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Leder
(side 1)
av Bente Martinsen Woythal
MRC’s rammeprogram som forskningsmetode i klinisk sygepleje
The MRC-framework as research method in clinical nursing practice
Vitenskapelig publikasjon
(side 2-15)
av Connie Bøttcher Berthelsen
Sammendrag

The discussion in European research evolves around a paradigm shift in nursing research from descriptive studies towards intervention research purposive to support evidence-based practice and nursing care. Since nursing consists of many complex actions, it is natural to focus on intervention and implementation research. One solution could be to use Medical Recearch Council's framework for development and evaluation of complex interventions, which provides guidelines and methodologies that can be advantageous for further development of clinical nursing. The aim of this article is to describe how the MRC-framework can be used as a research design to develop and evaluate complex interventions in clinical nursing. The article will be based on examples of considerations and choices from a Danish intervention study designed to evaluate a case management program with home visits to the elderly who live alone, after a total hip replacement through an accelerated orthopedic surgical process The HOOPLA-project.

Deeskaleringsprocesser
En gennemgang af litteraturen om deeskalering af vold og trusler på psykiatriske afdelinger
Vitenskapelig publikasjon
(side 16-33)
av Lene Lauge Berring og Niels Buus
Sammendrag

Managing aggression in mental health hospitals is an important and challenging task for clinical nursing staff. Insufficient knowledge and skills about interacting with patients in a non-confrontational manner can initiate a vicious cycle, where restrictive interventions, such as limit setting, provoke further violence. De-escalation is recommended as an intervention that can avoid violence through psychosocial and verbal interventions. However, there is limited knowledge about what de-escalation and de-escalation processes are.

An integrative review using Whittemore and Knafl’s framework was undertaken to explore how the research literature defined and described de-escalation processes. De-escalation was described as experience based knowledge that could be organised under four themes: 1) Definitions and understanding, 2) Actions and strategies, 3) Competences and skills, and 4) Education and learning. These themes highlighted an emerging common understanding of de-escalation as a graduated solution of potential violence where staff members express empathy and solidarity with the patient. However, knowledge about how staff members learn de-escalation remains limited and more research is needed in order to develop efficient learning programs.

(side 34-46)
av Charlotte Bjerg Sand Riis og Charlotte Delmar
Sammendrag

This article is a contribution to the professional understanding of patient involvement. The findings of an explorative study of the specific expectations and experiences of involvement in priorities and decisions concerning treatment of hospitalized patients with affective disorders are described. The purpose is to achieve a better understanding of patients’ expectations to their level of involvement. The empirical data are collected through three individual interviews and analyzed through a Ricoeur-inspired process. Although patients with an affective disorder find it difficult to describe their specific expectations of involvement, the analysis shows that: To be listened to, To experience attention and To hand over responsibility are very important enablers of the experience of involvement. Patients expect to be met by a care ethical rationale in a dialectical division of responsibility, where the professionals bear the responsibility of discovering the patients’ need for treatment, help and care throughout the hospitalization.

(side 47-59)
av Malene Coulthard og Sanne Lemcke
Sammendrag

Only a minority of pregnant women with eating disorders (ED) is referred to treatment, and the pregnant woman is often uncertain on whether she is sick enough from ED to require treatment.

The aim of the paper is to contribute with professional input to the knowledge about pregnant women with ED. The paper includes a survey of the literature, a description of experiences from a specialized treatment center for ED, and recommendations for clinical practice.

The paper describes how vulnerable pregnant women with ED are, and that the group is easily overlooked. Professionals in contact with pregnant women has the opportunity to identify ED but often lack knowledge about the symptoms of ED in pregnancy, and what treatment is offered. GPs and other health professionals have potential to increase the detection, and local discussions of the interdisciplinary collaboration are recommended.

(side 60-72)
av Annemi Lund Joensen og Elisabeth Hall
Sammendrag

Over the last years, automated external defibrillators are placed in many public areas leading to positive outcomes after sudden cardiac arrest. Automated external defibrillators are also becoming frequent in nursing homes where most residents are suffering from chronic illnesses and dementia and they are in old age indicating that they are in an end of life situation. Therefore, nursing home health care providers are faced with both legal and ethical challenges when deciding to resucitate nursing home residents who get a cardiac arrest. The purpose of this article is to discuss these dilemmas drawing on research and legal and ethical theories. The analyses show that in such cases health care providers always are in a dilemma between juridical and ethical reasoning. We argue that these dilemmas can be minimized by openness and knowledge, by using professional judgment and discernment and by discussions with the residents and their relatives about their wishes and wants.

Essay
(side 73-78)
av Dorthe Boe Danbjørg og Finn Olesen
Sammendrag

The aim of this essay is to show how technology in nursing can be analysed in order to describe how technology shapes nursing. We take on a sociotechnical approach, where the postphenomenological concepts: mediating, constitution and multistability show how we can study relations that connect humans with social and technological entities in everyday work situations.

We conclude that with the use of postphenomenology we can systematically discuss technology in nursing, and hereby contribute to shaping the use of technology in the profession, enabling technology to interact with the nursing ideals.

1/2018 Årgang 32

www.idunn.no/klinisk_sygepleje

Redaktør

Bente Martinsen Woythal, Aarhus Universitet

Vitenskapelig redaktør

Annelise Norlyk, Aarhus Universitet / ViA University College

Redaksjonssekretær

Aud Aasen

Redaksjonens adresse

Aarhus Universitet v/ Bente Martinsen Woythal

Institut for Folkesundhed, Sektion for Sygepleje, Campus Emdrup

Tuborgvej 164, bygning B

2400 København NV

Redaksjonens E-post

E-post: klinisksygepleje@gmail.com

Redaksjonsråd

Ingrid Poulsen, Dr.med.sci., leder af Forsk­ningsenheden, Afd. for Hojt specialiseret Neuro­rehabilitering/ Traumatisk Hjerneskade, Glostrup HospitalFrederik Alkier Gildberg, cand.cur., ph.d., Center for Psykiatrisk Sygepleje- og Sundhedsforskning (CPS), Syddansk Universitet

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