Hospitalized older peoples' views of health and health promotion.

Older peoples' health varies considerably and the number of older people who need hospital care will increase in the future. Traditionally, the focus of nursing care in hospitals is oriented towards diagnosis and treatment of disease, although health and health promotion are inherent in theories and definitions of nursing. This is an important issue in health politics, in new laws and regulations in Norway. However, it was difficult to find research-based knowledge about how nurses work with health promotion and health related to older hospitalized patients. This study aimed at describing older hospitalized patients' experiences of health and health promotion. The study used a descriptive and explorative qualitative design, with an interpretative-phenomenological approach. Ten older hospitalized patients, recruited through purposeful sampling, were interviewed during their hospital stay. The informants described health as Being able to be the person I am, to do what I want to do, and feel well and have strength. Health promotion was described as Being enabled through being the person I am, through information and knowledge and through hope and motivation. The findings may be applied to nursing practice in order to focus on promotion of health as an individual process built upon the unique person's life and situation, supported by nursing care and medical treatment.

A holistic approach to the promotion of older hospital patients' health.

PURPOSE: To describe how nurses interpreted health promotion related to older patients in a medical hospital ward and the presuppositions for this work. METHODS: The study had a descriptive and explorative design. Data were created through participant observation of five nurses and informal dialogues with four nurses working in an infection unit in a small hospital in Norway. The nurses where followed during a period of 6 months. The observations and dialogues were interpreted and transformed into text. This text was analysed with qualitative content analysis and interpreted hermeneutically on three levels: (1) reading the text to get an overview of the themes; (2) systematically separating central patterns; and (3) highlighting the patterns with examples. FINDINGS: The nurses' interpretation of health promotion was closely connected to their interpretation of health and holistic nursing. Two main aspects were uncovered in the informal dialogues: a biomedically oriented nursing view and a holistically oriented nursing view. The observations showed that presuppositions, such as waiting for something or somebody, constantly changing situations, complexity and diversity in patient cases, influenced the nurses' work in general and also their focus on health promotion. The nurses balanced between the biomedical and the holistic approach. It seemed to be important for the nurses to be the masters of walking on a tightrope and to have professional clinical competence. CONCLUSION: It was difficult to find a clear focus on health promotion. The most visible focus was on diagnosis and treatment, while the more complex and comprehensive situations related to health promotion of older patients seemed to be underprioritized. The phenomenon of 'waiting' may be an important issue for further research.

Mutuality as background music in women's lived experience of mental health and depression.

Mental health problems, especially depression, have turned into an extensive public health problem, affecting women in particular. The aim of this study was to obtain a deeper understanding of mental health phenomena through elderly women's lived experiences of mental health and depression. The phenomenological approach was chosen for collecting experience-based and person-centred descriptions from 21 women, focusing on mental health and depression. The interviews were analysed using Giorgi's phenomenological descriptive method. Mutuality in their relationships with themselves and others emerged as a major element in the women's experience of mental health and depression. When the women's existence and value were confirmed in relation to themselves and others, mental health appeared as an ascending spiral. When the women's value and self-esteem in relation to themselves and others were violated, the result was a descending spiral. Metaphorically speaking, 'mutuality' provided the 'background music' to the women's lives. Being a skilled professional psychiatric nurse means making the best use of mutuality as a creative power in the nurse-patient relationship. This means that the nurse must be aware that her/his attitude, appearance and behaviour are interpreted as a confirmation of the patient's worthiness or worthlessness.

The meaning of mental health from elderly women's perspectives: a basis for health promotion.

PROBLEM: To gain a deeper understanding of the meaning of mental health. METHODS: Qualitative interviews with 16 women between the ages of 71 and 92. The data were collected and analyzed using a phenomenological approach. FINDINGS: The essence of mental health is the experience of confirmation, trust and confidence in the future, as well as a zest for life, development, and involvement in one's relationship to oneself and to others. CONCLUSIONS: Creating arenas for encounters confirming the individual's human existence and dignity is an important basis for the psychiatric nurse's health-promotion work.

The meaning of depression from the life-world perspective of elderly women.

Depression is a serious public health problem that particularly affects women and elderly people. The aim of this phenomenological study was to gain a deeper understanding of depression in elderly women by investigating and describing the meaning of depression from a life-world perspective. Qualitative interviews were conducted with five elderly women suffering from depression; they were transcribed and analysed using the phenomenological method. The essence of depression emerged as 'reexperiencing a severe personal insult' and the perception of 'increased sensitivity and vulnerability.' These two components constituted the breeding ground for an additional five characteristics. Depression was perceived as a severe multidimensional suffering that affected physical, mental, social, and spiritual aspects, where previous experiences merged with the current situation. Thus, the whole life space of these women was affected. In its most severe form, depression and, thereby, life was perceived as unbearable. The meaning that emerged from the women's descriptions can be understood against the background of the aging individual's retrospection and summation of life.

Psychiatric nursing for promotion of mental health and prevention of depression in the elderly: a case study.

The aim of this case study was to describe and analyse the basic pre-conditions for an intervention programme focusing upon mental health promotion and prevention of depression in an elderly community group and to discuss the psychiatric nurse's community-oriented health promotion work. The intervention programme, which was led by a psychiatric nurse, was built on intersectorial co-operation between public and voluntary organizations, development of social networks to promote social support, and target group participation. The nurse's function in the community-oriented work was to act at the individual, group and society level, as well as to mobilize resources among individuals and organizations, in order to create a favourable interaction, resulting in health and empowerment for the individual. Pre-conditions for leading this work were: knowledge of health and mental all health among the elderly, investigation methodology, knowledge about the local society, as well as pedagogical, supervisory and social competence.