The purpose of this study was to investigate what concept of health was relevant for old people. Interviews were made with men and women aged over 60, institutionalised for somatic long-term care. Data were gathered in unstructured interviews and analysed by means of the ethnonursing method. The interviewees' descriptions of health were arranged as a concept model, consisting of three hierarchical levels. The first level dealt with the possibility of living a fairly comfortable life. The second level was concerned with positive self-esteem and the third and most crucial one described the existence or non-existence of a mental state of mind defined as peace of mind. The results were compared with existing health definitions and psychological/philosophical theories. The conclusion was that health definitions stressing physical, mental, and social perfection were not relevant for old people, whereas multidimensional health models such as those of Eriksson and Smith appeared to be adequate measures in planning for old people. The comparison with Homburger Erikson's theory and with existentialism revealed many corresponding traits, which might explain some of the differences between the patients and might also give the hope of a possibility of adequate nursing support. Religion was no discriminating factor in this material. As the third level was presented as the most important one and nursing support seemed possible, further investigations were suggested.
The Swedish concept "trygghet" is multidimensional and includes notions such as security, safety, confidence, certainty and trust. Patients in coronary pain are in special need of "trygghet". In order to study the certainty dimension of the concept the Mishel Uncertainty in Illness Scale, MUIS, was used. This 34 item Likert scale is based on four factors: multidimensional ambiguity, complexity, deficit information and unpredictability. A special Cardiovascular Population Scale is formed by utilising 16 of the items included in MUIS. Patients' experiences of uncertainty were studied in two Intensive Coronary Care Units, in different locations, and with different staffing and nursing routines. There were almost no significant differences in scores on MUIS between the two ICCU wards. In the background data, the only discriminating factor was the time between previous and current hospital stays. The shorter the time, the more the uncertainty.
In an out-patient clinic for specialised medical care, 30 patients were questioned about their worries prior to the visit. The purpose of the study was to obtain basic knowledge about emotional experiences of patients visiting a doctor. The theoretical viewpoint was that of social interaction and social construction of reality. The statements of the patients were categorized as follows: before the encounter, the social interaction, the outcome of the encounter, and unspecific worries. A tool for measuring the degree and profile of the worries will be developed. Some of the worries described will be studied in depth. An education programme for all staff members is planned.
The questionnaire CICI:PQ for measuring needs, concerns and coping of parents of chronically ill children was mailed to 85 families with children with cystic fibrosis (CF). Some questions about the parents' experiences of the health care system were also included. Fifty-four per cent responded--in all cases but two the mothers. More than half of the mothers wanted help with or opportunities to discuss the state of health and the emotional development of the child and dietary issues. Many of them were concerned about the child's future. Shortage of time was another problem. The coping strategies used when having problems with the child were partly different from those used when problems arose with the partly different from those used when problems arose with the spouse. Most mothers were satisfied with the hospital care and the CF paediatrician. They wanted further support from the physiotherapist and many of them missed a CF nurse. The project illuminated many areas for further investigation.
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