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Background: The goal of the Cooperation Reform is to transfer a larger part of the health care service to the municipalities. The pressure is increasing on the health care service in the municipalities – especially on the home care service. Aim: To gain knowledge about how nurses experience and manage the challenges in their daily work in the home care service as a result of the new reform. Method: Grounded Theory. Data was collected through participating observation and qualitative interviews with 11 nurses in the home care service in two municipalities. Results: The main challenges of the nurses in the home care service are making difficult decisions in the clinical practice in the home care service. These decisions involve making valuations of ethical competence, and a follow-through of a complicated practice and priorities. Conclusion: This study shows how the Cooperation Reform has contributed to the increased pressure on the home care service – in the form of time reductions and a larger field of responsibility for the nurses. In addition, there is a need for an increase in competence. The study contributes to differentiate the understanding of the home care service.
Patients with colorectal cancer are offered multi-factual treatment which means long-term treatment followed by severe side effects. Within a phenomenological-hermeneutical frame of reference, the aim of this study was to explore the patients’ perceptions of the challenges they experience during treatment for colonic cancer. Ten patients participated in the study. Data were collected through semi-structured interviews and analysed using the guidelines for meaning interpretation laid out by Kvale and Brinkmann. The analysis led to one dominating theme: endurance, and four subthemes: coping with bodily changes; the reorganization of everyday life; getting support from close relatives; seeing life from a different perspective. The patients struggled to endure both the ongoing treatment and the changes in their everyday lives related to the disease and the unpleasant side effects, such as diarrhea. The findings demonstrate a need for an increased awareness of the impact of diarrhea on patients’ everyday lives during treatment.
Aim: This study examines what patients, who have been undergoing Dialectical Behavior Therapy (DBT), consider to be a life worth living, and in which way DBT contributes to this result. Background: The existing research points to the effectiveness of DBT in treating borderline personality disorder. However, little qualitative research has been conducted to explore the reasons for the success of DBT from the patients’ perspectives. Method: This study proceeds from a qualitative hermeneutic approach. Three participants were interviewed following a semi-structured format. The interviews were transcribed verbatim by the interviewer and analyzed with qualitative content analysis. Results: Four themes emerged through the analysis process: “A life not worth living”,” A life worth living”,” Creating a new identity” and “Meeting a human being and being met as a human being”. Conclusion: Individually adjusted challenge in a long lasting relationship helps the patients to gain control over their lives which is associated with a life worth living.
The health care system is expected to become more complex and specialized. This calls for nurses with good skills in making judgments, taking action, and organizing patient care. At the Nursing school in Aarhus, Denmark, we meet these requirements by developing experimental teaching reflecting practice. Aim: To explore how the development of clinical imagination and relevance assessment can prepare nursing students for clinical studies and act as educated nurses. Methods: The study consists of qualitative interviews with students who have followed an experimental course and a regular course. Results: Clinical imagination and relevance assessment presented themselves in three themes: Experiencing context. Using imagination. Being part of a professional cooperation. Conclusion: Working with the entire range of nursing activities in a real-life department seems to contribute to the development of nursing students’ clinical imagination and ability to make relevance assessments, preparing them to act, organize, and cooperate in a complex, clinical practice.
Background: When patients are psychotic, and the use of forced medication is necessary, the autonomy of the patients is disregarded, but they still have the right to be informed and involved in their treatments. Purpose: To investigate how the patients are involved during hospitalization, when forced medication is necessary, to improve the patients’ experienced quality of treatment. Method: The study is a qualitative study with a phenomenological and hermeneutic frame of understanding. Patient interviews make out the data collection. Results: The patients want to form an alliance with their contact persons, and they want to be integrated in the settings of the ward. They need support from human beings who know and respect them. Conclusion: There is a discrepancy between the legislative demand for treatment and the patients’ experiences of involvement. It is essential to inform and involve the patients in the considerations concerning their treatments and to try to get their consents for treatment, despite their psychoses.
In a project initiated by a local branch of the Danish Nurses’ Organization in 2011-2012, 11 Danish nurses from different workplaces photographed their own professional practices. Based on theory and qualitative methods related to learning processes, narrative interviews, and photo-documentation, the project develops a new method which enables healthcare professionals and other professional experts to use a creative-reflective process to “provide … an opportunity to express, communicate, reflect upon, and discuss their professional identities”. The project presents new ways of shedding light upon nurses’ professional identities – a focus that is an important element in developing nurses’ professional practices. Photos and interviews from the project have been published in the book Øjeblikke. Sygeplejerskers hverdage fotograferet af sygeplejersker. The book was presented at the ICN congress in Melbourne in May 2013.