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Experiences of being a relative to a person receiving palliative care in the end of life : A literature based study
No full textBackground – Most likely, nurses will be in contact with patients and their relatives in palliative care at the end of life at some point in their careers. Studies have shown that relatives (family members or close friends) play a crucial role in palliative care, and that communication is a key factor in providing support for relatives. For optimal care provision, it is essential for nurses to consider and comprehend the experiences of relatives involved in palliative care at the end of life. Aim – The aim of the study was to describe the experiences of being relative to a person receiving palliative care in the end of life. Method – For this study a literature-based study grounded in analysis of qualitative researchwas used (Friberg, 2017). The qualitative method aims to create an understanding of individual’s experiences, perceptions, and needs. Nine scientific studies where analyzed. Results – Three themes where found; 1) The importance of communication and cooperation, 2) Respect and understanding, 3) Emotional challenges. Relatives express a need for clear and accessible information to alleviate stress and enhance their ability to support their loved ones effectively. Active involvement in care decisions and a person-centered approach were underscored as pivotal. Conclusion – The study underscores the significance of tailored information dissemination, active involvement of relatives in care decisions, and a person-centered approach to honor the dignity of patients in end-of-life care. Addressing these aspects can significantly improve the end-of-life experience for patients and their relatives.Syftet med denna studie var att beskriva erfarenheter av att vara närstående till en person som erhöll palliativ vård i livets slutskede. Närstående påverkas betydligt av situationen då livets slutskede hos deras anhörige väcker många olika känslor och upplevelser. Efter noggrann granskning och analys av nio vetenskapliga artiklar framkom att närstående önskade att få detaljerad information och ville vara mer involverade i vårdbeslut som tas för deras anhörige. När närstående fick vara delaktiga i vården ökade deras välbefinnande. Resultatet tydliggjorde även vikten av att bevara patientens integritet genom att individanpassa vården för att säkerställa en lugn och fridfull palliativ vård i livets slutskede. Närstående uttryckte en önskan om att undvika onödigt lidande för sin anhörige. Närstående menade att detta kunde uppnås genom att deras anhörige fick smärtlindring vid behov. Dessutom efterfrågade närstående stöd från sjuksköterskan, vilket visade sig vara av stor betydelse för att hantera denna känsliga period i livet. Diskussionen belyser sjuksköterskans centrala roll i att möta närståendes behov. Detta inkluderar att patientens integritet beaktas genom att ge en respektfull vård. Diskussionen framhåller närståendes behov av stöd och sjuksköterskans roll i att tillhandahålla känslomässigt stöd och lindra lidande. Genom att bättre förstå och tillgodose närståendes behov kan sjuksköterskan skapa en mer stödjande och empatisk vårdmiljö för både patienten och deras närstående under livets slutskede
See and understand me who suffers : Patients’ experiences of suffering and alleviation in palliative care
No full textBackground: The population is growing, which places higher demands on palliative care and the need for knowledge development in nursing. Suffering is a big part of living with a terminal illness and relive suffering is part of the nurses' area of responsibility. It is of value for nurses to get insight into the patients' world of life, to provide individual palliative nursing measures. The aim in nursing is to promote quality of life through person-centered care. Aim: The aim of this study was to describe adult patients' experiences of suffering and alleviation in palliative care. Method: The study was based on a qualitative literature study, with six scientific articles. The articles were selected from the databases Cinahl and PsycInfo, with delimitations for Peer- Reviewed, adults, English language and published between 2013-2023. To analyze the articles, the five-step model of Friberg (2017) was used. Results: Three themes emerged from the analyses: Emotional suffering, Physical suffering and Close to death. This study showed patients different and similar experiences of suffering and alleviated suffering at the end of life. Reliving experiences was based on preparation for death, be treated with respect and compassion, be seen and heard, discuss thoughts about life and death and maintain the activities of importance. Conclusion: By providing compassionate care, active listening, and being genuinely interested in the patients' wellbeing, increased patients' experience of life quality and gave them a sense of relief. The care measures should be individually tailored due to every patient’s unique needs. It is therefore important for nurses to have a knowledge of how suffering could appear and choose fitting palliative care measures to reach the goal of relieved sufferin
Metal loss and corrosion attack of FeCrAl overlay welds on evaporator tube shields of a waste‐fired power plant
No full textThree FeCrAl alloys (APMT, EF100 and EF101) from Kanthal® and the reference Ni‐Cr Alloy 625 were used as weld cladding materials on tube shields in the evaporator tube bank of a waste‐fired combined heat and power plant. For each alloy type, the overlay welded tube shields were placed in both roof and floor positions within the evaporator for 6 months. The metal‐loss rate, the microstructure and hardness of the overlay welds before and after exposure and the corrosion products were analysed. The results showed higher metal‐loss rates in the welds placed in the roof position, confirming heterogeneities in the evaporator bank environment. Alloys were ranked from higher to lower erosion–corrosion resistance as follows: APMT≈Alloy 625 > EF101 > EF100. The analysis of the corrosion attacks showed a significant variation among the alloys, from a primarily homogeneous corrosion attack on APMT tointergranular corrosion in EF100 and pit formation in EF101.CC BY</p
When the Relationship Is at Stake: : Parents’ Perception of the Relationship with a Child with Problematic Gaming and Their Perceived Need for Support
No full textIntrapersonal parental factors play a significant role in the development of problematic gaming in children. However, few studies have explored parental perspectives on their relationship with a child engaged in problematic gaming, as well as the need for support parents perceive in relation to the child’s gaming. We conducted semi-structured interviews with 12 parents (83.3% women) of 11 children (81.8% boys, Mage = 15 ± 2) to examine how parents of children with problematic gaming behavior perceive the parent–child relationship and their need for additional support. We analyzed qualitative accounts using thematic analysis to identify themes and subthemes while drawing on the theoretical frameworks of Aaron Antonovsky’s theory of sense of coherence (SOC) and Jürgen Habermas’ theory of logic. Participants described difficulties regarding all three components of SOC (meaningfulness, comprehensibility, and manageability) in relation to their child’s gaming, with the most significant challenge being manageability. Parents primarily sought assistance from institutions and organizations, such as mental health services, to enhance manageability. The findings emphasize parents’ need for relational and practical support tailored to their unique context, as well as their wish to be more involved in the treatment of their children.CC BY 4.0</p
Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden : a multicentre repeated cross-sectional study
No full textObjective The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work. Design The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors. Setting Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers. Participants Of 2283 students, 851 (37.3%) participated. Results The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11. Conclusions The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students’ health and well-being in the long run.CC BY NC 4.0</p
Management learning in public healthcare during pandemics
No full textPurpose: This study aims to explore the management learning during a long-term crisis like a pandemic. The paper addresses both what health-care managers have learnt during the COVID-19 pandemic and how the management learning is characterized. Design/methodology/approach: The paper is based on a qualitative case study carried out during the COVID-19 pandemic at two different public hospitals in Sweden. The study, conducted with semi-structured interviews, applies a combination of within-case analysis and cross-case comparison. The data were analyzed using thematic deductive analysis with the themes, i.e. sensemaking, decision-making and meaning-making. Findings: The COVID-19 pandemic was characterized by uncertainty and a need for continuous learning among the managers at the case hospitals. The learning process that arose was circular in nature, wherein trust played a crucial role in facilitating the flow of information and enabling the managers to get a good sense of the situation. This, in turn, allowed the managers to make decisions meaningful for the organization, which improved the trust for the managers. This circular process was iterated with higher frequency than usual and was a prerequisite for the managers’ learning. The practical implications are that a combined management with hierarchical and distributed management that uses the normal decision routes seems to be the most successful management method in a prolonged crisis as a pandemic. Practical implications: The gained knowledge can benefit hospital organizations, be used in crisis education and to develop regional contingency plans for pandemics. Originality/value: This study has explored learning during the COVID-19 pandemic and found a circular process, “the management learning wheel,” which supports management learning in prolonged crises. © 2024, Ritva Rosenbäck and Ann Svensson.CC BY 4.0</p
Extending powder particle size distribution of laser powder bed fusion Ti-6Al-4V : investigation of single tracks and multilayer experiments.
No full textLaser powder bed fusion (PBF-LB) is one of the most widespread additive manufacturing (AM) methods, spanning multiple industrialsectors such as medical, automotive and more recently aerospace. Current limitations to its large-scale adoption include low build rates,machining often required and consolidation via hot isostatic pressing (HIP). Productivity enhancement of PBF-LB has been investigated extensively and among the strategies adopted, that of combining high-speed parameters with HIP to achieve full density, has proven to beviable. This study puts forward a new approach for Ti-6Al-4V material, investigating if employing a wide particle size distribution (PSD)of the powder, with a range between 15 to 90μm, with a high layer thickness achieves comparable levels of bulk density, whilst improvingthe sustainability of the overall process and decreasing build times. If packing density can be improved by ensuring a more varied spreadof particle sizes, the thermal conductivity of the powder bed increases. Combination of small and large diameter particles would result in a reduction of the number of interparticle cavities upon powder spreading, therefore enhancing the contact and the efficiency of melting between neighbouring particles, upon laser heating. An EOS M290 machine was used to establish a processing window for the extendedPSD and increased layer thickness. Laser power, scanning velocity and hatch distance were varied to identify and exclude parametervalues that render extremes such as lack of fusion or keyholing defects. Single, multiple tracks and cubes were produced as part of a studythat aims to characterise the material’s response in terms of microstructure, defect density and hardness. It was possible to establish correspondence between tracks and cubes behaviour and isolate a design region that yielded minimal porosity.CC-BY 4.0</p
Palliative care consultation in the last week of life and associated factors : a cross-sectional general population study
No full textBackground: Knowledge of access to palliative care services, such as palliative care consultation teams, is crucial to identify areas of improvement for policy and practice. Research on general populations spanning all disease groups and multiple healthcare contexts is needed. Objective: The objective was to investigate the sociodemographic, disease- and care-related, and care structure-related factors associated with palliative care consultations for adult patients in the last week of life.Design:Cross-sectional, general population-level study based on linked Swedish national public authority registers and a national palliative care quality register. Methods: The study population included all adult patients deceased in Sweden between 2013 and 2019 and registered in the Swedish Register of Palliative Care, with an anticipated death, and not enrolled in specialised palliative care. Multivariable logistic regression analyses to investigate association with palliative care consultations. Results: In total, 8.2% of the 265,129 participants had received a palliative care consultation in the last week of life. The main multivariable analysis (Model 1) showed that those dying from neoplasms were more likely to receive a palliative care consultation (odds ratio (OR) 8.55, 95% CI 8.15–8.98) than those dying from circulatory diseases. Palliative care consultation was more likely with an increasing number of symptoms (OR 1.35, CI 1.32–1.37). Patients of old age and patients deceased in hospitals were less likely to receive a palliative care consultation. Moreover, factors such as educational attainment, healthcare region, living in a single-person household, and year of death were also associated with a palliative care consultation in the last week of life. Conclusion: Our findings show inequities in access to palliative care consultations in the last week of life. Considering changes to policy and clinical practice is motivated.CC BY 4.0</p
The development of prosocial behavior from late childhood to adolescence : a longitudinal and multicultural study
No full textIntroduction Prosocial behavior (i.e., voluntary actions aimed at benefiting others, such as helping, comforting, and sharing) has proven beneficial for individuals' adjustment during the transition to adolescence. However, less is known about the role of the broader sociocultural context in shaping prosocial development across different cultures. Thus, the present study explored the longitudinal trajectory of prosocial behavior in the transition to adolescence (from ages 9 to 16) by examining the role of the Human Development Index (HDI) in relation to prosocial development. Methods A sample of 915 children (Time 1: 50.5% males; M age = 9.24, SD = 0.69) across six countries (Colombia, Jordan, Italy, the Philippines, Thailand, and the United States) participated in the study. Over four time points covering 7 years, prosocial behavior was assessed using a self-report measure. Results A second-order Latent Growth Curve Model, controlling for child gender and family SES, showed that prosocial behavior remained stable in contexts with high HDI, whereas increases in prosocial behavior were evidenced as children moved into adolescence in contexts with low HDI. Moreover, cultural differences in the mean level of prosocial behavior were shown during late childhood and the earliest phase of adolescence, whereas the national development of a given context did not account for differences in prosocial behavior during late adolescence. Discussion Findings underscore that national life expectancy, education, and wealth play a role in age-related changes in other-oriented behaviors during adolescence. The role of sociocultural factors in shaping trajectories of prosocial behavior across six countries is discussed.CC BYThe author(s) declare financial support was received forthe research, authorship, and/or publication of this article. Thisresearch was funded by the Eunice Kennedy Shriver NationalFrontiers in Developmental Psychology 10 frontiersin.orgCirimele et al. 10.3389/fdpys.2024.1472589Institute of Child Health and Human Development, Bethesda, MD,United States, grant RO1-HD054805.</p
"We have these prejudices that are based on norms in society" : A qualitative study on social workers' participation-promoting work for children with neuropsychiatric disabilities from a norm-conscious perspective
No full textFamiljer med barn med neuropsykiatriska funktionsnedsättningar (NPF) kan behöva stöd av samhället för att leva under jämlika levnadsvillkor. Barn med NPF är överrepresenterade klienter hos socialtjänsten samtidigt som antal diskrimineringsärenden avseende denna grupp ökar beträffande socialtjänstens verksamheter. Riksförbundet Attention har rapporterat att dessa familjer upplever en bristfällig kunskap hos socialtjänsten men även att insatserna är undermåliga. Studien syftar till att undersöka hur socialsekreterare, utifrån ett normmedvetet perspektiv, använder sitt handlingsutrymme för att främja delaktighet utifrån den enskildes behov för familjer med barn som har NPF. Studiens teoretiska ramverk utgörs av den relativa modellen, Shiers delaktighetsmodell, tremunksmodellen och slutligen reflektion för normmedvetenhet. Studien utgår från en kvalitativ metodologi. Empirin samlades in från sju semistrukturerade intervjuer med socialsekreterare som arbetar inom socialtjänstens enhet, Barn och Unga, med varierat antal yrkesår. Materialet analyserades med tematisk analys. Studiens resultat visade att socialsekreterare har stort handlingsutrymme som möjliggör att göra familjer med barn med NPF delaktiga under bedömningsprocessen inför ett beslut. Reflektion för normmedvetenhet ses som ett centralt verktyg för att identifiera barnens behov. Dock visade resultatet på stora brister vad gäller möjlighet att skräddarsy insatser utifrån barnens behov, där valen i stället utgörs av rådande utbud av insatser. En slutsats är att frågor om delaktighet för barn med NPF i möten med socialtjänsten behöver uppmärksammas i högre grad för att undvika arbetssätt som baseras på normativa föreställningar i stället för barnets faktiska behov