The purpose of this article is to contribute to the discussion of self-care as a concept and practice in relation to clinical nursing and health care. Theoretically, the article is based on Focault’s theory of the technologies of the self and the technologies of power. Methodologically, it is based on a review of articles on self-care, carried out by the authors for the Danish National Board of Health.
The aim of this project is to describe how the subject of self-care in relation to the prevention of lifestyle diseases was treated in the articles. The result of the literature review is used to discuss self-care as technologies of the self and technologies of power aimed at getting patients to change direction. Power relations will always be at stake when the overall aim of nurses and other health professionals are to encourage people to take responsibility for their own health.
The purpose of this article is to describe how elderly patients in a nursing home in Norway experience meal times. A knowledge of meal times as an opporunity for social interaction can be important in improving nursing practice. The methodology used was a qualitative research interview based on the guidelines from Fog and Kvale. Seven patients aged between 82-96 years were interviewed. Data was analysed in a qualitative content analysis.
Results showed that meal times played an important role in the patients’ social life with one another besides the enjoyment of the meal itself. Mealtimes were a source of well-being to the patients whether they were by themselves or in the company of others, although reduced conversation ability limited social interaction. Patients were pleased when members of staff took part in the conversation. Unfortunately, the staff were mainly busy serving the food. in spite of the lack of conversation partners, some just enjoyed sitting there with someone else around. Few preferred to eat alone in their private rooms.
The aim of this study was to describe how people with Parkinson’s disease experience life during their first year of treatment with Deep Brain Stimulation. Four people were interviewed at three different times during the first year following the operation. Data were analysed using the phenomenological-hermeneutic methodology of Max van Manen, and the data analysis revealed a uniting theme, that can be described as the experience of being a participant in making decisions in life. The meaning of this theme changes during the first year, involving other themes and, in time, changing themes. An important finding is that previous experience with Parkinson’s disease reflects on life after the operation, creating both hope and uncertainty about the future. Therefore, nurses must be aware that patients may need help and support in order to believe in their own ability to challenge life, to create new meaning and to recapture life itself.
Bereavement care is an essential part of working with palliative care. Most reactions to bereavement are natural and do not require treatment. However, some bereaved persons develop more complicated symptoms for which treatment is necessary in order to avoid pathological disorder.
As there is no diagnostic category for complicated grief, the clinical implications can be undifferentiated intervention for the bereaved person, the danger of medicalizing bereavement and the lack of clinical guidelines for bereavement care in hospital wards.
At the same time, in Denmark the understanding of bereavement has traditionally been Freudian, which possibly entails certain shortcomings. The article presents a revised model of understanding and coping with bereavement – the Dual Process Model. The implementation of the model by a palliative care team is discussed.
Access to electronic patient records opens up new opportunities in care. These records are available to all providers of health care and are constantly kept updated with the latest changes in treatment. Status diabetes comprising demographic data; ICD-10 diagnoses; lab-system data; medication; self-care, awareness, life-style risk factors; results of feet inspection and eye examination; comprise the central nerve in our EPR.
Various warnings advise the patient and health care providers about risk factors and time schedules for screening programmes. Important areas concerning the treatment of diabetes and the risk factors are shown graphically in order to view the process over time.
In the nearest future patients with access to the internet will be able to see their own records, thus providing them with the opportunity to plan their next visit to the clinic. Focuses have changed giving patients a more active role in the taking of decisions and administration of treatment.
Hildegard E. Peplau has had a major influence on nursing since she wrote the first comprehensive, theoretically informed nursing theory after Florence Nightingale’s. Peplau’s perspective was psychodynamic and her theoretical writing has influenced almost every area of nursing practice. In this article I introduce the life and work of Peplau, taking Peplau’s classic Interpersonal Relationships in Nursing as my point of departure. Moreover, I discuss some of the later developments of the theory. I criticize Peplau’s theoretical position and evaluate it in the light of present day nursing practice.
The article emphazies the problems in an organizational learning process when it is implemented as a management strategy in a hospital. The strategy has to do with patient safety and adverse events. The core issues of the article are single-loop learning, double-loop learning and second order learning (Argyris & Schön), as well as various scientifically theoretical ways of regarding learning, dualism versus dialectics in particular. The article concludes that learning regarded as double-loop learning cannot be provided by a management strategy.
The use of massage and touch by a Danish palliative care team has revealed that this intervention is especially beneficial to patients suffering from dyspnoea, muscle tension, anxiety and emotional disturbances, and is appreciated by patients in that it gives a „time-out“ from illness. Literature on the subject shows that the most consistently found effect is on anxiety. Reduction in pain and nausea is also found but evidence of the effect on depression is variable. A minor study showed improved immune and neuroendocrine function.