Biomedical subjects

Anna-Karin Dykes

Publications and source records attributed to Anna-Karin Dykes.

14 recordsLinked to original sources

PubMed2006

The experience of Middle Eastern men living in Sweden of maternal and child health care and fatherhood: focus-group discussions and content analysis.

OBJECTIVE: To describe how men from the Middle East experience Swedish maternity and child health care. An integral part of the aim of this study has also been to describe the experiences of men from the Middle East when becoming and being a father in Sweden. DESIGN, SETTING AND PARTICIPANTS: an exploratory, qualitative study using focus-group discussions and individual interviews, with a semi-structured interview guide and content analysis. A total of 16 men participated. Ten Arabic-speaking men from the Middle East living in Sweden participated in three focus-group discussions. Six men from the Middle East living in Sweden, and speaking Swedish, participated in individual interviews. FINDINGS: three main categories were developed: meeting empathic professionals; finding new positions within the family; and experiencing social demands. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: seeing their partners being met individually and with empathy by midwives and child health-care nurses encouraged men to become involved in areas not previously open to them (i.e. pregnancy, childbirth and the care of babies and young children). As the women often lacked knowledge of Swedish, they depended on the help of their partners when meeting maternity and child health-care professionals. The men found the experience of living in an alien country difficult. They were often unemployed, felt they were a burden to their wives after emigrating to Sweden, and that they were no longer a suitable role model for their children.

Adaptation, Psychological↗

PubMed2005

Sympathetic responsibility in ethically difficult situations.

BACKGROUND: Ethical issues arise in many obstetric situations and demand constant consideration by obstetricians. The aim of this study was to highlight the meaning of being in an ethically difficult situation as narrated by obstetricians. METHODS: A descriptive design with a qualitative approach using a hermeneutic phenomenological method for analysis. Interviews were performed with 14 obstetricians working in a Swedish hospital setting. RESULTS: The overriding theme was Sympathetic responsibility in the decisions of critical importance for the mother and her infant. Five related themes were to: (i) proceed with a moral reasoning that leads to the choice of a possible solution; (ii) balance one's own medical knowledge and moral insight with the needs and requests of the parents; (iii) be aware of one's medical and moral responsibility in relation to the decision made; (iv) experience the ability to take action and to make and carry out difficult and important decisions relating to the health of the mother and infant; and (v) reflect on a given situation in a manner leading to a rational acceptance of one's own conduct. CONCLUSIONS: Sympathetic responsibility is the structure of the meaning of the obstetricians' lived experience, which means that the obstetricians with the help of their medical knowledge and their desire to support the mother's autonomy do what is best for the mother and her infant. Implications include that an exchange of ethical thoughts and moral reasoning should lead to a higher degree of mutual understanding between colleagues and between the different professionals. Co-operation is important to achieve the best outcome for the mother and her infant.

Adult↗

PubMed2005

Young women's lifestyle behaviours and their bone mineral density changes: a grounded theory analysis.

BACKGROUND: Only limited information is available on healthy young women's perspective of their own lifestyle behaviours. By lifestyle behaviours, e.g. smoking and physical activity, individuals have the possibility to influence bone mineral density (BMD). The aim of this study was to generate a theoretical model of lifestyle behaviours among young women with different BMD changes. METHODS: Data were collected by interviewing with 11 women, and the material was analysed by means of the grounded theory. FINDINGS: Two core categories were generated: (i) the respondents' outlook on life and (ii) their life situation. The respondents' outlook on life was either 'rigid' or 'relaxed'. Respondents who had a rigid outlook on life adjusted with others and had a decreased BMD while those with a relaxed outlook on life were doing things for fun and had an increased BMD level. Life situation also consisted of two categories: 'stagnation' and 'development'. Respondents in a static life situation did not pursue any active actions while in a developing life situation, the respondents were actively striving towards a goal. Four dimensions which characterized the respondents' outlook on life in relation to their life situation emerged: subordinating and enduring with a decreased BMD level or compromising and discerning with an increased BMD level. CONCLUSION: It seems as if the outlook on life has a greater influence than the acted lifestyle behaviour for bone development. Further research is needed to generalize the findings of this study and to explore the importance of the outlook on life among women of all ages.

Adult↗

PubMed2004

A qualitative study of mothers' and fathers' experiences of routine ultrasound examination in Sweden.

OBJECTIVE: to conceptualise mothers' and fathers' thoughts and feelings before, during and after the routine ultrasound examination during the second trimester of pregnancy. DESIGN, SETTING AND PARTICIPANTS: a grounded theory study. Two to four weeks after their ultrasound examination, 22 Swedish mothers and 22 fathers were interviewed in their homes. FINDINGS: the basic social process was confirmation of a new life. The four categories, visualising-the evident option, overwhelming to see life; becoming a family and reassuring, all represent a time span in the parents' process towards confirmation of a new life. The caregivers' way of assisting and supporting the process by information and treatment was very important to parents. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: as the ultrasound examination is perceived as a confirmation of a new life it is an extremely important milestone for both parents so the father should be encouraged to participate. It is an important and unique event for both women and men in their process towards becoming parents. This process was largely dependent on the treatment the parents had received during the examination and the information given. The findings of this study are of interest to midwives and others who perform ultrasound examinations as it explains why adequate time must be allowed for the examination and the importance of the information given before hand. When introducing new forms of fetal diagnosis in the future it should be kept in mind that this might irrevocably be accepted by parents who long for confirmation of a new life.

Adult↗

PubMed2004

Quality of life in old people with and without cancer.

The aim was to investigate the influence of age and gender on quality of life (QoL), complaints, and the presence and nature of self-reported diseases in persons aged 75 and older with cancer (n = 150), compared to a matched group without cancer (n = 138). A second aim was to investigate factors associated with poor QoL in people aged 75 and older. QoL was measured with Short Form (SF-12) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-30). The study showed that the cancer group had lower (poorer) scores in different domains of QoL, more complaints, and more self-reported diseases than the group without cancer. In both groups, oldest old persons had more complaints than the youngest old. The cancer group had significantly more complaints than the noncancer group. In the youngest old, the cancer group had significantly more complaints than the comparison group. Women with cancer reported the poorest QoL compared to men with cancer and women without cancer. Receiving help for daily living from others and degree of complaints were associated with poor QoL for both the physical and mental component scores (PCS, MCS) of the SF-12. Thus, caregivers should be aware that the most vulnerable cancer patients are women, and that the complaints by cancer patients have implications for QoL especially among the youngest old.

Activities of Daily Living↗

PubMed2003

Home care with regard to definition, care recipients, content and outcome: systematic literature review.

In spite of the fact that home care has grown considerably during the last few years and will continue to grow even more in the future, home care as a phenomenon and a concept is not clearly defined. The aim of this study was to review the empirical literature for the description of home care as a phenomenon and as a concept, especially with regard to who the care recipients are, what actions and assessments are performed and what effects are achieved for the care recipient in terms of functional health status and quality of life (QoL). Twenty-six relevant studies meeting the inclusion criteria and requirements for methodological quality were identified. The phenomenon of home care is described through content, outcome and objectives. The content of home care involved a range of activities from actions preventing decreased functional abilities in old people to palliative care in advanced diseases. The outcome had two different underlying foci: (1). for the benefit of the patient based on the assumption that being cared at home increases their QoL, (2). in the interests of the society, to minimize hospital care by moving activities to the home of the patient. The objectives were found to be aiming at improving the QoL and/or maintaining independence, by means of actions and assessments, based on the patient's needs, undertaken to preserve and increase functional ability and make it possible for the person to remain at home. In conclusion, home care as a phenomenon was the care provided by professionals to people in their own homes with the ultimate goal of not only contributing to their life quality and functional health status, but also to replace hospital care with care in the home for societal reasons; home care covered a wide range of activities, from preventive visits to end-of-life care.

Activities of Daily Living↗

PubMed2003

Maternal serum screening for Down syndrome--opinions on acceptance from Swedish women.

BACKGROUND: Different screening procedures are becoming an important part of health care. Information about screening and its consequences can be difficult to both impart and understand. This study examined women's theoretical acceptance of a new screening procedure, before its introduction. METHODS: A group of women (n = 823), who had made an informed choice about the form of foetal diagnosis they wished for, were also asked, in a questionnaire, about their opinion on the acceptability of serum screening for Down syndrome. The main purpose of the this was to ascertain their feelings when making a choice. RESULTS: Replies were received from 80.4%. The answers indicated that serum screening would be acceptable to 86% of the women who had chosen a second trimester ultrasound examination. Of the women who had chosen amniocentesis, 51% would consider the test acceptable as a first alternative. CONCLUSIONS: The ease with which the women were able to make their choice of prenatal diagnosis had bearing on their degree of acceptance of serum screening for Down syndrome.

Adult↗

PubMed2003

The experiences of older people living with cancer.

Nursing care for older people with cancer requires an understanding of their history and current needs from both an individual and generalized view. The aim of this study was to investigate the experience of older people living with cancer and the way it affects their daily life. During the study, 41 individuals 75 years of age and older (mean age, 83 years) who had a cancer diagnosed within the past 5 years were interviewed in their homes. After verbatim transcription, the interviews were analyzed with latent content analysis. Four main categories were identified: 1) living with cancer means bodily, mental, social, and existential experiences; 2) being aware of the disease or not; 3) handling of daily life; 4) feeling affirmation or rejection from healthcare professionals. Experiences of daily life with cancer were influenced by the combination of old age, comorbidities, and the perception of current and previous life. This combination more or less affected all aspects of life. The power to choose the approach to daily life with cancer, the disease, and its treatment proved to be crucial for handling cancer and the outcome. It seems that the main role for healthcare professionals is to empower the older person to choose for himself or herself. Furthermore, it seems to be important that healthcare professionals support older persons in their choices, whether they choose to take an active part in understanding the disease and handling of daily life or whether they decide to be more passive and hand themselves over to the healthcare system.

Activities of Daily Living↗

PubMed2002

Both empowered and powerless: mothers' experiences of professional care when their newborn dies.

BACKGROUND: The death of a newborn is a complex and tragic situation, the uncertain and stressful nature of which places emotional burdens on the parents. The aim of this study was to examine and illuminate mothers' experiences and perceptions of the care given to them at neonatal clinics while facing the threat and the reality of losing their baby. METHOD: Interviews were performed, in the form of conversations, with 16 mothers approximately 2 years after the death of their newborns. The interviews were analyzed using a hermeneutic phenomenological method. RESULTS: The primary themes identified were feeling empowered and feeling powerless. Three related themes to feeling empowered were a sense of nearness--supporting confidence; a sense of encouragement--supporting self-esteem; and a sense of empathy--supporting comfort. Three related themes to feeling powerless were a sense of distance--leading to strength or adjustment; a sense of violation--leading to helplessness and despondency; and a sense of disconnection--leading to insecurity and discouragement. All mothers felt both empowered and powerless. When experiencing empowering care, they had a feeling of encountering benevolence, with respect to their individual desires. Experiencing competent care without humane treatment madethemfeel powerless, and they were neither respected as a mother nor a person. CONCLUSIONS: Feelings of empowerment emerged when the health care professionals not only saw the mother as an individual but also "saw through the mothers' eyes" and "felt with the mother's feelings". Feelings of powerlessness emerged when the similarity in the lifeworld (i.e., the world of lived experiences) differed, and the perspectives of the mothers and the health care professionals did not correspond.

Adult↗

PubMed2002

Parents' experience of early discharge from hospital after birth in Sweden.

OBJECTIVE: to investigate the factors that influence the experience of mothers and fathers when they have chosen to return home, earlier than is the normal routine, following the birth of their baby. DESIGN: a qualitative study, using open interviews, was undertaken. The text of the transcripts was coded and categorised according to the grounded theory method using constant comparative analysis. SETTING: interviews were carried out with 12 parents, six mothers and six fathers, individually in their own homes. They had all left a maternity/family ward at the Helsingborg Hospital in southern Sweden within 26 hours of birth whereas the normal discharge time is 72 hours. MEASUREMENTS AND FINDINGS: 'a sense of security' was the core category. Achieving a sense of security linked to informed choice for early discharge appeared to be dependent on the following categories: (l) the midwives' empowering behaviour; (2) affinity within the family; (3) the parents' right to autonomy/control; (4) physical well-being. There appears to be an inner connection between each of these categories. KEY CONCLUSIONS: the midwife's empowering behaviour supports the parents' sense of security and encourages their informed choice of earlier discharge after birth. When the mothers' and babies return home it strengthens the affinity within the family and the father's sense of participation.

Adult↗

PubMedDate not supplied

Neonatal end-of-life care in Sweden.

A survey was carried out of Swedish neonatal end-of-life regarding practice before birth, at birth, during dying and after death using a descriptive questionnaire with close-ended questions and individual comments. The practice in 32 of 38 neonatal units, as described by the head nurse or the registered nurses, was largely similar. Respectful treatment of both the neonate and the parents during neonatal end-of-life care was indicated. Differences were found in pre-natal care concerning the information about the risks of pre-term birth, the opportunity for parents to view a pre-term neonate and meet its family, as well as a social worker. Practice directly after birth was also different. A little less than half of the units answered that they gave a description of the seriously ill neonate to the parents before the first visit to the ward. Practice during dying indicated that only a few units permitted the neonate to die at home.

Attitude to Death↗

PubMedDate not supplied

Neonatal end-of-life care in Sweden: the views of Muslim women.

OBJECTIVE: To explore Muslim women's views of neonatal end-of-life-care in Sweden. METHODS: Interviews using a standardized questionnaire with open-ended questions about care before birth, directly after birth, and during and after the death of the infant. Content analysis was performed on the data. PARTICIPANTS: Eleven immigrant women of Muslim background living in Sweden. RESULTS: The categories identified were information both useful and threatening, priority of medical facts, maternal feelings, roles of significant others, predetermined lifetime, protection of the dying infant, staff's role, memories aggravate the grief, special tradition, life after death and belief in the future. CONCLUSIONS: The women provided suggestions for improvement of care including being given sufficient information of and the need for culturally sensitive care. In providing care for Muslim women it is imperative that care take into account the woman's religion and ethnicity as well as individual preferences.

Adult↗

PubMedDate not supplied

Experiencing neonatal death: an ambivalent transition into motherhood.

OBJECTIVE: To illuminate the lived experience of women facing the threat of lossing their newborn child and then experiencing the reality of their infant's death. STUDY DESIGN: Sixteen women were interviewed approximately 2 years after the death of their infant using a hermeneutic phenomenological approach. FINDINGS: The main theme was ambivalent transition into motherhood. The women went through the whole life-span of their infant during a very short time. The women's narratives were interpreted as broken expectations, total confusion, reality awareness, consciously leave-taking, and elusive grief. CONCLUSIONS: Women need the opportunity to evolve their own patterns and rhythms in the ambivalent transition from expected motherhood to experiencing neonatal dying and death. Knowledge about the individuality of this process may assist nurses in improving the quality of care.

Adaptation, Psychological↗

PubMedDate not supplied

Practices for preparing children for clinical examinations and procedures in Swedish pediatric wards.

This study sought to elucidate Swedish pediatric wards concerning the practice of informing children and their parents about clinical examinations and procedures. A semi-structured questionnaire was distributed to all 36 pediatric departments in Sweden, comprising of 83 wards. Fifty-eight (70%) of the wards responded. The results showed that 55 (95%) of the wards provided regular planned information programs. Twenty-seven (47%) of the wards had formulated quality goals for their information program, but in only nine (16%) of the wards were the goals quality assured. Although the results showed that most pediatric wards in Sweden inform children about hospitalization, formulated quality goals remain uncommon. In some wards, economic cutbacks had led to reduction of information for preparation. Despite obstacles, nurses try to give priority to the giving of information. Further studies should focus on children's and parents' experience and satisfaction.

Adolescent↗