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Enmarker, Ingela
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Andreassen Devik, S., Enmarker, I. & Hellzén, O. (2019). Nurses’ experiences of compassion when giving palliative care at home. Nursing Ethics
Open this publication in new window or tab >>Nurses’ experiences of compassion when giving palliative care at home
2019 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised. Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data. Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes. Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content. Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective. © The Author(s) 2019.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Compassion, home nursing care, palliative care, quality of interaction, secondary qualitative analysis, adult, article, home care, human, interview, narrative, Norway, palliative therapy, qualitative analysis, registered nurse, sociology
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-30511 (URN)10.1177/0969733019839218 (DOI)2-s2.0-85064909761 (Scopus ID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Voraroon, S., Hellzen, O., Enmarker, I., Meebunmak, Y. & Devik, S. A. (2019). The impact of shareholding networks for facilitating care in rural Thailand.. Geriatric Nursing
Open this publication in new window or tab >>The impact of shareholding networks for facilitating care in rural Thailand.
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2019 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984Article in journal (Refereed) Epub ahead of print
Abstract [en]

This study explored the existential meaning of being a participant in shareholding networks for the care of older people in Thailand. Ten older persons were interviewed about their experiences of participating in the networks. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that participating in shareholding network activities entails an always-present existence of aging intertwined with life. Its constituents further describe the essential meaning of the phenomenon: "experience of improved self-management", "feeling of increased self-esteem", and "bridging a gap in the care of older people". Participation in shareholding network activities means keeping contact with oneself and being able to have a life that corresponds to how one perceives oneself to be and must therefore be understood from a holistic perspective. The present study recommends that older persons' need for support include places where safe and profound reflection on existential issues.; Copyright © 2019. Published by Elsevier Inc.

Place, publisher, year, edition, pages
Mosby-Yearbook, 2019
Keywords
Holistic understanding, Lifeworld research, Older people, Phenomenology, Shareholding network
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hig:diva-30477 (URN)10.1016/j.gerinurse.2019.01.002 (DOI)30765176 (PubMedID)2-s2.0-85061332676 (Scopus ID)
Available from: 2019-08-09 Created: 2019-08-09 Last updated: 2019-08-09Bibliographically approved
Eivergård, K., Enmarker, I., Livholts, M., Aléx, L. & Hellzén, O. (2019). The Importance of Being Acceptable - Psychiatric Staffs' Talk about Women Patients in Forensic Care. Issues in Mental Health Nursing, 40(2), 124-132
Open this publication in new window or tab >>The Importance of Being Acceptable - Psychiatric Staffs' Talk about Women Patients in Forensic Care
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2019 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 2, p. 124-132Article in journal (Refereed) Published
Abstract [en]

Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead self-harm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff's talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hig:diva-28741 (URN)10.1080/01612840.2018.1514551 (DOI)000463571900006 ()30481089 (PubMedID)2-s2.0-85057627205 (Scopus ID)
Available from: 2018-12-03 Created: 2018-12-03 Last updated: 2019-08-15Bibliographically approved
Rönngren, Y., Björk, A., Audulv, Å., Enmarker, I., Kristiansen, L. & Haage, D. (2018). Educational nurse-led lifestyle intervention for persons with mental illness.. International Journal of Mental Health Nursing, 27(3), 1022-1031
Open this publication in new window or tab >>Educational nurse-led lifestyle intervention for persons with mental illness.
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2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 3, p. 1022-1031Article in journal (Refereed) Published
Abstract [en]

Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
clinical practice, educational intervention, healthy lifestyle support, interpersonal relationship, severe mental illness
National Category
Clinical Medicine
Identifiers
urn:nbn:se:hig:diva-25733 (URN)10.1111/inm.12410 (DOI)000431999300011 ()29171905 (PubMedID)2-s2.0-85035026741 (Scopus ID)
Available from: 2017-12-05 Created: 2017-12-05 Last updated: 2018-12-21Bibliographically approved
Rasmussen, H., Hellzen, O., Stordal, E. & Enmarker, I. (2018). Family caregivers experiences of the pre-diagnostic stage in frontotemporal dementia. Geriatric Nursing
Open this publication in new window or tab >>Family caregivers experiences of the pre-diagnostic stage in frontotemporal dementia
2018 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984Article in journal (Refereed) Epub ahead of print
Abstract [en]

Frontotemporal dementia (FTD) is a neurodegenerative disease with symptoms that differs from other dementias. Commonly early symptoms in FTD are changes in personality and behavior, which can be interpreted as psychiatric disease. The delay in FTD diagnosis contributes to the burden of family caregivers. Therefore, it is important to have more knowledge about the pre-diagnostic stage. In this qualitative interview study, we explored fourteen family caregiver's experiences of the pre-diagnostic stage of frontotemporal dementia (FTD). Our findings suggest that the family caregivers experienced the pre-diagnostic stage of FTD as changes in the interpersonal relationship with their loved one. These changes were often subtle and difficult for family caregivers to explain to others. The findings from our study illuminate the importance of medical staff paying attention when a next of kin is concerned about subtle changes in a loved one. The findings also illuminate that awareness of FTD should be raised.

Place, publisher, year, edition, pages
Mosby Inc., 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-28700 (URN)10.1016/j.gerinurse.2018.10.006 (DOI)30424902 (PubMedID)2-s2.0-85056274633 (Scopus ID)
Available from: 2018-11-28 Created: 2018-11-28 Last updated: 2018-12-06Bibliographically approved
Rönngren, Y., Björk, A., Kristiansen, L., Haage, D., Enmarker, I. & Audulv, Å. (2018). Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting. International Journal of Mental Health Nursing, 27(1), 390-399
Open this publication in new window or tab >>Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting
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2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 390-399Article in journal (Refereed) Published
Abstract [en]

Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.

Keywords
health information management, mental illness, primary health care, young adult
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-24167 (URN)10.1111/inm.12333 (DOI)000419717100039 ()28374967 (PubMedID)2-s2.0-85017454831 (Scopus ID)
Available from: 2017-06-12 Created: 2017-06-12 Last updated: 2018-12-21Bibliographically approved
Devik A., S., Olsen, R. M., Fiskvik, I. L., Halbostad, T., Lassen, T., Kuzina, N. & Enmarker, I. (2018). Varations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care. Scandinavian Journal of Primary Health Care, 36(3), 291-299
Open this publication in new window or tab >>Varations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care
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2018 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 3, p. 291-299Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

Traditionally, nursing homes have been associated with suboptimal drug therapy and drug-related problems (DRPs). In contrast, less is known about drug safety in homecare. The aim of this study was to describe and compare DRPs in older persons across two care settings: nursing homes and home nursing care.

DESIGN:

Cross-sectional study using descriptive and inferential statistics.

SETTING:

Nursing homes (n = 5) and home nursing care units (n = 8) across nine municipalities in the middle of Norway.

PARTICIPANTS:

Multidisciplinary medication reviews for 61 nursing home residents and 93 patients receiving home nursing care performed over the 2013-2014 period, were mapped and examined (N = 154).

MAIN OUTCOME MEASURES:

DRPs classified by a Norwegian Classification Tool.

RESULTS:

In all, 740 DRPs were detected in the total sample, 227 in nursing homes and 513 in home nursing care. DRPs were significantly higher among patients receiving home-based care (Mean =5.5) compared to patients in nursing homes (Mean =3.7, p = 0.002). Among the problem categories, the need for additional drug was most frequent in nursing homes (p = 0.001), while documentation discrepancies reached the highest numbers in patients receiving home nursing care (p = 0.000). Additionally, patients in home nursing care had more problems concerning adverse reactions (p = 0.060); however, this was not statistically significant. Differences in DRP categories leading to changes in the patients' medication lists were also discovered.

CONCLUSIONS:

The frequency of unclear documentation and adverse reactions found in the homecare setting is alarming. This is an important issue given the trend in aged care towards caring people in their own homes. Further research is warranted to explore how different care settings may influence the safety of pharmacotherapy for older persons.

Key Points

Drug related problems are a significant cause of concern among patients receiving home nursing care as well as for patients living in nursing homes. The findings of this study showed that:

  • Significantly more DRPs were detected among patients receiving home nursing care than patients living in nursing homes.
  • While patients living in nursing homes were often undermedicated, documentation discrepancies were more frequent in home nursing care.
  • DRP categories leading to changes on the medication lists differed between the settings.
Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keywords
Drug safety; Norwegian Classification Tool for DRPs; cross-sectional study; medication review; older patients; primary healthcare
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-27794 (URN)10.1080/02813432.2018.1499581 (DOI)000445265000009 ()30139278 (PubMedID)2-s2.0-85052290924 (Scopus ID)
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2018-10-15Bibliographically approved
Andreassen Devik, S., Hellzén, O. & Enmarker, I. (2017). Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: a qualitative study. European Journal of Cancer Care, 26(6)
Open this publication in new window or tab >>Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: a qualitative study
2017 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, no 6Article in journal (Refereed) Published
Abstract [en]

Little is known about experiences with receiving home nursing care when old, living in a rural area, and suffering from end-stage cancer. The aim of this study was thus to investigate bereaved family members' perceptions of suffering by their older relatives when receiving palliative home nursing care. Qualitative semi-structured interviews were conducted with 10 family members, in Norway during autumn 2015, and directed content analysis guided by Katie Eriksson's theoretical framework on human suffering was performed upon the data. The two main categories identified reflected expressions of both suffering and well-being. Expressions of suffering were related to illness, to care and to life and supported the theory. Expressions of well-being were related to other people (e.g. familiar people and nurses), to home and to activity. The results indicate a need to review and possibly expand the perspective of what should motivate care. Nursing and palliative care that become purely disease and symptom-focused may end up with giving up and divert the attention to social and cultural factors that may contribute to well-being when cure is not the goal.

Keywords
bereaved family members; home nursing care; palliative care; qualitative directed content analysis; rural; suffering
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-22873 (URN)10.1111/ecc.12609 (DOI)000414613000027 ()27859824 (PubMedID)2-s2.0-85006049737 (Scopus ID)
Available from: 2016-11-28 Created: 2016-11-28 Last updated: 2018-03-13Bibliographically approved
Bell, H.-T., Granas, A.-G., Enmarker, I., Omli, R. & Steinsbekk, A. (2017). Nurses’ and pharmacists’ learning experiences from participating in interprofessional medication reviews for elderly in primary health care - a qualitative study. BMC Family Practice, 18, Article ID 30.
Open this publication in new window or tab >>Nurses’ and pharmacists’ learning experiences from participating in interprofessional medication reviews for elderly in primary health care - a qualitative study
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2017 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 18, article id 30Article in journal (Refereed) Published
Abstract [en]

Background: Traditionally, drug prescription and follow up have been the sole responsibility of physicians. However, interprofessional medication reviews (IMRs) have been developed to prevent drug discrepancies and patient harmespecially for elderly patients with polypharmacy and multimorbidity. What participating nurses and pharmacists learn from each other during IMR is poorly studied. The aim of this study was to investigate nurses’ and pharmacists’ perceived learning experience after participating in IMRs in primary health care for up to two years.

Methods: A qualitative study with semi-structured focus group interviews and telephone interviews with nurses and pharmacists with experience from IMRs in nursing homes and home based services. The data was analysed thematically by using systematic text condensation.

Results: Thirteen nurses and four pharmacists were interviewed. They described some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient. As expected, both professions talked of an increased awareness with time of the benefit of working as a team and the perception of contributing to better and more individual care. The nurses’ perception of the pharmacist changed from being a controller of drug management routines towards being a source of pharmacotherapy knowledge and a discussant partner of appropriate drug therapy in the elderly. The pharmacists became more aware of the nurses’ crucial role of providing clinical information about the patient to enable individual advice. Increasingly the nurses learned to link the patient’s symptoms of effect and side effect to the drugs prescribed.

Conclusions: Although experiencing challenges in conducting IMRs, the nurses and pharmacists had learning experiences they said improved both their own practice and the quality of drug management. There are some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient.

Keywords
Medication review, Nurse, Pharmacist, Lear ning, Inappropriate drug use, Primary care
National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-23780 (URN)10.1186/s12875-017-0598-0 (DOI)
Available from: 2017-03-20 Created: 2017-03-20 Last updated: 2018-03-13Bibliographically approved
Voraroon, S., Hellzén, O., Meebunmak, Y. & Enmarker, I. (2017). Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand: A Phenomenological Hermeneutic Study. Open Journal of Nursing, 7(7), 875-892
Open this publication in new window or tab >>Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand: A Phenomenological Hermeneutic Study
2017 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 7, p. 875-892Article in journal (Refereed) Published
Abstract [en]

Background: Older people participating in shareholding networks are exposed to diverse situations, which may be associated with dignity. Aims: This study aimed to illuminate the meaning of lived experiences when participating in shareholding networks for the care of older people in rural areas. Methods: This qualitative study is based on individual interviews. Ten older Thai persons with at least 12 months of lived experiences participating in shareholding networks for older people in rural areas were interviewed. A phenomenological-hermeneutic approach, inspired by Ricoeur, was used to understand the meaning of the narrated text. Findings: The structural analysis resulted in four themes: 1) being satisfied with activities, 2) being valued as important, 3) being frustrated and feeling sad, and 4) being bored and feeling disinterest. The meaning of participation in a shareholding network for the elderly can be understood as a pathway to feelings of confidence and presence of others. Confidence and allowing the presence of others mean facing humanity and sensing vulnerability, because in a trusting relationship the person who gives confidence is susceptible to the other’s betrayal. Conclusion: An individual’s dignity should be a high priority in health and social care strategies. Therefore, it is important for healthcare professionals to initiate a dialogue with the shareholding participants for support and information. The narrations in this study can be used as a basis for developing cooperating care with older people in shareholding network focusing on their needs and dignity.

Keywords
Shareholding Networks
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:hig:diva-25071 (URN)10.4236/ojn.2017.77065 (DOI)
Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2018-03-13Bibliographically approved
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