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Sykepleierens utfordringer i omsorgen av palliative kreftpasienter i hjemmet
Get PDFInnledning: Omsorg av palliative kreftpasienter hjemme er en stadig mer utfordrende oppgave i dagens samfunn. Med økende forekomst av kreft i Norge, er det behov for sykepleiere med tilstrekkelig kompetanse til å gi riktig omsorg og lindring. Imidlertid står hjemmesykepleiere overfor ulike utfordringer, inkludert manglende oppdatert kunnskap, begrensede ressurser og krevende arbeidsmiljøer. Denne litteraturgjennomgangen tar sikte på å utforske og analysere spesifikke utfordringer sykepleiere står overfor ved omsorg av palliative kreftpasienter hjemme.
Problemstilling: Hvilke utfordringer opplever sykepleiere i omsorgen av palliative kreftsyke pasienter i hjemmet?
Metode: En litteraturgjennomgang ble gjennomført for å systematisk og kritisk vurdere eksisterende forskning om utfordringene sykepleiere møter i omsorgen av palliative kreftpasienter hjemme. Ni kvalitative forskningsartikler ble valgt ut basert på deres relevans for forskningsspørsmålet. Den kvalitative forskningsmetoden ble valgt for å få en grundig forståelse av sykepleiernes erfaringer og utfordringer i denne konteksten.
Resultater: Litteraturgjennomgangen identifiserte flere utfordringer sykepleiere møter ved omsorg av palliative kreftpasienter hjemme. Disse utfordringene kan deles inn i fire hovedtemaer: samarbeid og kommunikasjon, emosjonell og personlig påvirkning, kunnskap og ferdigheter, samt systemiske og strukturelle faktorer.
Konklusjon: Sykepleiere i hjemmeomsorg møter mange utfordringer ved omsorg av palliative kreftpasienter. Det er viktig å adressere disse utfordringene for å forbedre omsorgen og støtten som tilbys både pasienter og sykepleiere i denne konteksten. Videre forskning, opplæring og ressurser er nødvendig for å styrke sykepleiernes kompetanse og ferdigheter i denne omsorgssettingen
‘A story of being invisible’: A single case study on the significance of being recognised when needing acute healthcare in the early COVID-19 Pandemic
Get PDFSevere illness is often an existential threat that triggers emotions like fear, stress, and anxiousness. Such emotions can affect ill patients’ encounters with healthcare personnel. We present a single case study of an older woman who contracted COVID-19 and her challenge to be recognised by healthcare personnel in the early pandemic. Storytelling is vital to understand how patients can create meaning in illness as it gives them the opportunity to reshape and restore their past and to project a future. We used Arthur Frank’s dialogical narrative analysis to explore how one patient experienced her encounters with healthcare personnel. Although she felt very ill from COVID-19, she experienced being almost invisible and not being believed by healthcare personnel in a system marked by high stress levels and uncertainty. Despite rejections and illness, she managed to mobilise her resources, even though she depended on significant others. Her story brings forward altered self-understanding and growth. The importance of facilitating dialogical settings for healthcare professionals through patient storytelling also contributes to a broader societal understanding of illness beyond a biological perspective.publishedVersio
The unintended church: The movement for church unity and the establishment of the Kinki Evangelical Lutheran Church in Japan
Get PDFDette verket er lisensiert under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Norsk Tidsskrift for Misjonsvitenskap er i dag et digitalt tidsskrift som er tilgjengelig gratis for alle. Artikler gjøres offentlig tilgjengelige med en såkaldt Creative Commons lisens CC BY-ND på tidsskriftets hjemmeside. Dette innebærer at alle står fritt til å gjenbruke artikkelen under forutsetning av at opphavspersonen blir navngitt.When Norwegian Lutheran missionaries first came to Japan early in the 1950’s, they had no plans of establishing a separate Lutheran Church. There was already a well-established Lutheran Church in Japan, and the intention was to become a part of this Church. This paper traces the history of the movement for Lutheran unity in Japan which ultimately led to the establishment of the Kinki Evangelical Lutheran Church as an independent church. What were the goals of the movement for church unity, and why did it not succeed? This story has been told once before.2 However, the relevant sources both in Japan and Norway have now been collected, presented, and discussed again in a master thesis recently submitted to the Asian Graduate School of Theology at Kobe Lutheran Theological Seminary in Japan.3This is a fascinating story which concerns both the development of Japanese Lutheranism and the history of Norwegian foreign mission. As the study of the thesis and its sources requires competence in Japanese, we have decided to make its main findings more easily accessible through this article.
1In transcribing Japanese names, we follow the Japanese tradition of giving the surname first.
2 See Tor Berger Jørgensen, «Japan», in Torstein Jørgensen (ed.), I tro og tjeneste: Det norske misjonsselskap 1842-1992 II, 229-292, her s. 248-255.
3 松田聖一、近畿福音ルーテル教会とは誰か～ルーテル諸派合同運動の中で(Matsuda Seiichi, “Kinki Fukuin Ruteru Kyokai to wa dare ka – Ruteru Shohagodoundo no naka de” [Who is the Kinki Evangelical Lutheran Church – in the midst of the Lutheran union movement]), AGST/J 2023, 239 pp, quoted as Matsuda, “Ruteru Shohagodoundo”. The thesis has an appendix with a collection of sources both in Japanese, English and Norwegian. The authors of this article are the writer and super-visor of this thesis.publishedVersio
Activistic citizenship in nursing homes: co-ownership in the mundane
Get PDFThe traditional narrative of dementia, focused on cognition as constructive of personhood, has been challenged by person-centred care as well as a rights-based citizenship lens. However, reports of everyday discrimination leading to occupational deprivation and pathologising interpretations of people living with dementia in nursing homes highlight the need for further investigation. The purpose of this study was to investigate the transformative power of mundane and relational enactments of citizenship in nursing homes, exploring the potential of adding an activistic lens of citizenship to our interpretive practices. Through an ethnographic study in Norwegian nursing homes, a narrative analysis of fieldnotes and interview transcripts was conducted. Narratives were interpreted using narrative theory, occupational perspectives and theories of citizenship. Findings reveal a phenomenon of shared ownership between residents and staff, and a vulnerable balance between silence and active social and occupational engagement in the nursing homes. Further, they shed light on how group-based assessments of residents’ abilities or occupational needs may constrain opportunities, and staffs’ options, to facilitate co-ownership. We suggest that a lens of activistic citizenship implies interpreting residents’ behaviours as mundane forms of subtle re sistance. A professional and ethical responsibility building on such interpretive practices may turn attention towards structures that constrain residents’ expressions of citizenship.publishedVersio
One step forward and two steps back: The role of civil society organizations in reversed integration processes among refugees in Norway
Get PDFThis is an open-access article distributed under the terms of the Creative Commons NonCommercial-NoDerivatives Attribution 4.0 International License (CC-BY-NC-ND 4.0), which permits unrestricted distribution, and reproduction in any medium, provided the original author and source are credited, the material is not used for commercial purposes and is not altered in any way. See https:// creativecommons.org/ licenses/by-nc-nd/4.0/Refugees settling in Norway experience several barriers to labour market integration, such as language insufficiency, low or unrecognised formal competence, and discrimination. While numerous scholars have dealt with the issues of both policy implementation and the outcome of public measures, there is a growing interest in the contributions of civil society organizations (CSOs) to the labour market integration of refugees. Such an interest is fueled by the proliferation of neoliberal reforms in European welfare states and restrictive budgets, leading to increased recognition of CSOs as resolutions to social issues. Based on ethnographic fieldwork among refugees and employees in two CSOs in Norway, the findings suggest a particularly vulnerable phase immediately after the public introduction programme for refugees not moving on to employment, education, or training. Drawing on Bourdieu’s concept of different forms of capital in addition to Granovetter’s theory of social network, I argue that CSOs have a profound role in preventing the reversed integration processes that occur in this specific phase of settlement.publishedVersio
Redefining sexual health after gynaecological cancer: Lived experiences from Gynea, a digital rehabilitation programme
Get PDFThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background: Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to en-hance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea.
Methodology: This is a phenomenological hermeneutic study. Individual, in-depth semi-structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method.
Findings: Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships.
Conclusion: Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and com-municate these with their partners.
Implications for Patient Care: Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not nec-essarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment
Patient or Public Contribution: Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in GyneapublishedVersio
Managing diversity and inclusion in nursing homes: Practices and regulations
Get PDFThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Changing demographics and a rising number of immigrants entering the labor market have posed new challenges to managers in work organizations. Within this context, Norway has been noted to have a highly regulated work sector that is considered beneficial for minorities and marginalized groups. Through a case study of three nursing homes in Norway, this paper analyzes how manag-ers engage with diversity-related regulations when addressing their everyday challenges, and how their enacted practices affect the inclusion of immigrants in the workplace. The study applies a practice-theoretical approach and contributes to diversity management research by identifying how managers’ differing enactments of inclusion-related practices are connected to competing institutional logics. The analysis shows how the co-existence of multiple institutional logics in this context represents an arena for political struggle.publishedVersio
Postsekulære tilnærminger: Nye muligheter for sosialt arbeid i Norge
Get PDFArtikkelen presenterer postsekulære tilnærminger med Jürgen Habermas som utgangspunkt og spør hvilke muligheter de kan gi sosialt arbeid i Norge i dag. Den viser hvordan religion og livssyn har vært behandlet i et bredt, men eklektisk utvalg av norsk sosialfaglig litteratur fra 1970-tallet og frem til i dag. Litteraturgjennomgangen tyder på at norsk sosialfaglig litteratur om religion og livssyn speiler bredere trender mot individualisering og privatisering av religion i samfunnet. Mot denne bakgrunnen argumenterer artikkelen for at postsekulære tilnærminger åpner for å forstå både religion, livssyn og sosialt arbeid som etiske tradisjoner og verdibaserte praksiser. Det kan gi nye muligheter for fagkritikk og -utvikling i sosialt arbeid og åpne for utveksling og solidaritet med religiøse aktører som utøver praktisk arbeid basert på teologiske ideer. Særlig åpner det for å stille spørsmål om det tette forholdet mellom sosialt arbeid og velferdsstaten i Norge.publishedVersio
Striving for a safe ground—A lifeworld approach of family members' experiences of the critical illness trajectory
Get PDFThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aims and Objectives: To explore the experiences of family members after they have lived through a close one's illness trajectory starting with critical illness and intensive care treatment, throughout hospitalisation and after their return home, and describe what was important and challenging for them during this time.
Background: Being family during and after critical illness and intensive care treatment may be traumatic and challenging. An in-depth understanding of family members’ lifeworld throughout a close one's illness trajectory is needed.
Design: A qualitative design with a phenomenological approach.
Methods: We held ten interviews with eleven next of kin, nine of which were individual and one with a parent couple. The interviews lasted 90 minutes, on average, and were transcribed verbatim. Giorgi's phenomenological method guided the analysis.
Results: The overall structure was ‘striving for a safe ground for themselves and their close one’, which was dependent on the three constituents of ‘in need of care’, ‘to take on responsibility’ and ‘to create new understanding’. Throughout the illness trajectory, the family members required care to increase their feelings of safety in the context of their close one being unsafe. They described taking on responsibility for their close one—a responsibility that increased after hospital discharge—as demanding new knowledge which they were often unable to obtain.
Conclusions: Families of critically ill patients need to be seen on their own behalf. Moreover, when taking on responsibility for their close one, they regularly need more knowledge than they get. There seems to be an absence of a support system for families with caring responsibilities after their relatives are discharged from hospitals.
Relevance to Clinical Practice: This study shows the importance of family carers being considered in their own right, as well as their individual needs throughout a close one's illness trajectory. There seems to be a gap in the knowledge of what family members require when their close one is discharged. Indeed, a better support system is essential for families following a hospital discharge.publishedVersio
Efficacy and moderators of efficacy of cognitive behavioural therapies with a trauma focus in children and adolescents: an individual participant data meta-analysis of randomised trials
Get PDFThis is an Open Access article under the CC BY 4.0 license. Print version: 2024. 8, (1), 28-39Background: Existing clinical trials of cognitive behavioural therapies with a trauma focus (CBTs-TF) are underpowered to examine key variables that might moderate treatment effects. We aimed to determine the efficacy of CBTs-TF for young people, relative to passive and active control conditions, and elucidate putative individual-level and treatment-level moderators.
Methods: This was an individual participant data meta-analysis of published and unpublished randomised studies in young people aged 6−18 years exposed to trauma. We included studies identified by the latest UK National Institute of Health and Care Excellence guidelines (completed on Jan 29, 2018) and updated their search. The search strategy included database searches restricted to publications between Jan 1, 2018, and Nov 12, 2019; grey literature search of trial registries ClinicalTrials.gov and ISRCTN; preprint archives PsyArXiv and bioRxiv; and use of social media and emails to key authors to identify any unpublished datasets. The primary outcome was post-traumatic stress symptoms after treatment (<1 month after the final session). Predominantly, one-stage random-effects models were fitted. This study is registered with PROSPERO, CRD42019151954.
Findings: We identified 38 studies; 25 studies provided individual participant data, comprising 1686 young people (mean age 13·65 years [SD 3·01]), with 802 receiving CBTs-TF and 884 a control condition. The risk-of-bias assessment indicated five studies as low risk and 20 studies with some concerns. Participants who received CBTs-TF had lower mean post-traumatic stress symptoms after treatment than those who received the control conditions, after adjusting for post-traumatic stress symptoms before treatment (b=−13·17, 95% CI −17·84 to −8·50, p<0·001, τ2=103·72). Moderation analysis indicated that this effect of CBTs-TF on post-traumatic stress symptoms post-treatment increased by 0·15 units (b=−0·15, 95% CI −0·29 to −0·01, p=0·041, τ2=0·03) for each unit increase in pre-treatment post-traumatic stress symptoms.
Interpretation: This is the first individual participant data meta-analysis of young people exposed to trauma. Our findings support CBTs-TF as the first-line treatment, irrespective of age, gender, trauma characteristics, or carer involvement in treatment, with particular benefits for those with higher initial distress.
Funding: Swiss National Science Foundation.publishedVersio