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Biomedical subjects

Marit Kirkevold

Publications and source records attributed to Marit Kirkevold.

12 recordsLinked to original sources
PubMed2007

Participatory design in health sciences: Using cooperative experimental methods in developing health services and computer technology.

Participatory design (PD) is a research approach to the development of technological solutions to real-world problems, an approach that shares many concerns and some of its roots with action research. In this article, the authors discuss their experience in conducting a PD research project intended to develop a technological and a related organizational intervention to support the treatment of foot ulcers for people with diabetes at home. They provide a historical overview of the PD approach and a description of how they used it in their research study. They describe their experience in conducting the research, including the participants' responses, the outcomes of the research, and the challenges confronted in bridging the practical and disciplinary issues that arose. In the conclusion, they propose that PD holds potential as a research approach that might effectively merge computer technology and health-related interventional research.

Biomedical Research↗
PubMed2005

Thriving in nursing homes in Norway: contributing aspects described by residents.

BACKGROUND AND OBJECTIVES: Knowledge about residents' perception of what contributes to well-being and thriving in nursing homes is scarce. The aim of this study was to investigate mentally lucid residents' perspective on what contributes to thriving in a nursing home. DESIGN: A qualitative study with a descriptive-exploratory design. SETTINGS: Two nursing homes in Norway. PARTICIPANTS: 26 mentally lucid nursing home residents. METHODS: Data collection comprised participant observation and open-ended interviews. RESULTS: Two core aspects contributing to thriving were identified: The residents' attitude towards living in a nursing home and the quality of care and caregivers. The residents' attitude was the innermost core aspect. Five additional aspects contributing to thriving were identified: Positive peer relationships, participation in meaningful activities, opportunities to go outside the ward or nursing home, positive relationships with family, and qualities in the physical environment. CONCLUSION: Several factors contribute to an experience of thriving. The findings challenge the 'traditional' passive role of residents by documenting their active contributions to their level of thriving in a nursing home.

Aged↗
PubMed2005

Resident-caregiver relationships and thriving among nursing home residents.

The purpose of this study was to describe nursing home residents' experiences and perceptions of relationships with caregivers and to explore their importance to thriving. Data were collected through field observations and open-ended interviews with 26 residents. Receiving appropriate care from kind caregivers made life easier for all residents but contributed to thriving only for some. One group of residents emphasized personal relationships to individual caregivers as essential to thriving. A second group reported that non-personal relationships contributed to thriving. A third group preferred distant relationships to the caregivers but reported thriving as well. Personal relationships to individual caregivers were not essential to thriving for all residents.

Aged↗
PubMed2005

Body care experienced by people hospitalized with severe respiratory disease.

AIM: The paper gives a theoretical account of experiences of assisted personal body care (APBC) in hospitalized patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: Body care has been identified as a central but underestimated area of nursing. Hospitalized patients with severe COPD suffer from breathlessness on exertion and are dependent on help with personal body care. Studies have described patient strategies for managing breathlessness and preferences regarding nursing care during hospitalization. Yet the problems that patients can experience because of their inability to manage personal body care by themselves have not previously been explored. This study explored patients' experiences of being assisted with personal body care. METHODS: A grounded theory methodology was used with a convenience sample of 12 patients. Data were gathered from participant observation of sessions of APBC, in-depth interviews after the observed sessions and measurement of breathlessness perceived by patients before and after the sessions. FINDINGS: The patients perceived body care as a significant daily activity that needed to be carried out in order to preserve their integrity. Dependency and breathlessness, however, impeded the performance of body care activities and patients were struggling for self-preservation. They managed APBC by using a threefold strategy of not letting go, coping with dependency, and minimizing the risk of escalating breathlessness. Two dilemmas were identified as being inherent to the strategy. CONCLUSION: Increased knowledge of the complexities involved in providing assistance might improve nurses' ability to facilitate patients in managing APBC. Dependency is a central issue to address in order to support patients' efforts to preserve integrity and resolve dilemmas inherent to the strategy they use.

Adaptation, Psychological↗
PubMed2005

The nature of nursing care and rehabilitation of female stroke survivors: the perspective of hospital nurses.

AIMS AND OBJECTIVES: The aim of this study was to explore the nature of nursing care and rehabilitation of female stroke survivors, as described by hospital nurses. The objectives were to uncover how the nurses perceived the care of female stroke survivors and to explore whether, and in what way, the nurses paid attention to the fact that the patients were women. BACKGROUND: Nursing care is an important aspect of the rehabilitation of stroke survivors. Little attention has been paid to gender differences in the health care system in general and in the nursing profession in particular, although it is reasonable to think that gender issues may have important implications in the rehabilitation process following a stroke. DESIGN: Design was phenomenological with feminist perspective. METHODS: The nurses were interviewed in-depth. In the data analysing process we were inspired by Giorgi's phenomenological method. RESULTS: The nurses were focusing primarily on functional and practical aspects of the women's situation. They perceived the rehabilitation process predominately from a professional rather than the patient point of view, and from a non-conscious and primarily gender-neutral perspective. CONCLUSIONS: The results indicate that the nurses perceived nursing care primarily in terms of practical actions to promote the body's functional and practical abilities. Little attention was directed to the stroke survivors' experiences of their life body, nor to the fact that the patients were women. RELEVANCE TO CLINICAL PRACTICE: In order to promote care from the perspective of the female stroke survivors, we believe it is necessary to attend to the life experiences of the patient, which also mandates paying attention to how gender has an impact on their diseased bodies, every day life, values and preferences in the situation.

Adult↗
PubMed2005

Curtailing: handling the complexity of body care in people hospitalized with severe COPD.

Assisted personal body care (APBC) tends to be regarded as an unproblematic nursing activity with little professional challenge. For severely ill patient diagnosed with chronic obstructive pulmonary disease (COPD) daily bathing and washing is, however, a significant self-preserving activity that requires substantial efforts on the part of both patients and nurses. The aim of this study was to report on the complex pattern of APBC in hospitalized patients with severe COPD and highlight significant characteristics that should be considered in clinical practice in order to support patients' comfort and well-being. The study used a grounded theory design with a generative and constant comparative approach. The sample consisted of 12 cases of nurse-patient interaction, based on data from participant observation of sessions of APBC, measures of patient's perceived degree of breathlessness and individual interviews with patients and nurses after the sessions. Findings show that APBC in hospitalized patients with severe COPD is a complex integrated pattern of body care activities that can proceed with a greater or lesser degree of success. The main problem is how to keep the patient's breathing under control while optimizing comfort and well-being. Curtailing addresses this problem. Curtailing is a subtle, purposeful balancing of protection from breathlessness and promotion of patients' present and future functional capacity in order to preserve their integrity. The idea that body care is a simple task belonging to patients' private daily lives may obscure the importance of determining a mutual nurse-patient agenda and the professional nurse responsibility may consequently be nebulous. Finding in this study will contribute to the development of a comprehensive and detailed understanding of the APBC and suggest the need for further investigation of the interaction perspective.

Activities of Daily Living↗
PubMed2005

Life versus disease in difficult diabetes care: conflicting perspectives disempower patients and professionals in problem solving.

Conflicts in problem solving are known from diabetes research on patients with good glycemic control but have rarely been studied in the care of patients with poor glycemic control. Equally, the different perspectives of health care providers and patients have not been a focus in previous studies. The authors studied the interactions between health care providers and 11 diabetes patients with poor glycemic control in a grounded theory study at a Danish university hospital. Keeping Life and Disease Apart was identified as a core category. It involved a pattern of conflicts both between and within patients and health professionals, which disempowered them in problem solving. Three approaches to problem solving were identified: A compliance-expecting approach kept the pattern unchanged, a failure-expecting approach deadlocked the pattern, and a mutuality-expecting approach appeared to neutralize the conflict.

Adolescent↗
PubMed2004

Fighting back--struggling to continue life and preserve the self following a stroke.

The aim of this longitudinal phenomenological study was to explore how female stroke survivors experienced their life following a stroke and how they managed their altered situation. Twenty-five women suffering first-time stroke were interviewed in depth three times during the first one and a half years after the stroke. Applying the method of Giorgi, we found that there was a lengthy struggle to continue life and preserve the self following the stroke. The struggle was closely related to their deeply rooted identity as mothers, wives, grandmothers, and housewives. The situation of women following a stroke needs particular attention because their needs may conflict with their female caring roles. On the other hand, supporting them in transforming these roles may secure their sense of self and a continued meaningful life.

Adaptation, Psychological↗
PubMed2003

Truth and validity in grounded theory -- a reconsidered realist interpretation of the criteria: fit, work, relevance and modifiability.

Grounded theory is a frequently used approach in nursing research. Over the years the methodology has developed in different directions with ambiguous answers to questions of truth and validity. This ambiguity influences the interpretation of the criteria for quality judgement of grounded theories: fit, work, relevance and modifiability. In particular, the criterion fit seems to be caught in a vacuum between different epistemological and ontological positions. Fit can be interpreted either from a realist or from a nonrealist position but both present problems. A realist position is problematic if it insists on an immutable empirical world and ignores the social and psychological aspects of human life. A nonrealist position can either be argued to rely on hidden realist assumptions and therefore to be inconsistent, or it can be relativistic, opening up the possibility of 'anything goes' attitudes in research and solipsistic confirmations of the world view of researchers with little or misleading practical impact. A reconsideration of the realist position is suggested, in which validity is regulated by the social constructed reality 'as it really is'. From this position fit is a matter of correspondence to facts in social reality. The criteria work, relevance and modifiability are argued to support the fitness of a theory, and to be useful in the broader evaluation of the quality of grounded theories.

Humans↗
PubMed2003

Living with bodily strangeness: women's experiences of their changing and unpredictable body following a stroke.

The authors' aim in this phenomenologial and feminist study was to gain a deeper understanding of how female stroke survivors experienced their body after a stroke. They recruited 25 women in a rural area in eastern Norway who had suffered a first-time stroke and interviewed them in depth three times each during the first 1 1/2 to 2 years following the stroke. The data analysis was inspired by phenomenological method. The stroke survivors' experiences of their bodies were characterized by profound, disturbing, and, in part, unintelligible changes during the onset and the process of recovery from the stroke. Their experiences can be summarized under three major themes: The Unpredictable Body, The Demanding Body, and The Extended Body.

Adaptation, Psychological↗
PubMed2002

Gaining access to the life-world of women suffering from stroke: methodological issues in empirical phenomenological studies.

AIM: First to give a brief introduction to some dimensions of phenomenology as philosophy, and then to discuss some problems related to empirical research. The objectives of the discussion are: (1) to show what is involved in investigating changes in the life-world caused by illness and (2) to show what must be taken into consideration to obtain adequate descriptions of the changes. RATIONALE: To discuss some of the methodological requirements and challenges that phenomenological studies are expected to meet, particularly focusing on the data collection phase. METHODS: This is primarily a theoretical analysis supplemented by illustrations drawn from an ongoing study of women who have had suffered stroke. FINDINGS: Openness is essential in the whole research process. It is a precondition for conversation with the informants. In interview-based investigations two forms of openness are at issue - the informant's openness in describing his/her life-world, and the sensitivity of the researcher as regards seeing and hearing what is conveyed in the situation. Both forms of openness can be influenced positively or negatively by many factors, including the physical and mental health of the informants, the researcher's theoretical insight, her ability to communicate, and not least the relationship between the informant and the researcher. A relationship of power, for example, might reinforce gender differences, differences in cultural background, education and social status. CONCLUSION: Openness on the part of the researcher is a prerequisite in order to gain access to the informant's life-world.

Activities of Daily Living↗