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Leder
(side 256-257)
av Olle Söderhamn
Vitenskapelig publikasjon
(side 257-271)
av Ulla-Britt Lilleaas & Drude von Der Fehr
Engelsk sammendrag

This article is an interdisciplinary discussion of the assertion that a «bodily state of preparedness for others» is a gendered deep habit, through the concepts of habitus and habit. Through these concepts we combine vocabulary from the social sciences and American pragmatism. We argue that a bodily state of preparedness for others is based on embodied habits or deep habits, and that these are both physical and mental. In order to be able to understand the depth of embodied habits, we put forward the hypothesis that we can interpret the meaning of chronic pain conditions as the bodyŽs own self-reflexive warning system. These symptoms do not address the outer world, but the body itself. As a conclusion we argue that discussions of gender practice should play an important part in any curative activity which could be organized by the health service.

Vitenskapelig publikasjon
(side 272-284)
av Lene Seibæk, Lone Kjeld Petersen, Jan Blaakær & Lise Hounsgaard
Engelsk sammendrag

Aim: To provide knowledge about health status, socio-economic status and use of public health care in women undergoing ovarian cancer surgery, in order to improve their care during the perioperative period. Method: An epidemiological methodology was applied. The material consisted of data from the Registry of Health and Social Conditions and the Danish Gynaecological Cancer Database on women diagnosed in 2007; this material underwent descriptive statistical analysis. Results: Data from 666 women were suitable for analysis. The majority were older, with moderate to severe systemic illness and a tendency to be overweight. Many had a low educational level, were retired, and lived alone with few financial resources. The quality of the surgical treatment had improved in terms of centralisation and staging procedures. Conclusions: As a group the women proved to be in a vulnerable position in terms of living conditions and general health. Some of these factors might be compensated via health promotion and supportive preoperative care, others by appropriate organisation of treatment. Substantial advantages might therefore be within reach by introducing nurse-led, supportive preoperative care during the wait for surgery.

Vitenskapelig publikasjon
(side 285-297)
av Inger Emilie Værland & Kjell Kristoffersen
SammendragEngelsk sammendrag

Innføring av protokollbasert behandling er aktuelt innen intensivsykepleie. Avvenningsprotokoll brukes når pasienter skal avvennes fra respirator. Hensikten med studien var å undersøke hvordan en gruppe intensivsykepleiere erfarte en avvenningsprotokoll som er basert på medisinsk evidens og hvilken rolle medisinsk evidens spiller i forhold til andre typer evidens når pasienter skal avvennes fra respirator. Det ble utført intervjuer av åtte intensivsykepleiere om deres erfaringer med avvenningsprotokoll. Det ble benyttet innholdsanalyse og følgende kategorier framkom: 1) avvenning og protokollen, 2) avvenning og sykepleie, 3) avvenning og erfaring, og 4) avvenning og samarbeid. Funnene viser at avvenningsprotokollen er nyttig som et felles utgangspunkt for avvenningsprosessen. Sansemessig nærvær beskrives som grunnleggende for å kunne vurdere pasienten. Kommunikasjonen med pasienten og formidling av trygghet er også viktig. Sykepleie som går utover det som protokollen beskriver læres ved erfaring og i praksisfellesskapet. Funnene peker mot at flere former for evidens er aktuelle som kunnskapsgrunnlag når intensivsykepleiere skal avvenne pasienter fra respirator. Klinisk skjønn blir brukt som en formidlende instans mellom ulike former for evidens og kunnskap. Medskjønnere er viktige.

Weaning from Mechanical Ventilation – Protocol and Evidence

Protocol-based care has been introduced in critical care nursing. Protocols are used when patients are being weaned from mechanical ventilation. The aim of this study was to examine how a group of critical care nurses experienced using a weaning protocol based on medical evidence as well as the role of medical evidence in relation to other sources of evidence when patients are being weaned from mechanical ventilation. Interviews were performed with eight critical care nurses. The interviews were recorded, transcribed verbatim and analysed with content analysis. Four categories emerged in the findings: 1) weaning and protocol, 2) weaning and nursing, 3) weaning and experience, and 4) weaning and cooperation. The weaning protocol seems useful as a mutual strategy. Sensitive presence is fundamental when assessing the patients’ ability to make progress in the process. Communication with the patient to increase the feeling of safety is important. Additional nursing actions not described in the protocol are learned by experience and from colleagues. A variety of evidence and knowledge is used when critical care nurses are weaning patients from the ventilator. Clinical judgement is important as a bridge between different notions of evidence and knowledge.

Vitenskapelig publikasjon
(side 299-313)
av Anne Marie Rovik
SammendragEngelsk sammendrag

Forskning kan indikere at sterke negative holdninger til selvskadende pasienter nå er en akseptert og tolerert del av den profesjonelle omsorgskulturen. Målet med denne studien var å undersøke hvordan selvskadende pasienter erfarte å være innlagt i psykiatriske avdelinger. Fjorten respondenter bidro med data via et spørreskjema med åpne spørsmål. Den kvalitative tekstanalysen fulgte de tre analysefasene til Corbin og Strauss. Funnene viste at respondentene sine erfaringer var relatert til hvordan miljøpersonalet møtte deres forventninger om omsorg. Analysen identifiserte ulike aspekter ved miljøpersonalet og situasjoner i avdelingen som respondentene knyttet sine positive og vanskelige erfaringer til. Positive aspekter ved miljøpersonalet var tilgjengelighet, engasjement og gratifikasjon, mens vanskelige aspekter var utilgjengelighet, ignorering og krenkelse. Positive aspekter ved situasjoner i avdelingen var overraskelse, velvære og læring, mens vanskelige aspekter var skuffelse, psykisk smerte og traume. Mer kvalitativ forskning trengs for å få en utdypet forståelse for disse og andre aspekter ved selvskadende pasienters erfaringer i psykiatriske avdelinger.

Self-Harming and Milieu Therapy: Self-Harming Inpatients’ Experiences from Psychiatric Units

Research might indicate that strong negative attitudes towards people who self-harm are now an accepted and tolerated component of the professional health culture. The aim of this study was to examine how self-harming inpatients experienced their stay in psychiatric units. Fourteen respondents provided data through open-ended questionnaires. The qualitative text analysis followed the three steps of Corbin and Strauss. The respondentsŽ experiences were related to their perception of how their expectations of caring were met by the staff, and both positive and difficult experiences were narrated. The respondents appreciated accessible staff who offered them commitment and gratification, and situations that generated an inner sense of surprise, well-being and learning. The respondents connected difficult experiences with inaccessible, disregarding and offensive staff, and to situations which generated an inner sense of disappointment, emotional pain and trauma. To develop further understanding about these and other aspects of self-harming inpatients’ experiences in psychiatric units, more qualitative research is needed.

Fagartikkel
(side 314-321)
av Sigrun Hvalvik
Engelsk sammendrag

The modernization of nursing has to be understood in the context of a general modernization process that developed in the society. As the modernization of the Norwegian society progressed between the wars, Norwegian nurses found themselves torn between different kinds of values. Within the medical area the scientific and technological progresses were significant. To strengthen status and position nursing had to relate to the same progresses. Nurses in general feared that modern demands would make it difficult to take care of the traditional values in nursing. With great visions, and expectations to nursing as a profession, the Norwegian nursing leader, Bergljot Larsson, saw both traditional and modern values as a challenge to the modernization of nursing. As traditional and feminine values were a threat to the professionalization of nursing, the modern values were a threat to the traditional ideals of nursing. To solve the dilemmas and challenges this caused, Bergljot Larsson emphasized both traditional and modern ideals as a benefit and strength for nursing. Doing this she acted and argued in ways that seemed incompatible. By seeing women both similar and different to men, she tried to exceed the limitations society had set for women, and make nursing a professional and significant part of the modernization process.

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