Biomedical subjects

E H Bunch

Publications and source records attributed to E H Bunch.

14 recordsLinked to original sources

PubMed2004

Symptom management for HIV-positive persons in Norway.

PURPOSE: To record symptoms experienced by people with HIV/AIDS, and describe useful self-care strategies and how symptoms impact on daily life. METHOD: A questionnaire was used with self-reported answers and descriptions of how symptoms impact on daily activities and suggestions for useful self-care strategies. Four hundred and twenty-two (n = 422) HIV-positive persons from seven sites in the USA and one site in Norway (n = 20) answered the questionnaire. RESULTS: In this article subjective symptom descriptions from the Norwegian sample are presented along with self-care strategies and their effectiveness. Findings revealed the Norwegian sample to be a little older, maybe less anxious and depressed, than participants in the larger study. This difference might be explained by the structure of the national social and health care system in Norway, where treatments, medications and social services are available to all citizens without cost. Respondents described a number of related symptoms as well as their subjective explanations of what triggered the symptoms. Most of the self-care strategies were learnt by trial and error. RECOMMENDATIONS: Community health providers, nurses and physicians should become more knowledgeable about the symptoms that infected persons struggle with, as well as the impact these symptoms have on routine daily self-care activities and a person's quality of life. There is need for more research about helpful self-care strategies to assist HIV-positive persons to manage their symptoms and to disseminate these to community health providers and support groups for HIV infected persons.

Adult↗

PubMed2001

Hidden and emerging drama in a Norwegian critical care unit: ethical dilemmas in the context of ambiguity.

The study presented in this article is based on field observations over one year on a critical care unit in Norway. Data were analysed according to Glaser's grounded theory and generated a theory of hidden and emerging drama in the context of ambiguity while the nurses routinized the handling of complex technology. To the untrained eye the unit presented a picture of calm competence, while under the surface one finds hidden drama full of difficult interacting clinical and ethical problems. The nurses identified six ethical dilemmas: (1) end of life issues; (2) whether there should be an age limit for coronary surgery; (3) distributing limited resources; (4) resource allocation in terms of better staffing; (5) situations in which is it more harmful than beneficial to continue treatment; and (6) transferring patients to other facilities. The six problems overlap and have clinical as well as ethical components, but it was the ethical dimensions that the nurses identified and discussed. The significance for nursing is the importance of well-educated and well-qualified nurses and how they find viable solutions to complex ethical and clinical problems.

Adult↗

PubMed2000

Delayed clarification: information, clarification and ethical decisions in critical care in Norway.

Following the analysis of about 150 hours of field observation on a critical care unit in Norway a theory was generated to explain the actual ethical decision-making process. This was grounded in the empirical reality of physicians, nurses and family. The core theme in this study was a delayed clarification in assessing the prognosis of accident victims with neurosurgical traumas. The physicians, nurses and family had to wait for the clinical picture to clarify, during which time there was an exchange and emergence of information. Exchanging information, a subprocess to delayed clarification, involved a continuous flow of collecting and dispersing information about the clinical status of the patient. The nurses engaged in two useful strategies: grading information to family when the patient prognosis was poor, and providing grieving strategies for themselves, colleagues and family members. The core variable, delayed clarification has three dimensions: clinical, psychological and ethical. The nurses participated in the decision-making process to discontinue treatment as passive participants, they did not engage in collegial deliberations with the physicians. Ethical dilemmas were end of life questions, resource allocations, and questions of justice and organ transplants.

Bereavement↗

PubMed1998

Quality of life in people with advanced HIV/AIDS in Norway.

This article reports findings from Phase 1 of a replicated study conducted in Norway. The study is part of a cross-national study developing an ethnically sensitive instrument to assess quality of life for people with advanced HIV/AIDS. Interpretive data generated from interviews with 10 men and 3 significant others, a total of 19 interviews, shows that they learn to live with the virus but that after crossing over (the time when AIDS was diagnosed), they became aware that there was no turning around. Useful strategies for maintaining quality of life were controlling, hoping, talking, and reminiscing. Reminiscing was like a sentimental journey into the past, not looking to the future, letting go while planning and preparing to die. Comparing findings from the Norwegian study replication with the San Francisco study shows that similar themes were of concern to the subjects but they were played out differently.

Adaptation, Psychological↗

PubMed1998

AIDS in Norway: a post hoc evaluation of an AIDS home care project.

Norway's National Health Care system guarantees all citizens a right to health care within a decentralized system based on values like solidarity and equality. Seventy-five per cent of people with HIV/AIDS live and are treated in Oslo, the capital. Local home care agencies have minimal, if any experience working with AIDS patients residing in the community. Therefore a home care team with two nurses employed by the hospital was established as a 2-year trial project to establish a home care system for AIDS patients. In March 1993 a post hoc evaluation of the project for AIDS patients was completed, based on descriptive data. Results seem to indicate that a prerequisite for patients to live at home is someone to do chores like cleaning, laundry and shopping. The home care nurses functioned as vital links between the hospital, the outpatient clinic and the local home agency.

Acquired Immunodeficiency Syndrome↗

PubMed1994

The impact of public health in Norwegian postgraduate programmes of psychiatric nursing.

The purpose of this descriptive study was by means of a questionnaire to obtain data on how 13 nursing schools, offering a postgraduate specialization in psychiatric nursing in Norway, have incorporated a public health perspective into their curricula. Since the mid-1980s, national health policies and Health for All by A.D. 2000 have placed emphasis on decentralization of all health care services, including services for the mentally ill. The Community Health Law of 1984 guarantees all Norwegian citizens such services in their local communities. The schools have traditionally emphasized curative services in hospitals, rather than health promotion and preventive measures at community level. Are the new graduates prepared for psychiatric work at community level? A content analysis of a semistructured questionnaire revealed that a social psychiatric perspective has indeed been incorporated in today's curricula. This was supported by reviewing the required reading lists for each of the 13 schools. Roughly one can say that the schools represent two perspectives: 1) those focusing primarily on relational aspects, and 2) those focusing on relational aspects within a social psychiatric framework.

Curriculum↗

PubMed1991