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  • 1.
    Anbäcken, Els-Marie
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    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.
    Zander, Viktoria
    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.
    A holistic way ofworking interprofessionally in home care with and for older people2016Conference paper (Refereed)
  • 2.
    Anbäcken, Els-Marie
    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.
    Bondesson, Anna
    Mälardalen University, School of Health, Care and Social Welfare.
    Pettersson, Tina
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Team-Talk and Time; keys to support in complex care of older adults at home2021In: ECSWR 2021 10th European Conference for social work research: Book of abstracts, 2021, p. 215-Conference paper (Refereed)
  • 3.
    Asztalos Morell, Ildikó
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Urban and Rural Development, Swedish University of Agricultural Sciences (SLU), Uppsala, 75007, Sweden.
    De, S.
    College of Nursing, Bharati Vidyapeeth Deemed University (BVDU), Pune, 411043, India.
    Mahadalkar, P.
    College of Nursing, Bharati Vidyapeeth Deemed University (BVDU), Pune, 411043, India.
    Johansson, Carl
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Silence or voice?: Agency freedom among elderly women living in extended families in urban India2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 23, p. 1-18, article id 8779Article in journal (Refereed)
    Abstract [en]

    The preferential form of living for the elderly in India is within the extended family. India is undergoing rapid economic development, an increase in mobility, and changes in gender norms due to an increase in women’s labour force participation, which places challenges on traditional intergenerational relationships. Ageing and the well-being of the elderly is a rising concern, especially considering that their proportion of the population is expected to grow rapidly in coming decades. There is a lack of universal state provision for the elderly’s basic needs, which is especially profound for elderly women, since most do not have an independent income. This leaves the elderly dependent upon the benevolence of their adult children’s families or other relatives. This paper explores, with help of narrative analysis and critical contributions from capability theory, elderly women’s agency freedoms and how this can be contextualised with their varying capability sets. With help of Spivak’s notion of the silent subaltern, the paper anchors elderly women’s abilities to voice to their agency freedom. The master narrative of the silent supportive wife and side-lined mother-in-law as well as three counter-narratives explore alternative agencies taken by elderly women.

  • 4.
    Asztalos Morell, Ildikó
    et al.
    The Swedish University for Agricultural Sciences, Uppsala, Sweden.
    De, Santa
    Science in Nursing, RN RM, Sandra Shroff ROFEL College of Nursing, Vapi, India.
    Johansson, Carl
    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.
    Middle-class older adults living alone in urban India: Older adults’ understandings of ageing alone2023In: Journal of Religion, Spirituality & Aging, ISSN 1552-8030, p. 1-26Article in journal (Refereed)
    Abstract [en]

    This study sheds light on the value systems of the middle-class metropolitan older adults living alone, on the ageing self and the person's relationship to the surrounding society based on eight interviews. Ageing research has emphasized the traditional features of elderly care in India including its collectivist values rooted in filial piety and the extended family as well as embracement of disengagement influenced by the Hindu texts on two phases in later life: "hermit" and "renunciate". Increased social and geographical mobility, however, challenges traditional family systems. Using the example of the urban middle-class older adults living alone, this study explored whether living alone constitutes a challenge to the norms that previous research associated with Indian elderly care. Using abductive phenomenographic analysis the study found that the understandings of older adults in the study show great reflexivity concerning key aspects of their lives. Although the life conditions of older adults living alone deviated in many aspects from dominant traditional norms of filial piety and a care regime based on strong intergenerational interdependence, their responses and reflections mirrored assemblages of values deeply rooted in Hindu Vedic philosophy of the Ashramas and perceptions of independence, autonomy and self-reliance associated with Western "productive" aging.

  • 5.
    Elfström, Magnus
    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.
    Anbäcken, Els-Marie
    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.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Reablement for older persons by an interprofessional home rehabilitation team: An ongoing RCT2018Conference paper (Other academic)
    Abstract [en]

    The aim is to evaluate the effects of intensive home rehabilitation regarding multidimensional health perceptions and other quality of life domains, physical ability and capacity among older people (65+). The design is a randomized controlled study of a reablement intervention with controls receiving traditional home care. The intervention is goal- and user oriented, home-based, time limited (3 months), and organized by an interprofessional team consisting of the professions nurse, enrolled nurses, physiotherapists, social worker, and occupational therapists. The effects of the intervention are measured by self-reported health and quality of life (EQ-5D-5L, HACT) including psychological well-being (GP-CORE), physical capacity (SPPB, hand dynamometer test), activity performance (COPM), and home care hours needed. Data are collected at inclusion (T1; applying for home care), after the three months intervention (T2), and at six months (T3). Primary outcome analyses will be performed according to intention to treat; 2 x 3 mixed design (group x time) ANCOVA with each dependent variable at T1 as covariate. Based on a medium effect size in favour of the intervention in the pilot study, and a dropout of 20%, the power calculation indicated that 240 persons should be included. The project will contribute with evidence of the effects of interprofessional home rehabilitation for reablement, and consequences for older persons’ bio-psycho-social health. The project is ongoing with more than 120 persons included. The intervention may result in reduced costs for care, but especially individual gains in relation to reduced care needs, maintained independence and good health.

  • 6.
    Eriksson, Susanne
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
    Gustafsson, Lena-Karin
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.
    Gaining reconciliation when living with insulin treated diabetes: a qualitative study using content analysis2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1Article in journal (Refereed)
  • 7.
    Gusdal, Annelie K
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderman, Mirkka
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Pettersson, Tina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kaup, Jaana
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Healthcare and social care professionals’ experiences of respite care: a critical incident study2024In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 19, no 1Article in journal (Refereed)
    Abstract [en]

    IntroductionAging in place is favoured among older persons and supported by research in Sweden, although it poses challenges for overburdened informal caregivers. While respite care can offer support, its accessibility is hindered by organizational challenges and informal caregivers' delays in using it. The experiences of informal caregivers are well-studied, but the professionals' experiences of respite care quality and critical incident management are underexplored.AimTo explore professionals' experiences of critical incidents in respite care, consequences for the persons being cared for, and strategies to manage critical incidents.Materials and methodsA qualitative, critical incident technique was used, and three group interviews with a total of 16 professionals were conducted.ResultsBarriers to quality respite care included communication gaps during care transitions, environmental shortcomings in respite care facilities, lack of support for informal caregivers, and inadequacies in respite care decisions. Strategies to manage critical incidents included individualized care, continuity and communication in care transitions, a conducive environment, support for informal caregivers, and care professionals' positive approach.ConclusionsThe study emphasizes the need for focused efforts on communication, continuity, and a supportive environment. Addressing identified challenges and applying suggested strategies will be key to maximizing the potential of respite care as a vital support for care recipients and their informal caregivers.

  • 8.
    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, E-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

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  • 9.
    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.))
  • 10.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Arbete i multiprofessionella team2022In: OMVÅRDNAD I HEMMET VID KOMPLEXA VÅRDBEHOV / [ed] Lena-Karin Gustafsson & Mirkka Söderman, Lund: Studentlitteratur , 2022, 1, p. 35-50Chapter in book (Other (popular science, discussion, etc.))
  • 11. Gustafsson, Lena-Karin
    Avskurenhet och gemenskap2010In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur , 2010, 1, , p. 32:432p. 181-198Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    När en person befinner sig i ett psykotiskt lidande så kan detta också vara förknippat med att vara avskuren från andra människor. Även när man är tillsammans med andra så kan upplevelsen av avskurenhet vara stark. Detta syns också i det vardagliga språket, där vi ibland kan tala om en psykotisk person – eller en människa som i sin tankevärld är någon annan stans – i termer av att ”vara på en annan planet”. För vårdaren innebär det en stor utmaning att trots delvis skilda världar, där patientens verklighet ibland kan te sig helt oförståelig, skapa förutsättningar för en god vård. Vårdaren behöver utveckla en etisk hållning med respekt för patientens ”annanhet” och unika upplevelser för att på ett respektfullt vis närma sig patienten och därmed få en grogrund för gemenskap. Denna vårdgemenskap kan skapa möjligheter till lindrat lidande och stödja patienten på resan ut ur avskurenheten.

    Att genomgå ett psykiskt lidande ställer ofta tillvaron på sin spets. Livet blir aldrig mer detsamma, även om de psykiska symtomen avklingar. Människan kan därför behöva försonas med livet som det blivit, och också med att livet är ständigt föränderligt, och försoningen kan här liknas vid ett pusselbyggande. Denna process är ofta en existentiell utmaning för patienten, och också vårdaren utmanas i mötet med patientens lidande. Trots att vårdaren aldrig kan försona patienten – försoningen är på det viset patientens ”egen” process – så kan vårdaren ändå vara ett stöd och underlätta detta arbete för patienten.

  • 12.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare.
    Försoning2012In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Lena Wiklund Gustin och Ingegärd Bergbom, Lund: Studentlitteratur, 2012, 1:1, p. 472-485Chapter in book (Other academic)
  • 13.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare.
    Försoning: ur ett vårdvetenskapligt perspektiv2008Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The main aim of the research was to, from a caring perspective, lighten up the meaning of reconciliation in relation to the human health and suffering. The perspective is based on caring science standpoints related to health and suffering. Main standpoints for the research are that health is more than absence of illness, that health meaning is wholeness and holiness, that suffering is an inseparable part of life and that suffering and health are each other’s prerequisites. The choice of perspective is also based on the clinical caring science thoughts of base research that has its main task to form ideals for caring. Base research in clinical caring science aim in the first instance to the development of knowledge around health, suffering, caring and understanding of these phenomena in clinical settings.

    The overarching research questions were:   That is the meaning of reconciliation? which was followed by: What is reconciliation related to health and suffering? The thesis is built around four sub-studies that all have differences in relation to material and methods. The overall methodological approach has its standpoint in hermeneutics inspired by Paul Ricoeur. The first sub-study is a meta-synthesis of current research that touches on reconciliation. While the second sub-study is a concept analysis of Swedish dictionaries. The third sub-study consists of fiction texts that lighten the meaning of reconciliation. The process of interpretation in the third sub-study has followed the direction of phenomenological hermeneutics. Fourth sub-study is empiric and focus narratives about reconciliation. These reconciliation narratives, told by eight women with experience of grief, has been interpreted with a hermeneutic narrative approach.

    Finally a frozen picture has been created from the understanding in front of the text when the different sub-studies of the thesis have met dialectically with the theoretical assumptions. The picture involves a clarification of the meaning of reconciliation in relation to the human health and suffering. In the picture two forms of meaning appears; The outer forms of the meaning of reconciliation illustrating its shape and position in relation to health and suffering. Reconciliation has a progressive form that means a changeover from an experience of parents to an experience of wholeness but also a whole creating process between past, present and builds a link to the future. The inner forms of the meaning of reconciliation elucidate the inner relation to health and suffering. The meaning of reconciliation can be seen as a merge who shelter contrasts that earlier has been separated and impossible to reconcile in human as a heterogenic synthesis.

  • 14.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare. Care, Recovery & Health.
    Maintaining patient's dignity in forensic care: The challenge of maintaining patient's dignity in clinical caring situations2011Conference paper (Refereed)
    Abstract [en]

    Introduction: Human dignity is one of the basic attributes caring ethics and pushed to its limits in the context of forensic care. We must recognise the importance of increased understanding for maintaining patient's dignity to expand earlier formulated knowledge about caring ethics. Illuminations of this topic can create conditions for changing and develop care and make human's dignity and caregivers preservation of dignity evident. The aim in this study was to illuminate the meaning of maintenance of patient's dignity in forensic care.

    Methods: A qualitative explorative design with a hermeneutic narrative approach was used to analyse and interpret focus groups interviews with caregivers in forensic care. Caring theory about dignity as an important concept within caring ethics provided the point of departure for the analysis. The study was approved by an ethical research committee. Findings: revealed different themes that gave light to the meaning of the phenomena. In the text the meaning of maintenance of patient's dignity was protection and respect, but also brotherly humanity. The themes protection and respect had an outer and inner form. Protection was shown outwards as cover or screen the patient and to guard against danger. The inner form of protection was described as to protect the patients' needs and to arouse the patients' protection recourses. The theme respect was shown outwards as taking the patient seriously and to show others that patient were someone to count with, inwards as teaching patient create respect and teaching patient to expect respect from others being a worthy person. The meaning of maintenance of dignity was also to meet patient with human brotherhood, to do "the little extra" and to show human similarity.

    Conclusions: Understanding the meaning of maintenance of patient's dignity in forensic care will enable nurses to plan and provide professional care, based on caring science. 

  • 15.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health, Care and Social Welfare Mälardalen University Eskilstuna Sweden.
    Vård av multisjuka äldre i hemmet2022In: Omvårdnad i hemmet vid komplexa vårdbehov, Lund: Studentlitteratur AB, 2022, 1, p. 339-348Chapter in book (Other (popular science, discussion, etc.))
  • 16.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Anbäcken, Els-Marie
    Mälardalen University, School of Health, Care and Social Welfare.
    Zander, Viktoria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Elfström, Magnus L.
    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.
    Working with short-term goal-directed reablement with older adults: strengthened by a collaborative approach2019In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 39, no 4, p. 178-185Article in journal (Refereed)
    Abstract [en]

    The increased number of older adults who experience longevity requires increased investment in healthcare services. Short-term goal-directed reablement is expected to strengthen the functional capacity and quality of life of older adults, while homecare hours, and thus municipal expenditures, decrease. Facilitation of successful interprofessional collaboration includes not only enhancing coordination structurally, but also establishing a commitment regarding culture that overcomes professionally differentiated attitudes. Nurses have an obvious role in these multi-professional teams and the study explores some aspects' of working in this type of collaboration. The aim was to illuminate the meaning of working with short-term goal-directed reablement of older adults as experienced by an interprofessional team. Data were collected after an intervention with goal-directed time-limited reablement of older people. Written narratives from an interprofessional team were analyzed using a phenomenological-hermeneutic approach. Findings identified four major thematic structures that characterized the meaning: 1) Reliable relationship; including the aspects ‘Confidence between the older adult and staff’, ‘A sense of security’ and ‘Continuity’, 2) Empowered participation, including the following aspects: ‘Listen to the older adult’s desires’ and ‘Put the person in control’, 3) Team with a negotiated approach, including the aspects: ‘Closeness’, ‘Same direction and overarching goal’, ‘Learning from interprofessional dialogue’, 4) Time for growth with the aspects ‘Creating harmony’ and ‘Building the older adult’s self-confidence’. The process of reablement seemed strengthened by the collaborative approach of different professions and their combined efforts. The present study argues that teamwork gives confidence both in terms of general knowledge of reablement but also specific confidence in one’s profession.

  • 17.
    Gustafsson, Lena-Karin
    et al.
    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.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bondesson, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Pettersson, Tina
    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.
    Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs2024In: Journal of Multidisciplinary Healthcare, E-ISSN 1178-2390, Vol. 17, p. 2879-2890Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims to describe experiences of the implementation of a new integrated healthcare model for older adults with complex care needs due to multimorbidity, living at home, from a health and welfare personnel perspective. The goal was to diminish hospitalization and still carry out high quality care at home for older adults living with multimorbidity. The model was implemented by two organizations working in cooperation, the municipality, and the region that handles interprofessional social care and healthcare in people's homes. Materials and Method: Open-ended group interviews with personnel were carried out, three of the group interviews preimplementations of the model, and three of the group interviews post -implementation. The interviews were audiotaped and analysed according to the procedure of thematic analysis. Results: The quality of the integrated care model was based on care -chain cooperation, shared professionalism, and creating relations with the patient including closeness to next of kin, which was underlined by the participants. Unencumbered time gave the professionals the possibility to develop quality in integrated healthcare as part of integrated and person -centred care. The coproduction of education, research interviews and the follow-up meeting identified successes in diminishing hospitalization rates according to the participants' experiences of the post -implementation interviews. An identified failure was, however, that shared professionalism was not developed over time, rather the different responsibilities were accentuated according to the information retrieved at the follow-up meeting. Conclusion: Quality aspects of the model were identified in the present study. However, when implementation of a new model is completed, the organizations always have their own interpretation of how to further understand the model in question. Plain language summary: The intention of the present study was to follow the process of working with a new model of providing care at home, thus preventing increased numbers of hospital readmissions, based on the professionals<acute accent> point of view of what quality care is for older adults with complex care needs due to multimorbidity, living in their own home. The professionals were interviewed in group settings on several occasions during the implementation. The result showed hopeful expectations expressed by the professionals before the new model was implemented, such as a hope for getting more time for high -quality care for the older adults with multimorbidity. During the teamwork, the conversation within the team members was praised as a key factor that included shared professionalism from professionals with different levels of education and focus on their work. According to the staff, unnecessary hospital stays were reduced, while the interprofessional care -chain cooperation was improved through the work of the integrated care team. For many team members, the positive difference in both work and care satisfaction was highlighted in comparison to regular home care as they were able to use their multi -disciplinary skills and support.

  • 18.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Urban and Rural Development Swedish University of Agriculture, Uppsala, Sweden.
    Johansson, Carl
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ray, Santa De
    School of Nursing Bharati Vidyapeeth University deemed College, Pune, India.
    Informal caregiving from the perspectives of older people living alone in India2022In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Article in journal (Refereed)
    Abstract [en]

     Background:  The cultural and social norms in India stipulate that family and preferably children of the older person, provide the support and care that is needed. In recent years, we have witnessed an overall upsurge in interest in informal care from all countries in the developed world considering their ageing populations. The older people living alone group is, especially interesting in this matter, since it seems to deviate from the expectations of extended family living.

     Objective:  The aim was to describe older persons' experiences of informal care when living alone in India.

     Methods:  The study has a hermeneutic design, analysing interviews of older persons living alone in India.

     Results:  Findings revealed informal care as the thematic patterns: Informal care as a fundamental human responsibility, an obligation and thereby a way to act in 'common sense'. It was a way of 'paying-back' care that they had received from others in their life history, motivated by governmental care was not presented as an option. Informal care also created safety by the provision of alert and actionable care by loved ones, including spatial safety. Most of the informants experienced themselves as informal caregivers assisting others in need even if they themselves were old and fragile. Providing self care was also seen as a part of informal care conducted by capable and worthy persons. They also pointed out their own obligation to seek informal care and even to listen to the suggestions of younger generations regarding the type and scope of care.

     Conclusions/implications for practice:  Informal care in India is not only dependent on having children who ensure that you receive the care you need. Extended family, neighbours and friends feel a basic human obligation to care for the older people in their environment. This responsibility is deeply rooted even within the older people who become fragile in old age.

  • 19.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bondesson, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Pettersson, Tina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderman, Mirkka
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dilemmas in rehabilitation and patient strategies in an intensive home intervention: a follow-up study2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2253001Article in journal (Refereed)
    Abstract [en]

    Background The original project, where older persons received reablement performed by an interprofessional team showed success factors for IHR. However, since there is a lack of knowledge about why some persons do not recover despite receiving IHR, this study follows up patients' experiences of IHR.Aim To describe older persons' perceived dilemmas in the reablement process within the framework of IHR.Method 11 CIT interviews with participants who have previously received IHR, were analysed, interpreted and categorized according to CIT. The study was approved by the Swedish Ethical Review Authority.Results The results showed disease-related dilemmas, fatigue or pain so that participants could not cope with the prescribed exercises. New diseases appeared, as well as medication side effects made exercising difficult, and painkillers became a prerequisite for coping with IHR. Low self-motivation and mistrust towards the staff emerged like lack of trust due to otherness such as sex, cultural background, or language also became critical.Conclusions Interventions that consider individual- and contextual dilemmas are very important. By recognizing critical situations, this study can work as a basis of evidence to further develop interventions for older people living in their own homes and to ensure them to stay there.

  • 20.
    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.

  • 21.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rylander, Annelie
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Experiences of surviving life-threatening illness: The meaning of recovery2021In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 4, p. 1160-1168Article in journal (Refereed)
    Abstract [en]

    Background

    Recovery from life‐threatening illness may be experienced as more demanding and lasts longer than patients first expect. Many patients experience recovery after life‐threatening illness, as filled with complex problems. These problems are primarily physical and psychological, although also social, and adversely affect daily life as well as perceived quality of life. Patients experience uncertainty about living with the legacy of a life‐threatening illness and how it negatively limits their daily lives and experienced health.

    Aim

    The purpose is to illuminate experiences of the meaning of recovery from life‐threatening disease.

    Ethical approval

    Approval for the study was obtained through a Regional Research Ethics Committee.

    Methods

    This study was conducted as a qualitative narrative study. This means that written stories of human recovery beyond suffering from life‐threatening disease were collected and analysed with a phenomenological hermeneutic method.

     Results

    The findings reveal two major areas – intrapersonal meanings and relational meanings. Four themes were found in these areas, each of which was divided into subthemes as follows: obstacles, for example disappointment of life, alienation of self and opportunities/resources: for example balance, own knowledge, hope and gratitude; relational obstacles, for example a lack of care, stigmatisation and economic stress; and relational resources such as informal care and professional care.

    Study limitations

    The informants were predominantly women that may be explained by the fact that females seem to be more often engaged in social media and willing to participate in these kinds of studies. Another limitation is that we only reached out to Swedish speaking Facebook groups when recruiting our informants.

    Conclusions

    In the narratives of their recovery process, surprisingly few focused on professional health care as a resource. Experiences from the study may be used to further develop care, especially to support patient self‐care regarding intrapersonal and relational resources that promote patient recovery beyond suffering from life‐threatening disease.

  • 22.
    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.

  • 23.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stenberg, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Crucial contextual attributes of nursing leadership towards a care ethics2017In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 24, no 4, p. 419-429Article in journal (Refereed)
    Abstract [en]

    Background: It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. Aim: The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. Research design: The design of the study was descriptive and qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee’s aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. Findings: When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Discussion: Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager’s role, which probably has different attributes and more focus on an organizational level. Conclusion: Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care. 

  • 24.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderman, Mirkka
    Mälardalen University, School of Health, Care and Social Welfare.
    Omvårdnad i hemmet vid komplexa vårdbehov2022 (ed. 1)Book (Other academic)
    Abstract [sv]

    God och nära vård innebär att vård som utförs i hemmet ska likställas med övrig vård. Skillnaden är endast platsen där alltmer komplexitet inryms i sjuksköterskans vardag.

    I boken beskrivs patientens hem som en vårdplats, förutsättningar för kvalitativ vård i hemmet samt komplexa vårdsituationer kopplade till olika patientfall. Dessa sträcker sig från neonatal hemvård till multi­sjuka äldre och specifika tillstånd som ALS, cancer, hjärtsvikt, KOL samt kognitiv svikt och demenssjukdomar. Omslagsbilden, en ”vårdfläta”, symboliserar både samordnade och integrerade insatser som går över varandras traditionella gränser för att möta patientens behov.

    Omvårdnad i hemmet vid komplexa vårdbehov fokuserar sjuksköterskans aktuella och breda arbetsfält – hälso- och sjukvård i hemmet och vänder sig till blivande sjuksköterskor och studenter på avancerad nivå, andra vårdprofessioner samt yrkesverksamma.

  • 25.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderman, Mirkka
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bondesson, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Pettersson, Tina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kaup, Jaana
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    HEMMA projektet - om äldres förutsättningar för kvarboende2023Report (Other academic)
    Download full text (pdf)
    fulltext
  • 26.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderman, Mirkka
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bondesson, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Pettersson, Tina
    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.
    Gusdal, Annelie K
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Växelvård idag och i framtiden2023Report (Other academic)
    Download full text (pdf)
    fulltext
  • 27.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wigerblad, Åse
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindwall, Lillemor
    Department of Nursing Science, Karlstads universitet.
    Respecting dignity in forensic care: the challenge faced by nurses of maintaining patient dignity in clinical caring situations2013In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Introduction: We must recognise the importance of increased understanding for maintaining patient dignity to expand earlier formulated knowledge about caring ethics. Illuminations of this topic can create conditions for changing and developing care, as well as making caregivers’ preservation of dignity evident. The aim was to illuminate the meaning of maintenance of patient dignity in forensic care.

    Methods: A qualitative design with a phenomenological- hermeneutic approach was used to analyse and interpret focus group interviews with nurses in forensic care.

    Findings: In the text the meaning of maintenance of patient dignity was protection and respect but also brotherly humanity. Protection was shown outwards to cover or screen the patient and to guard against danger. The inner form was described as protecting the patients’ needs and arousing the patients’ protection resources. Respect was shown outwards to take the patient seriously and to show others that patients are to be reckoned with, inwards in teaching patients to create respect and in teaching patients to expect respect from others. Meeting patients with human brotherhood was shown in doing “the little extra” and demonstrating human similarity.

    Conclusions: The new understanding will enable nurses to plan and provide professional care, based on caring science.

  • 28.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wigerblad, Åse
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindwall, Lillemor
    Karlstads universitet, avd för omvårdnad.
    Respecting dignity in psychiatric care:: Working Together for Health Security2012Conference paper (Refereed)
  • 29.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wigerblad, Åse
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindwall, Lillemor
    Karlstad University.
    Undignified care: Violation of patient dignity in involuntary psychiatric hospital care from a nurse's perspective2014In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 21, no 2, p. 176-186Article in journal (Refereed)
    Abstract [en]

    Patient dignity in involuntary psychiatric hospital care is a complex yet central phenomenon. Research is needed on the concept of dignity's specific contextual attributes since nurses are responsible for providing dignified care in psychiatric care. The aim was to describe nurses' experiences of violation of patient dignity in clinical caring situations in involuntary psychiatric hospital care. A qualitative design with a hermeneutic approach was used to analyze and interpret data collected from group interviews. Findings reveal seven tentative themes of nurses' experiences of violations of patient dignity: patients not taken seriously, patients ignored, patients uncovered and exposed, patients physically violated, patients becoming the victims of others' superiority, patients being betrayed, and patients being predefined. Understanding the contextual experiences of nurses can shed light on the care of patients in involuntary psychiatric hospital care.

  • 30.
    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.

  • 31.
    Gustafsson, Lena-Karin
    et al.
    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.
    Bondesson, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Pettersson, Tina
    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.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Actions taken to safeguard the intended health care chain of older people with multiple diagnoses-a critical incident study2022In: BMC Nursing, E-ISSN 1472-6955, Vol. 21, no 1, article id 260Article in journal (Refereed)
    Abstract [en]

    Background: Older people with multiple diagnoses often have problems coping with their daily lives at home because of lack of coordination between various parts of the healthcare chain during the transit from hospital care to the home. To provide good care to those persons who have the most complex needs, regions and municipalities must work together. It is of importance to develop further empirical knowledge in relation to older persons with multiple diagnoses to illuminate possible obstacles to person-centred care during the transition between healthcare institutions and the persons livelihood. The aim of the present study was to describe nurses' experienced critical incidents in different parts of the intended healthcare chain of older people with multiple diagnoses.

    Methods: The sample consisted of 18 RNs in different parts of the healthcare system involved in the care of older people with multiple diagnoses. Data were collected by semi structured interviews and analysed according to Critical Incident Technique (CIT). A total of 169 critical incidents were identified describing experiences in recently experienced situations.

    Results: The result showed that organizational restrictions in providing care and limitations in collaboration were the main areas of experienced critical incidents. Actions took place due to the lack of preventive actions for care, difficulties in upholding patients' legal rights to participation in care, deficiencies in cooperation between organizations as well as ambiguous responsibilities and roles. The RNs experienced critical incidents that required moral actions to ensure continued person-centred nursing and provide evidence-based care. Both types of critical incidents required sole responsibility from the nurse. The RNs acted due to ethics, 'walking the extra mile', searching for person-centred information, and finding out own knowledge barriers.

    Conclusions: In conclusion and based on this critical incident study, home-based healthcare of older people with multiple diagnoses requires a nurse that is prepared to take personal and moral responsibility to ensure person-centred home-based healthcare. Furthermore, the development of in-between adjustments of organizations to secure cooperation, and transference of person-centred knowledge is needed.

  • 32.
    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’perceptions2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 498-506Article in journal (Refereed)
    Abstract [en]

    This paper reports a study conducted to illuminate older adults’ perceptions of multiproffesional team's caring skills as success factors for health support in short-term goal-directed reablement. The fact that older adults are given perquisites to live in their own homes puts great demands on the professional care given them at home. An option offered could be short-term goal-directed reablement delivered by an interprofessional team. This means after periods in hospitals to strengthen their multidimensional health, older adults’ reablement processes are supported to return to their daily life as soon as possible. Crucial in making these intentions a reality seems to be identifying the professional's approach that works as success factors for health support in the reablement process. A descriptive qualitative design with a phenomenographic approach based on interviews with 23 older persons who had received short-term goal-directed reablement at home after a period at hospital was used. The study was approved by an ethical board. The analysis revealed four major referential aspects of multiproffesional team's caring skills as success factors for health-support in short-term goal-directed reablement: a motivating caregiver, a positive atmosphere-creating caregiver, a human fellowship-oriented caregiver and a caregiver that goes beyond the expected. In this study, all caring skills in the continuum are perceived as positively loaded necessities in different situations during the reablement process. Caring skills as success factors are initially shown at a practical level, such as how the professional caregivers encourage and motivate the older persons in different training situations. At a deeper level, the caregivers open their hearts and have the capacity to go beyond the expected in the professional caregiver–patient relationship. The multiproffesional team's best fit caring skills during the home reablement process need to be addressed as evidence base in the area of elderly home care.

  • 33.
    Hochwälder, Jacek
    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.
    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 L.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Psychometric evaluation of the subjective well-being measure GP-CORE in a group of older adults in Sweden.2022In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 22, no 1, article id 913Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The world's growing population of older adults is one population that needs to be focused more regarding subjective well-being. It is therefore important to evaluate self-report instruments that measures general well-being for this specific group - older adults. The aim of the present study was to investigate psychometric properties of the Swedish translation of the GP-CORE (general population - Clinical Outcomes in Routine Evaluation) in a group of older adults (> 65 years).

    METHODS: In this study, a psychometric evaluation of the GP-CORE is presented for 247 Swedish older adults (> 65 years), 184 women and 63 men who applied for home care assistance for the first time.

    RESULTS: The psychometric evaluation showed high acceptability; provided norm values in terms of means, standard deviations and quartiles; showed satisfactory reliability in terms of both internal consistency and stability; showed satisfactory validity in terms of convergent and discriminant validity; provided a very preliminary cut-off value and quite low sensibility and sensitivity and showed results which indicated that this scale is sensitive to changes. One gender difference was identified in that women without a cohabitant had a higher well-being than men without a cohabitant (as measured by GP-CORE).

    CONCLUSIONS: The GP-CORE showed satisfactory psychometric properties to be used to measure and monitor subjective well-being in older adults (> 65 years) in the general population of community dwelling. Future studies should establish a cut-off value in relation to another well-being measure relevant for mental health in older adults.

  • 34.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    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.
    Spotting good ageing: using welfare theory of health to frame the agency of older adults with immigrant backgrounds to attain good ageingIn: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Article in journal (Refereed)
    Abstract [en]

    Care providers for older immigrants in Sweden find themselves in a paradox. Individuals and associations call for culturally sensitive elderly care. However, implementing this comes at the risk of over-culturizing needs and behaviours, drawing a negative picture of ‘the problem of immigrants’ that needs to be solved with special interventions. To find a balance in this paradox, we applied the welfare theory of health to grasp a new understanding of the phenomena and draw a holistic picture of a person’s needs and resources available to achieve good ageing, reaching beyond the cultural paradox. Semi-structured qualitative interviews were conducted with older adults with immigrant backgrounds in Sweden. The interviews were analysed using content analysis. Combining welfare theory of health with immaterial capital theories offered a holistic theoretical approach to good ageing. This took its departure from the agency of older adults, mitigating the gap between their vital life goals and available resources to reach these goals. Although informants wanted caring interventions from close family, we identified distinct responses to mitigate the diminished trust older adults had in the capability of welfare institutions to provide adequate elderly care.

  • 35.
    Johansson, Carl
    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.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Urban and Rural Development, Swedish University of Agriculture, Uppsala, Sweden.
    Culturally sensitive active ageing seen through the lens of the welfare theory of health: assistant nurses’ views2023In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1161688Article in journal (Refereed)
    Abstract [en]

    Assistant nurses caring for older adults with immigrant backgrounds are on the front lines of a practical, theoretical, and policy battlefield. They need to implement culturally sensitive care provision while not overstating the importance of culture, thereby, contributing to a negative picture of older immigrants as especially problematic. One proposed way to strike such a balance is the welfare theory of health (WTH). In this article, we let assistant nurses apply the WTH to a series of questions in four different vignettes representing the life stories of older persons who characterize typical dilemmas described by the theory. The results show that, through the lens of the WTH, assistant nurses looked for individual care preferences rather than stereotypical ideas about cultural characteristics. Further, the assistant nurses expressed a desire to get to know the persons more deeply to better interpret and understand their individual preferences. Thus, the theoretical framework is useful not only for exposing vulnerabilities to which some older adults with immigrant backgrounds may be exposed, but also for finding ways to mitigate the vulnerability by illuminating vital life goals and using them as a framework to organize care. This approach allows for mitigating the gap between the vital life goals and available resources to achieve a holistic state of health.

  • 36.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    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.
    Culturally sensitive active ageing through the Welfare Theory of Health. Views of assistant nursesManuscript (preprint) (Other academic)
  • 37.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    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.
    Holistic health amongst older adults – A validation study of the health measure Health as Ability of ActingManuscript (preprint) (Other academic)
  • 38.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Swedish Univ Agr Sci, Dept Urban & Rural Dev, Uppsala, Sweden..
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Swedish experts' understanding of active aging from a culturally sensitive perspective - a Delphi study of organizational implementation thresholds and ways of development2022In: Frontiers in Sociology, E-ISSN 2297-7775, Vol. 7, article id 991219Article in journal (Refereed)
    Abstract [en]

    BackgroundInternational migration and aging populations make for important trends, challenging elderly care regimes in an increasingly globalized world. The situation calls for new ways of merging active aging strategy and cultural sensitivity. This study aim to illuminate the gap between cultural sensitivity and active aging to identify perceived thresholds by Swedish municipal officials in the understanding of older late-in-life-immigrants situation. MethodsDelphi methodology in three rounds. Twenty-three persons in municipal decision-making positions participated and generated 71 statements, of which 33 statements found consensus. ResultsThe 33 statements show that the decision makers prefer not to use cultural sensitivity as a concept in their work, but rather tailor interventions based on individual preferences that may or may not be present in a certain culture. However, as the complexity of care increases, emphasis drifts away from personal preferences toward text-book knowledge on cultures and activity.

  • 39.
    Johansson-Pajala, Rose-Marie
    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.
    Jorsäter Blomgren, Kerstin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Fastbom, Johan
    Stockholm University, Stockholm.
    Martin, Lene
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nurses' use of computerised decision support systems affects drug monitoring in nursing homes2017In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, no 1, p. 56-64Article in journal (Refereed)
    Abstract [en]

    Aim: To describe variations in nurses' perceptions of using a computerised decision support system (CDSS) in drug monitoring. Background: There is an increasing focus on incorporating informatics into registered nurses' (RNs) clinical practice. Insight into RNs’ perceptions of using a CDSS in drug monitoring can provide a basis for further development of safer practices in drug management. Method: A qualitative interview study of 16 RNs. Data were analysed using a phenomenographic approach. Results: The RNs perceived a variety of aspects of using a CDSS indrug monitoring. Aspects of ‘time’ were evident, as was giving a ‘standardisation’ to the clinical work. There were perceptions of effects of obtained knowledge and ‘evidence’ and the division of ‘responsibilities’ between RNs and physicians of using the CDSS. Conclusion: The RNs perceived a CDSS as supportive in drug monitoring, in terms of promoting standardised routines, team-collaboration and providing possibilities for evidence-based clinical practice. Implications: Implementing a CDSS seems to be one feasible strategy to improve RNs’ preconditions for safe drug management. Nurse managers’ engagement and support in this process are vital for a successful result.

  • 40.
    Jonasson, Karin
    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.
    You Live as Much as You Have Time To: The Experience of Patients Living with Hemodialysis2017In: Nephrology Nursing Journal : Journal of The American Nephrology Nurses Association, ISSN 1526-744X, E-ISSN 2163-5390, Vol. 44, no 1, p. 35-41Article in journal (Refereed)
    Abstract [en]

    Changes in their daily lives that patients endure because of hemodialysis are major and also essential so they can stay alive. The aim of this study was to describe changes in life for patients with renal failure undergoing hemodialysis. The study has a qualitative descriptive approach with a qualitative content analysis based on in-depth interviews with patients undergoing hemodialysis. Results show that life in hemodialysis is experienced as a transition from liberty to captivity, adjusting to the new life, and the new life moving towards reconciliation. This study shows that support towards reconciliation is crucial for patient health.

  • 41.
    Kirvalidze, Mariam
    et al.
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden..
    Bostrom, Anne-Marie
    Karolinska Inst, Div Nursing, Dept Neurobiol Care Sci & Soc, SE-14183 Huddinge, Sweden.;Karolinska Univ Hosp, Theme Inflammat & Aging, Stockholm, Sweden.;Stockholms Sjukhem, Res & Dev Unit, Stockholm, Sweden..
    Liljas, Ann
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Karolinska Inst, Dept Global Publ Hlth, Solna, Sweden..
    Doheny, Megan
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden..
    Hendry, Anne
    Int Fdn Integrated Care IFIC, Glasgow, Scotland.;Univ West Scotland, Sch Hlth & Life Sci, Blantyre, Scotland..
    Mccormack, Brendan
    Univ Sydney, Susan Wakil Sch Nursing & Midwifery, Sydney Nursing Sch, Fac Med & Hlth, Camperdown, NSW, Australia..
    Fratiglioni, Laura
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Gerontol Res Ctr, Stockholm, Sweden..
    Ali, Sulin
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Karolinska Inst, Dept Global Publ Hlth, Solna, Sweden.;Univ Duisburg Essen, Inst Sociol, Duisburg, Germany..
    Ebrahimi, Zahra
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Ctr Person Centred Care GPCC, Gothenburg, Sweden..
    Elmstahl, Soelve
    Lund Univ, Dept Clin Sci, Div Geriatr Med, Lund, Sweden..
    Eriksdotter, Maria
    Karolinska Univ Hosp, Theme Inflammat & Aging, Stockholm, Sweden.;Karolinska Inst, Div Clin Geriatr, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Glaske, Pascal
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Karolinska Inst, Dept Global Publ Hlth, Solna, Sweden.;Univ Duisburg Essen, Inst Sociol, Duisburg, Germany..
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rundgren, Asa Hedberg
    Stockholm Gerontol Res Ctr, Stockholm, Sweden..
    Hvitfeldt, Helena
    Norrtalje Hosp, Vardbolaget Tiohundra, Stockholm, Sweden..
    Lennartsson, Carin
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Swedish Inst Social Res SOFI, Stockholm, Sweden..
    Marmstål Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Dalarna Univ, Sch Hlth & Welf, Falun, Sweden..
    Nilsson, Gunnar H.
    Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Nilsson, Peter
    Myndigheten Card & Omsorgsanalys, Stockholm, Sweden..
    Ohlen, Joakim
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Ctr Person Centred Care GPCC, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Palliat Care Ctr, Gothenburg, Sweden..
    Sandgren, Anna
    Linnaeus Univ, Ctr Collaborat Palliat Care, Dept Hlth & Caring Sci, Växjö, Sweden..
    Soderman, Annika
    Örebro Univ, Fac Med & Hlth, Sch Hlth Sci, Örebro, Sweden..
    Swedberg, Karl
    Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden..
    Vackerberg, Nicoline
    Jönköping Univ, Jönköping Acad Improvement Hlth & Welf, Jönköping, Sweden..
    Vetrano, Davide Liborio
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Gerontol Res Ctr, Stockholm, Sweden..
    Wijk, Helle
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Ctr Person Centred Care GPCC, Gothenburg, Sweden.;Chalmers Univ Technol, Dept Architecture & Civil Engn, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Qual Assurance & Patient Safety, Gothenburg, Sweden..
    Agerholm, Janne
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Karolinska Inst, Dept Global Publ Hlth, Solna, Sweden..
    Calderon-Larranaga, Amaia
    Care Sci & Soc, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Univ, Tomtebodavagen 18a, S-17165 Solna, Sweden.;Stockholm Gerontol Res Ctr, Stockholm, Sweden..
    Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts' perspective2024In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796Article in journal (Refereed)
    Abstract [en]

    Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field. image

  • 42.
    Kumpula, Esa
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ekstrand, Per
    Swedish Red Cross Univ Coll, Stockholm, Sweden.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Balancing security and care: Gender relations of nursing staff in forensic psychiatric care2021In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 29, no 4, article id e12478Article in journal (Refereed)
    Abstract [en]

    This study departs from the built-in tension of the dual goals of forensic psychiatric care in Sweden, which are to protect society as well as to care for patients. The majority of violence that takes place is perpetrated by men. Therefore, the views of nursing staff on violence as a gendered phenomenon have an impact on the care provision. There is a need for further knowledge of how norms of violence are intertwined with the construction of gender. The aim of this study was to use a gender perspective to demonstrate the views of nursing staff on security and care and the consequences for their relationships with patients. The study adopts an ethnographic approach, with data consisting of field notes from participatory observations and interviews with nursing staff at two maximum-security clinics. We show how the perceptions of nursing staff about gender relations are based on heteronormative thinking, which affects their practice. This implies that if gender is ignored in relation to the dual goals, there is a risk of perpetrating patterns of unequal conditions. Therefore, it is vital to make gender visible to counteract unequal conditions for nursing staff and address patients' individual care needs.

  • 43.
    Kumpula, Esa
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ekstrand, Per
    Röda korsets högskola, Stockholm.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The interplay between security and gender in forensic psychiatric care: an ethnographic study among nursing staffManuscript (preprint) (Other academic)
    Abstract [en]

    The fact that violence affects nursing staff’s ability to care for patients in Forensic Psychiatric Care (FPC) has been well documented. What has not been adequately addressed is how the interaction between security and gender affects the care given the patients. The aim was to illuminate, from a gender perspective, patterns of nursing staff´s views on security and its consequences for care in FPC. This study adopts an ethnographic approach and the data consists of field notes from participatory observations and interviews with nursing staff at two different FPC clinics in Sweden. Data was processed with thematic analysis. The results showed that when protecting society is given higher priority than care, it should not be separated from nursing staff´s values about gender.  For the female nursing staff this means that the care was linked to a mothering role, whereas male nursing staff duties were not linked to a fathering role. The latter’s focus on security created obstacles for the nurse-patient relationship, which were not experienced to the same extent by female staff. Making gender invisible in FPC creates unequal conditions for nursing staff’s tasks, which can lead to difficulties in achieving improved health for patients.

  • 44.
    Kumpula, Esa
    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.
    Ekstrand, P.
    The Swedish Red Cross University College, Flemingsberg Stockholm, Sweden.
    Illuminating the gendered nature of health-promoting activities among nursing staff in forensic psychiatric care2020In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, no 2, article id e12332Article in journal (Refereed)
    Abstract [en]

    When people in Sweden are sentenced and handed over to forensic psychiatric care (FPC), the authorities have overall responsibility for their health recovery. How nursing staff construct gender through their relations in this context affects their understanding of health promotion activities. The aim of this study was to illuminate, using a gender perspective, the understanding of nursing staff with respect to health promotion activities for patients. Four focus group interviews were conducted with nursing staff in two FPC clinics in Sweden. The study has a qualitative inductive design with an ethnographic approach. This study sheds new light on FPC in which its dual goals of protecting society and providing care are viewed from a gender perspective. When relationships within the nursing staff group and the nurse–patient relationship are justified by the goal of protecting society, gender becomes invisible. This might cause patients' individual conditions and needs for certain types of activities to go unnoticed. One of the implications of ignoring gender relations in nursing staff health promotion activities is that it risks contributing to gender stereotypes which impact on the nurse–patient relationship and the quality of care.

  • 45.
    Kumpula, Esa
    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.
    Ekstrand, P.
    Department of Health Sciences, Swedish Red Cross University College, Sweden.
    Nursing Staff Talk: Resource or Obstacle for Forensic Psychiatric Patient Care?2019In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 15, no 1, p. 52-59Article in journal (Refereed)
    Abstract [en]

    Although forensic psychiatric care is located at the intersection of health care and the Swedish legal system, nursing research has not yet evaluated how language is context bound or its consequences for understanding patient care. The aim of this study was to explore how nursing staff talk about patient care in Swedish forensic psychiatric care and the implications for the care given to patients. The theoretical framework is based on social constructionism and sheds light on how language use can be understood as a social action. Twelve interviews were conducted with nursing staff working in forensic psychiatric settings. The questions focused on patient care in relation to activities, security, relationships with patients, and rules and routines. The results show that nursing staff assignments are encouraging them to use various interpretative repertoires to make meaning about their practice. The three interpretative repertoires were "taking responsibility for correcting patients' behavior," "justifying patient care as contradictory practice," and "patients as unpredictable." However, although forensic psychiatric care emphasizes both security and care, nursing staff's use of these interpretative repertoires provided multiple interpretations that lead to contradictory ways of understanding patient care. These findings show that talk itself can be understood as problematic in various situations. A possible implication for clinical forensic nursing practice might be that the nurse-patient relationship does not support patients' best interests. For example, when language endows the patient with certain characteristics, this talk is justified and given meaning by its context and thus has an influence on a patient's individual need for care.

  • 46.
    Pongthippat, Weerati
    et al.
    Mental Health and Psychiatric Nursing Department, Boromarajonani College of Nursing, Udon Thani, Thailand.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Darvishpour, Mehrdad
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kijsomporn, J.
    Nursing Faculty, Shinawatra University, Bang Toei, Thailand.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Illuminating health aspects for immigrant Thai women in Swedish transnational marriages2024In: BMC Women's Health, E-ISSN 1472-6874, Vol. 24, no 1, article id 337Article in journal (Refereed)
    Abstract [en]

    Background: Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration. Methods: A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas. Results: The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma. Conclusion: Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations. 

  • 47.
    Pongthippat, Weerati
    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.
    Darvishpour, Mehrdad
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kijsomporn, J.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Multidimensional health goal a driving force in relationship management among Thai women in marriages migrationManuscript (preprint) (Other academic)
  • 48.
    Pongthippat, Weerati
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani Coll Nursing, Dept Mental Hlth & Psychiat Nursing, Udon Thani, Thailand..
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Darvishpour, Mehrdad
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kijsomporn, Jureerat
    Minist Publ Hlth, Praboromarajchanok Inst Hlth Workforce Dev, Nonthaburi, Thailand..
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Perceptions of transnational family responsibilities' effects on subjective health and wellness - voices of Thai immigrant women2020In: International Journal of Migration, Health and Social Care, ISSN 1747-9894, E-ISSN 2042-8650, Vol. 16, no 3, p. 225-240Article in journal (Refereed)
    Abstract [en]

    Purpose Globalisation provides new opportunities for immigrant women to supply financial benefits transnationally to uphold their families in their home countries. The purpose of this study is to explore the experiences of Thai immigrant women regarding transnational family responsibilities effects on their health and wellness. Design/methodology/approach Qualitative data were collected using semi-structured interviews with 40 Thai immigrant women, of which 34 described having transnational family responsibilities. The transcribed data were analysed using a phenomenographic approach. Findings The findings revealed five structural aspects of transnational family responsibilities of Thai immigrant women: being a dutiful daughter, being a caring mother, being a kind relative, being a "giving" person and striving for a wealthy life. The interviewees seldom encountered enough support from the spouse in handling their transnational family responsibilities. In general, a transnational marriage includes family responsibilities that are continuous and that often is the cause of migration. Practical implications This paper illuminates the transnational responsibilities of marriage migration and argues for women's rights of culturally congruent health care. Originality/value Traditionally Thai women's values are based on how they handle family responsibilities and acknowledging own health needs are not. These interviewees perceived doubled burden in terms of family responsibilities and workload in employed work, which contributed to poor health and wellness.

  • 49.
    Rylander, Annelie
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Fredriksson, Stina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stenwall, Ewa
    Karolinska Institutet, Sweden.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Significant aspects of nursing within the process of end-of-life communication in an oncological context2019In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 39, no 2, p. 85-91Article in journal (Refereed)
    Abstract [en]

    The complexity of end-of-life communications has previously been described and found to be given late in the patient’s palliative care. There is a need for earlier and more continuous end-of-life-communications throughout the patient’s care to reduce anxiety, confusion, and promote participation. Registered nurses (RNs) have a unique closeness to the patient and the ability to identify early the need for end-of-life communication. The aim of this study was to describe crucial aspects of nursing in end-of-life communication in an oncology context. The study was designed as a qualitative content analysis of in-depth interviews with RNs working in oncology in-patient care units. Two domains were identified: before, and after end-of-life communications, with the categories importance of being well prepared to identify both the patient’s and their family’s needs. Cooperation and interaction between physicians and RNs were crucial to be able to support patients and their relatives around the clock. The presence of RNs encouraged further conversations about the patients’ conditions to gain insight into the new situation. End-of-life communication should not only be medicine oriented and performed by physicians. Involvement of RNs’ expertise enables increased patient/relative participation as well as reduced anxiety and suffering, creating clarity and safety for all involved in care.

  • 50.
    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.

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