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Biomedical subjects

M Kihlgren

Publications and source records attributed to M Kihlgren.

At least 19 recordsLinked to original sources
PubMed1995

Women's perceptions of childbirth and childbirth education before and after education and birth.

OBJECTIVE: to illuminate women's perceptions of childbirth and childbirth education before and after education and birth. DESIGN: qualitative, using tape-recorded interviews to collect data. Interpretation was performed from Antonovsky's concept sense of coherence. SETTING: childbirth education, a part of parent education in Sweden. PARTICIPANTS: eleven women expecting their first child, where the pregnancy was planned and normal MEASUREMENTS AND FINDINGS: the development of perceptions of childbirth and childbirth education was described. The women adopted the content of the education in different ways. Fear as well as unreflected knowledge seemed to block acquisition of new knowledge. Factors which contributed to a childbirth experience worse than expected were lack of or inconsistent information. Increased knowledge about childbirth and experiences of confirmation during childbirth contributed to a good or better experience than expected. KEY CONCLUSION: any model of childbirth education which does not take into consideration the individual woman's perceptions of childbirth and childbirth education seems to be inadequate. IMPLICATIONS FOR PRACTICE: the findings stress the importance of individual assessment of expectations of and experiences of childbirth education. Consistency in information given before and during childbirth supports a sense of comprehensibility, manageability and meaningfulness.

Adult↗
PubMed1994

A descriptive study of childbirth education provided by midwives in Sweden.

OBJECTIVE: to describe the content, modes of working and reaction/interaction of childbirth education provided by midwives in Sweden. DESIGN: qualitative, using non-participant observation to collect the data. Grounded theory approach was used. SETTING: antenatal classes provided in the community in Sweden. PARTICIPANTS: twelve midwives with varying lengths of experience in teaching antenatal classes, and the prospective parents who attended these classes. MEASUREMENTS AND FINDINGS: three perspectives on the content and three modes of working were found. Combinations of the differing perspectives and working modes provided differing interactions within the classes. KEY CONCLUSIONS: the confirming/mixed model resulted in dialogue in the classes. It was assumed that this model would contribute to an increased understanding of the coming experience of giving birth. IMPLICATIONS FOR PRACTICE: the findings provide midwives with a basis for reflection on their experiences as leaders in the childbirth preparation part of education for parenthood.

Curriculum↗
PubMed1994

Emotional experiences, empathy and burnout among staff caring for demented patients at a collective living unit and a nursing home.

Experiences of empathy and burnout were compared among staff caring for demented patients, at a collective living unit (n = 10) and a nursing home (n = 10) in the middle of Sweden. In both milieus, the staff showed great confidence in their own caring ability and disclosed a deep care and concern for their patients. All staff had the requisite attributes of empathy, and none had burnout scores indicating risk of burnout. The staff of the collective living unit gave exclusively positive descriptions of their patients, but expressed an emotional exhaustion and a feeling of being overutilized. The staff of the nursing home gave positive and negative descriptions of their patients, and experienced physical exhaustion and a feeling of being only partly utilized. The study indicates that exhaustion in staff may be related both to overwhelming experiences connected with being close to demented patients, and to feelings of guilt for not being closely related to their patients.

Adult↗
PubMed1994

Integrity promoting care of demented patients: patterns of interaction during morning care.

Video-recorded morning care sessions (n = 49) of demented nursing home patients (n = 5), were analyzed before, as well as after, training of the staff in integrity promoting care. A phenomenological-hermeneutic analysis was performed based on the Erikson theory of "eight stages of man" and musical notations were used for the analysis of courses of events. The analysis revealed five main patterns of interaction; positive, negative, intermediate, negative/intermediate turned into positive by the patient, and negative/intermediate turned into positive by the caregiver. Before the training, negative and intermediate patterns dominated (58%), while positive patterns dominated (84%) after the training. The positive patterns of interaction were characterized by the caregiver communicating with the patient as a competent partner, showing humanity, respect and support. The activity was carried out in intimacy. This led to the patient displaying more and more ability.

Baths↗
PubMed1994

[Effects of the training in integrity-promoting care on the interactions in a long-term ward].

A training programme in integrity-promoting care was given the staff of a long-term ward and practised during a three months intervention period. The effects were analysed in different parameters and compared with a control ward. This report describes analysis of video-recorded interactions (12 hs) during social activities between demented patients and caregivers and changes induced by the programme. The video-recorded episodes, containing mainly music and coffee sessions were interpreted from a model on interaction with demented patients suggested by Athlin and Norberg. The results indicate that the training programme and the guidance during the intervention resulted in increased understanding of demented patients' situation among the staff. They became more sensitive, adapted their cues and made the environment easier to interpret for the patients. This in turn led to the fact that the patients appeared more sensitive and clear in their cues. A positive circle developed.

Empathy↗
PubMed1992

The content of the oral daily reports at a long-term ward before and after staff training in integrity promoting care.

This study was based on the assumption that the daily report between different caregivers are of great importance for the quality of the care delivered and that they guide the content of it. The staff of a nursing home ward were given training in integrity promoting care and special training in reporting. After a three months' intervention period effects on patients and staff were evaluated and compared with a control ward. Positive patient outcomes have been reported earlier. The aim of this study was to describe the content of the oral daily reports between staff members in long-term care and investigate whether some changes occurred after training that might have contributed to the positive results for the patients. Another aim was to assess whether the staff regarded the reports as satisfactory. Oral reports were tape-recorded before and after staff training. A content analysis by a scheme based on Henderson's description of components of nursing care and a form analysis based on the nursing process were made. The reports were highly task oriented and the staff often discussed the patients' reaction in vague and general terms. The steps of the nursing process did not seem to be used. The answers to a questionnaire about the staff's satisfaction with the oral reports showed some increasing dissatisfaction and also comments about needs of more collaboration between different groups of personnel. More messages were given per report after the intervention compared to the control ward and the messages with psychosocial content had doubled.(ABSTRACT TRUNCATED AT 250 WORDS)

Communication↗
PubMed1990

Effects of the training of integrity--promoting care on the interaction at a long-term ward. Analysis of video-recorded social activities.

A training programme in integrity-promoting care was given the staff of a long-term ward and practised during a three months intervention period. The effects were analysed in different parameters and compared with a control ward. This report describes analysis of video-recorded interactions (12 hs) during social activities between demented patients and caregivers and changes induced by the programme. The video-recorded episodes, containing mainly music and coffee sessions were interpreted from a model on interaction with demented patients suggested by Athlin & Norberg. The results indicate that the training programme and the guidance during the intervention resulted in increased understanding of demented patients' situation among the staff. They became more sensitive, adapted their cues and made the environment easier to interpret for the patients. This in turn led to the fact that the patients appeared more sensitive and clear in their cues. A positive circle developed.

Aged↗
PubMed1989

Elevated CSF somatostatin concentrations in demented patients parallel improved psychomotor functions induced by integrity-promoting care.

Elderly demented patients from 2 nursing homes participated in this study. An experimental group (n = 17) was subjected to a 3-month program with integrity-promoting care resulting in emotional, intellectual and physical activation, whereas a control group (n = 18) had no change from the regular ward care. Dementia rating scales and psychological tests were administered before the start of the study and at the end of the 3-month study period. Lumbar punctures were performed at the same time for assessment of neuropeptide concentrations (somatostatin (SRIF), arginine vasopressin (AVP) and corticotropin-releasing factor) in the cerebrospinal fluid (CSF). In the control group no significant changes were found in the ratings before and after the study. In contrast, improvements in intellectual and motor functioning were observed in the experimental group. Concomitantly, the SRIF concentrations in CSF were significantly elevated in the experimental group and not affected in the control group. The CSF AVP concentrations were reduced in both groups at the end of the study, but considerably more in the control group. It is concluded that environmental factors can improve intellectual and motor functioning in demented patients and also alter CSF biochemical measures of dementia.

Aged↗
PubMed1983

Intellectual function late after open-heart operation.

Cerebral emboli are not uncommon complications after valve replacements. We investigated the hypothesis that there are emboli that are clinically unnoticeable but that may affect the intellectual function of the brain. One hundred sixty-five patients were studied with a battery of psychometric tests before and after operation, two months postoperatively, and 2 to 8 years after operation. Ten patients sustained late cerebral infarction or hemorrhage. Their late intellectual function was low, indicating an impairment in brain performance. The remaining 155 patients had had no cerebral complications postoperatively. Eighty-three had had valve replacement (Björk-Shiley valves); 51, aortocoronary bypass operations; and 21, closure of an atrial septal defect (all adult patients). Late intellectual function was significantly lower in the patients with a valve prosthesis than in the other two groups. However, this difference could be traced back to the operation. Thus, we have not been able to confirm our hypothesis that late intellectual function in patients with a heart valve prosthesis deteriorates as a result of clinically silent emboli. On the contrary, patients who have undergone aortocoronary bypass operation sustain more deterioration in late intellectual function than the other groups. Late intellectual function in this study population clearly was influenced by events during the operation. Because cerebral injury can be shown almost regularly after open-heart operation, this investigation provides an incentive for further efforts to improve the quality of open-heart surgery with the aim of keeping brain function as intact as possible.

Cardiac Surgical Procedures↗
PubMed1977

Rehabilitation after aortic valve replacement with autologous fascia lata: a sociomedical study.

In a series of 50 patients who underwent aortic valve replacement with frame-supported fascia lata, 32 were seen for a combined medical and psychosocial examination 10 to 33 months postoperatively. The investigation included a psychometric test battery and an interview concerning the patient's social and psychological situation at the time of the operation and at follow-up. Twenty-seven patients had improved in their New York Heart Association Functional Classification at the time of follow-up. In most instances NYHA classification correlated well with the patients' subjective opinion on their recovery. Those who for various reasons were not able to return to work did not consider themselves recovered. The employment rate after operation was 66%. There is a great need for more information and support to families as well as for more intensive rehabilitation efforts, especially vocational, for the postoperative patient.

Adaptation, Psychological↗
PubMed1977

Cerebral protection during open heart surgery. A comparison between a disk oxygenator and two bubble oxygenators.

A disk oxygenator (Björk-AGA HLM) with a moderate hemodilution prime and two bubble oygenators (Harvey H 800 and Galen Optiflo 42-201) with a clear fluid prime are compared in regard to their effect upon postoperative intellectual function as measured by psychometric tests. There was no difference between the two bubble oxygenators. There was a marked, statistically significant difference between the bubble oxygenators and the disk oxygenator, the disk oxygenator yields considerably worse results. The reason for this is obscure but probably lies in the different microembolic output. The literature, however is not consistent on this question. At the present time, only bubble oxygenators are used in our unit.

Brain Damage, Chronic↗
PubMed1977

Cerebral protection during open-heart surgery.

To reduce the incidence of cerebral damage after open-heart surgery measures were undertaken based on physiological principles and consideration of the possible injury caused by microemboli. Intellectual function was measured by psychometric tests before and after operation. The results were compared with those of an earlier series. There was a striking reduction in the incidence of neurolocial complications. There was also a considerable reduction in the degree of impairment of intellectual function previously shown to develop after open-heart surgery. However, there are still signs that cardiopulmonary bypass brings about subclinical cerebral injuriies. The measures taken and their rationale are discussed. Psychometric testing is a useful method for evaluating the quality of cardiopulmonary bypass as it allows a quantitative assessment of postoperative cerebral function.

Adult↗