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Biomedical subjects

G Elander

Publications and source records attributed to G Elander.

29 records · Page 2Linked to original sources
PubMed1991

The autonomy of nurses in high dependency care. Conflicts of loyalties and their consequences for patient care.

The aim of this study is to enquire into the kind of ethical dilemmas reported by nurses in the high dependency health care sector. Nurses from different intensive care units at one British hospital were interviewed. The interviews, which were tape recorded, show that nurses often found themselves in conflict between the patient's interests and those of other people, such as physicians, relatives, other patients, colleagues, etc. Competing loyalties and role conflicts contributed to complicate the nurses' ethical problems.

Conflict, Psychological↗
PubMed1989

Autonomy and paternalistic behaviour in care.

The aim of the present study is to identify ethical dilemmas as experienced by hospital personnel. The dilemmas reported often focused on problems of hospitalised patients' autonomy. Tape-recorded interviews were performed with different categories of personnel, from different care areas. One of the problems was found to be a diminishing autonomy for hospitalised patients, especially in the areas of long-term and psychiatric care. According to the interviews the reasons for the obstacles for autonomy were due to the hospital organisation, the staff, the patients themselves and to relatives.

Authoritarianism↗
PubMed1986

Hospital routines in infants with hyperbilirubinemia influence the duration of breast feeding.

Twenty-nine infants undergoing phototherapy to treat hyperbilirubinemia were divided into two groups. One group of mothers (non-separated) were transferred with their infants to the paediatric ward and remained as the primary care provider. The other group of mothers (separated) remained on the maternity ward and went to the paediatric unit to care for their infants at feeding times. A third group of healthy mothers and infants served as controls. Mothers in the non-separated group were more satisfied with the care than mothers in the separated group. The duration of breast feeding in the separated group was significantly shorter than in the other groups. The urine cortisol levels in the separated mothers were the same at one week and three months after delivery. The mothers in the other two groups had significantly higher urine cortisol levels during the first week postpartum than three months postpartum. We conclude that routine phototherapy for jaundiced infants should not separate mothers and infants.

Breast Feeding↗
PubMed1984

Short mother-infant separation during first week of life influences the duration of breastfeeding.

Thirty term infants, who were separated 1-6 days (mean 3.3 days) from their mothers during the first week of life because of minor illnesses, were compared with 116 term non-separated infants with regard to breastfeeding. At 3 months of age the frequency of entirely breastfed infants was 37% in the separated group versus 72% in the non-separated group, p less than 0.001. Thus a few days of separation between mothers and infants during the first week of life seems to decrease the duration of breastfeeding.

Breast Feeding↗
PubMedDate not supplied

Reduction of noise levels in intensive care units for infants: evaluation of an intervention program.

OBJECTIVE: To investigate whether educational information for nurses concerning causes of noise would decrease noise levels in an intensive care unit for term newborns and infants. DESIGN: Pretest and posttest. SETTING: Children's surgical ward in a university hospital in southern Sweden. SUBJECTS: Fifty-two nurses in the surgical ward. OUTCOME MEASURES: Noise levels. INTERVENTION: An educational program consisting of a presentation of a videotape, presentation of the decibel values for various care activities, and a discussion of the problem. RESULTS: Statistical analysis with a paired two-tailed t test showed significant differences to exist between measurements in a cot and an incubator before the intervention (p = 0.0001), and between cot measurements before and after the intervention program (p = 0.0007). CONCLUSIONS: The results of this study show that through simple methods and without additional costs, and by making the staff aware of the problem, noise levels can be lowered considerably.

Adult↗
PubMedDate not supplied

Children's consent to treatment: using a scale to assess degree of self-determination.

Discussion and debate regarding decision-making that is 'in the best interest of the child' and that also considers the child's voice in these decisions have increased in recent years. A study was undertaken to identify everyday situations in medical and nursing care in which children had been allowed to have a voice or been denied the right. Twenty-six hospitalized children, ages 6 to 17 years, and 21 parents were interviewed concerning their experiences with hospitalization. The interviews contained examples of 100 situations in which the children could have had a say in decisions concerning their care and treatment. An instrument describing five levels of self-determination was used to analyze the situations. The results showed that there are situations in the daily care of children who are hospitalized where it is possible to discuss the degree of self-determination of the child. To different degrees, staff members honored children's choices in questions concerning their own health.

Adolescent↗
PubMedDate not supplied

Care of infants after major surgery: observation of behavior and analgesic administration.

To examine pain management in infants after surgery, 12 infants were observed and audiovisually recorded for 24 hours postoperatively following major surgery. Analgesic administration, sleep-awake states, facial expression-vocalization, and care routines were monitored. A clinical pain scoring system (Attia, Amiel-Tison, Mayer, Shnider, & Barrier, 1987) was used to analyze the video tapes. Only 5 infants showed occasional episodes of quiet sleep and were awake for 50% of the observed episodes. Moaning-crying was observed in 56% of the episodes for 4 infants and in 29% of the episodes for 6 infants. Analysis using the pain scoring system showed 36% of the episodes to have scores below 14 (M = 7.7). Results indicated that pain management was inconsistent, care routines need to be changed and better coordinated, and environmental issues must be addressed.

Analgesics↗
PubMedDate not supplied

Parents' experience of hospitalization: different strategies for feeling secure.

Twenty parents of boys (ages 2-14 years) hospitalized for hypospadias repair in a pediatric surgery department in Sweden, were interviewed concerning their experience when their child was hospitalized. A qualitative analysis of the interviews indicated that the most important issue to the parents was finding security at the hospital. Parents manifested one of three different strategies that enabled them to feel secure at the hospital; (a) relinquishing the care of their children to the nursing staff; (b) obtaining a measure of control over their children's care; and (c) relying on knowing their child best. The parental strategy adopted to feel secure was found to correspond with the way parents experienced the hospitalization. Differences were found in their children's experiences of pain and the alleviation of the pain during the hospitalization.

Adaptation, Psychological↗