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  • 1.
    Fen Tang, Ping
    et al.
    Kunming Medical College, Kunming, Province of Yunnan, China.
    Johansson, Camilla
    Örebro University, Örebro, Sweden.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Stig, Wenneberg
    Örebro University, Örebro, Sweden.
    Gerd, Ahlström
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Chinese nurses' ethical concerns in a neurological ward2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 6, p. 810-824Article in journal (Refereed)
    Abstract [en]

    Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: (1) conflicting views on optimal treatment and nursing; (2) treatment choice meeting with financial constraints; and (3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future.

  • 2.
    Hagerman, Heidi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China .
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The work situation for first-line managers in elderly care is complex and challenging. Little is known about these managers' work situation from a structural and psychological empowerment perspective.

    AIM:

    To describe first-line managers' experiences of their work situation in elderly care from a structural and psychological empowerment perspective.

    METHOD:

    Interviews from 14 female first-line managers were analysed using qualitative content analysis.

    RESULTS:

    The theme described the managers' work situation as "It's not easy, but it's worth it." In the four subthemes, the managers described their work in terms of "Enjoying a meaningful job," "A complex and demanding responsibility that allows great authority within set boundaries," "Supported by other persons, organisational preconditions and confidence in their own abilities" and "Lacking organisational preconditions, but developing strategies for dealing with the situations."

    CONCLUSION:

    The managers described having various amounts of access to structural empowerment and experienced a feeling of meaning, competence, self-determination and impact, that is, psychological empowerment in their work.

    IMPLICATIONS FOR NURSING MANAGEMENT:

    It is vital that first-line managers have access to organisational support. Therefore, upper management and first-line managers need to engage in continuous dialogue to customize the support given to each first-line manager.

  • 3.
    Hägglund, Doris
    et al.
    Department of Health Sciences, Örebro University, Örebro, Sweden.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Health Sciences, Örebro University, Örebro, Sweden.
    Fear of humiliation inhibits women's care-seeking behaviour for long-term urinary incontinence2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, p. 305-312Article in journal (Refereed)
    Abstract [en]

    Most women with urinary incontinence (UI) do not seek professional help. Women's experiences of their behaviour when seeking care for incontinence are important to improve understanding by nurses and encourage as well as enable women to seek help. The aim of this study was to illuminate the meaning of women's lived experiences of their behaviour when seeking care for long-term UI. Thirteen women were interviewed (range 37-52 years) who had not sought professional help for incontinence. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. Three themes evolved from data: being in an affected situation, having personal beliefs about seeking care and having desired expectations about care. Being in an affected situation, means that the women were negatively affected by their long-term incontinence. Living with shame, altered sexual relationships and a need for distancing have negatively influenced their care-seeking behaviour (CSB). Having personal beliefs about seeking care means that the women had their own beliefs regarding morally acceptable behaviour for seeking care because of incontinence. This led to a toning down of their problem and a minimization of the problem associated with incontinence as it was considered to be a normal consequence of pregnancy and childbirth. Having desired expectations about care means that the women had opinions relevant to the care and felt being asked about incontinence and an understanding atmosphere should be included. The conclusion is that fear of humiliation inhibited women from seeking care for long-term UI. The findings suggest that nurses should be precise when asking about women's experiences of UI because otherwise they do not bring it up. Additionally, CSB can help nurses to explain the experience and enable women to seek help for this manageable condition.

  • 4.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Engström, Maria
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Uppsala universitet.
    A nine-month intervention programme focusing on empowerment; caregivers' descriptions of changed behaviour and increased room for acting2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 6, p. 866-873Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe public nursing home Enrolled Nurses' and Nurses Aides' view of their work and their perceptions of themselves in their professional role while they were receiving a serious of role awareness sessions focusing on empowerment for nine months. BACKGROUND: According to several studies, it is typical that women may experience problems and injustices at work. The main focus of the intervention was to help enrolled nurses' and nurses aides' in developing their self-image and professional role. DESIGN: This study was descriptive and qualitative in design. METHODS: The present study comprises semi-structured interviews conducted with enrolled nurses and nurses aides (n = 14) from public nursing homes at start of the intervention and again nine months following the intervention. The text from the interviews was analysed using latent content analysis. RESULTS: The main findings primarily show an improved professional role for the caregivers, as described in the following themes: the move from passivity to activity, the move from complaining to understanding, the move from expectations to frustration and the move from being silent to speaking loud. CONCLUSIONS: For caregivers working with older people within public nursing home care, it seems to be a good form of clinical supervision to implement a serious of role awareness sessions in order to improve their professional role. RELEVANCE TO CLINICAL PRACTICE: The findings showed that an intervention providing opportunities with focus on empowerment improved the enrolled nurses' and nurses aides' professional role in working with older people. This can be useful information for managers and educators and they may want to adapt it when working in a public nursing home.

  • 5.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Hofsten, Anna
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för medicinsk vetenskap.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nurses’ opinions about a web-based distance course in a  specialist education programme for the care of older people: a questionnaire study2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 3, p. 177-184Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of the present study was to investigate students’ opinions about a web-based distance learning course that was part of a specialist education programme.

    Design.  Survey.

    Method. The study was a descriptive survey with both qualitative and quantitative questions.

    Results. The students found the web-based course very useful for their theoretical and professional development. New perspectives on ageing, increased knowledge about analysing and describing theories as well as practising interviews and qualitative analysis as methods were appreciated by the students.

    Conclusions. One way for RNs in Sweden to get a university specialist education in the care of older people is to have a distance web-based course, as it allows flexibility and improves the students’ theoretical and professional knowledge and communication skills.

    Relevance for clinical practice. Managers working in care for older people settings and educators will be interested in this study’s finding that distance learning is a useful strategy for providing education for RNs who work with older people.

  • 6.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Kihlgren, Mona
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Caregivers working with older people experience work dissatisfaction and low self-esteem orginating from power relations in municipal care organization2009In: Tidsskrift for Sygeplejeforskning, ISSN 0900-3002, Vol. 25, no 2, p. 27-33Article in journal (Refereed)
    Abstract [en]

    This study explores how a combined gender and power perspective might explain and help us understand caregivers´ expressions of low self-esteem and dissatisfaction in their work with older people. The aim of the study was to discover whether caregivers’ experiences in the nursing home can be understood on the basis of Ås´ framework of the Five Master Techniques. The study was conducted within the municipal gerontological care system in Sweden and has an explorative, qualitative design. Twenty caregivers were interviewed, and the interviews were analysed using a qualitative content approach. Based on Ås´ theory of Five Master Techniques, the caregivers’ experiences of being made to feel invisible, ridiculed, deprived of information, receiving double punishment and feelings of guilt and shame emerged from the analyses. The study shows that the caregivers’ experiences, listed above, were all obvious at the nursing home and that these experiences also affected their feelings of work dissatisfaction and low self-esteem. The findings show the importance of using a gender perspective in caring, so that power relations in the organization can be explored, understood and combated.

  • 7.
    Häggström, Elisabeth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Mbusa, Ester
    Kilimanjaro Christian Medical College, Tanzania.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nurses' workplace distress and ethical dilemmas in Tanzanian health care2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 4, p. 478-491Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe Tanzanian nurses’ meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers the 29 registered nurses’ supplied. The written answers were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. From the findings the theme, ‘Tanzanian registered nurses’ invisible and visible expressions about existential conditions in care’, emerged from the interpretation of the following sub-themes, which appeared from the structural analysis: (1) ‘Suffering from workplace distress’; (2) ‘Suffering from ethical dilemmas’; (3) ‘Suffering from maintaining a good quality of nursing’; (4) ‘Suffering from the lack of respect, appreciation, and influence’; (5) ‘Suffering from a heavy workload does not prevent the registered nurses from struggling for better care for their patients’. In this study, the deep analysis of the Tanzanian nurses’ work situations shows that on a daily basis, they find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. One of the conclusions is that the nurses need professional guidance so they can get insight into and also be able to reflect on the situations they are in, while also being made conscious of the fact that they do not have to overload themselves with ethical dilemmas and workplace distress.

  • 8.
    Silén, Marit
    et al.
    School of Health Sciences, Jönköping University, Jönköping, Sweden..
    Tang, Ping Fen
    Wadensten, Barbro
    Uppsala University, Emergency and Rehabilitation Division, Uppsala University Hospital, Uppsala, Sweden.
    Ahlström, Gerd
    Workplace distress and ethical dilemmas in neuroscience nursing2008In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 40, no 4, p. 222-231Article in journal (Refereed)
  • 9.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Health Sciences, Örebro University, Örebro, Sweden.
    An analysis of psychosocial theories of ageing and their relevance to practical gerontological nursing in Sweden2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 347-354Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Theories exist to challenge current practice, create new approaches to practice and remodel the structure of rules and principles. One question is whether nurses could find in psychosocial theories of ageing a theoretical foundation on which to base support of older people in their ageing process. AIM: The aim of the present paper was to analyse five psychosocial theories of ageing and to discover what they could mean for gerontological nursing in Sweden. METHOD: A literature search was conducted to find original works. Research questions inspired by Fawcett's framework guided the analysis. FINDINGS: Psychosocial theories of ageing cover different aspects of the ageing process, but do not address crucial issues regarding the attitudes and structure of good nursing care. These theories provide no clear guidance on how to care for older people and how to support them in their ageing process. However, the analysis did show that the theories contain underlying values that influence society and staff as regards their views on the ageing process and how care of older people should be carried out. Nursing interventions to support ageing will be quite different depending on the theoretical perspective taken by nurses. CONCLUSIONS: There is a need to translate the ageing theories into guidelines, so that staff in gerontological care will have tools to use in practice irrespective of which theoretical perspective they choose to use in care. This could also promote care that is tailored to each individual older person.

  • 10.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Life situation and daily life in a nursing home as described by nursing home residents in Sweden2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 3, p. 180-188Article in journal (Refereed)
  • 11.
    Wadensten, Barbro
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    The theory of gerotranscendence as applied to gerontological nursing - part I2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 4, p. 289-294Article in journal (Refereed)
  • 12.
    Wadensten, Barbro
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Carlsson, Marianne
    Adoption of an innovation based on the theory of gerotranscendence by staff in a nursing home - part III2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 4, p. 302-314Article in journal (Refereed)
  • 13.
    Wadensten, Barbro
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Carlsson, Marianne
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    The theory of gerotranscendence in practice:guidelines for nursing - part II2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 4, p. 295-301Article in journal (Refereed)
  • 14.
    Wadensten, Barbro
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Conden, Emelie
    Wahlund, Lena
    How nursing home staff deal with residents who talk about death2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 4, p. 241-249Article in journal (Refereed)
  • 15.
    Wadensten, Barbro
    et al.
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Public nursing home staff's experience of participating in an intervention aimed at enhancing their self-esteem2009In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 17, no 7, p. 833-842Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. Background Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. Method The study was explorative and qualitative in design. Findings The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. Conclusions The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. Implications for nursing management The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.

  • 16.
    Wadensten, Barbro
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Hägglund, Doris
    Older people's experience of participating in a reminiscence group with a gerotranscendental perspective: reminiscence group with a gerotranscendental perspective in practice2006In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 1, no 3, p. 159-167Article in journal (Refereed)
    Abstract [en]

    Tornstam's theory of gerotranscendence provides the theoretical underpinning for two small reminiscence groups that met for eight weekly sessions in a Swedish daycentre. Tornstams's theoretical perspective provides a developmental model for understanding positive progressive changes in values, attitudes and behaviour in the second half of life. Practical guidelines derived from this theory informed the group-work approach used. Participants' opinions about their reminiscence experience were analysed to determine the relevance of gerotranscendental theory as a basis for understanding older people's use of reminiscence in the ageing process. The study aimed at investigating older peoples' experiences of participating in a reminiscence group with a gerotranscendental perspective. The study used a qualitative approach. Older people were invited to participate in reminiscence group sessions arranged at a daycentre. When the sessions were finished, participants were interviewed about their experience of the reminiscence group. Data were analysed and categorized by using qualitative methods. The participants were satisfied with the arrangement of the group sessions. All participants believed they had reminisced and thought much more about their childhood and also recalled other memories from their lives during the period. Three quite different views emerged of the recall experience and effects of participating in the reminiscence group: 'An activity like any other; an activity that led to thoughts about memories from life or an activity that influenced my thoughts about life.' Findings suggest that it is possible to arrange reminiscence groups from a gerotranscendental perspective that serve as an intervention in gerontological nursing. This paper provides some guidance concerning how this type of group may be arranged and the various categories of participant response that may be expected.

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