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  • 1.
    Norell Pejner, Margaretha
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The bright side of life - Emotional support in elderly care2014In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 3, no 7, p. 75-75Article in journal (Refereed)
    Abstract [en]

    Introduction: When older patients are in need of care the desire for help is often related to practical duties, but they also express a preference for support with the emotional difficulties that disease and illness cause. The concept of support in nursing is widely used and in nursing practice it is seldom specified which kind of support that has been performed.

    Aim: Aim was to explore and describe which supportive intervention registered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences.

    Methods: One retrospective descriptive study (I) were conducted and followed up by three qualitative studies using Grounded Theory as a method (II-IV). Grounded Theory allowed to explore actions/interactions and processes that occur between complex social phenomena. A process is seen as a continuous action in relation to a determinate purpose to reach a goal with a problem or a situation and actors can choose actions to influence the course of events.

    Data collection and sampling: I/Using a web based form describing 7053 interventions given to patients 80 years or older during the months of April and October 2004-2008. II/ Observation of 12 registered nurses supportive interventions during the home visit of 36 patients between 80 and 102 years. III/ Interviews with 16 registered nurses. IV/Interviews with 18 patients between 80 and 96 years.

    Results: Combined, the four studies show in a substantive theory that supportive interventions were based on patient’s preferences and guided by their emotions. The emotional support resulted in that the patient could experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward. Patients lost or reduced ability to process their emotions makes that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient searched the registered nurse whose mission is to identify their needs in order that they could find relief. The theory also shows the strengths and weaknesses in the process. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing. 

  • 2. Norell Pejner, Margaretha
    The bright side of life: support in municipal elderly home care2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Registered nurses in municipal elderly home care have in some occasionsdifficulties in identifying the patients’ needs and prioritize intervention inaccordance with the patients’ preferences, which is to obtain social and emotional support. The overall aim was to explore and describe which supportive interventions registered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences. Methods: A retrospective descriptive study (I ) were conducted and followed up by a qualitative approach with Grounded Theory as a method (II IV ). Sample to study; I , registered nurses (62) performed interventions to 6138 patients between 80- 109 years. II , 12 registered nurses, who performed 36 home visits to patients between 80- 102 years. III , 16 registered nurses. IV , 18 patients between 80- 96 years. Data was collected by; I , between 2004- 2008, during the months of April and October using a web- based form which was filled in by registered nurses. II , through nonparticipant observations when the registered nurse made a home visit. III and IV , using informal conversational interviews. Results: Combined, the four studies show that emotional support is important to a group of older patients because it helps them to experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward in a dignify way. Patients lost or reduced ability to process their emotions makes so that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient uses the registered nurse as a reliever whose mission is to identify their needs and guide them into a state of serenity. Registered nurses on the other hand, makes priorities based on patients preferences. Registered nurses strengths was their profession that contributed to the patient's emotions became available to them. Weaknesses was registered nurses workload and lack of knowledge about the identification of emotions. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.

  • 3.
    Norell Pejner, Margaretha
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    The bright side of life Support in municipal elderly home care2014Conference paper (Refereed)
    Abstract [en]

    Registered nurses in municipal elderly home care have in some oc-casions difficulties in identifying the patients’ needs and prioritize intervention in accordance with the patients’ preferences. The overall aim was to explore and describe which supportive intervention regis-tered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences. Methods: One retrospective descriptive study (I) were conducted and followed up by three qualitative studies using Grounded Theory as a method (II-IV). Grounded Theory allow to explore actions/ interac-tions and processes that occur between complex social phenomena. A process is seen as a continuous action in relation to a determinate purpose to reach a goal with a problem or a situation and actors can choose actions to influence the course of events. Results: Combined, the four studies show in a substantive theory that supportive interventions were based on patients preferences and guided by their emotions. The aim with the emotional support was that the patient would experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward with dignity. Patients lost or reduced ability to process their emotions makes that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient uses the registered nurse as a reliever whose mis-sion is to identify their needs and guide them into a state of serenity. The theory also shows the strengths and weaknesses in the process. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.

  • 4.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Brobeck, Elisabeth
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Couples in Need of Home Care Services: Experiences With Support From Care Professionals2018In: Home Health Care Management & Practice, ISSN 1084-8223, E-ISSN 1552-6739, Vol. 30, no 3, p. 116-121Article in journal (Refereed)
    Abstract [en]

    Many older people desire to remain in their homes and be cared for by a family member, but this arrangement requires support from care professionals. The aim was to describe how couples in need of home care services experienced the received support from care professionals. A qualitative design with content analysis was used. Data were collected through diaries and focus groups consisting of eight couples between 65 and 80 years, and two registered nurses. The main findings are described by the following categories: Organizational adaptedWithholdingBeing in a gap, resulting in the theme Lack of professional support. Couples experienced shortcomings that were related to the organization, the care professionals, and the couples themselves. The theme Lack of professional support requires more knowledge. © The Author(s) 2018

  • 5.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundström, Jens
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS).
    Ourique de Morais, Wagner
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS).
    Laurell, Hélène
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL), Centre for International Marketing and Entrepreneurship Research (CIMER).
    Isaksson, Anna
    Halmstad University, School of Education, Humanities and Social Science, Centrum för lärande, kultur och samhälle (CLKS), Språk, kultur och samhälle.
    Stranne, Frida
    Halmstad University, School of Education, Humanities and Social Science, Centrum för lärande, kultur och samhälle (CLKS).
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Smart medication organizer – one way to promote self-management and safety in drug administration in elderly people2017Conference paper (Refereed)
  • 6.
    Norell Pejner, Margaretha
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Care priorities: Registered nurses’ clinical daily work in municipal elderly care settings2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 388-395Article in journal (Refereed)
    Abstract [en]

    Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. Inaccording to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure isperceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 – 2008, using a web-based form. The nurses filled in patient’s type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and wereattributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in southwestern Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient’s gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation. © 2012 Nordic College of Caring Science.

  • 7.
    Norell Pejner, Margaretha
    et al.
    Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Örebro University, Örebro, Sweden.
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Dealing with daily emotions – supportive activities for the elderly in a municipal care setting2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 9510Article in journal (Refereed)
    Abstract [en]

    There are diverse descriptions of supportive activities in nursing to be found in the literature. That which they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting registered nurses work in a consultative way and they describe a part of their tasks as being comprised of supportive activities without specifying what kind supportive activities they mean. The aim of the study was to explore the main concern of the support given by registered nurses to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory (GT). Data was collected using non participant observations regarding the supportive activities of 12 registered nurses at the home of 36 patients between 80 and 102 years. The core category was about dealing with today's emotions. This was done by encouraging the situation and reducing patient's limitations, but situations also occurred in which there was a gap of support. Support was about capture the emotions that the patient expressed for the moment, but there were also situations in which registered nurses chose not to give support. In order to develop a holistic eldercare more knowledge is needed about the factors causing the registered nurses to choose not to provide support on some occasions. Copyright © 2012 N. Dauman & S. I. Erlandsson.

  • 8.
    Norell Pejner, Margaretha
    et al.
    Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Dealing with today’s emotions - supportive activities for the elderly in a municipal care setting2012Conference paper (Refereed)
    Abstract [en]

    Background; There are diverse descriptions of supportive activities in nursing to be found in the literature. That which they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting registered nurses work in a consultative way and they describe a part of their tasks as being comprised of supportive activities without specifying what kind supportive activities they mean. Aim; The aim of the study was to explore the main concern of the support given by registered nurses to a group of patients in an elderly home care setting. Method; The study was conducted using Grounded Theory (GT). Data was collected using non participant observations regarding the supportive activities of 12 registered nurses at the home of 36 patients between 80 and 102 years. Result; The core category was about dealing with today's emotions. This was done by encouraging the situation and reducing patient's limitations, but situations also occurred in which there was a gap of support. Support was about capture the emotions that the patient expressed for the moment, but there were also situations in which registered nurses chose not to give support. Conclution; The main purpose of supportive activities to a group of elderly persons in a municipal care setting is about dealing with today's emotions. The core category reflects the moment and emotions significance in the care of elderly. In some occasions it occurred a gap of support and this coincided with the inability of the RN to identify the patient’s inner needs. In order to develop a holistic elderly care more knowledge about psychological and spiritual needs is needed.

  • 9.
    Norell Pejner, Margaretha
    et al.
    Doktorand School of Health and Medical Sciences Örebro University, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    School of Health and Medical Sciences Örebro University, Sweden.
    Maintaining wellness in everyday life- supportive activities to elderly in municipal care setting2011Conference paper (Other academic)
    Abstract [en]

    Literature describes supportive activities in nursing in many different ways. In common they have that they are associated with good care outcomes, but may differ depending on the context in which it is given. In Swedish municipal elderly care setting registered nurses works consultative. They describes part of their tasks as supportive activities without specifying what or what kind of support that is meant and it looks as in this form of organization supportive activities expanded to not only include patients. The aim of the study was to obtain a deeper understanding of which support RN express to elderly and explore the main concern of support in municipal care setting. The study was conducted using Grounded Theory. Data was collected using non participant observations. The observations were concerning registered nurses supportive activities interacting with the patient. A total of 12 registered nurses participated in the study which was performed at the home of 36 patients between 80- 102 years. The main concern of registered nurses supportive activities was maintaining wellness in everyday life. This was made by support patient’s internal and external resources, but it also turned out to be situations where it was lack of support.

     

  • 10.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI). Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Municipal Elderly Care – System For Registration of Registered Nurses' Priorities In Clinical Daily Work2010Conference paper (Refereed)
    Abstract [en]

    Aim: The purpose of the study was to investigate how RN prioritizes their activities in their clinical daily work in municipal elderly care setting. Study questions was: Where are the activities performed? How much nursing are performed of non certified personal? What activities are prioritized in time? Methods: The study used a quantitative descriptive method. Data collection took place during the months of April and October during 2004 –2008. For each patient the RN had a responsibility for during the corresponding measurement month, she/ he would fill in a web-based form with data on patient's gender, age, type of housing, performed actions, and if the actions were delegated. Actions were described as keywords in the web-based form and have been assigned a certain amount of time in minutes. The specified time for each keyword were calculated on the basis of data from previously conducted time studies in the municipality. A total of 4,000 different actions were clocked by RNs working in the same area and same organization. Each action was labeled with the related keyword and a mean time for each keyword was calculated. The web-based form summarizes delegated care time and the RN’s time separately. The web-based form also documented the action RN devoted most time to. All information was stored in a database. Result: Support was the activity RN prioritized in time in clinical daily work, but there was even difference in activities depending on patient’s gender or if the patient was living in sheltered or ordinary housing. Drug administration was prioritized for female patients, coordination for patients living in ordinary housing and monitoring for patients living in sheltered housing. RN spent more time to patients in sheltered than in ordinary housing, but the biggest difference was in the delegated time. Patient in sheltered housing received almost double position so much delegated health and care time than patients living in ordinary housing. Conclusion: The study shows that RN prioritized activities to patients 80 years and elderly depending of housing and gender. The activity that was most prioritized regardless housing or gender was support, but what support means in municipal health care setting is not clear and requires more knowledge.

  • 11.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Older patients’ in Sweden and their experience of the emotional support received from the registered nurse – a grounded theory study2014In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 1, p. 79-85Article in journal (Refereed)
    Abstract [en]

    Objectives: This study intends to explore older patients’ experiences of the emotional support received from registered nurses (RNs). We also aimed to gain deeper knowledge about the process of how getting the support they need is managed by the patient.

    Methods: The study was conducted using the grounded theory method. Data were collected by interviewing 18 patients between 80 and 96 years old.

    Results: Reasons why older patients experienced the emotional support received from the RN are reflected in the categories ‘Meets my needs when I am irresolute’, ‘Meets my needs when I am vulnerable’ and ‘Meets my needs when I am in need of sympathy’. Reasons to the emotional support resulted in that patients experienced ‘A sense of being able to hand over’, which is therefore the core category of this study.

    Conclusion: Older patients’ experiences of emotional support are about obtaining relief. Patients were active participants and had strategies for which they wanted to share their emotions with the RN. In order to develop participatory care for older patients, we need more knowledge about how emotional support can be used as a nursing intervention. © 2014 Taylor & Francis.

  • 12.
    Norell Pejner, Margaretha
    et al.
    School of Health and Medical Sciences, Örebro University, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Trying to cope with everyday life - Emotional support in municipal elderly care setting2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 19613Article in journal (Refereed)
    Abstract [en]

    Emotional support is considered to be important to older patients because it is a contributing factor to experiencing goodhealth and it has been shown that it can prevent depression after a hip fracture. Opinions differ on whether emotionalsupport falls within the field of nursing, and studies also show that nurses in an elderly home care setting fail when it comesto giving emotional support. The aim of this study was to explore reasons for registered nurses to give emotional support toolder patients in a municipal home care setting. The study was conducted using Grounded Theory. Data collection wascarried out through interviews with 16 registered nurses. The inclusion criteria were emotional support given to patientsaged 80 years and above living in ordinary or sheltered housing and who were in need of help from both the home helpservice and registered nurses. The results show that the main concern of emotional support was ‘‘Trying to relieve thepatient from their emotions so they are able to cope with everyday life.’’ This core category illustrates how registered nursestried to support the patients’ own strength, so that they were able to move forward. Registered nurses consider that theycould support the patients because they give them access to, or could create access to, their emotions, but there were alsotimes when they felt helplessness and as a result, consciously opted out. The results also indicate that registered nurses werekeen to give emotional support. To develop patient-centered elderly care, more knowledge of emotional support and theelderly’s need for this support is required. © 2012 N. Dauman & S. I. Erlandsson.

  • 13.
    Pejner, Margaretha Norell
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    "It's amazing that I can take coverage!": emotional support to a group of older patients in municipal home care settingManuscript (preprint) (Other academic)
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