Bakgrund: Alzheimers är den fjärde vanligaste dödsorsaken i Sverige och kallas även för de anhörigas sjukdom. Sjukdomen har stor påverkan på livet och vardagen både för den drabbade och för de anhöriga. Syfte: Syftet var att belysa en partners upplevelse av att leva i en parrelation med en person som har Alzheimers sjukdom. Metod: Kvalitativ litteraturstudie baserad på självbiografier analyserades med manifest innehållsanalys enligt Graneheim och Lundmans analysmetod. Resultat: Sjukdomen leder till att relationen och vardagen förändras, den friska partnern tar på sig en ny roll och nya ansvar i förhållandet. Den friska partnern utsätts för stora belastningar vilket leder till att hälsan påverkas. Partnern behöver hitta nya strategier för att klara av vardagen. Slutsats: Att leva med en person med Alzheimers sjukdom innebär förändringar i livet som kan försämra välbefinnandet hos partnern och vården har en viktig uppgift att underlätta för paret. / Background: Alzheimer’s disease is the fourth most common cause of death in Sweden and is also called the relative’s disease. Alzheimer has a big impact on everyday life, not only for the one affected by the disease but also for the relatives. Aim: The aim with the study was to illustrate a partner’s experiences of being in a relationship with a person affected by Alzheimer’s disease. Method: Qualitative literature study based on autobiographies, analyzed with manifest content analysis according to Graneheim and Lundman’s method. Result: The disease results in changes in the relationship and everyday life, the healthy partner has to take on a new role and new responsibilities in the relationship. The healthy partner is exposed to a big burden which impacts health. The partner has to find new strategies to be able to manage everyday life. Conclusion: Living with a person affected by Alzheimer’s disease means changes in everyday life that can decrease the wellbeing of the partner and the health care system has an important task to facilitate the couple’s life.

I Sverige är stroke den tredje vanligaste dödsorsaken och den vanligaste orsaken till funktionsnedsättning bland vuxna människor. Stroke är ingen enhetlig sjukdom utan ett samlingsnamn på den symptombild som utvecklas. Symptomen yttrar sig oftast genom svaghet i armar och ben, förvirring, försämrad balans och talsvårigheter. Rehabiliteringen efter insjuknandet påbörjas redan efter första dygnet på sjukhus och fortsätter sedan i hemmet efter utskrivning. I hemmet är det vanligt att vårdtagarens make/maka eller sambo väljer att bli informell vårdgivare. För att lyckas hantera den nya rollen är det av stor vikt att han/hon får den information och förberedelse som krävs för att kunna vårda den insjuknade. I tidigare forskning upplevdes vårdandet stressigt och tidskrävande vilket delvis kunde bero på brist på information och förberedelse från hälso- och sjukvården. Syftet med arbetet är att beskriva upplevelsen av att vårda sin partner som insjuknat i stroke. Arbetet var en litteraturstudie där kvantitativa och kvalitativa artiklar analyserades enligt Axelssons (2008) modell. Resultatet består av tre huvudteman: En ny livssituation, Ett behov av stöd och En fysisk och känslomässig påverkan samt sju underteman. I artiklarna framkom det att partners upplevde en förändrad livssituation och att rollen som vårdgivare och partner var svår att hantera vilket påverkade relationen. Det ökade ansvaret som kom med vårdrollen krävde mycket energi och den egna tiden var svår att finna. Vänner och familj visade sig vara ett viktigt stöd där ny energi kunde hämtas. Stödet från hälso- och sjukvården uppskattades men upplevdes i de flesta fall otillräcklig. I diskussionen diskuteras sjuksköterskans pedagogiska ansvar och dess funktioner i mötet med närstående. Vidare i diskussionen beskrivs sjuksköterskans förmåga att förmedla trygghet och vilken betydelse det har för hälsan samt belyses behovet av anhörigstöd. / Program: Sjuksköterskeutbildning

The rate of DV for AA women is higher than other groups and often more severe; however, some AA women are successful in leaving the violence for good. Researchers continue to examine how victims move beyond their former life and into an abuse free environment by directing more attention on positive dynamics of victims of DV. One area is the study of resilience; however, little is known about the lived experience of resilience. The purpose of this phenomenological study was to explore the lived experiences of resilience in AA women who successfully abandoned an abusive relationship. The interview questions were used assist the participants in describing the lived experience of resilience. The survivor theory (ST) was used to demonstrate the participants' active role in leaving the relationship. ST was also used to dispute past research that indicated victims give up hope and therefore remain in the abusive relationship. Ten AA women from the Bell County, Texas area who are at least 18-years-old and have been free of an abusive relationship for 2 years were interviewed. Participants' perceptions were extracted and analyzed for patterns and themes using face-to-face interviews and written surveys. Data analysis procedures included the process of reducing participants' similar themes and statements in search of meaning. Results revealed three common themes that include having a positive mindset, establishing a strong relationship with God, and taking various forms of actions toward gaining control. Implications for social change include using the findings toward increasing education, intervention, and other supportive means used by those who provide services to victims.

Aging may bring mental and/or physical decline. There may come a point when a loved one needs long-term care in a nursing home. The purpose of this phenomenological study was to examine the community dwelling spouses' emotional state. A study was conducted with 10 individuals (5 men and 5 women) who had a spouse in long-term nursing care. Inclusion criteria was to be at least 65-years old, have been married at least 30 years, and reside alone in his or her own home. The social emotional selectivity theory and the construct of boundary ambiguity were applied to view the epoch. Data were collected with audio recorded interviews and coded as to major idea in each response. Five themes evolved from the responses: reduction of friends, ease or difficulty with change, companionship, vows are forever, and why. The community-dwelling spouse tended to be sad, anxious, and angry. Loss of companionship, increased isolation due to reduction of friends prior to placement, concern about the well-being of his or her spouse, and feelings of 'why did this happen to me?' were common themes by the community dwelling spouse. Wives who did all household chores prior to their husband's institutionalization were more able to accept the placement of their spouse than were husbands who had depended on their wives. There is a need for treatment for the community-dwelling spouse by nursing home staff, friends, and family. Nursing homes can encourage support through community-dwelling support groups and mealtime with their institutionalized spouses. Children of community-dwelling spouse can provide support through contacting their parents frequently, clergy, and friends of the church through visiting the community-dwelling spouse after placement of their spouse.

<p>Studien utforskade de närståendes livsvärld när partnern drabbats av Alzheimers sjukdom. Deras livsvärld och existentiella villkor var i fokus. Studien utgick från ett existentiellt fenomenologiskt tolkande perspektiv. Den teoretiska grunden bestod av ett tänkande kring de närståendes livsvärld utifrån fyra existentialer: det levda rummet, den levda tiden, den levda kroppen och den levda relationen. Datainsamling skedde utifrån Max van Manens utforskande intervjuer med tio närstående, fem kvinnor och fem män i yrkesverksam ålder 40 till 64 år, de levde alla tillsammans med en partner som fått sin diagnos för ett år sedan eller längre. Data analyserades genom att lyssna igenom de digitala inspelningarna flera gånger, transkribering av desamma och genomläsning av de utskrivna texterna, nya genomlyssningar och genomläsningar. Analysen utvecklades genom en hermeneutisk, fenomenologisk reflektion beskriven av van Manen. Studiens resultat kategoriserades och dessa analyserades sedan i fyra delar utifrån de fyra existentialerna. Resultatet visade att upplevelsen av den levda tiden blev annorlunda mot tidigare då framtiden fick stå tillbaka för nuet, som var det som de närstående måste förhålla sig till för att vardagen skulle fungera. Det levda rummets aspekter förändrades utifrån skyddsaspekten och nya roller inom familjen. Den levda kroppen krävde egen återhämtning och längtade efter närhet. Den levda relationen förändrades, när upplevelsen av närhet och behovet av distans ändrades. De existentiella villkoren förändrades radikalt och nya strategier gav en ny livsstil i en förändrad och sammanflätad livsvärld.</p> / <p>The study explored the lifeworld of being a partner to a person with Alzheimer’s disease. Lived experience and existential conditions were focused. The study has an existential phenomenological hermeneutic perspective. The theoretical underpinnings consist of thinking of lifeworld by means of four life existentials: lived space, lived body, lived time and lived relations. Data collection was done by Max van Manens reflective dialog interview with ten respondents, five women and five men at age between 40 and 64, living with a partner who had had their diagnosis the last year or longer. Data analyses took place listening and re-listening the recorded interviews, transcribing, reading and re-reading the texts. The analysis evolved through hermeneutic, phenomenological reflection described by van Manen. The result of the study was categorized and the analysis was done in four parts following the four life existentials. The result showed that lived time is different than before since the future has to stand back in favour of here and now in order to be able to cope with everyday life. The lived space changed to secure the partner and everyday roles changed in the family. The lived body needed to rest and longed for closeness. The lived relation changed when the need of closeness and distance changed. The existential conditions changed radically and a new way of living was found in new strategies in a changed and interlaced lifeworld.</p>

<p>Abstract</p><p>Kerstin Forslund (2007): Challenges in prehospital emergency care – patient, spouse and personnel perspectives. Örebro Studies in Caring Sciences 16. 75 pp.</p><p>Prehospital emergency care (PEC) with the emergency call to the Emergency Medical Dispatch (EMD) centre is an essential part of the health-care system. It is important to obtain knowledge about the links in the PEC chain from the perspectives of those providing the service and those receiving it. The overall aim of this thesis was to describe the challenges surrounding PEC based on the experiences of patients, spouses and personnel. A qualitative descriptive design was used in the five papers included. The data analysis methods were phenomenological-hermeneutics (I–III), qualitative content analysis (IV–V) and descriptive statistics (V).</p><p>Interviews with thirteen patients who had called the EMD-centre due to acute chest pain (I) revealed a general satisfaction with PEC. They were aware of the number to call in an emergency but were uncertain when to call. The potentially life threatening emergency situation was marked by vulnerability and dependency and was fraught with pain, fear and a sense of aloneness.</p><p>An overall theme of aloneness emerged from the interviews with nineteen spouses who had placed an emergency call for their husband or wife that was experiencing acute chest pain (II). The challenges in being a spouse to a person in need of PEC were associated with: “Being responsible and trying to preserve life” and “Being able to manage the uneasiness and feel trust in an uncertain situation”. The spouses were in an escalating spiral of aloneness, worry, uncertainty, stress, fear of loss and desperation.</p><p>Interviews with sixteen emergency operators dealt with situations they considered difficult to deal with and their reflections on how they managed such situations (III). Uncertainty, communication difficulties and insufficient resources characterized those situations. Skills, knowledge, experience, as well as personal qualities such as sensitivity, self-insight, empathy and intuition were regarded as important when handling them.</p><p>Interviews with four nurses and fifteen emergency operators related to their experiences of working together for two years at an EMD-centre were conducted after the nurses were added to the EMD-centre to increase medical and nursing competence (IV). Initial frustration and scepticism changed to positive experiences with improved cooperation and service. The nurses voiced difficulties dealing with the more medically urgent calls and the emergency operators with the more complicated and diffuse medical cases.</p><p>A total of 336 questionnaires related to alarms involving acute chest pain and given the highest priority by the emergency operator were collected in a study aimed at describing the ambulance personnel’s perceptions of the quality of the information received from the EMD-centre (V). The ambulance personnel perceived most of the information such as patient assessment, condition, history, preparedness and in particular pain status to be of high quality.</p><p>In summary: In PEC there is many interdependent complexities that present demands and challenges to the actors involved (I–V). In general those who received emergency assistance from PEC were satisfied, but the margins between success and failure are small. Risks for errors exist throughout the PEC chain and time poses a challenge. Understanding is crucial for all involved, and the same situation can be experienced differently. Challenges inherent in PEC are the communication problems, unpredictability and uniqueness along with daring to be in the acute situation and dealing with a sense of aloneness, uncertainty and dependency. The personnel that do not have the ability to see the person they are helping are even more challenged. Important attributes for PEC personnel are caring attitudes, personal skills, experiences and professional knowledge. PEC personnel have the authority and power to act and make decisions, in which responsibility, sensitivity, and human dignity must be addressed. Lives are saved with PEC despite all the challenges and possibilities for error, such as those that exist between the different actors. It is vital that the PEC chain is as strong as possible.</p><p>Keywords: challenge, prehospital, emergency, care, patient, spouse, personnel,</p><p>chain, acute chest pain.</p>

Studien utforskade de närståendes livsvärld när partnern drabbats av Alzheimers sjukdom. Deras livsvärld och existentiella villkor var i fokus. Studien utgick från ett existentiellt fenomenologiskt tolkande perspektiv. Den teoretiska grunden bestod av ett tänkande kring de närståendes livsvärld utifrån fyra existentialer: det levda rummet, den levda tiden, den levda kroppen och den levda relationen. Datainsamling skedde utifrån Max van Manens utforskande intervjuer med tio närstående, fem kvinnor och fem män i yrkesverksam ålder 40 till 64 år, de levde alla tillsammans med en partner som fått sin diagnos för ett år sedan eller längre. Data analyserades genom att lyssna igenom de digitala inspelningarna flera gånger, transkribering av desamma och genomläsning av de utskrivna texterna, nya genomlyssningar och genomläsningar. Analysen utvecklades genom en hermeneutisk, fenomenologisk reflektion beskriven av van Manen. Studiens resultat kategoriserades och dessa analyserades sedan i fyra delar utifrån de fyra existentialerna. Resultatet visade att upplevelsen av den levda tiden blev annorlunda mot tidigare då framtiden fick stå tillbaka för nuet, som var det som de närstående måste förhålla sig till för att vardagen skulle fungera. Det levda rummets aspekter förändrades utifrån skyddsaspekten och nya roller inom familjen. Den levda kroppen krävde egen återhämtning och längtade efter närhet. Den levda relationen förändrades, när upplevelsen av närhet och behovet av distans ändrades. De existentiella villkoren förändrades radikalt och nya strategier gav en ny livsstil i en förändrad och sammanflätad livsvärld. / The study explored the lifeworld of being a partner to a person with Alzheimer’s disease. Lived experience and existential conditions were focused. The study has an existential phenomenological hermeneutic perspective. The theoretical underpinnings consist of thinking of lifeworld by means of four life existentials: lived space, lived body, lived time and lived relations. Data collection was done by Max van Manens reflective dialog interview with ten respondents, five women and five men at age between 40 and 64, living with a partner who had had their diagnosis the last year or longer. Data analyses took place listening and re-listening the recorded interviews, transcribing, reading and re-reading the texts. The analysis evolved through hermeneutic, phenomenological reflection described by van Manen. The result of the study was categorized and the analysis was done in four parts following the four life existentials. The result showed that lived time is different than before since the future has to stand back in favour of here and now in order to be able to cope with everyday life. The lived space changed to secure the partner and everyday roles changed in the family. The lived body needed to rest and longed for closeness. The lived relation changed when the need of closeness and distance changed. The existential conditions changed radically and a new way of living was found in new strategies in a changed and interlaced lifeworld.

This study was designed to explore the acculturation experiences of military-related immigrant wives enrolled in an ESL program in a selected community college. More specifically, the purpose of the study was to understand the personal and structural forces that facilitated or hindered their acculturation process into their community of residence and whether their participation and retention in ESL classes contributed to their acculturation. Using a qualitative design with the basic interpretive paradigm, data collection consisted of face-to-face interviews with 14 immigrant military wives from 10 differing countries who were either enrolled or had been enrolled in a community college ESL program. The site chosen served a multicultural population of military spouses who enrolled in educational programs that offered English language development. The nearest ESL program, located at a community college near the military base, became an information-rich site for the study. The findings from the study highlighted the role of English language as an essential element to adjustment into the society of the United States for military immigrant wives, leading to acculturation and subsequently personal transformation. The data revealed both external and internal forces that influenced the acculturation process. External (structural) forces included community, workforce, the military, and an educational institution. The secondary forces included racial discrimination, cultural differences, and social networks within the community. Internal forces included love and care and self-efficacy. Self-efficacy was manifested through their persistence, patience, and resilience.

Although several scholars have argued that the spouses failure to adjust is one of the main reasons expatriate employees return prematurely from international assignments, research about spouse adjustment is scarce, and existing research about the phenomenon was conducted almost two decades ago. Therefore, our research was conducted in order to empirically examine theoretical variables that historically relate to host country adjustment of the spouse in order to see if these variables are still valid today. The present study focused on personality, family characteristics and anticipatory and in-country adjustment variables of the intercultural adjustment of expatriate spouses. Among a sample of 105 expatriate spouses it was shown that the variables measuring time in host-country, positive pre-move opinion held by the spouse, living conditions at least equal to home, cultural novelty, personality traits, and family cohesion were significant moderators of the adjustment to the new country of the spouse. We could also show that the adjustment of the spouse affects the adjustment of the expatriate, thus increasing the relevance for companies to aim more attention to the spouse well-being. An area for future research could be to investigate more closely if there is different effectiveness of different types of training.

A family violence prevention program for incarcerated male offenders was evaluated. One hundred and one (101) offenders incarcerated in minimum and medium security facilities participated in a high intensity family violence prevention program offered by Correctional Services of Canada. Thirteen psychological, attitudinal, and behavioural measures were administered to the offenders. The measures were administered either pre-treatment only, pre-and post-treatment, or post-treatment only. Five measures were self-report measures completed by offenders, and eight were administered and scored by qualified corrections personnel. The offenders showed a number of positive pre- to post-treatment changes. Following treatment, offenders reported that they were less likely to rationalize their abusive behaviour or believe that being a man grants one special privileges and entitlements over women. Offenders were less likely to support the use of power and control tactics over women or to endorse an assortment of myths that can foster inequality and abuse. Following treatment, offenders were judged to have shown an improvement in their willingness to sympathize with their partner as well as an improvement in their conflict-resolution skills. Offenders were also judged to show substantial pre- to post-treatment improvements in their compliance with, and response to, treatment, as well as demonstrating an improved ability to apply the knowledge and skills learned from treatment. The Statistical Information on Recidivism (SIR) Scale failed to demonstrate concurrent and predictive validity on a sub-sample of these domestic violent offenders.