, Lillemor
    Nordic School of Public Health, Gothenburg, Sweden.
    Harmonizing dilemmas.: Siblings of Children with DAMP and Asperger Syndrome's Experiences of Coping with Their Life Situations2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 3, p. 172-178Article in journal (Refereed)
    Abstract [en]

    The aim of this qualitative study was to describe, from their own perspective and experiences, how siblings of children with deficits in attention, motor control and perception (DAMP) and Asperger syndrome cope with their life situations in their families. Fifteen adolescent females 12–18 years old, siblings of boys with DAMP (8 subjects) and Asperger syndrome (7 subjects), were interviewed. The method used in sampling and analysis of interview protocols was the constant comparative method for grounded theory. The inductive categorization of data produced two core concepts, one about the siblings' life situations in DAMP and Asperger syndrome (‘dilemma of requirements and concerns’) and one about the siblings' coping processes (‘harmonizing’). Of the six categories identified, four were categories of the processes of coping (‘gaining understanding’, ‘gaining independence’, ‘following a bonding responsibility’ and ‘balancing’). The qualitative differences between coping processes were related to the two categories of context to cope within the experienced dilemma ‘requirements’ and ‘concerns’. The findings contribute to a deeper understanding of the siblings' life situations, and may be important for health personnel in encounter families and for identifying siblings with special needs. The findings may also aid in the development of preventive programs for siblings of children with DAMP and Asperger syndrome.

  • 4.
    Ellingsen, Sidsel
    et al.
    University College, Bergen, Norway .
    Roxberg, Åsa
    Linnéuniversitetet.
    Kristoffersen, Kjell
    University of Agder, Norway .
    Rosland, Jan-Henrik
    University in Bergen, Norway .
    Alvsvåg, Herdis
    University College, Bergen, Norway .
    Entering a world with no future: A phenomenological study describing the embodied experience of time when living with severe incurable disease2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 165-174Article in journal (Refereed)
    Abstract [en]

    This article presents findings from a phenomenological study exploring experience of time by patients living close to death. The empirical data consist of 26 open-ended interviews from 23 patients living with severe incurable disease receiving palliative care in Norway. Three aspects of experience of time were revealed as prominent: (i) Entering a world with no future; living close to death alters perception of and relationship to time. (ii) Listening to the rhythm of my body, not looking at the clock; embodied with severe illness, it is the body not the clock that structures and controls the activities of the day. (iii). Receiving time, taking time; being offered - not asked for - help is like receiving time that confirms humanity, in contrast to having to ask for help which is like taking others time and thereby revealing own helplessness. Experience of time close to death is discussed as an embodied experience of inner, contextual, relational dimensions in harmony and disharmony with the rhythm of nature, environment and others. Rhythms in harmony provide relief, while rhythms in disharmony confer weakness and limit time.

  • 5.
    Eriksson, Henrik
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Salzmann-Erikson, Martin
    Oslo Univ Hosp.
    Supporting a caring fatherhood in cyberspace - an analysis of communication about caring within an online forum for fathers2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 63-69Article in journal (Refereed)
    Abstract [en]

    Supporting a caring fatherhood in cyberspace an analysis of communication about caring within an online forum for fathers Background: Today's parents seek out social support on the Internet. A key motivation behind the choice to go online is the need for more experience based information. In recent years, new fathers have increasingly taken on an active parental role. Men's support for their caring activities for infants on the Internet needs attention. Aim: The aim was to describe communication about caring activities for infants among men who visited an Internet-based forum for fathers and elaborate on the dimensions of support available in the forum. Method: An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online: nethnography. A total of 1203 pages of data from an Internet forum for fathers were gathered and analysed. Result: Support for a caring fatherhood in cyberspace can be understood as fathers' communicating encouragement, confirmation and advice. The findings show that important ways of providing support through the forum included a reciprocal sharing of concerns how to be a better father in relation to caring for an infant. Concerns for their child's well-being and shared feelings of joy and distress in everyday life were recurrent supportive themes in the communication. Information gained from contacting others in similar situations is one important reason for the fathers' use of the Internet. Discussion: Support offered in this kind of forum can be considered as a complement to formal support. Professionals can use it to provide choices for fathers who are developing themselves as caregivers without downplaying the parental support offered by formal health care regimes. Further research: Online support will probably be one of the main supporting strategies for fathers in Scandinavia. Caring and nursing researchers need to closely monitor support activities that develop, and over time, as these ill likely become an important source of support for people.

  • 6.
    Eriksson, Monica
    et al.
    Mid Sweden University.
    Asplund, Kenneth
    Mid Sweden University.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare.
    Svedlund, Marianne
    Mid Sweden University.
    Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 295-302Article in journal (Refereed)
    Abstract [en]

    Acute myocardial infarction (AMI) is a life-changing event that affects both the patient and the family and can have an influence on hope as well as HRQoL during the recovery period. Aims: To compare self-rated scores of hope and health-related quality of life (HRQoL) 1, 7, 13 and 25months, after an AMI with regard to (i) differences across time, and (ii) differences between patients and their partners. Design: Explorative and longitudinal study. Methods: In this nonrandomized study, Short Form 36 Health Questionnaire (SF-36) and Herth Hope Index-Swedish (HHI-S) questionnaires were completed by thirteen post-AMI patients and their partners. Data were collected on four occasions. Results: In general, hope as well as HRQoL scores increased over time. A 2 (groups)×4 (times) anova for mixed design showed significant changes in mental as well as in physical health over time but no significant effect of group on mental or physical health. Calculation of the minimum detectable change (MDC-index) for HHI-S and SF-36 revealed that scores between data collection points were not stable. Conclusion: Our results show that although hope and HRQoL scores increased, only a few of the changes were statistically significant. Neither HHI-S nor SF-36 seems to measure stable states. Changes in hope and HRQoL levels may be due to participants striving to adapt to the current situation. Relevance to clinical practice: These results can be used in the training of nursing staff to enhance their understanding of the significance of a family-centred approach after an AMI. © 2012 Nordic College of Caring Science.

  • 7.
    Golsäter, Marie
    et al.
    Hälsohögskolan Jönköping, Sweden.
    Enskär, Karin
    Hälsohögskolan Jönköping, Sweden.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nurses´encounters with children in child and school health care: negotiated guidance within a given frame2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 591-599Article in journal (Refereed)
    Abstract [en]

    Background:Throughout childhood, children take part in health visits according to a health-monitoring programme. The visits are aimed to promote the children’s development and health and to strengthen them to take own responsibility for their health. Nurses’ actions when encountering children at these visits are not explored to any great extent. Exploring nurses’ actions can facilitate their reflections on their actions towards children and thereby promote children’s involvement in such visits. Aim: The aim of this study was to explore nurses’ actions when encountering children at health visits. Method: A qualitative explorative design, based on 30 video recordings of health visits in child and school health care, was used in this study. These visits were ordinary real-life health visits. The data were subjected to qualitative content analysis. The right to conduct video recordings during health visits was approved by appropriate research ethics committees. Results: The findings show that nurses, in order to carry out the health visits, encounter children through negotiated guidance. This guidance is understood as the process through which the nurses reach agreement with the children, and is comprised of directed and pliable strategies. At one moment, the nurse can use a directed strategy to inform the child and at the next moment a pliable strategy to provide the child space within the given frame, the health-monitoring programme. By using these strategies intertwined, the nurse can provide the child space within the given frame and, at the same time, fulfil his/ her responsibility to promote children’s health and development. Conclusion: The results highlight nurses’ challenging and complex assignment of guiding children to promote their engagement in the health visits, thereby enabling the nurses to promote the children’s health and development according to the national health-monitoring programme.

  • 8.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Dependency in autonomous caring: – night nurses’ working conditions for caring in nursing2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 312-320Article in journal (Refereed)
    Abstract [en]

    Few research studies have focused on nurses' working conditions for caring provided at night, and these studies have mainly described nurses' work in hospital settings, not in a municipal, social-care context. In Swedish municipal care, nurses have responsibility for hundreds of older people in need of care. This working condition compromises caring encounters; instead the nurses' caring is mainly mediated through care staff (or relatives). In considering that caring based on caring encounters is fundamental to ethical nursing practice questions leads to the aim: to explore Swedish municipal night nurses' experiences of their working conditions for caring in nursing. All municipal night-duty nurses (n = 7) in a medium-sized community in Sweden participated in interviews, while six of them also wrote diaries. Thematic content analysis has been used in analysing the data. The findings revealed that the nurses experienced their working conditions for caring in nursing in the themes of Dependency in the Organisation and Other Staff, Vocational Responsibility, Deficiency in Conditions for Caring and Autonomous Caring. The findings illustrate privileged, as well as, poor working conditions for caring in nursing. The nurses' role as consultants emerge as their main function. The consultant function implies that nurses do not participate in ordinary bed-side caring, which makes it easier for them to find time for caring in situations that arise when nurses' skills, expertise and authority are called upon. Conversely the consultancy function entails short-term solution of complex caring problems, which can signify deficient caring due to prevailing working conditions. The findings also point to nurses' possible problems in fulfilling their own and vocational demands for ethics in the practice of caring in nursing related to existing working conditions.

  • 9.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Mattsson, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dubbelman, Kerstin
    Snöljung, Åsa
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aspects of nursing with evidence-base when nursing frail older adults: a phenomenographic analysis of interviews with nurses in municipal care2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, ISSN 0283-9318, Vol. 28, no 4, p. 793-801Article in journal (Refereed)
    Abstract [en]

    In earlier research as well as in political discussion and documents, the topic of evidence has been highlighted as one of the most important concerns in nursing care. This study focuses on understanding what lies behind nurses' ways of acting regarding evidence-based nursing through an illumination of the way they perceive the phenomena.AIM: The aim was to identify and describe the different ways municipal care nurses perceive aspects of working with evidence when nursing frail older adults.METHODS: An explorative design with a phenomenographic approach based on interviews with nurses working with home-based care within the municipality was used in order to gain understanding of nurse's perceptions of the phenomena.RESULTS: Findings revealed that the nurses perceived a variety of aspects when working with evidence when nursing frail older people. Aspects with a spectra of different perceptions shown in the analysis were as follows: Evidence-based nursing as a desired intention/mission, lack of practical supporting structures to apply evidence, lack of confidence in own capacity to apply evidence and a belief that it will work anyway.CONCLUSIONS: Findings reveal that it is a challenge to implement research both on an individual as well as on an organisational level. Understanding the contextual perceptions of evidence by nurses can cast light on the barriers as well as the prerequisites of working with evidence while caring for frail older adults in municipal care.

  • 10.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wiklund-Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindström, Unni Å
    Enheten för vårdvetenskap, Åbo Akademi, Finland.
    The meaning of reconciliation: Women’s stories about theirexperience of reconciliation with suffering from grief2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 525-532Article in journal (Refereed)
    Abstract [en]

    Introduction: Grief can be seen as a form of suffering. In this study grief was not only defined as loss, but as the process of inner suffering caused of some kinds of loss. We must recognise the importance of increased understanding for patient reconciliation with grief to expand earlier formulated knowledge about health and suffering. The aim in this study was ti illuminate the meaning of reconciliation among women suffering from grief.

    Methods:A qualitative explorative design with a hermeneutic narrative approach was used to analyse and interpret the interviews. Caring theory abouth health, suffering and hermeneutical philosophy about understanding provided the point of departure for the analysis. The study was approved by an ethical research committé.

    Results:Findings reveal different plots that give light to the meaning of reconciliation in the different phases of analysis. In the Women´s narratives the meaning of reconciliation is a process to a new way of seeing, but also to opening and transition from the experience of grief and suffering to the experience of health and holiness.

    Conclusions: Reconciliation has a progressive form and the meaning of reconciliation cannot be seen as synonymous or homogenous but an understanding of reconciliation as a heterogenic synthesis of health and suffering. Understanding the reconciliation process will enable nurses to plan and provide professional care, based on caring science.

  • 11.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Zander, Viktoria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Elfström, Magnus
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Anbäcken, Els-Marie
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    ‘Best fit’ caring skills of an interprofessional team inshort-term goal-directed reablement: older adults’perceptionsIn: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
  • 12.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Christensson, K.
    Karolinska Institutet, Stockholm, Sweden.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Undergoing an immunization is effortlessly, manageable or difficult according to five-year-old children2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 2, p. 268-276Article in journal (Refereed)
    Abstract [en]

    Background: To prevent diseases among children they regularly undergo immunizations. Previous research show different approaches available to facilitate immunization-procedures for children to protect them from harm. To complement this research and provide care suited for children, research recognizing their perceptions of undergoing such a procedure is needed. Aim: The aim of this study was to describe 5-year-old children's perceptions of undergoing an immunization. Method: A phenomenographic approach and analysis was used to describe the children's (n = 21) various perceptions. The data-collection was accomplished directly after the immunization to grasp the children's immediate perceptions. Drawings and reflective talks were used as they are considered as suitable methods when involving young children in research. The right to conduct research with children was approved by the appropriate research ethics committee and also by each child and the parents. Results: The findings show that children's perceptions of an immunization-procedure may vary from effortlessly, to manageable or difficult. Regardless of how the child perceive the immunization-procedure each perception embrace the children's descriptions of actors and articles in the situation, their feelings in the situation and also their actions to deal with the immunization. Nevertheless, these descriptions vary according to how the children perceive the immunization as effortlessly, manageable or difficult. Conclusion: Children's and adults' perceptions of medical procedures may differ and children need guidance, time and space to deal with them. Recognizing children's perceptions of undergoing an immunization contributes to the promotion of their right to be involved in their own health care and towards the development of child-centred care. 

  • 13.
    Harstäde, Carina
    et al.
    Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV.
    Roxberg, Åsa
    Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV.
    Andershed, Birgitta
    Department of Nursing, Gjøvik University College; Norway.
    Brunt, David
    Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV.
    Guilt and shame: a semantic concept analysis of two concepts related to palliative care2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, p. 787-795Article in journal (Refereed)
    Abstract [en]

    The theoretical viewpoint of the study was based on the fundamental motive in caring science, the suffering person and his/her health and life situation,which according to the philosophy of palliative care also includes the next of kin. The latter often wish to participatein the care of their loved ones and it is thus important for them to be able to make decisions that can generate a meaningful participation. Unfulfilled obligations or wrongdecisions, concerning their dying relative, can result in experiences of guilt and shame in relation to the care of the loved one. A semantic concept analysis can provide a deeper understanding of these concepts and create a deeper insight into what the concepts mean for the individual. Aim: The aim of the study was to elucidate the meaning of and the distinction between the concepts of guilt and shame. Methods: Semantic concept analysis based on Koort and Eriksson. Findings: The findings show that guilt and shame are two separate concepts. Guilt contains meaning dimensions of being the cause of and sin. Shame contains meaning dimensions of something that gives rise to shame and ability to experience shame. The synonyms for each concept do not overlap each other. Conclusion: The semantic analysis creates an understanding of the concepts ontologically and provides a basis for theoretical, contextual and clinical understanding and development.

  • 14.
    Hjelmblink, Finn
    et al.
    Uppsala universitet, Sweden.
    Holmström, Inger
    Uppsala universitet, Sweden.
    To cope with uncertainty: stroke patients' use of temporal models in narratives2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 4, p. 367-374Article in journal (Refereed)
    Abstract [en]

    Stroke victims have to cope with a disrupted autobiography and anxiety because of an uncertain future. Professionals share this uncertainty. The patients reveal their experiences in narratives, and when they try to regain coherence and confidence in life, they use narratives in the reconstructions. Because they have a temporal problem, time might be an important issue in these narratives. The aim of this study was to elucidate the use of time models in stroke patients' narratives. Nineteen stroke patients, who had recently been discharged to their homes after the stroke, accepted to participate in the study. Their age span was between 56 and 89 years. They had lived active urban lives before the stroke, and poststroke only three had more serious physical impairment, and none was demented. They were asked to talk about their present life and their conceptions of future life. The interviews were audio-taped and transcribed verbatim and narratives that referred to temporal aspects were thematically analysed with reference to narrative time models. The stroke accident had caused an autobiographical disruption and a temporal split because of a new awareness of human temporality and an uncertainty of the future. Confronted with these problems of time, the stroke victims constructed narratives based on the time models: time cycles and dissolution of time limits, exchange of time and exclusion from time. Hence, the time models worked as tools when the stroke victims re-established coherence in their present and future life. Stroke patients handled an uncertain future by using temporal models in their narratives. Professionals can support stroke patients by reinforcing these models.

  • 15.
    Hjelmblink, Finn
    et al.
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Kjeldmand, Dorte
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Stroke patients' delay of emergency treatment2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 307-311Article in journal (Refereed)
    Abstract [en]

    Treatment of stroke victims with fibrinolysis should take place within a time limit of 3 hours. In spite of comprehensive endeavours to reduce hospital arrival time, too many patients still delay arrival beyond this time limit. This qualitative case study explored the meaning of acute stroke and treatment to four patients with more than 24-hour delayed arrival. The setting of the study was the catchment area of a university hospital. Semi-structured interviews were analysed through the empirical psychological, phenomenological method. An essence was found which was constituted by four themes. The essence of stroke symptoms and treatment was: 'Threatened control of bodily function, autonomy and integrity'. When the patients fell ill they acted as if nothing had happened. They treated their body like a defective device. In encounters with physicians they demanded to be met as a person by a person; otherwise they rejected both the physician and her or his prescriptions. They did not involve their near ones in decision-making. The conclusions were the following: Health care information about how to act in cases of early stroke symptoms may need to imbue people with an understanding of how early treatment of neurological symptoms and preserved control of life are intimately connected. Furthermore emergency care of acute stroke patients might need to take place in an organisation where patients are sure to be met by physicians as a person by a person.

  • 16.
    Holmberg, Mats
    et al.
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society.
    Forslund, Kerstin
    Örebro Universitet, Institutionen för hälsovetenskaper och medicin.
    Wahlberg, Anna Carin
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola, Institutionen för vårdvetenskap.
    To surrender in dependence of another: The relationship with the ambulance clinicians as experienced by patients.2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 544-551Article in journal (Refereed)
    Abstract [en]

    Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care.

  • 17.
    Holmgren, Jessica
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Emami, Azita
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Lars E.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Henrik
    Röda Korsets Högskola, Sweden.
    Being perceived as a ‘visitor’ in the nursing staff’s working arena: the involvement of relatives in daily caring activities in nursing homes in an urban community in Sweden2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 677-685Article in journal (Refereed)
    Abstract [en]

    Background

    It is both complex and difficult for relatives when a loved one moves into a nursing home and many relatives are not prepared for the realities these new situations entail. Little attention has been paid to scrutinising the involvement of relatives in patient care, particularly in relation to the structures and routines of nursing homes or to the staff's reasoning concerning their involvement.

    Aim

    To describe, from a gender perspective, how nursing staff's routines and reasoning act to condition the involvement of relatives in nursing homes.

    Methods

    Focused ethnographic fieldwork was conducted in a medium-sized urban community in central Sweden in three different nursing homes.

    Results

    The nursing staff assigns a certain code of conduct to all relatives they perceived as ‘visitors’ in their working arena. This code of conduct was related to the routines and subcultures existing among the nursing staff and stemmed from a division of labour; the underlying concept of ‘visitor’ predetermined the potential for relatives' involvement. This involvement is explicitly related to the general gendered characteristics that exist in the nursing staff's perception of the relatives.

    Discussion

    The study's limitations are primarily concerned with shortcomings associated with a research presence during the fieldwork. The discussion focuses on the dimensions of power structures observed in the nursing home routines and the staff's reasoning based on their gendered assumptions. We argue that it is important to develop mechanisms that provide opportunities for nursing staff in elderly care to reflect on these structures without downplaying the excellent care they provide. We stress the importance of further exploring these issues concerning relatives and their involvement in nursing homes to facilitate the transition from informal caregiver to ‘visitor’.

  • 18.
    Holmström, Inger
    et al.
    Uppsala University, Uppsala, Sweden .
    Dall' Alba, Gloria
    Karolinska Institutet, Stockholm, Sweden.
    'Carer and gatekeeper' - conflicting demands in nurses' experiences of telephone advisory services2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 2, p. 142-148Article in journal (Refereed)
    Abstract [en]

    Millions of calls are made to the telephone advisory services in primary health care in Sweden. The patients seem happy with the advice and counselling they receive, but little has been written about nurses' experiences of performing telephone advisory services. Yet, the nurses are expected to be patient, sensitive and have a broad knowledge of medicine, nursing and pedagogy. The aim of this study was to describe how nurses experience the patient encounter when performing telephone advisory services. A strategic sample of five nurses were interviewed and asked to describe how they experienced the central aspects of the patient encounter by telephone. The transcribed interviews were analysed by the Empirical Phenomenological Psychological method. The nurses' experience of the patient encounter when performing telephone advisory services can be characterized in terms of the conflicting demands of being both carer and gatekeeper. The constituents of these conflicting demands were: reading between the lines while pressed for time; educating patients for self-care while fearful of misinterpreting the situation; encountering patients' satisfaction and dissatisfaction. The conflicting demands of being both professional carer and gatekeeper caused stress among the nurses. The organization of the telephone advisory services seems to hinder high-quality care.

  • 19.
    Hägglund, Karin
    et al.
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University,.
    Helsing, Christer
    Tabelloform, Sollentuna, Sweden.
    Sandmark, Helene
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University.
    Assistant nurses working in care of older people: associations with sustainable work ability2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 325-332Article in journal (Refereed)
    Abstract [en]

    Indicators of health have shown improvements in the Swedish working population during the past decades, but with the exception of low-skilled women. Earlier research has shown that assistant nurses belong to an occupational group, which has the lowest share of individuals with long-term health in the total Swedish workforce. Sick leave research has mostly focused on determining risk factors for the development of diseases and dysfunctions. In the process of acquiring knowledge about mechanisms for sick leave, it has become obvious that there is also a need to focus on what contributes to work ability. The aim in this study was to explore what promotes sustainable work ability in female assistant nurses working in care of older people. Associations between factors related to work, health, lifestyle and sustainable work ability were investigated in a cross-sectional nested case–control study in a cohort of 366 female assistant nurses. Data were collected in self-reports in a questionnaire. Odds ratios were calculated, and a multiple logistic regression analysis was performed with sustainable work ability as the dependent variable. Sustainable work ability was associated with good self-rated health, a BMI <30, ability to sleep well, recuperation, low stress level, support from family and friends, being over 25 years of age at birth of the first child, and control over one’s own life in the ≥50 age group. In the logistic regression analysis, the significant associations were good self-rated health, being over 25 years of age at the birth of the first child and recuperation. In conclusion, the study showed that self-rated health and factors in private life are important for assistant nurse’s sustainable work ability over time. The results from this study could be applied in health promotion work for employees in the care sector to strengthen and enhance sustainable work ability.

  • 20.
    Häggström-Nordin, Elisabet
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Sandberg, Jonas
    Mälardalen University, Department of Caring and Public Health Sciences.
    Hanson, U.
    Uppsala University, Uppsala, Sweden.
    Tydén, T.
    Uppsala University, Uppsala, Sweden.
    “It's everywhere!” Young Swedish people's thoughts and reflections about pornography.2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 4, p. 386-393Article in journal (Refereed)
    Abstract [en]

    Pornography is one of the most sought-after topics on the Internet, and is easily available for anyone, including children and adolescents. At youth centres, nurse-midwives have noticed that young people have different kinds of questions about sexual practices compared with a few years ago. The aim of this study was to gain an understanding of thoughts and reflections about pornography consumption, and its possible influence on sexual practices, among young women and men. The staff at a youth centre in a city in central Sweden asked the visitors if they had seen pornography and if they wanted to be interviewed about their experiences. Ten young women and eight men, aged 16–23 years, participated. In-depth interviews were performed and open-ended questions about pornography and sexuality were posed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. The core category 'Living with the current sexual norm' depicted how pornography created sexual expectations and demands, for instance, to perform certain sexual acts. The informants expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. A moral attitude was described and examples of stereotypic gender roles were given. To deal with the current sexual norm, informants had different individual handling strategies and attitudes to pornography, namely liberal, normalization, distance, feminist or conservative. Limitations of this study were the small sample size and that results from a qualitative research study cannot be generalized. The results contribute to an understanding of how pornographic material can influence young peoples' thoughts, reflections and sexual behaviour. This indicates the importance, for personnel at youth centres and schools, to discuss sexual behaviour and how sexuality is portrayed in pornographic material with young people.

  • 21.
    Johansson, Louice
    et al.
    Mälarsjukhuset MSE, Eskilstuna, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT-Norges Arktiske Universitet.
    The multifacetted vigilance - nurses’ experiences of caring encounters with patients suffering from substance use disorder2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 303-311Article in journal (Refereed)
    Abstract [en]

    Background

    Nursing care is guided by a value base focusing on promoting dignity and health by means of the caring relationship. However, previous research has revealed that negative attitudes towards ‘addicted’ patients, as well as these patients’ behaviour, can give rise to negative emotions such as frustration and disappointment among nurses. This can contribute to a judgmental and controlling attitude towards patients. To preserve order, nursing interventions focusing on creating structure and stability could be applied in a way that challenges caring values.

    Aims and objectives

    This study aimed to describe how nurses’ working in inpatient psychiatric care experience caring encounters with patients suffering from substance use disorder (SUD).

    Design

    This qualitative study is part of a clinical application project focusing on value-based care of patients suffering from SUD. Data were obtained during four reflective group dialogues with six nurses in a psychiatric hospital.

    Methods

    The transcribed dialogues were subjected to latent qualitative content analysis.

    Results

    The analysis facilitated the organisation of the findings into a coherent pattern. A common thread of meaning was conceptualised as a theme labelled ‘the multifaceted vigilance’, describing how nurses strived to deliver good care, while at the same time being vigilant towards patients’ behaviour as well as their own reactions to it. Within that theme, four categories described experiences related to different challenges nurses face in caring encounters.

    Conclusion

    We suggest that this perhaps unavoidable aspect of caring encounters can be an asset. Thus, if acknowledged and subject to reflection, being vigilant could be understood as a strength enabling nurses to safeguard caring values, and to use their authority to promote patients’ health and alleviate suffering.

  • 22.
    Karlsson, Inger
    et al.
    Karolinska Institutet, NVS, Enheten för omvårdnad.
    Ekman, Sirkka-Liisa
    Karolinska Institutet, NVS; Enheten för omvårdnad.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    A difficult mission to work as a nurse in a residential care home - some registered nurses´experiences of their work situation2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2, p. 265-273Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe Registered Nurses' (RNs) experiences of their work environment in residential care homes for older persons. Twelve RNs were interviewed and latent content analysis was used for analysing the data. The data were collected in the spring of 2006. The findings revealed that these RNs experienced a paradoxical work environment: feeling appreciated and valuable, whilst at the same time feeling underestimated and frustrated. They felt appreciated and valuable when they provided nursing care and trust and support to others. The RNs experienced a positive work environment when the border between social and nursing care were clear. They also felt frustrated when they were expected to 'be everywhere and to know everything', but at the same time they felt invisible and underestimated. They experienced themselves as 'lonely fixers', having the ability to solve practical problems when the older persons were discharged from hospital and expected to be able to provide specialist nursing care without having specialised competence and specialist staff team members. In conclusion, it is important that the RNs can identify the border for nursing care. When these are clear, the nursing care objectives are apparent and the RNs become more autonomous, visible and listened to. The manager should listen to and support the RNs, with continuous supervision and competence development being mandatory elements. It is a difficult task for RNs working in residential care homes to meet all of the expectations placed on them, resulting in a risk of moral distress, making mistakes and developing illnesses caused by stress.

  • 23.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wells, M.
    Karolinska Institute, Stockholm, Sweden.
    Andersson, E.
    Karolinska Institute, Stockholm, Sweden.
    Father group leaders' experience of creating an arena for father support: A qualitative study2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 943-950Article in journal (Refereed)
  • 24.
    Lindstedt, Helena
    et al.
    Uppsala University, Uppsala, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, Örebro, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Background factors related to and/or influencing occupation in mentally disordered offenders2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 331-338Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Knowledge of background and occupational related factors of mentally disordered offenders are missing. It is essential to understand these issues when planning discharge from forensic psychiatric hospital care to enable community dwelling. AIMS: One aim was to investigate mentally disordered offenders' background factors, confidence in and how they value occupations. Another aim was to investigate MDOs background factors' in relation to and the influences on Occupational Performance and Social Participation. METHOD: Data was collected with an explorative, correlative design after informed consent, from 74 mentally disordered offenders (mean age 34,2) cared for in forensic psychiatric hospitals. Assessments were Allen Cognitive Level Screen, Capability to Perform Daily Occupations, Interview Schedule of Social Interaction, Manchester Short Assessment of Quality of Life, Self-efficacy Scale and Importance scale. Eight background factors were assembled from the individual forensic psychiatric investigation. FINDINGS: Most of the investigated background factors relate to and half of them influence occupational performance, particular the cognitive aspect of occupational performance. The influences on occupation originate from adulthood, such as suffering from schizophrenia, psycho/social problems, and having performed violent crimes. These findings indicate that staff in forensic hospital care should initiate rehabilitation with knowledge about MDOs' complex daily occupations. For avoiding information bias, information gathering preceding treatment planning should be performed in collaboration between caring staff and mentally disordered offenders.

  • 25.
    Lindwall, Lillemor
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    von Post, Irene
    Åbo Academy University, Vasa, Finland.
    Continuity created by nurses in the perioperative dialogue: a literature review2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2, p. 395-401Article in journal (Refereed)
    Abstract [en]

    This literature review analyses eight research reports dealing with perioperative dialogues conducted between patients and nurses. The aim of this study was to summarise studies concerned with the perioperative dialogue as an organisation model for bringing safe operative practices and caring into perioperative nursing, by creating continuity for both patients and nurses in perioperative praxis and its research. How do patients and perioperative nurses experience the perioperative dialogue as a model? Perioperative nursing should be perceived as a caring profession emphasising that the focus is on perioperative caring. The perioperative dialogue has a humanistic and caring perspective and presents an ideal model on which to base perioperative nursing. There is general acceptance of the value of the perioperative dialogue for both patients and nurses as means of alleviating suffering and creating a safety nursing, with continuity in the process provided by nursing staff. This study suggests further research and that a means of measuring caring in the perioperative dialogue should be more developed. 

  • 26.
    Lännerström, Linda
    et al.
    Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University.
    Wallman, Thorne
    Centre for Clinical Research Sörmland, Uppsala University.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Nurses' experiences of managing sick-listing issues in telephone advisory services at primary health care centres2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 857-863Article in journal (Refereed)
    Abstract [en]

    Objective. To describe Swedish nurses’ experience of managing sick-listing issues in telephone advisory services in a primary health care setting.

    Design. The study was a qualitative focus group study.

    Setting. Data collection was conducted in three focus group conversations in a county in central Sweden in 2009. The conversations were recorded, transcribed and analyzed using qualitative content analysis.

    Subjects. The study included fourteen nurses, purposively sampled as having current experience of telephone advisory services at primary health care centers.

    Main outcome measures. How nurses experience and handle sick-listing issues in telephone advisory services.

    Results. Nurses’ management of sick-listing issues was described in three themes: the Nurses Actions which are affected by Enabling conditions and Obstructing conditions. The Nurses’ Actions included making an assessment for appropriate action, making an appointment and/or giving information and guidance to the patient and/or monitoring patient’s rights. Enabling conditions included documentation, routines, supportive co-operation and training in insurance medicine. The obstructing conditions were related to patients’ expectations, co-operation with other professionals, lack of training and the nurses’ professional role.

    Conclusion. The nurses demonstrated difficulties to find themselves as active care-givers in health care of sick-listed patients. They also experienced difficulties due to lack of training and the need to balance demands from the organisation and the patient. By engaging nurses more consciously in the sick-listing process a new perspective will be added in care of sick-listed patients.

  • 27.
    Marmstål Hammar, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Emami, Azita
    College of Nursing, University of Seattle, USA.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    Götell, Eva
    Mälardalen University, School of Health, Care and Social Welfare.
    Communicating through caregiver singing during morning care situations in dementia care2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 1, p. 160-168Article in journal (Refereed)
    Abstract [en]

    It is well known that persons with dementia (PWD) have problems expressing and interpreting communication, making interaction with others difficult. Interaction between PWD and their caregivers is crucial, and several strategies have been investigated to facilitate communication during caregiving. Music therapeutic caregiving (MTC) - when caregivers sing for or together with PWD during caregiving activities - has been shown to enhance communication for PWD, evoking more vitality and positive emotions. The aim of this study was to describe how PWD and their caregivers express verbal and nonverbal communication and make eye contact during the care activity 'getting dressed', during morning care situations without and with MTC. Findings revealed that during the situations without MTC, the caregivers led the dressing procedure with verbal instructions and body movements and seldom invited the PWD to communicate or participate in getting dressed. Patterns in responses to caregivers' instructions included both active and compliant responses and reactions that were resistant and aggressive, confused, and disruptive. In contrast to the 'ordinary' morning care situation, during MTC, the caregivers seemed interested in communicating with the PWD and solicited their mutual engagement. Although verbal communication consisted of singing about things other than getting dressed, e.g. dancing, love, sailing, God, the PWD mostly responded to caregivers in a composed manner, by being active, compliant, and relaxed, though some were also resistant or incongruent. The authors conclude that MTC could be a way for PWD and their caregivers to successfully interact and co-operate during caring situations, as it seems to evoke enhanced communication for both partners in this context

  • 28.
    Müllersdorf, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Zander, Viktoria
    Mälardalen University, School of Health, Care and Social Welfare.
    Eriksson, Henrik
    Mälardalen University, School of Health, Care and Social Welfare.
    The magnitud of reciprocity in chronic pain management: experiences of dispersed ethnic populations of Muslim women2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 4, p. 637-645Article in journal (Refereed)
    Abstract [en]

    Dispersed ethnic populations believe their health to be worse than the ethnic majority group in Sweden. Most studies in rehabilitation exclude dispersed ethnic populations who can not read or speak the national language although this group seems to be in need of rehabilitation to a larger extent than privileged majority groups. The aim of the study was to examine the experience of living with musculoskeletal pain and experience of health care among dispersed ethnic populations of Muslim women. The method used was inspired by Grounded Theory in this study. Interviews were made with five first-generation Muslim immigrant women who had come to Sweden via Iraq as refugees. Two interviews were performed with interpreters. A preliminary core category ‘The magnitude of reciprocity’ based on three categories emerged from the analysis: (1) Impact of pain, (2) Managing pain and (3) Facing health care. Chronic pain limited the informants physically and emotionally, as well as impacting on their everyday life. Informants managed their pain primarily through medicine and physical activity, which gave at least temporary relief. Health care providers were perceived as doing their best but experiences of bad meetings were also witnessed. The factors important in achieving a good meeting in this study appeared to be; time, dialogue, honesty and understanding. Communication skills, feelings of being taken seriously and a sense of security were additional factors. Not being properly examined, or offered optimal treatment, not being believed or understood, were all seen as signs of dismissal within health care. The limitations of this study are primarily concerned with language difficulties resulting in various shortcomings. Reciprocal recognition and support connected to the specific life experiences of women that come with forced resettlement from the Muslim world to the European diaspora is a vital part of a holistic approach to pain management.

  • 29.
    Müllersdorf, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Zuccato, Linda Martinson
    Mälardalen University, School of Health, Care and Social Welfare.
    Nimborg, Jennie
    Mälardalen University, School of Health, Care and Social Welfare.
    Eriksson, Henrik
    Mälardalen University, School of Health, Care and Social Welfare.
    Maintaining professional confidence--monitoring work with obese schoolchildren with support of an action plan.2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 1, p. 131-138Article in journal (Refereed)
    Abstract [en]

    School nurses meet obese children in their everyday work. Although school nurses acknowledge the importance of getting hold of school children's obesity, they seem to lack strategies enabling them to handle the delicacy of the problem. The aim of this study was to describe how school nurses perceive their work with obese children with support of an action plan. Qualitative in-depth interviews were performed with six school nurses working in a municipality, where an action plan for the work with obese school-age children had been implemented. The transcribed data was analysed by a manifest content analysis. The results showed that the informants perceived having a key role in the obesity work, which they experienced as meaningful, but full of pitfalls. They found themselves suitable for the task, but perceived lacking deeper knowledge about specific modes of work such as motivational conversation. As the task was considered delicate, there were great demands for guidelines, education and cooperation. The action plan served as support for maintaining professional confidence throughout the process, but there was room for improvements.

  • 30.
    Nahlén Bose, C.
    et al.
    The Swedish Red Cross University College, Stockholm, Sweden .
    Elfström, Magnus
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Björling, G.
    The Swedish Red Cross University College, Stockholm, Sweden.
    Persson, H.
    Karolinska Institutet, Stockholm, Sweden.
    Saboonchi, F.
    Karolinska Institutet, Stockholm, Sweden.
    Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 4, p. 704-713Article in journal (Refereed)
    Abstract [en]

    Introduction: Emotional distress in patients with chronic heart failure (CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite. Aim: This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF. Method: Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression. Results: Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression. Conclusions: Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness.

  • 31.
    Nilsson, Annika
    et al.
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala; Department of Caring Sciences and Sociology, University of Gävle.
    Sjödén, Per-Olow
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University.
    Dahl, Joanne
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Denison, Eva
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. epartment of Caring Sciences and Sociology, University of Gävle.
    Factors related to long-duration pain and sick leave among Swedish staff working in the public health service.2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 419-26Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to provide information about factors related to long-duration pain (LDP) (>3 months), sick leave (SL) and long sick leave (LSL) (>3 months) among staff in the community health services. The specific research question was: To what extent do data on activity, physical function, pain severity, psychological/cognitive factors, expectations of LDP, expectations to be working within 6 months and work satisfaction predict LDP, SL and LSL respectively? Logistic regression analyses were used to test predicted membership in the groups LDP, SL and LSL. In this context prediction refers to statistical prediction only, due to the cross-sectional design. Staff (n = 914) in the public health services in a medium-sized Swedish city completed a questionnaire during the spring of 2000. The results show that musculoskeletal pain and SL for this occupational group are common. Pain severity, expectations of LDP and fear-avoidance increased the odds of being in the LDP group, while kinesiophobia decreased the odds. Pain severity and kinesiophobia increased the odds of being in the SL group, while expectations to be working in 6 months decreased the odds. Only expectations to be working in 6 months predicted membership in the LSL group, decreasing the odds. Although some caution is warranted concerning the representativity of the sample, the results indicate that expectations about pain duration and ability to work are important psychosocial factors in LDP and LSL.

  • 32.
    Roxberg, Åsa
    et al.
    Växjö University.
    Burman, Marianne
    Växjö University.
    Guldbrand, Mona
    Växjö University.
    Fridlund, Bengt
    Växjö University.
    Barbosa da Silva, António
    Stavanger University, Stavanger, Norway.
    Out of the wave: the meaning of suffering and relieved suffering for survivors of the tsunami catastrophe. An hermeneutic-phenomenological study of TV-interviews one year after the tsunami catastrophe, 20042010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 707-715Article in journal (Refereed)
    Abstract [en]

    The tsunami catastrophe, 26th December 2004, is one of a number of catastrophes that has stricken mankind. Climate reports forecast that natural disasters will increase in number in the future. Research on human suffering after a major catastrophe, using a caring science perspective, is scarce. The aim of the study was to explore the meaning of suffering and relieved suffering of survivors of the tsunami catastrophe, 26th December 2004. An explorative study design, inspired by the French philosopher Paul Ricoeur's hermeneutic-phenomenology, was used. Interviews made by the Swedish Television (SVT) in connection with the 1 year anniversary were carried out on site in the disaster area and in Sweden. The text analysis revealed four main themes: 'An incomprehensible event', 'A heavy burden', 'Help that helps', and to 'Being changed in a changed life situation'. The findings were mainly interpreted in light of Paul Ricoeur's thinking on suffering, quilt, forgiveness, time and narrative. The first year after the loss of loved ones in the tsunami catastrophe, 2004, was like starting an inner as well as an outer journey. This journey was experienced as living with the heavy burden of an incomprehensible event. Help that helped was mediated by consolers who endured the suffering of the other. An 'enduring courage' is a key moral virtue to encounter the alienation of the sufferer and how it in turn alienates from the sufferer. It is also important to recognize that the complexity of the world of those who have lost loved ones in major catastrophes includes possibilities for reconciliation with the loss. The reconciliation creates hope that opens up for being changed in a changed life situation.

  • 33.
    Röing, M.
    et al.
    Uppsala University.
    Rosenqvist, U.
    Uppsala University.
    Holmström, Inger
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Threats to patient safety in telenursing as revealed in Swedish telenurses’ reflections on their dialogues2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 969-976Article in journal (Refereed)
    Abstract [en]

    Telenursing is a rapidly expanding actor in the Swedish healthcare system, as in other Western nations. Although rare, tragic events occur within this context, and are reminders of the importance of giving patient safety the highest priority. As telenurses' main sources of information are their dialogues with the callers, the provision of safe care can depend on the quality of this dialogue. The aim of this study was to identify issues that could threaten patient safety in telenurses' dialogues with callers. As part of an educational intervention, a researcher visited a sample of six telenurses five to six times at their workplace to listen to and discuss, together with the telenurses, their dialogues with callers in stimulated recall sessions. Each call and the following discussion between researcher and telenurse was tape-recorded and transcribed as text, resulting in a total of 121 calls. Qualitative content analysis of the reflections and following discussions revealed that threats to patient safety could be related to the surrounding society, to the organisation of telenursing, to the telenurse and to the caller. This study gives insight into significant problem areas that can affect patient safety in telenursing in Sweden. Issues that need to be focused on in telenursing educational programmes and future research are suggested, as well as the need for organisational development. 

  • 34.
    Röing, Marta
    et al.
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Hirsch, Jan-Michaél
    Uppsala universitet, Käkkirurgi.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Living in a state of suspension - a phenomenological approach to the spouse's experience of oral cancer2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 1, p. 40-47Article in journal (Refereed)
    Abstract [en]

    The consequences of oral cancer may affect not only the patient, but also their spouses, as the mouth is vital for communication, social interaction and nutrition. Treatment is complex, lengthy and involves a large number of medical and dental professionals. During the treatment of oral cancer spouses are often present when the patients meet the treatment team. While nursing and medical staff have experience of meeting both patients and spouses, dental teams may not. The aim of this phenomenological study was to describe oral cancer and its treatment as experienced by the patient's spouses. A purposeful sample of seven spouses was interviewed. The existentials of lived relations, lived body and lived space and time were used as interpretive means in analysing the data to illuminate the spouses' everyday experiences during treatment. The findings reveal that the experience of lived relations changes from being spouse to supportive carer, the lived body is neglected and lived space and time becomes restricted. The essence of their lived experience can be described as living in a state of suspension. This knowledge may be useful in the education and organization of supportive communication for multiprofessional caregivers.

  • 35.
    Snellman, Ingrid
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wikblad, Karin
    Uppsala University, Uppsala, Sweden .
    Health in patients with type 2 diabetes: An interview study based on The Wellfare Theory of Health2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 4, p. 462-471Article in journal (Refereed)
    Abstract [en]

    Background:health as a person’s ability to fulfil vital goals in different life areas. In order to use the theory in nursing, a semi-structured interview guide was constructed including questions about which vital goals Type 2 diabetic patients have and believe are important for their own welfare in different life areas. In his Welfare Theory of Health Nordenfelt describes Aim:validation of the interview guide. Two hypotheses were formulated: (i) Dissatisfied or unhealthy diabetic persons score lower on health-related quality of life (HRQL) than do those classified as healthy; (ii) A person with diabetes who uses avoidance as his/her main coping strategy restructures his/her vital goals in order to avoid failure and thereby dissatisfaction increases. The aim of the study was to carry out preliminary Methods: diabetic patients were conducted using the interview guide. HRQL and coping were also measured. The interview data were analysed using content analysis. Interviews with 155 randomly selected Type 2 Results: theory, i.e. a person with Type 2 diabetes may be unhealthy, but still satisfied with life as a whole. Our two hypotheses were confirmed: Dissatisfied or unhealthy subjects with Type 2 diabetes had HRQL scores in all domains but physical functioning and bodily pain that were lower than scores of those who were satisfied or healthy, and a person with Type 2 diabetes who uses avoidance as his/her main coping strategy does seem to restructure his/her vital goals to avoid failure. The results were in accordance with the health Conclusion: study seemed to reflect the notion that health includes fulfilment of vital goals. The theory-based interview guide tested in this

  • 36.
    Summer Meranius, Martina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Marmstål Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    How does the healthcare system affect medication self-management among older adults with multimorbidity?2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 91-98Article in journal (Refereed)
    Abstract [en]

    Individuals with multimorbidity commonly have several concurrent prescriptions and experience healthcare obstacles related to managing different diagnoses and medications. This study aimed to provide a deeper understanding of how older adults with multimorbidity experience medication self-management and how this is affected by the healthcare system. The National Board of Research Ethics approved the study, and 20 older adults with multimorbidity participated in in-depth interviews that were analysed using a hermeneutic approach. Three levels of interpretation emerged. At the first level, lack of participation in healthcare communication hinders adherence and safety, and feeling abandoned to self-care leads to health risk-taking. At the second level, the healthcare organisation is seen as an obstacle to medication self-management. The overall interpretation was a system of repairing ‘parts’ but not enabling the experience of health. This study shows that the healthcare system is able to treat and relieve an individual's symptoms, but seems unable to help them achieve and promote good health, or to provide the support they need to function in everyday life.

  • 37.
    Svedberg, Petra
    et al.
    Halmstad University, Halmstad, Sweden.
    Johansson, Ingela
    Linköping University, Linköping, Sweden.
    Persson, Sylvi
    Linnéuniversitetet.
    Roxberg, Åsa
    Linnéuniversitetet.
    Fridlund, Bengt
    Linnéuniversitetet.
    Baigi, Amir
    Halland County Council, Falkenberg, Sweden.
    Brunt, David
    Linnéuniversitetet.
    Alm Roijer, Carin
    County Hospital Ryhov, Jönköping, Sweden.
    Malm, Dan
    County Hospital Ryhov, Jönköping, Sweden.
    Rask, Mikael
    Linnéuniversitetet.
    Nilsson, Ulrica
    Örebro University, Sweden .
    Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context :2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 203-208Article in journal (Refereed)
    Abstract [en]

    The patients' sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of 'The 25-item Sex after MI Knowledge Test' in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients' National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test-retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test-retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.

  • 38.
    Sverker, Annette
    et al.
    Göteborgs universitet.
    Östlund, Gunnel
    Linköpings universitet.
    Hallert, Claes
    Linköping universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    ‘I lose all these hours…’ – exploring gender and consequences of dilemmas experienced in everyday life with coeliac diseases2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2, p. 342-352Article in journal (Refereed)
    Abstract [en]

    Scand J Caring Sci; 2009; 23; 342-352 'I lose all these hours⋯'- exploring gender and consequences of dilemmas experienced in everyday life with coeliac disease Few studies have focused on gendered consequences of coeliac disease (CD), despite the fact that women with coeliac disease report lower health-related quality of life than men do. The aim of this study was to explore consequences of dilemmas in everyday lives for women and men, as personally affected by CD or as close relatives to someone affected by the disease and to put these experiences into context regarding household activities. This QUAL-quan study included 28 men and 38 women. A mix method design was used. The critical incident technique that captures, in a structured way, the qualities of experiences was used in interviews to identify dilemmas and their consequences. To describe the social context of these dilemmas, a quantitative questionnaire was developed on food preparations and purchase, as well as on cooking and meal behaviours. The study was approved by the Research Ethics Committee of the Faculty of Health Sciences. The consequences were found in cognitive, social, emotional and physical aspects of human life. The overall pattern of these consequences was similar in women and men irrespective of being personally affected or a close relative. The main consequences identified were: daily concerns about gluten, constant preparation, being different, emotional pressure and body sensations because of CD. Descriptive data extracted from the questionnaire showed that women and men reported having a different social situation in relation to preparing food, making decisions about purchases, buying food products and preparing meals. The clinical implications of these findings are that healthcare professionals need to develop family-oriented information in relation to CD. It is necessary to inform the close relatives irrespective of sex of the possible consequences of the disease and to take in to account the different social context that women and men report in relation to food preparations

  • 39.
    Thurang, Anna
    et al.
    Växjö Univ.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Palmstierna, Tom
    Karolinska Inst.
    Tops, Anita Bengtsson
    Växjö Univ.
    Women's experiences of caring when in treatment for alcohol dependency2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 700-706Article in journal (Refereed)
    Abstract [en]

    Despite the fact of increased levels of alcohol dependency in women and gender differences in how the disease affects men and women, the research on alcohol dependency continues to have a dominating perspective on men. The meaning of the phenomenon of caring in formal care for women with alcohol dependency is not well known. Thus, formal caregivers may find it problematic to know what is caring for women with alcohol dependency. The aim of the study was to illuminate the meaning of caring in formal care for women with alcohol dependency, as narrated by the women. The study was performed using a phenomenological-hermeneutic method. Data were collected in ten in-depth interviews with alcohol-dependent women. The themes presented are availability, being a patient and being a learner. The findings reveal that the women with alcohol dependency receiving a mandate from formal care, experience the relation between them and their caregiver as a mutual transformation. Within the mutual transformation, the participants experienced being respected as a responsible human being which renders possibilities for the women with alcohol dependency to continue in formal care even when the struggle against the disease became hard. Continual meetings with the caregiver allowed the women to gain structure in their daily life as well as allowing the women and their caregivers to develop mutual transformation, which both relieved the women's suffering and increased their experience of being involved in the care process.

  • 40.
    Widarsson, Margareta
    et al.
    Uppsala universitet, Sweden.
    Engström, Gabriella
    Uppsala universitet, Sweden.
    Berglund, Anders
    Uppsala universitet, Sweden.
    Tydén, Tanja
    Uppsala universitet, Sweden.
    Lundberg, Pranee
    Uppsala universitet, Sweden.
    Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 689-699Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Parental stress can negatively affect the parent-child relationship and reduce the well-being of the whole family. Family disagreement is associated with parental divorce and with psychological problems in children.

    AIMS: The aim was to examine perceived parental stress and draw comparisons among mothers and among fathers, in relation to educational level, parental experience, existence of a parental role model and sense of coherence. The aim was also to examine perceived dyadic consensus and its association with perceived parental stress within couples.

    METHODS: Questionnaires were completed by 320 mothers and 315 fathers at 1 week and 18 months post-partum. The Swedish Parenthood Stress Questionnaire, the Sense of Coherence Scale and the Dyadic Consensus Subscale were used.

    RESULTS: Low education, lack of a role model and poor sense of coherence promoted stress in mothers in the subareas social isolation and spouse relationship problems, while lack of a role model and poor sense of coherence promoted stress in fathers in the subarea social isolation. Furthermore, parental experiences promoted stress among mothers in the subarea incompetence while this was not seen among fathers. Mothers perceived a higher level of dyadic consensus than fathers in the items recreational activities, friends, aims and life goals, time spent together, and decisions regarding career and personal development. Household tasks was the only item where fathers perceived a higher level of dyadic consensus than mothers. Additionally, there were associations between perceived parental stress and dyadic consensus in several items and in the total score.

    CONCLUSIONS: To promote parents' health and family stability, health professionals should consider factors affecting stress and stress reactions, and take gender roles into account.

  • 41.
    Widarsson, Margareta
    et al.
    Uppsala University, Sweden.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rosenblad, A.
    Uppsala University, Sweden.
    Kerstis, B.
    Uppsala University, Sweden.
    Edlund, B.
    Uppsala University, Sweden.
    Lundberg, P.
    Uppsala University, Sweden.
    Parental stress in early parenthood among mothers and fathers in Sweden2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 839-847Article in journal (Refereed)
    Abstract [en]

    Background: Parental stress affects parenting behaviour and the quality of dyadic parent-child interactions. Mothers generally show higher parental stress than fathers. Aims: Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence. Methods: In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3. Results: Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas. Conclusions: Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress. 

  • 42.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT/The Arctic University of Norway.
    Compassion for self and others as key aspects of well-being in changing times2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 3, p. 427-433Article in journal (Refereed)
    Abstract [en]

    Compassion has been put forth as a core concept in caring science, although there has also been a debate over whether it is a nonprofessional sentiment or not. In this theoretical article, I reflect on compassion not only for others but also for oneself as being important for patients' as well as professionals' well-being. My reflections on compassion as being essential in caring are grounded not only in caring science but also in research from other disciplines, as a means of exploring why we need compassion in caring from different perspectives. My conclusion is that in changing times, where patients as well as caregivers are confronted with challenges in life, compassion for self as well as others must be acknowledged as pivotal in relation to well-being and care

  • 43.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Implications for theory: a challenge for researchers?2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 417-418Article in journal (Other academic)
  • 44.
    Wiklund Gustin, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wagner, Lynne
    Watson Caring Science Institute, Chelmsford, MA.
    The butterfly effect of caring: clinical nursing teachers’ understanding of self-compassion as a source to compassionate care2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 175-183Article in journal (Refereed)
    Abstract [en]

    This study has its roots in a clinical application project, focusing on the development of a teaching–learning model enabling participants to understand compassion. During that project four clinical nursing teachers met for a total of 12 hours of experiential and reflective work. This study aimed at exploring participants’ understanding of self-compassion as a source to compassionate care. It was carried out as a phenomenological and hermeneutic interpretation of participants’ written and oral reflections on the topic. Data were interpreted in the light of Watson’s Theory of Human Caring. Five themes were identified: Being there, with self and others; respect for human vulnerability; being nonjudgmental; giving voice to things needed to be said and heard; and being able to accept the gift of compassion from others. A main metaphorical theme, ‘the Butterfly effect of Caring’, was identified, addressing interdependency and the ethics of the face and hand when caring for Other – the ethical stance where the Other’s vulnerable face elicits a call for compassionate actions. The findings reveal that the development of a compassionate self and the ability to be sensitive, nonjudgmental and respectful towards oneself contributes to a compassionate approach towards others. It is concluded that compassionate care is not only something the caregiver does, nor is compassion reduced to a way of being with another person or a feeling. Rather, it is a way of becoming and belonging together with another person where both are mutually engaged and where the caregiver compassionately is able to acknowledge both self and Other’s vulnerability and dignity.

  • 45.
    Wiklund-Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Narrative Hermeneutics: In search of narrative data2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no Suppl 1, p. 32-37Article in journal (Refereed)
    Abstract [en]

    As human beings, we live in a storied world. This worldview requires us to think about how to re-present it in research. My purpose with this article is to reflect upon narratives from an ontological and epistemological point of view, taking Ricoeur's writings on narrative identity as a starting point. From this perspective, narration is an aspect of self-interpretation and self-understanding. Furthermore, self-understanding is not only achieved within our own narratives, but depends upon the regard, words and actions of others. This must be accounted for in our search for narrative data. Researchers would benefit from being alert to this and also aware of how narratives are co-authored in a dialogue with participants. Reflections on narration from this perspective could guide ethical considerations - and also methodological - as they could support questions that would create space for the narrative. Furthermore, the researcher must be aware that the quality and trustworthiness of narratives to a high degree depend on the researcher and not only on the participant.

  • 46.
    Östlund, Gunnel
    et al.
    Linköpings universitet.
    Cedersund, Elisabet
    Linköpings universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Alexandersson, Kristina
    Linköpings universitet.
    Domestic strain: A hindrance in rehabilitation?2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, ISSN 1369-6866, Vol. 18, no 1, p. 49-58Article in journal (Refereed)
    Abstract [en]

    Long-term sick leave due to musculoskeletal disorders has increased, especially for women. The aim of this paper was to explore women's and men's descriptions of the private arena in relation to rehabilitation and sickness absence. This study is part of a larger project focusing on consequences of sick leave. Individual interviews were conducted in 1997 and 1998 with 20 women and men who had been long-term sick-listed in 1985 with musculo-skeletal diagnoses. The data were analysed using Grounded theory in combination with gender analysis, which involved separately comparing men's and women's statements in order to find similarities and differences. According to the interviewees, factors in the private arena were closely associated with the rehabilitation process. Women described themselves as being responsible for the domestic work while men more often 'helped out' when asked to do so. Women and men described similar strategies to facilitate domestic work. Three dimensions of domestic life were identified, comprising division of domestic work and division of responsibility for domestic life and the amount of socio-emotional support or isolation at home. Using these dimensions, a 'domestic strain model' was developed. Our study indicates that long-term sicklisted women experiencing domestic strainwould rather stay at home than return to work. Domestic strain involves inequities in the division of work and responsibilities and a lack of socio-emotional support at home. However, the model of domestic strain needs further empirical testing.

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