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  • 1. Agneta, Breitholtz
    et al.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ingegerd, Fagerberg
    Ersta Skondal Univ Coll, Stockholm, Sweden..
    Older persons self determination within municipal home care services2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, p. 142-142Article in journal (Other academic)
  • 2.
    Andreae, Christina
    et al.
    Research and Development Center/Center for Clinical Research, Sörmland County Council,.
    Ekstedt, Mirjam
    Department of Health Care Sciences, Ersta Sköndal University,.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare.
    Patients’ Participation as It Appears in the Nursing Documentation,When Care Is Ruled by Standardized Care Plans2011In: ISRN Nursing, ISSN 2090-5483, Vol. 2011, no Article ID 707601Article in journal (Refereed)
    Abstract [en]

    This study aimed to describe inpatients with myocardial infarction and their participation in care as documented in the nursing

    records when standardized care plans are used in care. The use of standardized care plans not only has increased the quality of

    medical treatment but has also overlooked patients’ opportunities to participate in their own care. There is a lack of knowledge

    about how standardized care plans influence patients’ participation in nursing care. Data were collected from thirteen patients’

    records with diagnoses of myocardial infarction. Participation in the decision-making process and participation associated with

    “sharing with others” were searched for in the analysis. The analytical process was guided by content analysis. The findings were

    grouped into two categories: patients’ intermediary participation and patients’ active participation. The main results indicated that

    patients’ intermediary participation depended on healthcare professionals’ power to rule the nursing care situation.

  • 3.
    Bonander, Kristina
    et al.
    Högskolan i Borås.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare.
    Telefonmötets vårdrelation2007In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 86, no 27, p. 4-8Article in journal (Refereed)
    Abstract [en]

    Background: A large part of the work a nurse conducts at a Primary Care Centre consists of counselling patients over the phone. The patients are sorted and prioritised on the basis of these conversations. Aim: The aim of this study is to describe how the patients experience the caring relationship with the nurse during phone counselling at a Primary Care Centre. Method: In-dept interviews were conducted with ten adult Swedish speaking persons who contacted a nurse at two Medical Care Centres, during a two week period. Results: The patients experienced  that they received a good caring relationship with the nurses. This meant to be treated friendly, be taken seriously and to be able to have a dialog about their problems with the nurse. They wanted to feel unique, empowered and treated as individuals. They could sometimes feel disappointed when an unbalance occurred between the expectations of the patients and the advice they received. Nurses that were stressed influenced the caring relationship in a negative way. Conclusions: Overall the patients experienced a good caring relationship with the nurses, but the nurses were not always aware of how they where perceived.

     

     

     

  • 4.
    Breitholtz, Agneta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Stockholm, Sweden, Karolinska Institutet, Stockholm.
    Carers’ ambivalence in conflict situations with older persons2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 2, p. 226-237Article in journal (Other academic)
    Abstract [en]

    The aim of this study was to illuminate the meaning of professional carers’ experiences in caring situations when a conflict of interest arises with the older person receiving care. The findings reveal the complexity of the carers’ ambivalence when facing a conflict of interest, weighing between the older persons’ right to self-determination and external demands. The carers are alone in their ambivalence and the conclusion is that they need help and support to be more present in the encounter. The implication for this study is a person-centred practice, and to focus on people as interdependent on support carers to maintain older people’s right to self-determination in the relationship.

  • 5.
    Breitholtz, Agneta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Fagerberg, Ingegerd
    Department of Health Care Sciences of Ersta Sköndal University College and Researcher.
    Older people’s dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions2013In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, no 2, p. 139-148Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the meaning of older people’s dependence on caregivers’ help, and of their opportunity to make independent decisions.

    Background. Throughout the world, the older population is growing, and in Sweden, the system of care for older people is currently undergoing change. Older people in the need of care are expected to live at home for as long as possible.

    Design.A qualitative and life world approach was used.

    Methods. Audio-taped interviews were conducted with twelve older persons living at home, dependent on daily municipal home help service. A phenomenological hermeneutic method was utilised to disclose the meanings of lived experiences.

    Finding. The findings revealed three themes : being facilitated to make one’s own decisions, being hindered from making one’s own decisions, struggling for vs. resigning oneself to losing the opportunity to make one’s own decisions.

    The comprehensive understanding revealed that as older people become more dependent on caregivers’ help, their opportunity to self-determine is challenged and this is stressful for them.

    Conclusion. The older persons assess their opportunity to self-determine differently, depending on who they are as a person. The caregivers need an awareness of this, and further research is needed to gain knowledge and understanding of how caregivers can improve the way they support and enhance older people’s opportunity to decide for themselves.

    Implications for practice. The findings revealed older persons need to exercise more self-determination and caregivers’ need for knowledge to enable this. Further, it indicates a move towards a person-centred approach to focus on persons as individuals and see them as interdependent. The findings contribute to improvements in similar contexts worldwide.

  • 6.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Trust leading to hope - the signification of meaningful encounters in Swedish healthcare. The narratives of patients, relatives and healthcare staff2013In: International Practice Development Journal, ISSN 2046-9292, Vol. 3, no 1, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Background: The fact that patients and relatives experience poor healthcare encounters is evident in the number of complaints to patients’ advisory committees, and from studies and statistics. Looking at ‘the other side of the coin’, research into good caring encounters experienced as meaningful encounters in healthcare is scarce.

    Aim: To illuminate the signification of meaningful encounters in healthcare. 124 narratives from patients, relatives and healthcare staff regarding experiences of meaningful encounters in Swedish healthcare were analysed using a phenomenological hermeneutic research method.

    Conclusions: The results indicate that a meaningful encounter means gratefulness, is founded on trust, cooperation and courage, and results in self-trust through wellbeing, increased understanding and life-changing insights. The encounters have given insight into, and increased understanding of, the patient’s own life, the families’ lives, and/or healthcare professionals’ lives. With this, and awareness of the importance and power of meaningful encounters, healthcare staff might use a meaningful encounter as a powerful instrument in caring.

    Implications for practice:

    • For patients and relatives, trust derived from meaningful encounters in healthcare leads to self-trust
    • Caring within healthcare consisting of meaningful encounters, ‘the other side of the coin’ gives important knowledge that could facilitate improvements in healthcare staff’s encounters with patients and relatives, and also enrichment in their own professional development
    • Increased understanding and awareness of the power of meaningful encounters can be discussed in terms of patient safety

  • 7.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Betydelsefulla möten i vården: Du kan göra skillnad2015 (ed. 1)Book (Other (popular science, discussion, etc.))
  • 8.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Christine
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The meaningful encounter: Patient and next of kin stories about their experience of meaningful encounters in health care2013In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 20, no 4, p. 363-371Article in journal (Refereed)
    Abstract [en]

    This study focuses on the meaningful encounters of patients and next of kin, seen from their perspective. Identifying the attributes within meaningful encounters is important for increased understanding of caring and to expand and develop earlier formulated knowledge about caring relationships. Caring theory about the caring relationship and provided a point of departure for the study. The aim of this study was to illuminate the meaningful encounter in health care contexts narrated by patients and next of kin. A qualitative explorative design with a hermeneutic narrative approach was used to analyze and interpret the written narratives. Phases were: Naïve interpretation, structure analysis on two different levels a) analysis of narrative structure b) analysis of deep structure through metaphors and finally a dialectic interpretation. In the narratives the meaning of the meaningful encounter was sharing, a nourishing fellowship, common responsibility and coming together experienced as safety and warmth and gives, by extension, life changing moments, a healing force and dissipated insight. The meaningful encounter can be seen as a complex phenomenon that has different attributes. Understanding the meaningful encounter will enable nurses to plan and provide professional care, based on caring science focusing on patient and next of kin experience.

  • 9.
    Ingrid, Snellman
    Mälardalen University, School of Health, Care and Social Welfare.
    Den mänskliga professionaliteten: En filosofisk undersökning av det autentiska mötets betydelse för patientens välbefinnande2001Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The following study is based on observations made in practical medical and nursing care. A practical medical and nursing care problem is introduced, in which an imbalance is shown between the expectations on medical and nursing staff expressed by the patient and the fact that the medical and nursing staff has not had the opportunity to develop the ability to notice and meet the expectations of the patient. In order to solve the above-mentioned complex, practical medical and nursing care problem, it is essential to analyse such terms as: ‘authentic encounter’, ‘health’, ‘emotion’ and ‘personhood’ in order, thereby, to define the necessary conditions for a patient-carer encounter in which the independence and dignity of the patient is respected and active participation in the patient’s own health status is facilitated.

    In order for the patient’s independence and dignity to be respected, the fol­lowing conditions for the authentic encounter are discussed. One such fundamental condition for the authentic encounter is Martin Buber’s modified I-Thou relation, the characteristics of which are mutuality, acceptance and confirmation. The ability of medical and nursing staff to create such an encounter based on these characteristics is also emphasised in order to safeguard the dignity of the patient. In addition to the modified I -Thou relation, a number of other prerequisites are discussed, attention to which is essential when creating an authentic encounter. One such condition is the view of health held by the carer. A review of various perspectives on health shows that an individual oriented, social approach is applicable since the outlook on humankind characterising such an approach is that of seeing the patient as a freely acting being with abilities of his own. Another condition for the authentic encounter is the interactive attitude described by Martha Nussbaum, which stresses the importance of getting to know one’s own emotions by accepting them but also by trusting others. Finally, the concept of personhood is discussed in order to clarify a further condition for the authentic encounter, namely, that the carer show consideration for the patient as the person she or he actually is. Making this possible demands a non-static conception of personhood, the fundamental idea of which is that the encounter takes place on the basis of the patient’s abilities and resources.

  • 10.
    Liljeroos, Maria
    et al.
    Research and Development Center/Center for Clinical Research Sörmland County Council.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare.
    Ekstedt, Mirjam
    Department of Health care sciences, Ersta Sköndal University College.
    A qualitative study on the role of patient–nurse communication in acute cardiac care2011In: Journal of Nursing Education and Practice, ISSN 1925-4040, Vol. 1, no 1, p. 17-24Article in journal (Refereed)
    Abstract [en]

    Background:

    This study aimed to illuminate the meaning of the patient–nurse communication during a hospital stay as

    narrated by patients after a myocardial infarction (MI).

    Methods:

    Narrative interviews from 10 patients were analyzed, using a phenomenological-hermeneutic method.

    Results:

    The nursing dialogue meant a safe mooring point on the trajectory from initial chaos after a MI to a reoriented

    life. Nurses’ presence and availability for non-verbal and verbal communication created a trustful relationship where new

    knowledge was acquired and motivational strength for life-style changes was mobilized. A person-centered perspective

    was preferred, where relatives were invited into the conversation.

    Conclusions:

    These results highlight that patient–nurse communication based on the patient’s view is possible in acute

    care after MI, and is an issue of attitude rather than time. Trust lays the foundation for a person-centered communication

    and is developed through the nurse’s presence and availability not only in the emergency phase, but throughout

    hospitalization. Discussions focused on personal action plans with emphasis on the patient’s health assets may facilitate a

    successful rehabilitation.

  • 11.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare.
    Autonomi och delat beslutsfattande i diabetesvården2012In: Omvårdnad vid diabetes / [ed] Karin Wikblad, Lund: Studentlitteratur, 2012, 2:1, p. 193-203Chapter in book (Other academic)
  • 12.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare.
    Det goda vårdmötet2007In: Etik i basal omvårdnad ... i någn annans händer... / [ed] Kersti Malmsten, Lund: Studentlitteratur , 2007, 2, p. 171-195Chapter in book (Other (popular science, discussion, etc.))
  • 13.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare.
    Vårdrelationer-en filosofisk belysning2009In: Omvårdnadens grunder: Perspektiv och förhållningssätt / [ed] Febe Friberg, Joakim Öhlén, Lund: Studentlitteratur , 2009, 1:a, p. 377-407Chapter in book (Other academic)
  • 14.
    Snellman, Ingrid
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Christine
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare.
    Patients' and Caregivers' Attributes in a Meaningful Care Encounter: Similarities and Notable Differences2012In: ISRN Nursing, ISSN 2090-5483, Vol. 2012, no Article ID 320145Article in journal (Refereed)
    Abstract [en]

    In today's healthcare system, there is an imbalance between what patients expect of caregivers' care and their perception of the care they get. How is it possible to reduce this imbalance? The aim of this paper was to describe attributes associated with meaningful encounters in the Swedish healthcare system based on patients' and caregivers' written narratives and to note the differences and similarities between the attributes identified by the two groups. This paper is a qualitative descriptive study. The analysis was guided by qualitative content analyses. Based on patients' narratives, attributes associated with a meaningful encounter fell into four categories: the kind-hearted caregiver, the thoughtful caregiver, the mutually oriented caregiver, and the helpful caregiver. Based on caregivers' narratives, the attributes were categorized as being humane, caring through physical contact, caring by nurturing communication, joy and laughter in care, and a sense of mutuality. The results show that there are both similarities and differences in patients' and caregivers' opinions about the attributes of a meaningful encounter. Knowing more about the attributes associated with meaningful encounters makes it possible for caregivers to individualize care for patients and makes it easier to help and support patients in what they most need support with.

  • 15.
    Snellman, Ingrid
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Christine
    Mälardalen University, School of Health, Care and Social Welfare.
    Patients’ and Caregivers’ Attributes in a Meaningful Care Encounter: Similarities and Notable Differences2012In: Aging in a Changing World, 2012Conference paper (Other academic)
    Abstract [en]

    In today’s healthcare system, there is an imbalance between what patients expect of caregivers’ care and their perception of the care they get. How is it possible to reduce this imbalance? The aim of this paper was to describe attributes associated with meaningful encounters in the Swedish healthcare system based on patients’ and caregivers’ written narratives and to note the differences and similarities between the attributes identified by the two groups. This paper is a qualitative descriptive study. The analysis was guided by qualitative content analyses. Based on patients’ narratives, attributes associated with a meaningful encounter fell into four categories: the kind-hearted caregiver, the thoughtful caregiver, the mutually oriented caregiver, and the helpful caregiver. Based on caregivers’ narratives, the attributes were categorized as being humane, caring through physical contact, caring by nurturing communication, joy and laughter in care, and a sense of mutuality. The results show that there are both similarities and differences in patients’ and caregivers’ opinions about the attributes of ameaningful encounter. Knowing more about the attributes associated with meaningful encounters makes it possible for caregivers to individualize care for patients and makes it easier to help and support patients in what they most need support with.

  • 16.
    Snellman, Ingrid
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Jonsson, Bosse
    Mälardalen University, School of Health, Care and Social Welfare.
    Wikblad, Karin
    Medical Sciences, Uppsala University, Uppsala, Sweden.
    Validation and Test-Retest Reliability of a Health Measure, Health as Ability of Acting, Based on the Welfare Theory of Health2012In: Evaluation & the Health Professions, ISSN 0163-2787, Vol. 35, no 1, p. 87-103Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to conduct a validation and assess the test–retest reliability of the health questionnaire based on Nordenfelt’s Welfare Theory of Health (WTH). The study used a questionnaire on health together with the Short Form 12-Item Health Survey (SF-12) questionnaire, and 490 pupils at colleges for adult education participated. The results of the study are in accordance with Nordenfelt’s WTH. Three hypotheses were stated, and the first was confirmed: People who were satisfied with life rated higher levels than those who were dissatisfied with life concerning both mental and physical health, measured with the SF-12. The second hypothesis was partially confirmed: People with high education were more often satisfied with life than those with low education, but they were not healthier. The third hypothesis, that women are unhealthy more often than men, was not confirmed. The questionnaire on health showed acceptable stability.

  • 17.
    Snellman, Ingrid
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    M Gedda, Kersti
    Mälardalen University, School of Health, Care and Social Welfare.
    The value ground of nursing2012In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 6, p. 714-726Article in journal (Refereed)
    Abstract [en]

    The aim of this literature study was to suggest a value ground for nursing anchored in two ethical principles:

    the principle of human value and the right to experience a meaningful life. Previous nursing research

    between the years 2000 and 2009 was analysed. Presented values suggested in this value ground are

    thus in line with the nursing context and science of today. Statements within ethical literature have been

    used in order to formulate arguments aimed at supporting the values that were found in the study. In

    the literature study six values were found: trust, nearness, sympathy, support, knowledge and

    responsibility. These values hold equal status and are not presented in hierarchical order. They vary due

    to the persons involved, nursing situations and cultural surroundings, but have the common requirement

    of being non-excluding. In order to implement the values within the value ground, two prerequisites are

    discussed and claimed as essential: ethical dialogue and a caring encounter between care provider and

    patients.

  • 18.
    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

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