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  • 1.
    Andreassen Devik, S.
    et al.
    Centre of Care Research, Department of Health Sciences, Nord University, Steinkjer, Norway; Department of Health Sciences, Nord University, Namsos, Norway.
    Hellzén, Ove
    Department of Nursing Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Centre of Care Research, Department of Health Sciences, Nord University, Steinkjer, Norway; Department of Nursing Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: a qualitative study2017In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, no 6Article in journal (Refereed)
    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.

  • 2.
    Andreassen Devik, Siri
    et al.
    Fakultet for sykepleie og helsevitenskap, Nord universitet, Bodö, Norge.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Fakultet for sykepleie og helsevitenskap, Nord universitet, Bodö, Norge.
    Quality collaboratives used to improve drug safety for older patients in primary care in Norway2016Conference paper (Refereed)
  • 3.
    Andreassen Devik, Siri
    et al.
    Centre for Care Research Mid-Norway, Steinkjer, Norway; Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Centre for Care Research Mid-Norway, Steinkjer, Norway; Nord Trøndelag University College, Namsos, Norway.
    Bitnes Wiik, Guri
    Nord Trøndelag University College, Namsos, Norway.
    Hellzén, Ove
    Centre for Care Research Mid-Norway, Steinkjer, Norway; Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden; Nord Trøndelag University College, Namsos, Norway.
    Meanings of being old, living on one's own and suffering from incurable cancer in rural Norway2013In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 6, p. 781-787Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of this study was to explore and understand the lived experience of older people living alone and suffering from incurable cancer in rural Norway.

    Methods and sample

    Narrative interviews were conducted with five older people with incurable cancer (three women and two men, aged 71–79), receiving outpatient and life-prolonging chemotherapy and living alone in their homes in rural areas. A phenomenological hermeneutical approach was used to interpret the meaning of the lived experience.

    Key results

    Four main themes were found: enduring by keeping hope alive, becoming aware that you are on your own, living up to expectations of being a good patient and being at risk of losing one's identity and value. Enduring this situation means struggling with terminal illness and facing death in a brave manner, and replacing former ways of living. The process of providing treatment may threaten dignity and cause additional distress.

    Conclusions

    These results show a complex and comprehensive situation where physical symptoms and emotions are interwoven. Further the results describe how the ways of suffering caused by the manner in which care is delivered, suffering related to the cancer disease and existential suffering, may increase each other's impact. The social and rural context calls for special attention as the patients may lack recourses to gain sufficient care. Their comfort depends to a large extent on the health professionals' sensitivity.

  • 4.
    Andreassen Devik, Siri
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Haugum, Margrete Hembre
    Trøndelag Forskning og Utvikling.
    Evaluering av Mestring i lag – sammen om rehabilitering. Prosjekt ved Namdal rehabilitering2012Report (Other academic)
  • 5.
    Andreassen Devik, Siri
    et al.
    Centre of Care Research, Mid-Norway, Steinkjer, Norway; Department of Nursing, Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Centre of Care Research, Steinkjer, Mid-Norway; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    Hellzén, Per Ove
    Centre of Care Research, Steinkjer, Mid-Norway; Department of Nursing, Mid-Sweden University, Sundsvall, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    When expressions make impressions-Nurses' narratives about meeting severely ill patients in home nursing care: A phenomenological-hermeneutic approach to understanding2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, no 1, article id 21880Article in journal (Refereed)
    Abstract [en]

    Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses’ lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs’ lived experience of patients’ expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: “Sensing vulnerability” and “Empathizing with.” The second theme, Being satisfied, entails the subthemes, “Feeling exceptional” and “Being trusted.” The third theme, Being frustrated, contains the subthemes, “Being disappointed” and “Being angry.” The fourth and final theme, Being ambivalent, includes one subtheme: “Being generous or reserved.” Patients’ expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional role.

  • 6.
    Andreassen Devik, Siri
    et al.
    Centre for Care Research Mid-Norway, Steinkjer, Norway; Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Centre for Care Research Mid-Norway, Steinkjer, Norway;Nord Trøndelag University College, Namsos, Norway.
    Wiik, Guri Bitnes
    Nord Trøndelag University College, Namsos, Norway.
    Hellzén, Per Ove
    Centre for Care Research Mid-Norway, Steinkjer, Norway; Department of Health Sciences, Mid-Sweden University, Sundsvall, Sweden.
    Meanings of being old, living on one`s own and suffering from incurable cancer in rural Norway2014Conference paper (Refereed)
  • 7.
    Andreassen Devik, Siri
    et al.
    Centre of Care Research, Mid-Norway, Steinkjer, Norway; Department of Nursing, Mid-Sweden University, Sundsvall, Sweden.
    Hellzén, Ove
    Department of Nursing, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Centre of Care Research, Mid-Norway, Steinkjer, Norway; Department of Nursing, Mid-Sweden University, Sundsvall, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Stjørdal, Norway.
    "Picking up the pieces" - Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, no 1, article id 28382Article in journal (Refereed)
    Abstract [en]

    Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context.

  • 8.
    Bell, Hege Therese
    et al.
    Fakultet for sykepleie og helsevitenskap, Nord universitet, Bodø, Norge.
    Granås, Anne Gerd
    Universitetet i Oslo, Oslo, Norge.
    Omli, Ragnhild
    Institutt for sykepleievitenskap, Norges teknisk-naturvitenskapelige universitet, Trondheim, Norge.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap, Nord universitet, Bodø, Norge.
    Steinsbekk, Aslak
    UiT: Universitetet i Tromsø – Norges arktiske universitet.
    Nurses' and pharmacists' learning experiences from participating in inter professional medication reviews in primary health care: a qualitative study.2016Conference paper (Refereed)
    Abstract [en]

    Background and Objective: 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 harm. 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. Setting and Method: 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. Main outcome measures: A qualitative method is useful when looking at objects from the perspective of how they are experienced. Results: Sixteen nurses and four pharmacists were interviewed. 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. With time both professions jointly spoke of an increased awareness of the benefit of working as a team and the perception of contributing to better and more individual care. Conclusion: IMRs in primary health care meet some challenges especially concerning how to ensure participation of all three professions and how to get thorough information about the patient. Possible solutions might be to use shared communication tools like Internet based communication programs and to introduce the patient as a participant at the IMRs.

  • 9.
    Bell, Hege-Therese
    et al.
    Department of Pharmacy, Faculty of Health Sciences, Nord University, Namsos, Norway; Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
    Granas, A-G
    School of Pharmacy, University of Oslo, Oslo, Norway.
    Enmarker, Ingela
    Centre for Care research Mid-Norway, Steinkjer, Norway; Department of Nursing, Mid University, Østersund, Sweden.
    Omli, Ragnhild
    Department of Pharmacy, Faculty of Health Sciences, Nord University, Namsos, Norway; Centre for Care research Mid- Norway, Steinkjer, Norway.
    Steinsbekk, A.
    Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
    Nurses’ and pharmacists’ learning experiences from participating in interprofessional medication reviews for elderly in primary health care - a qualitative study2017In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 18, article id 30Article in journal (Refereed)
    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.

  • 10.
    Boman, Eva
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Enmarker, Ingela
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Factors affecting pupils’ noise annoyance in schools: The building and testing of models2004In: Environment and Behavior, ISSN 0013-9165, E-ISSN 1552-390X, Vol. 36, no 2, p. 207-228Article in journal (Refereed)
    Abstract [en]

    This article reports two studies intended to develop and assess conceptual models of how different factors mediate and moderate the annoyance reaction in school environments. In the first, a survey of 207 pupils was conducted where assumptions about mediators and moderators were formulated and tested. In the best model, general sensitivity and adaptation led to a higher degree of annoyance causing stress symptoms. In the second study, focus group interviews with 16 pupils were performed to set up a model of mediating and moderating factors from pupils' statements in the formation of annoyance. The objective was also to get their opinions about ways to improve the sound environment in school. The interviews indicated a serial arrangement in which stress symptoms and distraction mediated between chatter and disturbance. Thus, the two studies suggested different models for the prediction of the annoyance reaction. The pupils' views about how to improve the school sound environment are discussed in the framework of an empowerment model.

  • 11.
    Boman, Eva
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Enmarker, Ingela
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Hygge, Staffan
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Noise and age effects on reading comprehension (Poster)2004In: XXVII International Congress of Psychology, 2004Conference paper (Other academic)
  • 12.
    Boman, Eva
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Enmarker, Ingela
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Hygge, Staffan
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Strength of noise effects on memory as a function of noise source and age.2005In: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 7, no 27, p. 11-26Article in journal (Refereed)
    Abstract [en]

    The objectives in this paper were to analyse noise effects on episodic and semantic memory performance in different age groups, and to see whether age interacted with noise in their effects on memory. Data were taken from three separate previous experiments, that were performed with the same design, procedure and dependent measures with participants from four age groups (13-14, 18-20, 35-45 and 55-65 years). Participants were randomly assigned to one of three conditions: (a) meaningful irrelevant speech, (b) road traffic noise, and (c) quiet. The results showed effects of both noise sources on a majority of the dependent measures, both when taken alone and aggregated according to the nature of the material to be memorised. However, the noise effects for episodic memory tasks were stronger than for semantic memory tasks. Further, in the reading comprehension task, cued recall and recognition were more impaired by meaningful irrelevant speech than by road traffic noise. Contrary to predictions, there was no interaction between noise and age group, indicating that the obtained noise effects were not related to the capacity to perform the task. The results from the three experiments taken together throw more light on the relative effects of road traffic noise and meaningful irrelevant speech on memory performance in different age groups.

  • 13.
    Brenne, Tor S.
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Valderaune, Victor
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Etterutdanningsnettverket i Namdal: visjon og virkelighet2009Report (Other academic)
    Abstract [en]

    Etter 10 år som et forsøk/prosjekt har EiNa endelig fått sin permanente organisering gjennom en partnerskapsavtale. EiNa-partnerskapet har nå medlemmer som dekker det meste av helseog sosialtjenestene i Namdalen. I tillegg er også oppvekstsektorens ansatte tatt inn i målgruppen for EiNas aktivitet. Denne rapporten er del 2 i det evalueringsprosjektet som styret i EiNa initierte i 2009 og som ble gjennomført av Høgskolen i Nord-Trøndelag. Del 1 presenterte virksomheten gjennom 10 år dels som en historiefortelling, dels med dokumentasjon av prosess og avtaler som EiNa er bygd opp omkring og dels gjennom å presentere aktiviteten i oversikter og i statistikk. Denne rapporten tar for seg resultatene av en brukerundersøkelse som ble gjennomført våren 2009.

  • 14.
    Devik A., Siri
    et al.
    Centre of Care Research Mid-Norway, Steinkjer, Norway; Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway.
    Olsen, Rose M.
    Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway.
    Fiskvik, Inger Lise
    Centre for Development of Institutional and Home care Services in Nord-Trøndelag, Stjørdal, Norway.
    Halbostad, Terje
    Namsos Hospital, Hospital Pharmacy, Namsos, Norway.
    Lassen, Tone
    Apotek 1, Malvik, Norway.
    Kuzina, Natalia
    Department of Laboratory Medicine Children's and women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Centre of Care Research Mid-Norway, Steinkjer, Norway.
    Varations in drug-related problems detected by multidisciplinary teams in Norwegian nursing homes and home nursing care2018In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 3, p. 291-299Article in journal (Refereed)
    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.
  • 15.
    Eivergård, Kristina
    et al.
    Mid-Sweden University, Department of Nursing Sciences, SE- Östersund, Sweden.
    Enmarker, Ingela
    Mid-Sweden University, Department of Nursing Sciences, SE- Östersund, Sweden.
    Hellzén, Per Ove
    Mid-Sweden University, Department of Nursing Sciences, SE- Östersund, Sweden.
    The Talk About the Psychiatric Patient2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 756-764Article in journal (Refereed)
    Abstract [en]

    Essential to psychiatric nursing practice and care, verbal handovers and ward rounds are reporting systems for communication that shapes psychiatric staff's ability to recognize, understand, and construct patients, as well as patients’ ability to construct themselves. Given the centrality of such language in psychiatric practice, the aim of this study was to describe how psychiatric staff talk about patients in psychiatric wards, what their talk encompasses, and what consequences it might pose for patient care. Empirical data were collected from audio recordings of staff discussions of patients during nine verbal handovers and three ward rounds in six different general psychiatric wards in mid and southern Sweden. Findings showed that to describe patients’ mood, characteristics, and behavior, nurses used culturally common words and concepts related to three themes—good patients, bad patients, and to stay or be discharged—and six subthemes—looking well, looking poorly, desirable patients, undesirable patients, continuing work, and being discharged. However, since assessments of and decisions about patients’ conditions and care used everyday language and did not involve patients’ participation, opportunities for patients to participate in their own care were rare.

  • 16.
    Eivergård, Kristina
    et al.
    Department of Nursing Sciences, Mid-Sweden University, Östersund, Sweden; Department of Health Care Science, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Livholts, Mona
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Aléx, Lena
    Department of Nursing, Umeå University, Umeå, Sweden.
    Hellzén, Ove
    Department of Nursing Sciences, Mid-Sweden University, Östersund, Sweden.
    The Importance of Being Acceptable - Psychiatric Staffs' Talk about Women Patients in Forensic Care2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Article in journal (Refereed)
    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.

  • 17.
    Enmarker, Ingela
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Effects of meaningful irrelevant speech and road traffic noise on teachers' attention, episodic and semantic memory.2004In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 45, no 5, p. 393-405Article in journal (Refereed)
    Abstract [en]

    The aim of the present experiment was to examine the effects of meaningful irrelevant speech and road traffic noise on attention, episodic and semantic memory, and also to examine whether the noise effects were age-dependent. A total of 96 male and female teachers in the age range of 35-45 and 55-65 years were randomly assigned to a silent or the two noise conditions. Noise effects found in episodic memory were limited to a meaningful text, where cued recall contrary to expectations was equally impaired by the two types of noise. However, meaningful irrelevant speech also deteriorated recognition of the text, whereas road traffic noise caused no decrement. Retrieval from two word fluency tests in semantic memory showed strong effects of noise exposure, one affected by meaningful irrelevant speech and the other by road traffic noise. The results implied that both acoustic variation and the semantic interference could be of importance for noise impairments. The expected age-dependent noise effects did not show up.

  • 18.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    How will the nurse students be prepared to meet the older patient?2008Conference paper (Other academic)
  • 19.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    The effect of meaningful irrelevant speech on teachers´ attention and memory2003Conference paper (Refereed)
  • 20. Enmarker, Ingela
    The effect of road traffic noise on teachers´ attention and memory2003Conference paper (Refereed)
  • 21.
    Enmarker, Ingela
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Boman, Eva
    Improvement of the sound environment in schools2004Conference paper (Refereed)
  • 22. Enmarker, Ingela
    et al.
    Boman, Eva
    Noise annoyance in schools – Teachers’ perceptions2002Conference paper (Refereed)
  • 23.
    Enmarker, Ingela
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Boman, Eva
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Noise annoyance responses of middle school pupils and teachers2004In: Journal of Environmental Psychology, ISSN 0272-4944, E-ISSN 1522-9610, Vol. 24, no 4, p. 527-536Article in journal (Refereed)
    Abstract [en]

    The present survey study had three aims: (1) to compare pupils' and teachers' annoyance responses to classroom noise, (2) to compare females and males responses and (3) to test annoyance models that fitted both pupils and teachers. The study included 207 pupils, aged 13-14 years, and 166 teachers, aged 21-65 years. Both pupils and teachers rated chatter as the most disturbing noise source in the classroom. In line with predictions, the teachers experienced themselves as more sensitive to noise, had poorer hearing status, and reported more intense stress symptoms than the pupils. Contrary to expectations, the teachers were more annoyed and they perceived the noise to be more unpredictable than the pupils did. The control items showed a mixed pattern. There were no overall differences between females and males annoyance responses, but females reported having more stress symptoms than males. A conceptual model was tested with structural equation models, where noise sensitivity mediated the relationship between hearing status and annoyance, which in turn affected stress symptoms. Control and predictability were tested as moderators of the relations between stress symptoms and annoyance. The data fit the conceptual model reasonable well when both samples were included in the same test. (c) 2004 Elsevier Ltd. All rights reserved.

  • 24.
    Enmarker, Ingela
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Boman, Eva
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Pupils and teachers response structures of noise annoyanceManuscript (preprint) (Other academic)
  • 25.
    Enmarker, Ingela
    et al.
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för psykologi. Royal Institute of Technology, Stockholm, Sweden.
    Boman, Eva
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för psykologi. Royal Institute of Technology, Stockholm, Sweden.
    Hygge, Staffan
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Structural equation models of memory performance across noise and age2006In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 47, no 6, p. 449-460Article in journal (Refereed)
    Abstract [en]

    Competing models of declarative memory were tested with structural equation models to analyze whether a second-order latent variable structure for episodic and semantic memory was invariant across age groups and across noise exposure conditions. Data were taken from three previous experimental noise studies that were performed with the same design, procedure, and dependent measures, and with participants from four age groups (13-14, 18-20, 35-45, and 55-65 years). Two noise conditions, road traffic noise and meaningful irrelevant speech, were compared to a quiet control group. The structural models put to the test were taken from Nyberg et al. (2003), which employed several memory tests that were the same as ours and studied age-groups that partly overlapped with our groups. In addition we also varied noise exposure conditions. Our analyses replicated and supported the second-order semantic-episodic memory models in Nyberg et al. (2003). The latent variable structures were invariant across age groups, with the exception of our youngest group, which by itself showed a less clear latent structure. The obtained structures were also invariant across noise exposure conditions. We also noted that our text memory items, which did not have a counterpart in the study by Nyberg et al. (2003), tend to form a separate latent variable loading on episodic memory.

  • 26.
    Enmarker, Ingela
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Boman, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Psychology.
    Hygge, Staffan
    The effects of noise on memory1998Conference paper (Refereed)
  • 27. Enmarker, Ingela
    et al.
    Boman, Eva
    Hygge, Staffan
    The effects of noise on word fluency and word comprehension in different age groups2004Conference paper (Refereed)
  • 28.
    Enmarker, Ingela
    et al.
    Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Center for Care Research, Norway.
    Hellzén, Ove
    Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ekker, Knut
    Faculty of Agriculture and Information Technology, Nord-Trøndelag University College, Steinkjer, Norway.
    Berg, Anne Grethe
    Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Norwegian Food Safety Authority, Steinkjer, Norway.
    Health in older cat and dog owners: The Nord-Trondelag Health Study (HUNT)-3-study2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 8, p. 718-724Article in journal (Refereed)
    Abstract [en]

    Aim: The main objective was to compare older male and female cat, dog, and non-owners with regard to demographic and health-related characteristics. Method : Data in the present cross-sectional population study were drawn from HuNT-3 in Norway. A total of 12,297 persons (5631 men; 6666 women) between the ages of 65 and 101 years were included, of whom 2358 were pet owners. Results : The main finding was that owning a dog demonstrated several health-related characteristics to a higher positive degree than both non-pet and cat ownership among the participants. Cat owners showed higher body mass index values and higher systolic blood pressure, and reported worse general health status. They also exercised to a lower degree than the others. Conclusions : As the result implies that older cat owners are negatively outstanding in many aspects of health compared with the dog owners, in the future, more focus must be put on the worse health of those. Further, there were more married male than female cat and dog owners. This probably depends on traditional cultural thinking; the man is the owner of the pet even if the woman lives with and cares about it. It is important to point out that different groups in the population might select different pets. Consequently, the findings showing a correlation between pet ownership and health may be owing to unrelated confounding factors.

  • 29.
    Enmarker, Ingela
    et al.
    Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Center for Care Research, Mid-Norway, Norway.
    Hellzén, Ove
    Center for Care Research, Mid-Norway, Norway; Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ekker, Knut
    aculty of Agriculture and Information Technology, Nord-Trøndelag University College, Steinkjer, Norway.
    Berg, Anne-Grethe T.
    Norwegian Food Safety Authority, Steinkjer, Norway.
    Personalities and health in older cat and dog owners: A HUNT-study2013In: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 5, no 9, p. 1449-1454, article id 36906Article in journal (Refereed)
    Abstract [en]

    The aim of this population study was to identify personality traits among older (>65 years) male and female owners of cats and dogs and to compare their general health status in relation to their personality. Further, the aim was to examine whether current cat and dog ownership could be predicted by the owners’ personality and health. Data were collected from the NorthTrøndelag Health Study (HUNT) in Norway. Included were a total of 1897 cat or dog owners between the ages of 65 years and 101 years. The results showed that there were a higher proportion of introverted male cat owners than extraverted ones. Moreover, a majority of women with cats reported that their health was not good. Furthermore, female cat owners who displayed higher scores on neurotic traits experienced significantly poorer health compared to those female cat owners that experienced good health. The same was true for female cat owners who considered themselves to be introverted. Neither personality nor health could predict pet-ownership, but it was more likely for older individuals (80 - 101 years) to own a cat than a dog. This study has shown that human personality is associated with cat and dog ownership, but there are other factors connected with pet ownership as well.

  • 30.
    Enmarker, Ingela
    et al.
    Department of Health Sciences, Nord-Trøndelag University College, Steinkjer, Norway; Center for Care Research, Steinkjer, Norway.
    Hellzén, Ove
    Department of Health Sciences, Nord-Trøndelag University College, Steinkjer, Norway; Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ekker, Knut
    Department of Agriculture and Information Technology, Nord-Trøndelag University College, Steinkjer, Norway.
    T. Berg, Anne-Grethe
    Department of Clinical Medicine, Vivarium-Haukeland sykehus, University of Bergen, Bergen, Norway; Norway/Norwegian Food Safety Authority, Steinkjer, Norway.
    Depression in older cat and dog owners: The Nord-Trøndelag Health Study (HUNT)-32015In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 4, p. 347-352Article in journal (Refereed)
    Abstract [en]

    Objective: Depression constitutes a major health problem for older people, in this study defined as people 65 years of age and older. Previous studies have shown that mental health among older people who live with animals could be improved, but contrary results exist as well. Therefore, the objective of the present population study was to compare the self-rated depression symptoms of both female and male non-pet owners, cat owners, and dog owners.

    Method: The participants in this cross-sectional population study included 12,093 people between the ages of 65 and 101. One thousand and eighty three participants owned cats and 814 participants owned dogs. Self-rated depression symptoms were measured using HADS-D, the scale of self-administered depression symptoms in HADS (Hospital Anxiety and Depression Scale).

    Results: The main results showed higher mean values on the HADS-D for cat owners than for both dog and non-pet owners. The latter group rated their depression symptoms the lowest. When dividing the ratings into low- and high-depression symptoms, the logistic regression analysis showed that it was more likely that males who owned cats perceived lower depression symptoms than females who owned cats. No interactions were recognized between pet ownership and subjective general health status, loneliness, or marital status.

    Conclusions: Our results provide a window into the differences in health factors between older females and males who own cats and dogs in rural areas. Results from population studies like ours might increase the available knowledge base when using cats and dogs in clinical environments such as nursing homes.

  • 31.
    Enmarker, Ingela
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Hygge, Staffan
    The Effects of Aircraft Noise on Memory, Stress and Arousal in Older Persons2000Conference paper (Refereed)
  • 32.
    Enmarker, Ingela
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Olsen, R.
    Hellzen, O.
    Management of person with dementia with aggressive and violent behaviour: A systematic literature review2011In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 6, no 2, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Aim. Studies indicate that physical and pharmacological restraints are still often in the frontline of aggression management in a large number of nursing homes. In the present literature review the aim was to describe, from a nursing perspective, aggressive and violent behaviour in people with dementia living in nursing home units and to find alternative approaches to the management of dementia related aggression as a substitute to physical and chemical restraints. Methods. A systematic literature review in three phases, including a content analysis of 21 articles published between 1999 and August 2009 has been conducted. Results. The results could be summarised in two themes: 'origins that may trigger violence' and 'activities that decrease the amount of violent behaviour'. Together, the themes showed that violence was a phenomenon that could be described as being connected to a premorbid personality and often related to the residents' personal care. It was found that if the origin of violent actions was the residents' pain, it was possible to minimise it through nursing activities. This review also indicated that an organisation in special care units for residents who exhibit aggressive and violent behaviour led to the lesser use of mechanical restraints, but also an increased use of non-mechanical techniques. Conclusion. The optimal management of aggressive and violent actions from residents with dementia living in nursing homes was a person-centred approach to the resident. Qualitative studies focusing on violence were sparsely found, and this underlines the importance of further research in this area to elucidate how violence and aggressiveness is experienced and understood by both staff and patients. Relevance to clinical practice. To communicate with people with dementia provides a challenge for nurses and other health caregivers. To satisfy the needs of good nursing care, an important aspect is therefore to get knowledge and understanding about aggressive and violent behaviour and its management. © 2010 Blackwell Publishing Ltd.

  • 33.
    Enmarker, Ingela
    et al.
    Høgskolen i Nord - Trøndelag, Norge.
    Olsen, Rose Mari
    Høgskolen i Nord - Trøndelag, Norge.
    Utprøving av kommunal behandlingsenhet: erfaringer og utfordringer i bruk av akuttplasser i sykeheim2014Report (Other academic)
    Abstract [en]

    Denne rapporten redegjør for følgeforskning av det 3-årige prosjektet «Akuttplasser i sykehjem»(UP-8) –et prosjekt gjennomført i regi av Midtre Namdal Samkommune (Namsos, Overhalla, Fosnes og Namdalseid) i samarbeid medOsen kommune og Flatanger kommune. Prosjektet UP-8 er ett av flere underprosjekt til «Helhetlige helsetjenester». Følgeforskningen er bestilt av Midtre Namdal Samkommune, og har vært ledet av Ingela Enmarker.Hensikten med UP-8 har værtå klargjørehvordan sykehjemstjenesten kanstyrkes og utvikles i tråd med samhandlingsreformens ideer, herunder utrede hvordan kommunene skal kunne bli i stand til å gi tilbud til pasienter både før, istedenfor og etter sykehusinnleggelse. Under prosjektperioden våren 2011 til sommeren 2013 er akuttsenger utredet og prøvd ut ved Overhalla Sykehjem.

    Følgeforskningen avUP-8 har pågått fra våren 2012 til januar 2014, og har vært finansiert gjennom strategiske midler i Høgskolen i Nord-Trøndelag (HiNT); Namdalsmidler. Hensikten med prosjektet har vært å beskrive erfaringer og utfordringer i bruken av akuttplasser vedOverhalla sykeheim, samt skape aksjoner som kan lede til heving av kvaliteten på tjenestetilbudet. Vi vil rette en stor takk til pasienter, pårørende og pleiepersonale som har vært involvert.

  • 34. Hygge, Staffan
    et al.
    Boman, Eva
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    An experiment with children in the first grade to reduce their self-generated noise2003Conference paper (Refereed)
  • 35.
    Hygge, Staffan
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Boman, Eva
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Enmarker, Ingela
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    The effects of road traffic noise and meaningful irrelevant speech on different memory systems2003In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 44, no 1, p. 13-21Article in journal (Refereed)
    Abstract [en]

    To explore why noise has reliable effects on delayed recall in a certain text-reading task, this episodic memory task was employed with other memory tests in a study of road traffic noise and meaningful but irrelevant speech. Context-dependent memory was tested and self-reports of affect were taken. Participants were 96 high school students. The results showed that both road traffic noise and meaningful irrelevant speech impaired recall of the text. Retrieval in noise from semantic memory was also impaired. Attention was impaired by both noise sources, but attention did not mediate the noise effects on episodic memory. Recognition was not affected by noise. Context-dependent memory was Dot shown. The lack of mediation by attention, and road traffic noise being as harmful as meaningful irrelevant speech, are discussed in relation to where in the input/storing/output sequence noise has its effect and what the distinctive feature of the disturbing noise is.

  • 36.
    Hygge, Staffan
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Enmarker, Ingela
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för folkhälsovetenskap.
    Boman, Eva
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för folkhälsovetenskap.
    A comparison of structural equation models of memory performance across noise conditions and age groups2008In: ICBEN 2008: Machantucket Connecticut, USA, July 21-25, 2008 : the 9th Congress of the International Commission on Biological Effects of Noise : Noise as a Public Health Problem : Proceedings (edited by Barbara Griefahn), Dortmund: IfADo , 2008, p. 387-394Conference paper (Refereed)
  • 37.
    Knez, Igor
    et al.
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Enmarker, Ingela
    University of Gävle, Department of Technology and Built Environment, Ämnesavdelningen för inomhusmiljö.
    Effects of office lighting on mood and cognitive performance, and a gender effect in work-related judgement1998In: Environment and Behavior, ISSN 0013-9165, E-ISSN 1552-390X, Vol. 30, no 4, p. 553-567Article in journal (Refereed)
    Abstract [en]

    The study presents an investigation of the effects of the recommended office lighting on subjects' mood and cognitive performance in the physical setting of an office. In addition, a gender effect in the performance appraisal task was examined, both as a between- and within-subject factor. The results showed no significant effect of the lighting on the performance of cognitive tasks. However, an interaction between gender and color temperature on mood showed that 3000K (more reddish) and 4000K (more bluish) office lighting may communicate different affective loadings or meanings to each gender. The cognitive workload induced by almost 2 hours of intellectual work diminished the subjects' positive mood and augmented a negative mood. Moreover, independently of their gender, the raters evaluated the neutral female significantly different from the neutral male ratee. Implications of these findings for the mood effects of indoor lighting and the gender effect in work-related judgment are discussed.

  • 38.
    Mentsen Ness, Tove
    et al.
    Department of Nursing, Mid-Sweden University, Östersund, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    Hellzén, Ove
    Department of Nursing, Mid-Sweden University, Östersund, Sweden.
    Enmarker, Ingela
    Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Centre of Care Research, Steinkjer, Mid-Norway.
    "Embracing the present and fearing the future": The meaning of being an oldest old woman in a rural area2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, article id 25217Article in journal (Refereed)
    Abstract [en]

    In Western countries, the number of older people receiving home nursing care is increasing, and in rural areas they are at additional risk because of the distance between people and health care facilities. The aim of this study was therefore to illuminate the meaning of being an oldest old woman living alone in a rural area and receiving home nursing care. A sample of 11 oldest old women living in rural areas in the middle of Norway was chosen for this study. Narrative interviews were conducted, and the data were analyzed using the phenomenological hermeneutic method. After a naïve reading and a structural analysis of the text, we identified four themes: being satisfied with life, being thankful, feeling vulnerable, and feeling secure. The comprehensive understanding implied that being an oldest old woman living alone in a rural area meant living in the intersection between embracing the present in solitude and fearing the future with additional declining health. Living in this complex situation meant to enjoy the present, but still fear the future, as the oldest old women knew their present life situations were limited. This challenging emotional situation meant using their inner strength by trying to be optimistic and seeing opportunities in present life, even if losses were many and extensive. By using their inner strength in facing losses and declining health, the oldest old women managed to appreciate aloneness as solitude, and find new meaning in life.

  • 39.
    Mentsen Ness, Tove
    et al.
    Department of Nursing, Mid-Sweden University, Östersund, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    Hellzén, Ove
    Department of Nursing, Mid-Sweden University, Östersund, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    Enmarker, Ingela
    Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Centre of Care Research, Steinkjer, Mid-Norway.
    ‘Struggling for independence’; the meanings of being an oldest old man in rural areas. Interpretation of oldest old men’s narrations2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1, article id 23088Article in journal (Refereed)
    Abstract [en]

    The amount of older people receiving home nursing care is increasing; in rural areas, they are at additional risk because of the distance between people and health care facilities. No specific studies have been found about oldest old men living alone and receiving home nursing care and the meaning of living alone in one's own home. The aim of this study was therefore to illuminate the meaning of being an oldest old man living alone in a rural area and receiving home nursing care. A sample of 12 oldest old men living in rural areas in the middle of Norway was chosen for this study. Narrative interviews were conducted, and data were analyzed using the phenomenological hermeneutical method. After a naïve reading and a structural analysis of the text, we identified three themes: feelings of insufficiency in everyday life, finding hope in life, and feeling reconciliation with life. The comprehensive understanding suggested that being an oldest old man living alone in a rural area means a struggle between a dependent existence and a desire to be independent. Living in the tension between independence and dependency is a complex emotional situation where one is trying to accept the consequences of life and loss—reconciling the wish to live with the fact that life will come to an end.

  • 40.
    Mentsen Ness, Tove
    et al.
    Department of Nursing, Mid-Sweden University, Östersund, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    Hellzén, Per Ove
    Department of Nursing, Mid-Sweden University, Östersund, Sweden.
    Enmarker, Ingela
    Department of Nursing, Mid-Sweden University, Östersund, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Centre of Care Research, Mid-Norway, Steinkjer, Norway.
    The experience of nurses providing home nursing care to oldest old persons living alone in rural areas - an interview study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 336-344, article id 55301Article in journal (Refereed)
    Abstract [en]

    The rapidly increasing population of older persons worldwide, and the fact that the majority of them want to continue living in their own homes, mean there is a growing focus on home based care. Because of this, it is necessary to increase the number of studies, including rural areas, as earlier studies are sparse. Rural areas cannot be seen as a homogeneous phenomenon, meaning more research is needed to increase knowledge about cultural differences in rural areas. The aim of this study was therefore to describe registered nurses’ experiences of providing home nursing care to oldest old persons living alone in rural areas. A sample of 15 registered nurses in rural South Sami areas was chosen for this study, 13 women and 2 men. Narrative interviews were con- ducted, and qualitative content analysis was used to interpret the data. The analysis revealed four themes and eight subthemes in addition to a core-theme. The latent meaning of the themes “Feeling responsible”, “Trying to accommodate”, “Being challenged” and “Feeling significant” formed the core-theme: contradictions between nurses’ ideals of being professional and the reality faced in rural home nursing care with close social relationships. The findings in this study showed that the experiences of providing home nursing care in rural areas to oldest old persons were multi- faceted and altering, as well as emotionally and socially contradictory.

  • 41.
    Moe, Aud
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Levanger, Norway; Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Ekker, Knut
    Faculty of Agricuclture and Information Technology, Nord-Trøndelag University College, Steinkjer, Norway.
    Enmarker, Ingela
    Faculty of Health Science, Nord-Trøndelag University Collage, Namsos, Norway.
    A description of resilience for Norwegian home-living chronically ill oldest old persons2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, article id 32480Article in journal (Refereed)
    Abstract [en]

    Background: Despite worsening health the chronically ill oldest older persons have expressed feelings of inner strength, which can be understood as resilience. The objective was to describe and compare the characteristics of resilience in two different age groups of chronically ill oldest older persons living at home and who needed help from home nursing care. Design: Cross-sectional design was used to describe and compare the resilience qualities between the two age groups. Methods: The inclusion criteria were 80 years or older, living at home with chronic disease, receiving help from home nursing care, and with the capacity to be interviewed. A sample of 120 oldest older women (n = 79) and men (n = 41) separated in two age groups, aged 80 - 89 and 90+ years, participated in the study. Resilience characteristics were measured by Resilience Scale. Results: The whole group of oldest older people was vulnerable in relation to the characteristics of perseverance, self-reliance, and existential aloneness. Despite reduced physical health they reported a meaningful life, and equanimity. Even if there were no significant differences between the age groups among the oldest older persons in the characteristics of Resilience Scale (RS), in the characteristic of meaning there was a tendency of interaction between age and how much help from home nursing care the participants received. Conclusions: It is important to focus on the individual aging and the risk of developing illness and disabilities rather than focusing on chronologic age. Possessing meaning in life and equanimity may be strengths to meet challenges through illness and growing older.

  • 42.
    Moe, Aud
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Norway; Department of Health Sciences, Mid Sweden University, Sweden.
    Enmarker, Ingela
    Faculty of Health and Science, Nord-Trøndelag University College, Norway.
    Hellzén, Ove
    Faculty of Health and Science, Nord-Trøndelag University College, Norway; Department of Health Sciences, Mid Sweden University, Sweden.
    Daily Life for Chronically Ill Oldest Old Persons2012In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 2, no 1, article id e8Article in journal (Refereed)
    Abstract [en]

    In the past, the study of old age often focused on the losses and problems associated with ageing. In recent times, the focus has been on the positive aspects, such as quality of life, inner strength, and enjoying life. The aims of this study were to highlight the ways in which chronically ill older persons experience the meaning of daily life and to understand what it means to live at home with chronic disease. In-depth interviews were used to illustrate individual experiences. The sample consisted of 13 chronically ill persons, aged 80 to 94 years, living at home and receiving assistance in the form of home nursing care. Data were analyzed using the phenomenological hermeneutical method. After a naïve reading and a structural analysis of the text, we identified three themes: being insufficient, becoming dependent, and enjoying life. The comprehensive understanding suggested that daily life involved bad days, described as illness with dysfunctions, limited energy, and dependency on others. Daily life also had its positive aspects, described as enjoying life. Dignity was threatened by feelings of being a burden to others and was affirmed by experiencing a will to live. It was concluded that bad days with experiences of suffering and good days that provided the older with experiences of enjoying life could help them meet adversity through qualities of resilience that gave meaning to daily life and helped them to think positively in times of greater difficulty.

  • 43.
    Moe, Aud
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Levanger, Norway; Department of Health Sciences, MidSweden University, Sundsvall, Sweden.
    Hellzén, Ove
    Faculty of Health and Science, Nord-Trøndelag University College, Levanger, Norway; Department of Health Sciences, MidSweden University, Sundsvall, Sweden.
    Ekker, Knut
    Faculty of Agricuclture and InformationTechnology, Nord-Trøndelag University College,S teinkjer, Norway.
    Enmarker, Ingela
    Faculty of Health Science, Nord-Trøndelag University Collage, Namsos, Norway.
    Inner strength in relation toperceived physical and mental health among the oldest old people with chronicillness2013In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 17, no 2, p. 189-196Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to examine inner strength, defined as connectedness, firmness, flexibility, and creativity, and its relation to mental and physical health in a sample of the oldest old chronically ill women and men living at home.

    Methods: A sample of 79 older women and 41 men in the age range of 80–101 years old (mean = 87.5) participated in this study. Inner strength measured by Resilience Scale, Sense of Coherence Scale (SOC), Purpose in Life Test (PIL), and Self-Transcendence Test (STS) was viewed in relation to mental and physical health (SF-36 Health Survey).

    Results: Experiencing connectedness, firmness, flexibility, and creativity were equal for women and men. SOC, PIL, and STS showed moderate inner strength. Medium and low resilience made the participants feel vulnerable. A significant correlation was observed between the variables for inner strength and mental health for women, men, and the total sample. STS was associated with mental and physical health for the total sample and for women.

    Conclusions: Although the oldest old women and men were vulnerable, they had inner strength. Encouraging participation using the inner strength of the oldest old can contribute to strengthen their experiences of independence, integrity, and enjoying life.

  • 44.
    Moe, Aud
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Hellzén, Ove
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Assistance for the chronically ill older persons living at home2010Conference paper (Other academic)
    Abstract [en]

    Conclusion: The study indicated that elderly wanted to live at home. Life could be described as a battle with many trials, but they did not give up. They found happiness in life and events and expressed gratitude over physical and mental resources that were still intact. They had a life courage strengthened by life experience, gratitude to life, and by enjoying activities. Life courage was supported by having a box with happy memories, reminiscing about happenings in the past, assisted by nurses to meet the challenges of living with illness and aging. Introduction: The present study, which is a part of a larger project, will focus on the assistance for the chronically ill older persons living at home. (Chronic disease is one of the biggest health problems among Norways oldest citizens.) Getting in harmony with oneself may be a movement toward acceptance of chronic suffering and disease, conditioned by the existence of hope and life courage (Delmar et al. 2005). The aim of this paper is to describe how older persons living at home experience their chronically illness in relation to the assistance. Methods: Data was given by in-depth interviews, sample 13 elderly, women (n=5) and men (n=8), ages 80?94 living at home with chronically disease, receiving help from home nursing care. Transcripted data were analysed using manifest content analyses. Results: The identified meaning units could be described in three categories Assistance from family, Assistance through facilities and Assistance from home nursing care. The family contributed with practical help and social contact. The facilities contributed to a feeling of safety and reduced their dependence on others. The nurses were helpful, but receiving help from busy nurses emphasized dependency and they felt sorry for the nurses.

  • 45.
    Moe, Aud
    et al.
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Hellzén, Ove
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Enmarker, Ingela
    Fakultet for sykepleie og helsevitenskap - Nord universitet.
    Hjemmeboende kronisk syke eldre2010Conference paper (Other academic)
    Abstract [no]

    Introduksjon: Studien er en del av en større studie om hjemmeboende kronisk syke eldre som mottar hjelp fra hjemmesykepleien. Denne delen av studien fokuserer på de eldres sikkerhet. Målet med paperet er å beskrive eldre menneskers erfaringer opplevelser i forhold til sikkerhet. Metode: Inklusjonskriterier: 80 år eller eldre med en eller flere kroniske sykdommer, og som mottar hjelp fra hjemmesykepleien. Data ble samlet inn gjennom dybdeintervju med 13 eldre, kvinner (n=5) og menn (n=8), i alderen 80-94 år. Transkriberte data ble analysert gjennom manifest innholdsanalyse, og bearbeidet til kategorier og underkategori. Resultat: Dette paperet omhandler kategorien "Sikkerhet for hjemmeboende syke eldre" med underkategoriene "Assistanse gjennom tilrettelegging", "Assistanse gjennom hjelpemidler" og "Assistanse fra hjemmesykepleien". Studien viste at eldre ønsket å bo hjemme. For mange av de som bodde i tradisjonelt hjem var familien en forutsetning for å bo hjemme. Å bo i tradisjonelt hjem ga mulighet til å være i kjente omgivelser, og for noen ga det nærhet til familien. I omsorgsboligene hadde de eldre et hjem tilpasset dagliglivets aktiviteter, med private eiendeler og mulighet for sosiale aktiviteter. Konklusjon: Datamaterialet viste at de eldre som deltok i studien fikk oppfylt ønsket om å bo hjemme var, enten i tradisjonelle hjem tilpasset deres behov, eller gjennom tilpasning ved å flytte til omsorgsbolig tilrettelagt for deres behov.

  • 46.
    Moe, Aud
    et al.
    Nord-Trøndelag University College, Norway.
    Hellzén, Ove
    Nord-Trøndelag University College, Norway.
    Enmarker, Ingela
    Nord-Trøndelag University College, Norway.
    The meaning of receiving help from homenursing care2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 7, p. 737-747Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the meaning of receiving help from home nursing care for the chronically ill, elderly persons living in their homes. The study was carried out in Norway. Data were collected by narrative interviews and analysed by phenomenological hermeneutic interpretations. Receiving help from home nursing care sometimes meant ‘Being ill and dependent on help’. Other times it meant ‘Being at the mercy of help’. It could also mean ‘Feeling inferior as a human being’. Sometimes help was given by nurses who were respectful and proficient at caring for an elderly person, while at other times nurses seemed to be incompetent and worked with a paternalistic attitude without respect for privacy. Receiving help also meant elderly persons wanted to be regarded and approached as equal human beings, supported in the courage to meet challenges in life.

  • 47.
    Myren, Gunn Eva Solum
    et al.
    Centre for Care Research, Mid-Norway, Steinkjer, Norway; Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Department of Health Science, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Centre for Care Research, Mid-Norway, Steinkjer, Norway; Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
    Saur, Ellen
    Department of Education, Norwegian University of Science and Technology, Trondheim, Norway.
    Hellzén, Ove
    Centre for Care Research, Mid-Norway, Steinkjer, Norway; Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway; Department of Health Science, Mid-Sweden University, Sundsvall, Sweden.
    Relatives’ experiences of everyday life when receiving day care services for persons with dementia living at home: – It’s good for her and its good for us2013In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, no 8, p. 1227-1235Article in journal (Refereed)
    Abstract [en]

    Relatives often become involved in the care of people with dementia who are living at home. The caregivers' burdens are extensively described in several studies, and one of the most common, unmet needs of the caregivers is the opportunity for daytime activities. The aim in this qualitative study is therefore to explore the everyday lives of eight relatives of people with dementia who are receiving day care services. A content analysis is used, and three major themes emerge and are discussed: 1) when life becomes chaotic; 2) rebuilding a new, everyday life; and 3) the agonies of choice. The findings indicate that day care service offers respite care, and, at the same time, it gives both the relatives and those with dementia a meaningful day. These findings can also be described as relatives traveling a route from a situation characterized by chaos and suffering to a new life situation that has meaning through day care services. It is important to note that despite this new meaning in the relatives' lives, the relatives continue to struggle with decisions about the futures of their loves ones in regard to the dilemma of placing them in an institution versus aging in place.

  • 48.
    Myren, Gunn-Eva
    et al.
    Centre for Care Research, Mid-Norway, Steinkjer, Norway; Department of Nursing Science, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Centre for Care Research, Mid-Norway, Steinkjer, Norway.
    Hellzen, Ove
    Department of Nursing Science, Mid-Sweden University, Sundsvall, Sweden.
    Saur, Ellen
    Department of Education, Norwegian University of Science and Technology, Trondheim, Norway.
    The Influence of Place on Everyday Life: Observations of Persons with Dementia in Regular Day Care and at the Green Care Farm2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 9, no 2, p. 261-278Article in journal (Refereed)
    Abstract [en]

    Day care services for persons with dementia are becoming an important aspect of community services. Place, therefore, becomes vital concerning how such establishments are organized regarding both the physical and social environment and the programs that are offered. The aim of this study was to describe the influence of place on everyday life in two different organized daycare services for persons with dementia. Based on observations and informal conversations with persons with dementia and staff members at a green care farm and a regular day care, we used an inductive manifest content analysis. The analysis reveals a main category: enabling and collaboration in daily life. The results are discussed in light of Goffman’s analysis of the structures of social encounters from the perspective of the dramatic performance. The main findings in this study involve how place contributes to enabling activities and collaboration between participants and staff, as it influences participants’ ability to achieve an active or passive role in everyday life at the day care services.

  • 49.
    Ness, Tove Mentsen
    et al.
    Faculty of Health and Sciences, Nord-Trøndelag University College, Namsos, Norway; Department of Health Science, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Faculty of Health and Sciences, Nord-Trøndelag University College, Namsos, Norway; Centre for Care Research, Mid-Norway, Steinkjer, Norway.
    Hellzén, Ove
    Faculty of Health and Sciences, Nord-Trøndelag University; Centre for Care Research, Mid-Norway, Steinkjer, Norway College, Namsos, Norway; Department of Health Science, Mid-Sweden University, Sundsvall, Sweden.
    Experiences of being old and receiving home nursing care. Older South Sami narrations of their experiences - An interview study2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 1, article id 28575Article in journal (Refereed)
    Abstract [en]

    The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of different groups of Sami populations of which the South Sami population are one small group. For the South Sami this means a problem; they have to struggle against a general ignorance about the Sami people and culture, which also may affect received home nursing care. The aim of this study is to describe individual South Sami experiences of being old and receiving home nursing care. A sample of 10 older persons with South Sami background was chosen for this study. Narrative interviews were conducted and qualitative content analysis was used to identify and categorize primary patterns in data. The experience of being an old person with South Sami background who receives home nursing care was understood through the use of the following four themes developed from the informants’ own narratives: “Experience of losses in life”; “Feelings of being less valued”; “Feelings of gratitude”; and “Experience of meaning in daily life as old”. The main finding is that the South Sami population still is exposed to an ongoing subtle colonisation. Therefore, it is important to prepare and teach nurses who work in the South Sami area in cultural care, traditional values and beliefs specific to the South Sami population.

  • 50.
    Nordbøe, Christianne
    et al.
    Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Centre for Care Research, Mid-Norway, Nord University, Steinkjer, Norway.
    The Benefits of Person-Centred Clinical Supervision in Municipal Healthcare - Employees’ Experience2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 5, p. 548-560Article in journal (Refereed)
    Abstract [en]

    Satisfied employees in healthcare services who have opportunities to develop their professional competence by reflecting on professional challenges play an important role in the quality of care. The aim of the present study was to describe the employees’ experience of the benefits of participating in a person-centred clinical supervision setting. The supervision, guided by a professional supervisor, was carried out with a group of six day- and night-shift municipal healthcare professionals for a period of four months during their mandatory work hours. Data were obtained from written individual evaluations and group interviews shortly after the last session and again twelve months later. The results showed that the participants experienced that their internal resources and coping skills had been strengthened by the supervision. They developed abilities to meet the challenges more constructively than before. New understandings gave them the opportunity to alternative actions in practice. Further intervention studies of person-centred clinical supervision must focus on such clinical outcomes as patient safety and professional development.

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