Objective: Increasing awareness of well-being aspects of physical touch has spurred the appreciation for soft tissue massage (STM) as part of palliative care. Educational programs are available but with no specific focus on utilization for this kind of care. The aim was to study the feasibility of a 1-day course in STM in clarifying nursing staff's experiences and opinions, but also to shed light on their motivation and ability to employ STM in the care of dying cancer patients. Method: In all, 135 nursing staff participated. The course consisted of theory and hands-on training (hand-foot-, back massage). Focus-groups with 30/135 randomly chosen participants were conducted 4 weeks after the intervention. This study engaged a qualitative approach using content analysis. Results: The overall opinion of the 1-day course was positive. The majority experienced the contents of the course to be adequate and sufficient for clinical care. They emphasized the pedagogical expertise as valuable for the learning process. The majority of nurses shared the opinion that their extended knowledge clarified their attitudes on STM as a complement in palliative care. Still, a few found it to be too basic and/or intimate. Three categories emerged during the analysis: experiences of and attitudes toward the education, experiences of implementing the skills in every-day care situations, and attitudes to the physical body in nursing care. Significance of results: The approach to learning and the pedagogical skills of the teacher proved to be of importance for how new knowledge was perceived among nurses. The findings may encourage hospital organizations to introduce short courses in STM as an alternative to more extensive education. Copyright © 2008 Cambridge University Press 2008.

In a balanced between-participants experiment (N = 96) American and Swedish participants listened to tourist information on a website about an American or Swedish city presented in English with either an American or Swedish accent and evaluated the speakers' knowledge of the topic, the voice characteristics, and the information characteristics. Users preferred accents similar to their own. Similarity-attraction effects were so powerful that same-accents speakers were viewed as being more knowledgeable than different-accent speakers even when the information would be much better-known by the opposite-accent speaker. Implications for similarity-attraction overwhelming expertise are discussed.

[Abstract not available]

Background: Nurses' clinical reasoning is of great importance for the delivery of safe and efficient care. Pressure ulcer prevention allows a variety of aspects within nursing to be viewed. Objective: The aim of this study was to describe both the process and the content of nurses' reasoning during care planning at different nursing homes, using pressure ulcer prevention as an example. Design: A qualitative research design was chosen. Settings: Seven different nursing homes within one community were included. Participants: Eleven registered nurses were interviewed. Method: The methods used were think-aloud technique, protocol analysis and qualitative content analysis. Client simulation illustrating transition was used. The case used for care planning was in three parts covering the transition from hospital until 3 weeks in the nursing home. Result: Most nurses in this study conducted direct and indirect reasoning in a wide range of areas in connection with pressure ulcer prevention. The reasoning focused different parts of the nursing process depending on part of the case. Complex assertations as well as strategies aiming to reduce cognitive strain were rare. Nurses involved in direct nursing care held a broader reasoning than consultant nurses. Both explanations and actions based on older ideas and traditions occurred. Conclusions: Reasoning concerning pressure ulcer prevention while care planning was dominated by routine thinking. Knowing the person over a period of time made a more complex reasoning possible. The nurses' experience, knowledge together with how close to the elderly the nurses work seem to be important factors that affect the content of reasoning. © 2006 Elsevier Ltd. All rights reserved.

Tretton norrköpingsbor berättar om sina liv sedda i förhållande till hur boendet och vardagstekniken har förändrats från 1920 och 1930 talen, då de var unga, till nu, i början av 2000-talet, då de är pensionärer och på väg att bli gamla. När informanterna växte upp dominerade textilindustrin i Norrköping och arbetarnas bostäder var små och dåligt utrustade. När de bildade familj, på 1940 och 1950 talen, omskapades staden. Hyresbostäder, HSB och Riksbyggen uppförde nya stadsdelar, med moderna funktionalistiska lägenheter. Dit flyttade man. Deltagarna tillhör den generation som har upplevt de största förändringarna av vardagens tekniklandskap. Kedjan av nya, idag självklara, redskap, apparater, maskiner och tekniska system som har infogats i vardagens rutiner är lång: den elektriska spisen, radion, tvättmaskinen, kylskåpet, telefonen, teven, frysen, personbilen, videon, datorn, mobiltelefonen och Internet. Bokens huvudhistoria är hur åldrandet är relaterat till innehållet i den fysiska miljön. Vilken betydelse har teknik när man är gammal? Hur följer äldre med i teknikutvecklingen? I vilken mån kan ny teknik lösa vardagens problem? Vilken betydelse har den välkända och välanvända tekniken för livssyn och identitet? Är den nya vardagstekniken åldersdiskriminerande? 

I rapporten presenteras två typfall av äldre teknikanvändare. Porträtten är empiriskt grundade i en studie som genomförts vid Tema Äldre och åldrande, Linköpings universitet. I den har vardagstekniken studerats ur ett livsloppsperspektiv hos en grupp äldre män och kvinnor födda på 1920 och 1930 talen. Personorna som skapats representerar en äldre kvinna respektive en äldre man och deras förhållningssätt till vardagsteknik. Det som främst skiljer dem åt är att kvinnan har en hemdator vilket ger en annan plattform för att använda ny teknik, jämfört med mannen. Personerna är avsedda som stöd i teknik- och produktutveckling för äldre.

Skriften handlar om kvinnors och mäns deltagande och roller i det civila samhällets organisationer och sociala nätverk. Den grundläggande frågan är om det finns olikheter mellan kvinnors- och mäns inflytande inom civilsamhällets organisationer? Kan man i så fall se särskilda mönster i dessa olikheter?

This book will surely be of interest not only to students in the field of comparative politics and comparative welfare regimes, but mor broadly to analysts of the complex relationship between civil society and the state." American Journal of Sociology

"The book also provides a good overview of the historical influences that have shaped the current Swedish civil society, and offers insight into future challenges and opportunities. Rich in theoretical references, it is an essential resource in comparative studies of civil societies." Voluntas

"Lars Trgrdh's fascinating account of the Swedish model is an innovative addition to the body of scholarship on the relationship between state and civil society. The richness of the volume lies in its detailed theoretical discussion as well as extensive empirical insights on the interaction between state and civil society. The book invites the reader to be critical, reflective, and inquisitive in comprehending state-civil society interaction. This is an important book that carries the potential to attract a wide range of scholars in development studies in the social sciences and humanities...Written with sensitivity and scholarly perspicacity, the book has come on the scene at an appropriate time, especially when the issues of liberalization, privatization, globalization, participation, localization, and decentralization play a central role in influencing the contemporary political tradition of different nations." Quarterly Nonprofit and Voluntary Sector

In the current neo-liberal political and economic climate, it is often suggested that a large and strong state stands in opposition to an autonomous and vibrant civil society. However, the simultaneous presence in Sweden of both a famously large public sector and an unusually vital civil society poses an interesting and important theoretical challenge to these views with serious political and policy implications. Studies show that in a comparative context Sweden scores very highly when it comes to the strength and vitality of its civil society as well as social capital, as measured in terms of trust, lack of corruption, and membership of voluntary associations. The "Swedish Model," therefore, offers important insights into the dynamics of state and civil society relations, which go against current trends of undermining the importance of the welfare state, and presents autonomous civic participation as the only way forward.

Lars Trgrdh received his PhD in history from UC Berkeley and currently co-directs a research project concerning trust and state/civil society relations in Sweden at the Research Institute of Ersta Skndal University College in Stockholm. His most recent publications include (with co-editor Nina Witoszek) Culture and Crisis: The Case of Germany and Sweden (Berghahn Books, 2002), After National Democracy: Rights, Law and Power in America in the New Europe (Hart Publishing, 2004), and with Henrik Berggren r svensken mnniska: Oberoende och gemenskap i det moderna Sverige (Norstedts, 2006).

The study investigates how crime prevention activities frame the problem of crime against the elderly, regarding character, causes, effects and solutions. Data was collected through participant observations, interviews and analysis of a film produced by a local crime prevention council in Sweden. It is concluded that crime prevention for seniors produces complex and contradicting images of the problem. In situational crime prevention seniors are warned to look out for strangers stalking them or trying to access their homes. Statements that victimization is uncommon among the old are combined with warnings that invoke images of mysterious ever-present perpetrators. In social crime prevention, where causes and interventions of crime are discussed, crime prevention officers link the problem to established social problems such as drug abuse and juvenile delinquency. This way of framing the problem is typical for a Swedish Social Democratic perspective, where lack of community and integration are defined as causes of social problems. It is concluded that warnings to look out for strangers who ask for help may be at odds with this striving towards community.

The study investigates the occurrence and character of skepticism and resistance towards ethnic minority care workers among older care recipients in a municipality in Sweden. Twelve representatives of caregiver organizations were interviewed about their experience of this phenomenon. Three additional interviews were conducted with ethnic minority care workers. Representatives described the problem as rare and mostly occurring as language difficulties or as a temporary problem characterized as a fear of the unknown among some care recipients. They tended to apply a pragmatic or pathologizing approach when talking about causes of and solutions to the problem. These approaches enabled care providers to comply with "potential racism" without challenging an official ideology of anti-racism. In contrast, staff of foreign descent described the problem as more frequent and severe, particularly for short-term employees who experience many first-time encounters with care recipients. © by The Haworth Press, Inc. All rights reserved.

Aim. The aim of this paper is to report a study exploring how members of multiprofessional healthcare teams talk about their team. Specifically, the team members' talk was analysed to explore the discursive patterns that emerged and their functions.

Background. Over recent decades there has been an increasing demand in Western countries to change care organizations and to coordinate resources and professional competencies to meet the needs of patients/service users better. Because society promotes this kind of work, it may be valuable to explore the self-presentations of a multiprofessional healthcare team.

Methods. A discourse analysis was carried out on existing empirical data from focus group interviews with a member-identified category sample comprising 32 healthcare professionals in six authentic multiprofessional teams in south-east Sweden. The analysis focused on the participants' discursive constructions of multiprofessional teamwork, on the way they talked about their group, and, in particular, on their use of the pronouns we, they and I.

Findings. The constructions of 'we' by multiprofessional healthcare teams showed discursive patterns that are here referred to as knowledge synergy and trusting support, which included factors such as cross-learning and personal chemistry. The pronoun we was also used as a flexible resource to manage expertise, power and leadership within the teams, and it might also function to ease the pressure for consensus.

Conclusion. These discursive patterns provided powerful rhetorical resources for team members, both to affirm their choice of membership and to claim superiority in relations with the surrounding community (the others) by linking to a societal discourse that promotes collaboration.

The aim of this study was to develop a theoretical framework of family members' experience of palliative home care staff based on a secondary analysis of four previous studies. A salutogenic framework was used, i.e. with the origin of health in focus. Data had been collected (semi-structured tape-recorded interviews and postal questionnaires with open-ended questions) from 469 family members of mainly cancer patients referred to advanced palliative home care. Walker and Avant's strategies for theory construction were used. The secondary analysis generated three theoretical blocks: (1) general components of staff input (including five generalized resistance resources (GRRs): competence, support, spectrum of services, continuity, and accessibility); (2) specific interactions with staff (including two GRRs: being in the centre and sharing caring); (3) emotional and existential consequences of staff support (including six health-disease continuums: security-insecurity, hope-hopelessness, congruent inner reality-chaos, togetherness-isolation, self-transcendence-feelings of insufficiency and retained everyday life-disrupted everyday life). It seems important that all three aspects of family members' experience of palliative care staff are to be considered in evaluations of palliative care, in goal-setting and in teaching role models. The study is specific to the Swedish model of palliative home care and replication of the work in other countries is recommended.

  Avhandlingsarbete om afrikanska patienters upplevelse av att vistas och vårdas på ett modernt sjukhus i Namibia.  

Home care arrangements for older people are coordinated via a client-centred assessment process. This article describes how storylines and discursive positioning are used among older people and their relatives when divergent opinions of care needs are expressed. Eleven assessment interviews were studied using discourse analysis. The results show that relatives and older people advanced three major storylines, and positioned themselves within them with respect to the need for help. These storylines were based on whether the persons viewed home care as an intrusion into daily routines and relationships or as a complement and support in everyday life, or as a right. The content of the storylines and the ways in which positions were shaped within them illustrate how positioning is incorporated as part of the ongoing reflexive process in interaction in which participants form an image of the older person's needs. Assessments clarify the views of the participants on home care, but they also reflect the discourses that are prevalent in the aged care community and in society in general. The article raises questions about strengthening older people’s participation in the decision making process and also whether a new communicative practice is needed for assessments, i.e., one that proceeds on the basis of a broader family perspective.

Kapitlet inleds med en beskrivning av det forskningsprogram med rubriken Kommunikation i äldre människors livsmiljö, som bedrivits vid Tema Äldre och åldrande/NISAL sedan starten år 2000. Därefter ges ett exempel från vår forskning om behovsbedömning i äldreomsorgen där samtalsanalys är den metodologiska ansats som används. Vi visar här hur denna typ av forskning kan användas som verktyg för att studera situationer där samtalens deltagare – de äldre själva, deras närstående och handläggarna – har delvis olika åsikter om de äldre personernas hjälpbehov. Kapitlet avslutas med några tankar om vad samtalsanalytisk forskning kan bidra med för typ av kunskap och vad sådana studier i sin tur kan få för konsekvenser för utformningen av äldreomsorgen.

Aim: The aim is to understand and develop the concept of care and caring Culture and to do so based on the empirical/phenomenological standpoint of nurses lived experiences of working in different environments.

Background: Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the caring culture as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means.

Method: A phenomenological-hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working oil different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses I year later for validation of the findings.

Findings: Thematic analyses revealed five themes: you have to adapt to the existing care Culture: seeing the invisible: being Yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as "homelike", nurses may act in a way that reflects their own values.

Discussion: The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring Culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring.

Goals of work

Experiences of powerlessness and helplessness are closely linked to incurable diseases but seldom studied in patients with disseminated cancer. The aim is to explore the perception, experiences and significance of powerlessness and helplessness, to study triggering factors and to make quantifications.

Materials and methods

One hundred three patients, enrolled in four different palliative home-care settings, completed a questionnaire with both Likert-type questions and open-ended questions. The response rate was 58%, and background data was reported as frequencies, whereas the main material was analysed using a qualitative content analysis.

Main results

Impending death, symptoms, loss of control and autonomy, ignorance, isolation and uncertainty constituted the basis for powerlessness and helplessness, but each factor was reinforced by the occurrence of suddenness, high intensity and/or lengthiness. In total, 65% reported definite experiences of powerlessness and helplessness. These feelings also held a deeper meaning, involving aspects such as existential loneliness and hopelessness. They were ultimately caused by an incapacity to control feelings and cope with the situation related to the impending death. The results are discussed in relation to Cassel’s theory of suffering and existential psychology.

Studie av distriktssköterskans omvårdnadsdokumentation gjord i tre landsting med hjälp av enkät och journalgranskning. Resultatet visade att distriktssköterskan dokumenterar främst utförda vårdåtgärder och omvårdnadsstatus. Användningen av omvårdnadsdokumentation för utvärdering av vård varierade mellan de olika landstingen från 43 - 100% av vårdcentralerna.

The aim of this study was to describe, analyses and compare nursing documentation in primary health care in three county councils. The study was performed in Sweden during 2002-2004. 346 district nurses answered a questionnaire and 52 nursing records were audited by the audit instrument Cat-ch-Ing. The result of the survey from all three county council indicates that nurses felt that the structured form, with keywords, for the nursing record facilitated the documentation, clinical decisions and evaluation of care. The audit showed that nursing intervention and nursing status was frequently documented bur the key words nursing diagnosis and nursing goal occurred rarely. Medical facts dominated the nursing documentation and notes of the diseases effect on the individual-s daily life existed rarely. The nursing record was more a checklist for done interventions than an informative source of nursing facts.