Biomedical subjects

A Norberg

Publications and source records attributed to A Norberg.

At least 37 records · Page 2Linked to original sources

PubMed2001

A model of consolation.

Consolation is needed when a human being suffers (i.e. feels alienated from him- or herself, from other people, from the world or from his or her ultimate source of meaning). The aim of this study was to illuminate the meaning of consolation. Tape-recorded narrative interviews were carried out with 18 professionals from various spheres. The transcribed interviews were interpreted hermeneutically. A model of consolation is outlined in a drawing. It states that the mediator and the receiver of consolation must become ready for consolation before it can take place. To be ready means to be present and available. Availability means expressing suffering and listening respectively, and thereby opening up for communion and consoling dialogue. Communion brings about contact with the sacred dimension that human beings share and thus with goodness, light, joy, beauty and life. Consolation involves a shift of perspective and an experience of meaning in spite of suffering.

Adult↗

PubMed2001

The meaning of skilled care providers' relationships with stroke and aphasia patients.

Little is known about the reciprocal influence of communication difficulties on the care relationship. To illuminate care providers' lived experiences of relationships with stroke and aphasia patients, narrative interviews were conducted with providers particularly successful at communicating with patients. A phenomenological hermeneutic analysis of the narratives revealed three themes: Calling forth responsibility through fragility, restoring the patient's dignity, and being in a state of understanding. The analysis disclosed caring with regard to the patient's desire, which has its starting point in intersubjective relationship and interplay, in which nonverbal communication is essential--that is, open participation while meeting the patient as a presence. Thus, care providers prepare for deep fellowship, or communion, by being available. They described an equality with patients, interpreted as fraternity and reciprocity, that is a necessary element in presence as communion. The works of Marcel, Hegel, Stern, and Ricoeur provided the theoretical framework for the interpretation.

Adult↗

PubMed2001

The meaning of the lived experience of hope in patients with cancer in palliative home care.

The aim of this study was to illuminate the meaning of the lived experience of hope in patients with cancer in palliative home care. Narrative interviews with 11 patients were interpreted using a phenomenological-hermeneutic method, inspired by Ricoeur. The findings revealed a tension between hoping for something, that is a hope of getting cured, and living in hope, that is reconciliation and comfort with life and death. This tension is highlighted, according to the views of the French philosopher Gabriel Marcel, as a state of 'recollection'. The interviewees told of the hope of living as normally as possible and of the experience of confirmative relationships as dimensions of their lived experience of hope. These findings show that hope is a dynamic experience, important to both a meaningful life and a dignified death, for those patients suffering from incurable cancer.

Attitude↗

PubMed2000

Within- and between-subject variations in pharmacokinetic parameters of ethanol by analysis of breath, venous blood and urine.

AIMS: To evaluate the prerequisites for using ethanol dilution to estimate total body water, we studied the within- and between-subject variation in the parameter estimates of a two-compartment model for ethanol pharmacokinetics with parallel Michaelis-Menten and first-order renal elimination. Because sampling of breath might be preferable in some clinical situations the parameter estimates derived from breath and venous blood were compared. METHODS: On two occasions, ethanol 0.4 g kg-1 was given by intravenous infusion to 16 volunteers after they had fasted overnight. The proposed model was fitted by means of nonlinear regression to concentration-time data measured in the breath, venous blood and urine during 360 min. The model contained six parameters: Vmax and Km (Michaelis-Menten elimination constants), CLd (intercompartmental distribution parameter), VC and VT (volumes of the central and tissue compartment, respectively) and CLR (renal clearance). The volume of distribution, Vss, was calculated as the sum of VC and VT. RESULTS: The mean +/- total s.d. of the parameter estimates derived from blood data were Vmax 95 +/- 25 mg min-1, Km 27 +/- 19 mg l-1, CLd 809 +/- 232 ml min-1, VC 14.5 +/- 4.3 l, VT 21. 2 +/- 4.4 l, CLR 3.6 +/- 2.0 ml min-1 and Vss 35.8 +/- 4.3 l. The variation within subjects amounted to 3%, 9%, 21%, 21%, 17%, 26% and 2%, respectively, of the total variation. Breath samples were associated with a similar or lower variation than blood, both within and between subjects. About 1.5% of the infused ethanol was recovered in the urine. CONCLUSIONS: The low within-subject variation of the key parameter Vss (only 2%) suggests that ethanol dilution analysed by the pharmacokinetic model applied here may be used as an index of the total body water. Breath samples yielded at least as good reproducibility in the model parameters as venous blood.

Adult↗

PubMed2000

How people with stroke and healthy older people experience the eating process.

The aim of this study was to describe the process of eating, experiences of eating and oral functions. Participants consisted of 30 people with first stroke and localization of the damage verified by computer topography (CT), and 15 healthy older people. All were observed during test-meals, interviewed about eating, and oral functions were tested. The results demonstrated that most (21) people with stroke had some difficulties in eating and expressed feelings of fear and shame about eating and changed physical and social appearance, mainly related to difficulties in preparing and transporting food to the mouth as well as swallowing deficits.

Activities of Daily Living↗

PubMed2000

Communicating with people with stroke and aphasia: understanding through sensation without words.

To illuminate the phenomena of 'communicating with people with stroke and aphasia without words', 10 care providers particularly successful at communicating with stroke and aphasia patients who were working at a stroke rehabilitation ward narrated their experiences of communicating with such patients. A phenomenological hermeneutic approach, inspired by Ricoeur's philosophy, was used in the analysis. Two main themes were found: facilitating openness and being in wordless communication. The care providers sensed the feelings of the patients and experienced similar feelings themselves, thus, the communication is guided by the shared feelings between the care provider and the patient, i.e. communion. For this 'communication through sensation' to take place, the following factors were found to be necessary: creative closeness in combination with protective distance; striving for satisfaction and against exhaustion and desperation; meeting the patient halfway to gain understanding; exhibiting attention and accessibility to the patient; and trust and confidence for both care providers and patients. The findings were interpreted and discussed in the light of works by Levinas, Lögstrup and Stern.

Adult↗

PubMed2000

A qualitative study of childbirth as spoken about in midwives' ante- and postnatal consultations.

OBJECTIVE: To describe conversational topics concerning childbirth and illuminate the meanings of childbirth within the discourse of ante- and postnatal midwifery consultations. DESIGN: Video-recordings of midwives' consecutive encounters with women/couples, from early pregnancy until after birth. The encounters were analysed using content analysis and a phenomenological hermeneutic approach. SETTING: Swedish midwifery clinics at primary health care centres. PARTICIPANTS: Five midwives, five women and three men. FINDINGS: Bio-medical aspects of childbirth were given much importance in the consultations relative to the activities and lived experiences of the women and their partners. Two main features of the meanings of childbirth were found in the consultations; one in which childbirth was understood as a spontaneous and risky process needing to be controlled and to which the woman had to adapt; the other was characterised by being woman centred, pointing to her power and abilities in a process during which she is cared for and which leads to a satisfying result. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A mechanistic and medicalised understanding of childbirth seems to dominate this discourse but the 'natural childbirth perspective' also appears. This study could serve as a basis for reflection on the content and meanings of childbirth in ante- and postnatal midwifery care.

Adult↗

PubMed2000

Suffering from care as expressed in the narratives of former patients in somatic wards.

To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.

Humans↗

PubMed2000

The meaning of hope in healthy, non-religious Swedes.

This study aims to illuminate the meaning of the lived experience of hope as narrated by healthy Swedish adults, who considered themselves as non-religious. Twenty-four interviewees were asked to narrate their experience of hope. A phenomenological-hermeneutical analysis was performed and the meaning of the lived experience of hope was interpreted as an internal process (i.e., hope related to being), which is linked to the experience of meaning and the awareness of one's possibilities in life. This awareness releases energy and activates thoughts and feelings, enabling the person to make good and meaningful choices. The process generates a sense of independence, freedom, and inner peace. Hope related to being is a prerequisite for an external process (i.e., setting goals). Setting goals comprises action and the expectation of a positive outcome. Hope related to doing nurtures hope related to being. The findings also revealed that hope related to doing is reconstructed throughout the life process.

Adolescent↗

PubMed2000

Women physicians' narratives about being in ethically difficult care situations in paediatrics.

This study is part of a comprehensive investigation of ethical thinking among male and female physicians and nurses. Nine women physicians with different levels of expertise, working in various wards in paediatric clinics at two of the university hospitals in Norway, narrated 37 stories about their experience of being in ethically difficult care situations. All of the interviewees' narrations were concerned with problems relating to both action ethics and relation ethics. The main focus was on problems in a relation ethics perspective. The most common themes in an action ethics perspective were overtreatment and withholding treatment. The more experienced physicians reasoned differently from the group of less experienced physicians and they coped with pressure in different ways. The less experienced physicians disclosed their professional experience yet seemed uncertain, while putting on an air of certainty, but the more experienced physicians disclosed both their professional and personal experience of caregiving and they seemed to allow themselves to feel uncertain in their certainty. Both groups emphasized a need for deep discussion between colleagues about their being in ethically difficult care situations.

Adaptation, Psychological↗

PubMed2000

An exemplar of a positive perspective of being dependent on care.

This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger data set derived from 10 patients, interviews with one severely ill patient, her daughter and two of her professional nurses were selected to illuminate a "positive" meaning of being dependent on care. The interviews were tape-recorded and transcribed verbatim and followed by interpretation of transcripts using a phenomenological-hermeneutic approach inspired by Paul Ricoeur's philosophy. The interpretation discloses the meaning of being dependent on care as balancing between being free and negotiating when receiving care. Whether or not dependency on care is negotiated about seems to be about how the power that lies in the existing differences in ability is used. When ability, that is, power, is used to compensate inability, the patient appears free to be dependent on care. Dependency on care is accepted for what it is, when it is. When dependency on care is negotiated about, the differences in ability, that is, power, risk setting limits for what dependency on care is to be. There is a risk that dependency on care will be limited within the frame of what is regarded as polite, appealing and pleasing.

Activities of Daily Living↗

PubMed2000

Physicians' stories about suicidal psychiatric inpatients.

Fourteen Norwegian, three Danish, and two Swedish physicians employed at a Norwegian psychiatric hospital narrated their lived experiences in caring for suicidal psychiatric inpatients. The interview text was transcribed and interpreted using a phenomenological-hermeneutics method, inspired by Ricoeur's philosophy. Two main themes were found: Power Over, i.e. Communicating with the patients; Not accepting one's own mortality; Not accepting one's own vulnerability; Not accepting one's own fallibility; Being rejected by the patients; and Power To, Deep communicating with the patients; Accepting one's own mortality; Accepting one's own vulnerability; Accepting one's own fallibility; Being trusted by the patients. These findings were pondered in the light of Cissna's and Sieburg's writings about confirming. The study emphasizes the importance to physicians of confronting their own strong and frightening feelings about mortality, vulnerability and fallibility in order to confirm suicidal psychiatric patients during interactions with them, when in hospital after suicide thoughts and attempts.

Female↗

PubMed2000

The meaning of living with severe chronic heart failure as narrated by elderly people.

The meaning of elderly patients' experiences of living with chronic heart failure was studied. Narrative interviews were analysed using a phenomenological hermeneutic approach. 'Feeling imprisoned in illness' and 'feeling free despite illness' constituted the themes. These themes were interpreted as describing variations in awareness of the relationship between the self and the body. In theme 'feeling imprisoned in illness' the body's illness and disability hindered the subjects from being themselves. In the theme 'feeling free despite illness' the disabled body was not experienced as limiting, but rather as a part of the self. The patients' understanding of the illness must be interpreted by the caregiver, who also needs to be aware of different modes of communicating feeling about the illness.

Aged↗

PubMed1999

A C-terminally elongated form of PHI from porcine intestine.

A C-terminally elongated form of peptide histidine isoleucine amide (PHI) was isolated from porcine intestine based on its effect on cAMP production in IMR-32 cells. The structure was determined by amino acid sequence analysis of tryptic fragments and by mass spectrometry. The peptide has 42 amino acid residues like those described from human, rat and mouse, but the amino acid sequence of the C-terminal extension of pig PHI is unique. Unlike the other peptides, it has a C-terminal Ala and it differs at five positions from the human form and at six positions from the rat form, while the human and the rat forms differ by only two substitutions. To avoid confusion arising from different C-terminal residues, a unifying nomenclature is proposed: PHI-27 for the hormone and PHI-42 for the elongated product.

Adenylyl Cyclases↗

PubMed1999

Spleen antibacterial peptides: high levels of PR-39 and presence of two forms of NK-lysin.

Antibacterial peptides were isolated from porcine spleen by acetic acid extraction, ion exchange chromatography and reverse-phase high-performance liquid chromatography. C-terminal ladder sequence analysis of a bioactive peptide with matrix-assisted laser desorption/ionization mass spectrometry after digestion with carboxypeptidases P and Y showed that it is identical to the antibacterial proline/arginine-rich intestinal peptide PR-39. It is present at high levels in granulocytes of the spleen, and peptides with C-terminal proline amide and internal adjacent Pro residues can be analyzed with this method. In addition, two forms of NK-lysin (NKL) were found. One, NKLi, is identical to that isolated from pig intestine, and the other, NKLbw, to a mature peptide deduced from a clone from a porcine bone marrow cDNA library.

Amino Acid Sequence↗

PubMed1999

Mood and general behavior of patients with severe dementia during one year of supervised, individualized planned care and systematic clinical supervision. Comparison with a similar control group.

The aim of this study was to evaluate the effects of one year of systematic clinical supervision, and supervised individually planned care on the mood and general behavior of patients with dementia in relation to their cognitive function and level of confusion. The intervention was carried out in a ward devoted to the care of patients with severe dementia (EW), with a similar ward (CW) where no changes were made serving as a control. Each ward housed 11 patients, of whom 7 patients in each ward survived throughout the study time. Assessment of the patients' mood, general behavior, cognitive functions (MMSE), orientation and confusion (OBS) was made at baseline, and after 6 and 12 months of intervention. Significant deteriorations for the patients in CW were seen during the study period as regards the factor strength, functional performance and orientation in the ward, and speech performance and psychomotor slowing. For the patients in the EW, deterioration was seen only in the factor accessibility, and improvement was seen in the factor sensitivity and euphoria. The differences indicated that the development in the two wards went in opposite directions to the benefit of the patients in the EW. Because of the small sample size, the findings are more the result of a pilot trial, rather than generalizable. The intervention, however, seemed to have a positive effect on the secondary symptoms of the disease.

Affect↗

PubMed1999

Swedish fathers' involvement in and experiences of childbirth preparation and childbirth.

OBJECTIVE: To discover the expectations and experiences of childbirth preparation and childbirth of Swedish men in order to contribute to a basis of reflections in the midwifery profession. DESIGN: Three tape-recorded interviews were performed: before and after childbirth preparation, and between one and three weeks after the baby was born. SETTING: Swedish maternity care. PARTICIPANTS: Eleven men who participated with their partners in antenatal classes. MEASUREMENTS AND FINDINGS: The interviews were analysed in several steps and included co-assessments by co-workers. Finally, an interpretation based on the concept 'vital involvement' was undertaken. Indications of vital involvement as well as various levels of involvement or distance were found. The participation in childbirth was more demanding than expected for the eleven men. They felt unprepared for an unpredictable process, the experience of time and pain, the woman's action, and their own reactions. The men who were regarded by the authors as vitally involved seemed to manage overwhelming feelings of helplessness during childbirth, to support the women, and experience the meeting with the baby positively. KEY CONCLUSION: It seems important for midwives to meet men individually, design childbirth preparation from men's perspective, follow up interpretations of the content, discuss expectations with regard to the men's role, and assess their experiences during the birth process.

Adult↗

PubMed1999

Nurses' narrations about caring for inpatients with acute myocardial infarction.

The purpose of this study was to examine the meaning of lived experiences of caring for people affected by acute myocardial infarction. Thirty-four registered nurses at a Coronary Care Unit in the north of Sweden narrated their experiences of this specialized care of inpatients. The interview texts were transcribed and then interpreted using a phenomenological-hermeneutic method, inspired by the philosophy of Ricoeur. Two groups of texts were identified. One comprised 'narratives about the patient' within which were the themes: 'distancing oneself from what is happening' and 'showing oneself as vulnerable'. The other was 'narratives about caring', with the themes: 'reading of', 'adapting', 'coming close' and 'helping'. Various views on caring were disclosed and interpreted with reference to Martin Buber's philosophy. A comprehensive understanding of caring as oscillations between the poles distance and relation was formulated.

Adult↗