Biomedical subjects

Kerstin Segesten

Publications and source records attributed to Kerstin Segesten.

15 recordsLinked to original sources

PubMed2006

A transition from nurse to touch therapist--a study of preparation before giving tactile touch in an intensive care unit.

Tactile touch is a complementary therapy that is rarely undertaken in intensive care units (ICUs) in Sweden. This study was a part of a larger project that examines whether tactile touch can relieve the suffering of patients in the ICU. The aim of this study was to describe nurses' lived experience of preparation before giving tactile touch in an ICU. Four assistant nurses and one registered nurse, each with diplomas in tactile touch working at three different ICUs in Sweden, participated in the study. A phenomenological approach was chosen to achieve experience-based and person-centred descriptions. Data were collected through interviews and analysed following Giorgi's method. The main finding was that before providing tactile touch, the nurses needed to add the new role as touch therapists, to their professional one. The essential aspect being the transition from nurse to touch therapist. Findings included a general structure, with four constituents; a sense of inner balance, an unconditional respect for the patients' integrity, a relationship with the patient characterised by reciprocal trust, and a supportive environment. Furthermore, the study underlines the difficulties to integrate a complementary caring act, such as tactile touch, in a highly technological environment.

Adaptation, Psychological↗

PubMed2006

Assisting teens with asthma to take command.

To meet and work with teenagers may be a challenge for caregivers as adolescence is a period when youths try to establish autonomy. Although asthma is an increasing problem worldwide, few studies have addressed professional caregivers' motives and actions. Therefore, the aim of this study was to describe professional caregivers' strategies in their work with teenagers with asthma. Grounded theory, inspired by Glaser, was used to uncover the phenomenon. The informants were seven professional caregivers who worked at an eight-day asthma camp for teenagers in Sweden. Participant observations and interviews were used, and the first author collected the data and participated in the activities. Findings show that professional caregivers' core concern is to assist teenagers with asthma to take command. This core concern gives rise to five strategies: showing respect, being at hand, promoting own responsibility, promoting to exceed boundaries and promoting reflections. In professional caregivers' attempt to assist teenagers to take command some differences are seen in the way they support boys and girls. One conclusion drawn from our study is that the provisional theory of 'Assisting teenagers with asthma to take command' is not only suitable for professional caregivers working at asthma camps; it may, in some degree, also be used as a source of inspiration for professional caregivers in other settings.

Adaptation, Psychological↗

PubMed2005

Job satisfaction in relation to change to all-RN staffing.

BACKGROUND: A university hospital clinic changed from a mixed to only registered nurse staffing, to reduce the staff and to encourage a philosophy of patient centred care. The aim was to maintain the same level of service and quality of care at a lower cost. AIM: The main purpose of the study was to examine job satisfaction in relation to the change from mixed to only registered nurse staffing and reduction in number of staff. METHODS: Data were collected by an established questionnaire measuring job satisfaction. Non-parametric statistics were used to analyse the data. The questionnaire was distributed to 22 nurses on the ward on three occasions, covering a period of 3 years. RESULT: The experience of having time to plan patient care changed during the investigation period, from 'sometimes' to 'most often having time'. Nurses with longer work experience gave more verbal information to patients and perceived less stress. Information about job performance was more important to newcomers on the ward and became less important with time. However, quite a few have had regrets over choice of work and had considered non-caring work, nevertheless the results show no significant changes in overall job satisfaction.

Adaptation, Psychological↗

PubMed2005

Not letting the disease get the upper hand over life: strategies of teens with asthma.

Adolescence is a period when teens normally revolt against being dependent. For teens with asthma this period may be even more difficult to deal with, as they also have to deal with their illness. Since few studies describe this phenomenon, the aim of this study was to provide a theoretical understanding of how teens with asthma manage their everyday life in relation to their disease. A grounded theory research design, according to Glaser, was used to uncover the phenomenon. The study was undertaken at a camp for teenagers with asthma during the summer of 2003. Twelve girls and 11 boys with moderate to severe asthma participated in the study. Participant observations and interviews were used, and the first author collected the data and participated in the activities. The findings reveal a theoretical model which shows that teens' core concern is not to let the disease get the upper hand over life. To manage this core concern the teens were found to use three strategies: keeping a distance to the disease, challenging the disease and taking the disease into consideration. Boys mainly kept a distance to the disease while girls mainly kept the disease into consideration. Challenging the disease seemed to be a strategy used by both girls and boys. The teens' strategies were not studied close to their everyday life, but a conclusion drawn from our study was that the provisional theory in many respects can be transferred to their everyday life, even though further research is needed to develop this provisional theory in other settings.

Adaptation, Psychological↗

PubMed2004

Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel.

Post-traumatic stress symptoms among ambulance personnel are regarded as a natural behaviour and reaction to working with the severely injured, suicides, injured children and dead people. The findings show that post-traumatic stress symptoms, guilt, shame and self-reproach are common after duty-related traumatic events. To handle these overwhelming feelings it is necessary to talk about them with fellow workers, friends or family members. By using another person as a container it is possible to internalise the traumatic experience. Poor and un-emphatic behaviour towards a patient and their relatives can have its origin in untreated traumatic experiences. Personnel in ambulance organisations who perform defusing, debriefing and counselling have to be informed of the importance that the roll of guilt and shame may play in the developing of post-traumatic stress symptoms.

Adaptation, Psychological↗

PubMed2004

Relations governed by uncertainty: part of life of families of a child with asthma.

This study identifies what influences and characterizes family relations in families of a child with asthma. Seventeen mothers of children aged between 6 and 16 years participated in audio-taped in-depth interviews. The researchers were inspired by grounded theory in data collection and data analysis. The core category that developed was being governed by disease-engendered uncertainty. The category mothers' availability was seen in two dimensions. The first dimension, mothers' being available for the child with asthma, created two subcategories: 1. control and 2. tight bonds. The second dimension, mothers' being less available for other family members, also created two subcategories: 3. being forsaken and 4. lack of understanding. Nursing implications are discussed in relation to the findings.

Adolescent↗

PubMed2004

To be a helpless helpoholic--GPs' experiences of women patients with non-specific muscular pain.

OBJECTIVES: To explore and describe what it means to be a GP meeting patients with non-specific symptoms. DESIGN: Focus group interviews analysed in a phenomenological approach. SETTING: GPs at two urban healthcare centres from a big city, a low socioeconomic area with mostly immigrants and a high socioeconomic area, and from a smaller town. SUBJECTS: 14 GPs in 3 focus groups. RESULTS: The essence of the study was the GPs' feeling of being a "helpless helpoholic". All GPs specified the patient with non-specific symptoms as a female patient with muscular pain. The key constituents were: inconsistent patient, insufficient tools, frustration, helplessness, and devotion to help. The tools were described as communication skills, biomedical education, and holistic perspective. Even if most informants were trained in communication skills, this did not help to avoid the feeling of helplessness. CONCLUSIONS: To be a "helpless helpoholic" may make the GPs less patient-centred and may create even more feelings of frustration and helplessness. This can be an important reason why consultations with female patients with non-specific muscular pain often fail.

Attitude of Health Personnel↗

PubMed2003

The meaning of traumatic events as described by nurses in ambulance service.

Ambulance personnel are working with the injured and dead and are therefore exposed to a variety of stressors that can lead to the development of physical, psychological and social reactions. Stress among ambulance personnel can be regarded as a natural behaviour and reaction when experiencing a traumatic event. The aim of this phenomenological study is to uncover the essence of traumatic events experienced by Swedish ambulance personnel. Knowledge about such events contributes to the awareness of risk for post-traumatic stress symptom and serves as a platform for developing measures to handle such stress. In this study, written stories from 52 of 223 ambulance nurses and ambulance technicians describing an experienced traumatic event, are analysed by the method of van Kaam. Findings indicate that the nurses and technicians have a strong identification with the victims and it is impossible to prepare for events that are unforeseen and meaningless. To handle the overwhelming feelings of identification, the personnel have to gain understanding through talking about those feelings. Therefore it is important that ambulance management, following stressful events, provide the opportunity and time for ambulance personnel to share their feelings. Teaching ways of decreasing identification and emotional involvement with the victim may also be an effective preventive measure.

Adaptation, Psychological↗

PubMed2003

Strength of motherhood: nonrecurrent breast cancer as experienced by mothers with dependent children.

The experience of breast cancer in mothers of dependent children and the strategies these women use to handle their situation of illness in relation to the children was the focus of this study. Ten women with nonrecurrent breast cancer were interviewed using phenomenology as a theoretical framework. The findings reveal that the women needed to balance themselves from being needed and perhaps not existing, balancing between demands, a will to be strong and allowing herself to be sick, and balancing between telling the truth and protecting the children from the truth. The women had strategies to help them in this struggle. To carry on as usual and continue everyday life became very important to them. To do this they had to combine their own strength with support from others and try to turn things into a positive perspective. The essential meaning of living with breast cancer and having dependent children implied using the strength of motherhood to balance conflicting forces and thereby continuing everyday life. The clinical implications include awareness and support to maintain everyday routines and generate strength.

Activities of Daily Living↗

PubMed2002

Nurses' altered conceptions of work in a ward with all-RN staffing.

1. The aim of this study was to investigate how nurses' conceptions of their patients and work changed after reorganization to all RN-staffing and the adoption of a patient-in-focus philosophy on the ward. 2. The study builds on the perspective that the individual's conception of work precedes and forms the basis for the development of knowledge, skills and attributes used in accomplishing work. 3. The findings are based on a secondary analysis of two open interviews with 22 nurses on the ward. These interviews were conducted on two occasions with an interval of 2 years. The third interview was carried out 6 months later, when 10 nurses were asked to talk about a patient's care episode in a narrative form. 4. The nurses' conceptions changed towards a holistic view of the patient, they developed a new approach to work and they used the altered circumstances in their work.

Attitude of Health Personnel↗

PubMed2002

The enigma of severe mental illness: a Swedish perspective.

Today mental health professionals are challenged in supporting people with severe mental illness that live within their communities. The community treatment is, however, characterized by an uncertainty about how to best support them in their everyday lives, and professionals from different disciplines often have divergent opinions about the care. The aim of this study is to explicate the existential meaning of living with severe mental illness. Interviews with persons who relocated from an institutional setting to a community placement were analyzed within an interpretive approach. The results of the study found that people with severe mental illness experience an existential loneliness due to difficulties in changing previous suppositions about human relationships. They do not develop connections through shared new experiences with other people in their lives. One central implication of the findings is that because people with severe mental illness seem unable to benefit from new experiences, mental health nurses should consider relational aspects when planning, implementing, and evaluating nursing care.

Female↗

PubMed2002

Integration of information about cardiovascular risk factors: how do highly motivated women in a lifestyle intervention programme act and react?

OBJECTIVE: To understand the experience of being at risk and of participating in health interventions. How is information about risk factors handled on an individual level with respect to feeling, thinking and doing? DESIGN: Tape-recorded, open interviews, written out and analysed using a descriptive/analytical method. SETTING: Selected women who had participated in a lifestyle intervention programme aimed at reducing risk factors for cardiovascular disease in Strømstad, a community of 10 000 inhabitants on the west coast of Sweden. SUBJECTS: Eight women in the most active group who had had some contact with the project during the whole period 1985-94. MAIN OUTCOME MEASURES: The creation of core concepts as a result of close text reading through codes and categories. RESULTS: Three core concepts in relation to the handling of risk factors were identified: there is no one but yourself to rely on, resisting invasion, and living with incompatibility, based respectively on the subjects' self-efficacy and self-awareness, their ways of maintaining a good life and their trying to understand the risk-factor concept. CONCLUSION: Risk-factor-oriented health interventions focus on disease and create uncertainty as to the relationship between the concepts of risk and disease. The powerful health resources demonstrated by the women in this study to counterbalance the risk pre-occupation suggest changing to health-oriented interventions that focus on individual health resources.

Adaptation, Psychological↗

PubMed2002

GPs and lesbian women in the consultation: issues of awareness and knowledge.

OBJECTIVE: To study awareness of having lesbian women in the consultation among general practitioners (GPs) and their knowledge of lesbian health-related issues. DESIGN: A mailed questionnaire study using closed and open-ended questions, with an analysis using both quantitative and qualitative methods. SETTING: The city of Göteborg, Sweden. SUBJECTS: GPs working in the city of Göteborg. MAIN OUTCOME MEASURES: Frequencies are presented for closed questions. Open-ended questions are categorised and illustrated by citations. RESULTS: The response rate was 52%, but only 37% were aware of having had any lesbian patients despite many years in practice. Five per cent had ever asked their patients about sexual identity, and most questions concerning social network were put in terms of the heterosexual, nuclear family. Eleven per cent knew of any health issues relevant to lesbian women, but half of all informants declared an interest in learning more. CONCLUSION: Unreflected assumptions of heterosexuality and use of heterosexist concepts may work together in keeping the lesbian patient invisible to health care. Medical education needs to include issues of gender and sexual identity/orientation in the curriculum, and to address the health effects of marginalisation.

Attitude of Health Personnel↗

PubMed2002

Being in a lived retreat--embodied meaning of alleviated suffering.

Meanings of alleviated suffering in persons living with life-threatening cancer are explored in this life-world phenomenologic study. In repeated conversations, 16 patients with cancer who were receiving palliative care shared their embodied experiences in personal narratives. When interpreting the narratives, the following meanings of experiencing alleviation of suffering were disclosed: an endurable body being independent and feeling at home, feelings of connectedness, taking a long view of the suffering, being lifted out of the suffering, and an inner peace. Movements that were found in alleviation were dampening the suffering, arousing a zest for life, and focusing on both the present and the patient's dignity. As an interpreted whole, alleviation of suffering was found to be an embodied experience of "being in a lived retreat." This is a symbolic place owned by the person and is experienced in either the company of others or solitude. This lived retreat can provide a feeling of being at home, creating peace, rest, confidence, and breathing space in the person's suffering. It means coping with the altered lived body and feeling dignified. This is a personal experience that is both intersubjectively created and dependent. The importance of openness and responsibility in palliative care is emphasized in the findings and the notion of control of suffering in palliative care is accordingly rejected.

Aged↗

PubMedDate not supplied

Daily stress and concept of self in Swedish ambulance personnel.

INTRODUCTION: This study investigated the prevalence of post-traumatic stress symptoms among professional ambulance personnel in Sweden and investigated the question: "Does self-knowledge have influence on how well one copes with the effects of daily work exposure from such events?" Little is known about the variables that might be associated with post-traumatic stress symptoms in high-risk occupational groups such as ambulance service groups. METHODS: Data were gathered from ambulance personnel by means of an anonymous questionnaire. Survey responses of 362 ambulance personnel from the county of Västra Götaland were analyzed. A correlation was established between post-traumatic symptoms using the impact of event scale (IES-15) and the Professional Self-Description Form (PSDF). RESULTS: Of those who reported a traumatic situation, 21.5% scored > or =26 on the IES-15 subscale. Scores >26 indicate "PTSD caseness". There were significant differences on PSDF subscales between those presenting with or without post-traumatic symptoms. CONCLUSIONS: The mental health and emotional well-being of ambulance personnel appear to be compromised by accident and emergency work. The high prevalence of PTSD symptoms in ambulance personnel indicates an inability to cope with post-traumatic stress caused by daily work experiences.

Adult↗