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  • 1.
    Rönnerhag, Maria
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå. University of South-Eastern Norway, Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, P.O. Box 235, N-3603, Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, P.O. Box 235, N-3603, Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women's Health, Division of Health Sciences& Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
    Berggren, Ingela
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    A qualitative evaluation of healthcare professionals' perceptions of adverse events focusing on communication and teamwork in maternity care2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, nr 3, s. 585-593Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim of this study was to explore healthcare professionals' perceptions of adverse events during childbirth with focus on communication and teamwork.

    BACKGROUND: Inadequate communication, a poor teamwork climate and insufficient team training are harmful to women. Reviews of reported adverse events can be used to develop a safety culture based on preparedness for preventing adverse events and strengthening patient safety.

    DESIGN: Action research principles were used to facilitate the implementation and evaluation of this study.

    METHODS: An interprofessional team of healthcare professionals comprising obstetricians, registered midwives and assistant nurses employed at a labour ward agreed to take part. Data were collected from multistage focus group interviews (March 2016 - June 2016) and analysed by means of interpretative thematic analysis.

    FINDINGS: Two analytical themes based on five sub-themes emerged; Promoting interprofessional teamwork and Building capabilities by involving healthcare professionals and elucidating relevant strategies. The findings reveal the importance of facilitating relationships based on trust and respectful communication to ensure a safe environment and provide safe maternity care.

    CONCLUSION: There is a need for formal and informal support for quality interprofessional teamwork. Research on patient safety may reduce adverse events related to miscommunication and poor teamwork. We recommend different forms of communication and teamwork training in interprofessional teams to increase the ability to provide feedback. Accumulated research is required for the evaluation of evidence-based models in the patient safety context. This article is protected by copyright. All rights reserved.

  • 2. Sahlsten, Monika
    et al.
    Larsson, Inga
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    At möte patienten som en ligevaerdig part2019Ingår i: Patientindragelse: politik, profession og bruger / [ed] Kim Jörgensen (red.), Samfundslitteratur, 2019, s. 201-223Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 3.
    Dahlborg, Elisabeth
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Att bli sjuksköterska: en introduktion till yrke och ämne2019Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
  • 4.
    Magnusson, Ann-Sofie
    et al.
    Göteborgs universitet.
    Eriksson, Monica
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Barnkonventionen på samhällsagendan?: En studie om förekomst av konventionen i svensk tryckt press och på webb.2019Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 96, nr 4, s. 585-593Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Sverige ratificerade FN:s konvention om barns rättigheter, barnkonventionen, 1990. Juni 2018 beslutade riksdagen att göra barnkonventionen till svensk lag. Barnkonventionen har således varit en del av svenska samhället under trettio år. Huruvida människor känner till detta kan hänga samman med i vilken utsträckning svenska medier uppmärksammat barnkonventionen och dess eventuella status som svensk lag. En utgångspunkt är mediers roll i samhället. Det handlar om att ge information, granska makt, visa på olika uppfattningar och skapa underlag för debatt och beslut. I studien undersöks om barnkonventionen omnämns i svenska medier, ifall det nämns med koppling till lag och ifall det sker förändringar över tid.

  • 5.
    Fredriksson-Larsson, Ulla
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Cardiac Self-Efficacy and Fatigue One Year Post-Myocardial Infarction2019Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 9, nr 4, s. 396-407Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients and clinicians report that fatigue post-myocardial infraction (MI) is a bothersome symptom during recovery. Aim: The objective of this study was to explore whether there is a relationship between fatigue, cardiac self-efficacy, stress, breathlessness and physical activity one year post-MI. Method: Data were collected from a sample of patients diagnosed with MI one year earlier (n = 125) who responded to a questionnaire package measuring fatigue, cardiac self-efficacy, physical activity and the symptoms breathlessness and stress. Correlation and regression analyses were preformed to evaluate which factors were related to fatigue. Results: The results showed that cardiac self-efficacy was associated with fatigue (r = −0.611, p = 0.01) and the regression model, controlling for breathlessness and stress, showed an explained variance of 72% one year post-MI. Physical activity was not significant in this model and did not predict fatigue during this time period. Conclusion: Post-MI fatigue-relief support should rely not only on identification of fatigue and other concurrent symptoms, but also on identification of cardiac self-efficacy.

  • 6.
    Pennbrant, Sandra
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Karlsson, Margareta
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Caring for Older People: Improving Healthcare Quality to Ensure Well-Being and Dignity2019Ingår i: Universal Health Coverage / [ed] Aida Isabel Tavares, London: Intechopen Limited , 2019Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    The aim of caring is to promote health. The global trend is that people are living longer, but in many cases, there is no support system for the care of older people, leading to major challenges in ensuring their health and well-being. The proportion of older people is expected to increase globally, and skilled healthcare professionals will be required to care for them. There is a risk that older people as suffering and vulnerable human beings will be forgotten due to the increasingly effective and technical care worldwide. A caring culture and relationship should be prioritised and developed to promote participation, well-being and dignity for older people in order to fulfil their care needs and ensure quality healthcare. It is important that research focusing on universal health coverage identifies the benefits of increased investment in service quality. To contribute to the improvement of this output, we propose the application of Eriksson's caritative theory. The aim of this theoretical chapter is to provide examples of how the dignity and well-being of older people can be promoted, at no additional cost to the person, by means of Eriksson's caritative theory, which can strengthen healthcare for universal health coverage.

  • 7.
    Rejnö, Åsa
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.
    Nasic, Salmir
    Research and Development Centre, Skaraborg Hospital Skövde, Skövde, Sweden.
    Bjälkefur, Kerstin
    Department of Health and Social Care, Municipality of Lidköping, Sweden.
    Bertholds, Eric
    Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.
    Jood, Katarina
    The Sahlgrenska Academy at University of Gothenburg, Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Gothenburg, Sweden.
    Changes in functional outcome over five years after stroke2019Ingår i: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 9, nr 6, artikel-id e01300Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Data on the long‐term time course of poststroke functional outcome is limited. We investigated changes in functional outcome over 5 years after stroke in a hospital based cohort.

    Materials and Methods: Consecutive patients who were independent in activities of daily living (ADL) and admitted to a Stroke Unit at Skaraborg Hospital, Sweden for a first acute stroke from 2007 to 2009 (n = 1,421) were followed‐up after 3 months and thereafter annually over 5 years using a postal questionnaire. Clinical variables at acute stroke and 3 months post stroke were obtained from the Swedish Stroke Register. ADL dependency was defined as dependence in dressing, toileting or indoor mobility.

    Results: The proportions of survivors who reported ADL dependency remained stable throughout follow‐up (19%–22%). However, among survivors who were ADL independent at 3 months, about 3% deteriorated to dependency each year. Deterioration was predicted by age (HR 1.11; 95% CI 1.08–1.13), diabetes (HR 1.65; 95% CI 1.12–2.44), NIHSS score (HR 1.07; 95% CI 1.04–1.10), and self‐perceived unmet care needs one year post stroke (HR 2.01; 95% CI 1.44–2.81). Transitions from ADL dependency to independence occurred mainly during the first year post stroke. Improvement was negatively predicted by living alone before stroke (HR 0.41 95% CI 0.19–0.91), NIHSS score (HR 0.90; 95% CI 0.86–0.95) and ischemic stroke (vs. hemorrhagic stroke), HR 0.39; 95% CI 0.17–0.89.

    Conclusion: Transitions between ADL independence and dependency occur up to 5 years after stroke. Some of the factors predicting these transitions are potentially modifiable

  • 8.
    Holmgren, Daniel
    et al.
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden / Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Skyvell Nilsson, Maria
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Wekell, Per
    Department of Pediatrics, NU-Hospital Group, Uddevalla, Sweden / Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Combining learning for educators and participants in a paediatric CPD programme2019Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, nr 1, artikel-id 28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Most continuing professional development (CPD) programmes do not include an educational training module. In our country, educational practice in the areas of CPD and continuing medical education relies traditionally on conventional lectures. This is in sharp contrast to the educational research that clearly demonstrates that educational programmes emphasising adult learning methods have greater potential to change physicians'clinical practice. To investigate whether lecture-oriented educators were prepared to change their educational practice towards principles of adult learning, we decided to combine learning for educators and participants in a paediatric CPD programme.The aim of the study was to investigate educators' reflections on their learning and educational practice after they have undergone an educational skills component integrated in the implementation of a CPD learning module for paediatricians and evaluate the results from the participants' perspective.

    Methods: The objectives of the educational skills component of the learning module were developed according to adult learning theories. The learning objectives for the CPD learning module were based on a pre-course needs assessment. Evaluations were made using questionnaires.

    Results: Seven of 10 participants in the educational skills component of the learning module and all the participants, 13 paediatricians and 14 nurses, who participated in the learning module, answered the questionnaires.The results of this pilot study show that educators whose main experience of teaching was based on lectures were strengthened in their practice; they defined their competence and were prepared to move towards adult learning principles. The participants in the learning module expressed a high degree of satisfaction.

    Conclusions: We conclude that it is feasible to combine learning for educators and participants in a paediatric CPD programme and that lecture-oriented educators are prepared to change their educational practice towards principles of adult learning.

  • 9.
    Rejnö, Åsa
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Department of Medicine, Stroke Unit, Skaraborg Hospital Skövde, Skövde.
    Berg, Linda
    University of Gothenburg, Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg, Sweden.
    Communication, the key in creating dignified encounters in unexpected sudden death: With stroke as example2019Ingår i: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 25, nr 1, s. 9-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this study was to illuminate the communication and its meaning in unexpected sudden death with stroke as example, as experienced by stroke team members and next of kin. Subject and Methods: The study has a qualitative design. Secondary analysis of data from four previous interview studies with stroke team members; physicians, registered nurses, and enrolled nurses from the stroke units (SU) and next of kin of patients who had died due to acute stroke during hospital stay were utilized. <b>Results:</b> Communication is revealed as the foundation for care and caring with the overarching theme foundation for dignified encounters in care built-up by six themes illuminating the meaning of communication in unexpected sudden death by stroke. <b>Conclusion:</b> Communication shown as the foundation for dignified encounters in care as experienced by stroke team members and next of kin enables the patient to come forth as a unique person and uphold absolute dignity in care. Acknowledging the next of kin&#39;s familiarity with the severely ill patient will contribute to personalizing the patient and in this way be the ground for a person centeredness in care despite the patients&#39; inability to defend their own interests. Through knowledge about the patient as a person, the foundation for dignified care is given, expressed through respect for the patient&#39;s will and desires and derived through conversations between carers and next of kin.

  • 10.
    Tengelin, Ellinor
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Cliffordson, Christina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Dahlborg Lyckhage, Elisabeth
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Constructing the Norm-critical awareness scale: A scale for use in educational contexts promoting awareness of prejudice, discrimination, and marginalisation2019Ingår i: Equality, Diversity and Inclusion, ISSN 2040-7149, E-ISSN 2040-7157, Vol. 38, nr 6, s. 652-667Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Healthcare professionals' conscious or unconscious norms, values and attitudes have been identified as partial explanations of healthcare inequity. Norm criticism is an approach that questions what is generally accepted as "normal" in society, and it enables professionals to identify norms that might cause prejudice, discrimination and marginalisation. In order to assess norm-critical awareness, a measurement scale is needed. The purpose of this paper is to develop a scale for measuring norm-critical awareness. Design/methodology/approach: The scale-development process comprised a qualitative item-generating phase and a statistical reduction phase. The item pool was generated from key literature on norm criticism and was revised according to an expert panel, pilot studies and one "think aloud" session. To investigate the dimensionality and to reduce the number of items of the scale, confirmatory factor analysis was performed. Findings: The item-generation phase resulted in a 46-item scale comprising five theoretically derived dimensions revolving around function, consequences, identity, resistance and learning related to norms. The item-reduction phase resulted in an instrument consisting of five dimensions and 20 items. The analyses indicated that a summary score on the scale could be used to reflect the broad dimension of norm-critical awareness. Originality/value: The Norm-critical awareness scale comprises five theoretically derived dimensions and can be used as a summary score to indicate the level of norm-critical awareness in educational contexts. This knowledge is valuable for identifying areas in greater need of attention. © 2019, Emerald Publishing Limited.

  • 11.
    Alabaf, Setareh
    et al.
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology,Gothenburg, Sweden.
    Gillberg, Christopher
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology,Gothenburg, Sweden.
    Lundström, Sebastian
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology,Gothenburg, Sweden. Center for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Lichtenstein, Paul
    Karolinska Institute, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Kerekes, Nora
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Råstam, Maria
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Gothenburg, Sweden. Lund University, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden..
    Anckarsäter, Henrik
    University of Gothenburg, Center for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, Gothenburg, Sweden.
    Correction to: Physical health in children with neurodevelopmental disorders.2019Ingår i: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 49, nr 1, s. 96-97Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The original version of this article unfortunately contained a mistake in Fig. 2 part labels, the label "d" was incorrectly labelled as "c" and the subsequent labels should be corrected as d, e, and f. The corrected Fig. 2 is given below.

  • 12.
    Finnström, Berit
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Den professionella sjuksköterskan i dagens vård2019Ingår i: Att bli sjuksköterska: en introduktion till yrke och ämn / [ed] Elisabeth Dahlborg, Lund: Studentlitteratur AB, 2019, 3., s. 71-99Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 13.
    Flensner, Gullvi
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Det vetenskapliga ämnet2019Ingår i: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] Elisabeth Dahlborg, Lund: Studentlitteratur AB, 2019, 3., s. 103-129Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 14.
    Ko, Jong Mi
    et al.
    The University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Cardiology, Dallas, TX, USA.
    White, Kamila S
    University of Missouri, Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center,Saint Louis, MO, USA.
    Kovacs, Adrienne H
    University Health Network, University of Toronto, Peter Munk Cardiac Centre, Toronto, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA.
    Tecson, Kristen M
    Baylor Heart and Vascular Institute, Dallas, TX, USA.
    Apers, Silke
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
    Luyckx, Koen
    KU Leuven - University of Leuven, School Psychology and Child and Adolescent Development,Leuven, Belgium.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium..
    Enomoto, Junko
    Department of Adult Congenital Heart Disease,Cardiovascular Center, Chiba, Chiba, Japan.
    Sluman, Maayke A
    Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
    Wang, Jou-Kou
    Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
    Jackson, Jamie L
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.
    Chidambarathanu, Shanthi
    Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden; University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Berghammer, Malin
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Mackie, Andrew S
    University of Alberta, Division of Cardiology, Stollery Children's Hospital, Edmonton, Canada.
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta.
    Veldtman, Gruschen
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Fernandes, Susan M
    Stanford University School of Medicine, Department of Pediatrics and Medicine, Divisions of Pediatric Cardiology and Cardiovascular Medicine, Palo Alto, CA, USA.
    Callus, Edward
    Università degli Studi di Milano, Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy; Department of Biomedical Sciences for Health, Milan, Italy.
    Kutty, Shelby
    Adult Congenital Heart Disease Center, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA.
    Moons, Philip
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium; Centre for Person-Centred Care (GPCC), Gothenburg, Sweden; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Cedars, Ari M
    Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
    Differential impact of physical activity type on depression in adults with congenital heart disease: A multi-center international study2019Ingår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 124, artikel-id 109762Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: This study aimed to examine the association between physical activity (PA) and depression in a large international cohort of adults with congenital heart disease (ACHD) as data about the differential impact of PA type on depression in this population are lacking.

    METHODS: In 2018, we conducted a cross-sectional assessment of 3908 ACHD recruited from 24 ACHD-specialized centers in 15 countries between April 2013 to March 2015. The Hospital Anxiety and Depression Scale was used to assess self-reported depressive symptoms and the Health-Behavior Scale-Congenital Heart Disease was used to collect PA information. Cochran-Armitage tests were performed to assess trends between depressive symptom levels and PA participation. Chi-Square and Wilcoxon Rank Sum tests were utilized to examine relations between depressive symptom levels and patient characteristics. Stepwise multivariable models were then constructed to understand the independent impact of PA on depressive symptoms.

    RESULTS: The overall prevalence of elevated depressive symptoms in this sample was 12% with significant differences in rates between countries (p < .001). Physically active individuals were less likely to be depressed than those who were sedentary. Of the 2 PA domains examined, sport participation rather than active commute was significantly associated with reduced symptoms of depression. After adjustment in multivariable analysis, sport participation was still significantly associated with 38% decreased probability of depressive symptoms (p < .001).

    CONCLUSIONS: Sport participation is independently associated with reduced depressive symptoms. The development and promotion of sport-related exercise prescriptions uniquely designed for ACHD may improve depression status in this unique population.

  • 15.
    Rejnö, Åsa
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Skaraborg Hospital Skövde, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal Bräcke University College, Sweden.
    Nordenfelt, Lennart
    Ersta Sköndal Bräcke University College, Sweden.
    Silfverberg, Gunilla
    Ersta Sköndal Bräcke University College, Sweden.
    Godskesen, Tove E
    Ersta Sköndal Bräcke University College, Sweden; Uppsala University, Sweden.
    Dignity at stake: Caring for persons with impaired autonomy2019Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient's dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient's wishes and needs are the starting point.

  • 16.
    Sluman, Maayke A.
    et al.
    University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands; Department of Cardiology, Jeroen Bosch Hospital, ‘s Hertogenbosch, The Netherlands.
    Apers, Silke
    University of Leuven, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; University of Leuven, Leuven, Department of Public Health and Primary Care, KU Leuven, Belgium.
    Sluiter, Judith K.
    University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands.
    Nieuwenhuijsen, Karen
    University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands.
    Moons, Philip
    University of Leuven, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; University of Gothenburg, Center for Person‐Centered Care (GPCC), Gothenburg, Sweden .
    Luyckx, Koen
    University of Leuven, School Psychology and Development in Context, KU Leuven, Leuven, Belgium ; University of the Free State, Department of Psychology, UNIBS, Bloemfontein, South Africa.
    Kovacs, Adrienne H.
    University Health Network, Department of Psychology, Toronto, Canada; Oregon Health & Science University, The Knight Cardiovascular Institute, Portland, Oregon .
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Inselspital, Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Congenital and Structural Cardiology, Department of Cardiovascular Sciences, University Hospitals of Leuven, KU Leuven, Leuven, Belgium.
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.
    Yang, Hsiao-Ling
    National Taiwan University, School of Nursing, College of Medicine, Taipei, Taiwan.
    Jackson, Jamie L.
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio.
    Khairy, Paul
    University of Montreal, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C.
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, Michigan.
    Subramanyan, Raghavan
    Frontier Lifeline Hospital, Dr. K. M. Cherian Heart Foundation, Chennai, India.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    9Department of Cardiology, Oslo University Hospital, Oslo, Norway.
    Dellborg, Mikael
    Gothenburg University, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden; Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Berghammer, Malin
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Gothenburg, Center for Person‐Centered Care (GPCC), Gothenburg, Sweden.
    Mattsson, Eva
    Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
    Mackie, Andrew S.
    University of Alberta, Department of Pediatric Cardiology, Edmonton, Canada.
    Menahem, Samuel
    Monash Medical Center, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Msida, Malta.
    Gosney, Kathy
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
    Soufi, Alexandra
    Hospital Louis Pradel, Lyon, France.
    Fernandes, Susan M.
    Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children’s Hospital and Stanford Health Care, Palo Alto, California.
    White, Kamila S.
    Washington University, Adult Congenital Heart Disease Center, ; University of Missouri, Barnes Jewish Heart & Vascular Center, Saint Louis, Missour.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato Hospital, Milan, Italy.
    Kutty, Shelby
    Adult Congenital Heart Disease Center, University of Nebraska Medical Center/Children’s Hospital & Medical Center, Omaha, Nebraska.
    Bouma, Berto J.
    University of Amsterdam, Amsterdam UMC, Department of Cardiology, Amsterdam, The Netherlands.
    Mulder, Barbara J.M.
    University of Amsterdam, Amsterdam UMC, Department of Cardiology, Amsterdam, The Netherlands.
    Education as important predictor for successful employment in adults with congenital heart disease worldwide2019Ingår i: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 14, nr 3, s. 362-371Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an important determinant for quality of life, we assessed this in a large international adult CHD cohort.

    Methods

    Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross-sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models.

    Results

    Median age was 32 years (IQR 25-42) and 94% of patients had at least a high school degree. Overall employment rate was 69%, but varied substantially among countries. Higher education (OR 1.99-3.69) and having a partner (OR 1.72) were associated with more employment; female sex (OR 0.66, worse NYHA functional class (OR 0.67-0.13), and a history of congestive heart failure (OR 0.74) were associated with less employment. Limitations at work were reported in 34% and were associated with female sex (OR 1.36), increasing age (OR 1.03 per year), more severe CHD (OR 1.31-2.10), and a history of congestive heart failure (OR 1.57) or mental disorders (OR 2.26). Only a university degree was associated with fewer limitations at work (OR 0.62).

    Conclusions

    There are genuine differences in the impact of CHD on employment status in different countries. Although the majority of adult CHD patients are employed, limitations at work are common. Education appears to be the main predictor for successful employment and should therefore be encouraged in patients with CHD.

  • 17.
    Georgsson, Mattias
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Utah, Department of Biomedical Informatics, Salt Lake City, UT, USA; Blekinge Institute of Technology, Faculty of Computing, Karlskrona, Sweden.
    Staggers, Nancy
    University of Utah, Department of Biomedical Informatics, Salt Lake City, UT, USA; Summit Health Informatics, Salt Lake City, UT, US.
    Årsand, Eirik
    The Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; UiT The Arctic University of Norway, Department of Clinical Medicine, Tromsø, Norway .
    Kushniruk, Andre
    University of Victoria, School of Health Information Science, Victoria, Canada.
    Employing a user-centered cognitive walkthrough to evaluate a mHealth diabetes self-management application: A case study and beginning method validation2019Ingår i: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 91, artikel-id 103110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Self-management of chronic diseases using mobile health (mHealth) systems and applications is becoming common. Current evaluation methods such as formal usability testing can be very costly and time-consuming; others may be more efficient but lack a user focus. We propose an enhanced cognitive walkthrough (CW) method, the user-centered CW (UC-CW), to address identified deficiencies in the original technique and perform a beginning validation with think aloud protocol (TA) to assess its effectiveness, efficiency and user acceptance in a case study with diabetes patient users on a mHealth self-management application. Materials and methods: A total of 12 diabetes patients at University of Utah Health, USA, were divided into UC-CW and think aloud (TA) groups. The UC-CW method included: making the user the main evaluator for detecting usability problems, having a dual domain facilitator, and using three other improved processes: validated task development, higher level tasks and a streamlined evaluation process. Users interacted with the same mHealth application for both methods. Post-evaluation assessments included the NASA RTLX instrument and a set of brief interview questions. Results: Participants had similar demographic characteristics. A total of 26 usability problems were identified with the UC-CW and 20 with TA. Both methods produced similar ratings: severity across all views (UC-CW = 2.7 and TA = 2.6), numbers of problems in the same views (Main View [UC-CW = 11, TA = 10], Carbohydrate Entry View [UC-CW = 4, TA = 3] and List View [UC-CW = 3, TA = 3]) with similar heuristic violations (Match Between the System and Real World [UC-CW = 19, TA = 16], Consistency and Standards [UC-CW = 17, TA = 15], and Recognition Rather than Recall [UC-CW = 13, TA = 10]). Both methods converged on eight usability problems, but the UC-CW group detected five critical issues while the TA group identified two. The UC-CW group identified needed personalized features for patients’ disease needs not identified with TA. UC-CW was more efficient on average time per identified usability problem and on the total evaluation process with patients. NASA RTLX scores indicated that participants experienced the UC-CW half as cognitively demanding. Common themes from interviews indicated the UC-CW as enjoyable and easy to perform while TA was considered somewhat awkward and more cognitively challenging. Conclusions: UC-CW was effective for finding severe, recurring usability problems and it highlighted the need for personalized user features. The method was also efficient and had high user acceptance. These results indicate UC-CW’s utility and user acceptance in evaluating a mHealth self-management application. It provides an additional usability evaluation technique for researchers. © 2019

  • 18.
    Viking, Tuija
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    En studie om interprofessionellt lärande i teamarbete: Fallet med en 'best practice´ för tvångsvård2019Licentiatavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Det interprofessionella lärandet, IPL, i team har blivit ett populärt medel för att öka samarbete och kvalité i den sociala sektorn och hälso- och sjukvård. En alltmer specialiserad och fragmentiserad vård, som ofta genomförs i team, har lett till stor spridning av interprofessionell utbildning, IPE. Studerande och/eller medlemmar från olika professioner lär sig därmed, med, från och om varandra. Sådant lärande antas ske vid utbyte av och reflektion över varandras olika erfarenheter, perspektiv och kunskaper, d.v.s. professionella skillnader, och leda till förbättrad effektivitet och kvalitet i vården.

    Inom hälso- och sjukvårdsområdet har man dock bara i mindre skala undersökt vad IPL i etablerade team innebär och hur professionella skillnader påverkar lärandet. Denna licentiatuppsats hade som övergripande syfte att bidra med ökad kunskap inom detta område. Här studerades ett arbete, med kliniska riktlinjer för psykiatrisk tvångsvård, som skulle genomföras av ett interprofessionellt team. Huvudfrågan var hur teamet arbetade med riktlinjerna och hur professionella skillnader kom till uttryck och gav implikationer för IPL. Licentiatuppsatsen är en fallstudie. Undersökningen baseras dels på material (mötesprotokoll, mejlkommunikation, dokument och mediarapporter) från teamets tre-åriga arbete, dels nio intervjuer och en observation av seminariet där teammedlemmar presenterade de färdiga riktlinjerna. Studie 1 syftade till att undersöka hur teamet hanterade en kontrovers och hur de strategier som användes gav konsekvenser för interprofessionellt lärande. Studie 2 syftade till att studera hur teamet granskade kön/genus i arbetet med riktlinjerna och vilka implikationer det blev för riktlinjerna och för interprofessionellt lärande. Fokus här är därmed på ett lärande i ett "färdigt" team. Resultaten i studierna baseras på fallbeskrivning och narrativ analys. Fynden i studierna tolkades huvudsakligen utifrån sociokulturell teori och idéer och insikter från kontroversstudier (studie 1) och det genusvetenskapliga fältet (studie 2).

    Resultatet i studie 1 visade att kontroversen hanterades främst genom en kompromiss. Resultatet visar också hur lärandestrategier nyttjades vid användning av texter. Lärandet utmanades dock när maktstrategier användes genom hävdande av auktoritet snarare än utforskande av kunskapsläget.

    Resultatet i studie 2 visade hur kön/genus aktualiserades i en diskussion om könsskillnader i användning av tvångsbälten. I diskussionen användes professionsspecifika erfarenheter och kunskaper om kön/genus, vilket kan antas främjade IPL. Teamets lärande om komplexiteten kring kön/genus resulterade i riktlinjer som betonar makt och med fokus på den individuella patienten. Därmed ledde teamets analys och lärande relaterat till kön/genus paradoxalt till könsneutrala riktlinjer. Slutsatsen är att studierna, på olika sätt, visade förekomst av IPL och hur detta påverkades både positivt och negativt av professionella skillnader.

  • 19.
    Bador, Kourosh
    et al.
    AGERA KBT AB, Gothenburg, Sweden.
    Kerekes, Nora
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Evaluation of an Integrated Intensive Cognitive Behavioral Therapy Treatment Within Addiction Care2019Ingår i: Journal of Behavioral Health Services & Research, ISSN 1094-3412, E-ISSN 1556-3308Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The study aimed to evaluate an integrated intensive cognitive behavioral therapy (CBT) group treatment for people with substance-related syndrome in outpatient care and to identify eventual gender differences. The study population consisted of 35 outpatients (18 male, 17 female) at a clinic in Western Sweden. The patients completed a four-month period of intensive group therapy and participated in the data collection at admission and discharge. The data were collected using the following inventories: Beck Depression and Anxiety Inventories, Rosenberg Self-Esteem Scale,Hopelessness Scale, and Trait Hope Scale. Results showed decreases in anxiety, depression and experience of hopelessness, and increases in self-esteem and hope. In females, the most dramatic improvement was measured for the anxiety and depression attributes, while in males the strongest effect was measured for hope and self-esteem. This study provides clinical evidence of the positive effects of integrated intensive CBT in outpatient care of people with substance-related syndrome.

  • 20.
    Hrybanova, Yana
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Ekström, Anette
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Thorstensson, Stina
    School of Health and Education, University of Skövde, Sweden.
    First-time fathers' experiences of professional support from child health nurses2019Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, s. 1-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nowadays, in Sweden, fathers are expected to be active in their father role and to share caring responsibilities for their children equally with mothers. This active role of a father in a family can be challenging, especially for the first-time fathers. Child health nurses’ support is an important factor for fathers to become confident caregivers. The Father Perceived Professional Supportscale (FaPPS scale) can be used in nursing practice for better understanding father’s needs of professional support. The aim of this study was to describe first-timefathers’ experiences of the professional support received from child health nurses and to validate the instrument:‘FaPPS scale’. A qualitative design, with inductive and deductive approaches, was used in this study.Twelve first-time fathers participated in the semi-structuredinterviews, thereafter grading the FaPPS scaleitems and commenting on them. The fathersexperienced nurses’ support positively when nursesprovided practical information and stimulated them to be involved in care of their children. In contrast, thes upport was experienced negatively because of nurses’ lack of commitment, availability and adaptation to the fathers’ individual needs. The fathers also felt inequality between the support received by fathers and by mothers. Although some fathers perceived it as negative, others considered it fair, believing that mothers needed more support. In addition, fathers expect nurses to actively offer support to them and supervise them in childcare. The fathers also needed meeting other parents, for example in parental groups.This study also indicates that FaPPS scale can be used both in research and clinical practice, though still needing further development.

  • 21.
    Möller Ranch, Matilda
    et al.
    Neonatal Care Unit, NÄL Hospital Trollhättan, Sweden.
    Jämtén, Sofia
    Pediatric Healthcare Setting, Capio, Lysekil, Sweden.
    Thorstensson, Stina
    University of Skövde, School of Health Sciences, Skövde, Sweden.
    Ekström-Bergström, Anette
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Skövde, School of Health Sciences, Skövde, Sweden.
    First-Time Mothers Have a Desire to Be Offered Professional Breastfeeding Support by Pediatric Nurses: An Evaluation of the Mother-Perceived-Professional Support Scale2019Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, artikel-id 8731705Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although the World Health Organization recommends exclusive breastfeeding for six months, the rate of breastfeeding has decreased worldwide. Breastfeeding is the natural way of feeding a baby, but it is a process that has to be learnt. It is not unusual for problems to occur and hence support for breastfeeding is vital. The aim of this study was to explore first-time mothers' experiences of the breastfeeding support offered by pediatric nurses, as well as to develop and evaluate the Mother Perceived Support from Professionals (MoPPS) scale.

    Methods: A qualitative design involving both inductive and deductive approaches was chosen. Nine first-time mothers were interviewed regarding their experiences of the breastfeeding support offered by pediatric nurses. Semistructured interviews were conducted. The mothers were also asked to grade their experiences of breastfeeding support on the MoPPS scale. A qualitative content analysis was applied when analyzing the data obtained using both the inductive (interviews) and deductive (MoPPS scale) approaches.

    Results: The results revealed that the mothers felt the desire to breastfeed, although they all experienced some difficulties. They wanted the pediatric nurses to be perceptive and provide professional support based on their own experiences. When the pediatric nurses took time and booked extra appointments, the mothers felt supported. The inductive analysis resulted in one theme: "When wanting to breastfeed, mothers have a desire to be offered professional breastfeeding support". Two main categories were identified, namely "Mothers wanted but lacked breastfeeding support" and "Mothers received professional support." The deductive analysis of the MoPPS scale showed similar results, and the questions were perceived as relevant to the aim. The mothers considered it important that the pediatric nurses had sufficient knowledge about breastfeeding. It was also considered important that the pediatric nurses involved the mothers' partners in the breastfeeding support. Therefore, we suggest that these areas should be included in the MoPPS scale for pediatric nurses.

    Conclusions: The MoPPS scale can be a useful tool for helping pediatric nurses to offer mothers professional breastfeeding support. Indeed, when offering breastfeeding support, pediatric nurses can use the items included on the MoPPS scale as guidance.

  • 22.
    Karlsson, Margareta
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Karlsson, Ingrid
    Capio Läkarhus Almö, Myggenäs, Sweden.
    Follow-up visits to older patients after a hospital stay: nurses' perspectives.2019Ingår i: British Journal of Community Nursing, ISSN 1462-4753, E-ISSN 2052-2215, Vol. 24, nr 2, s. 80-86Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Older patients with multimorbidity and extensive healthcare needs are at risk of frequent readmission to hospital after discharge. With a Swedish report entitled 'Follow-up 48-72' as its basis, the present study aimed to describe nurses' experiences of follow-up visits to older patients with multimorbidity 48 to 72 hours after discharge from hospital. Semi-structured interviews were conducted with 10 nurses experienced with such home visits to older patients, and the material was analysed by qualitative content analysis. The results indicate that such visits by nurses can relieve patient anxiety, as patients are often unsure of the next steps, in terms of medication and care. According to the nurses, these visits created trust in the nurse-patient relationship and ensured patient safety. Follow-up visits soon after discharge from hospital should become a part of routine nursing, especially for older people with multimorbidity.

  • 23.
    Forsman, Berit
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Svensson, Ann
    Högskolan Väst, Institutionen för ekonomi och it, Avd för informatik.
    Frail Older Persons' Experiences of Information and Participation in Hospital Care2019Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, nr 16, artikel-id E2829Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this paper is to describe frail older persons' experiences of hospital care of information and participation when being an inpatient at a hospital. A qualitative method was used. Data were collected at the hospital from 20 interviews with frail older patients, together with observations in the environment at the hospital ward. A content analysis was performed. Patients experienced not receiving information about their care and rehabilitation, or receiving such information in noisy surroundings. They experienced situations of misunderstanding related to their medication, which indicates the need for appropriate discharge calls for frail older patients. They expressed feelings of distress concerning the future, caused by hasty admissions or relatives' problems to handle the situation. The results highlight the need to receive appropriate information and to participate in decision-making. The level of health literacy should be taken notice of when giving information, using peaceful and quiet environments when informing frail older persons. Person-centered care should be recognized to a greater extent in order for healthcare professionals to give information to frail older people in a health literacy-friendly way. This might make it easier for frail older persons to participate in a partnership in care.

  • 24.
    Bauer, G.F.
    et al.
    University of Zurich, Center of Salutogenesis, Institute of Epidemiology, Biostatistics, Prevention, Zurich, Switzerland.
    Roy, M.
    University of Sherbrooke, Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Quebec, Canada,.
    Bakibinga, P.
    Health Challenges and Systems Research Program, African Population & Health Research Center, Nairobi, Kenya,.
    Contu, P.
    University of Cagliari, Department of Medical Sciences and Public health, Cagliari, Sardegna, Italy.
    Downe, S.
    University of Central Lancashire, School of Community Health and Midwifery, Preston, UK.
    Eriksson, Monica
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Espnes, G.A.
    Norwegian University of Science and Technology, Center for Health Promotion Research, Trondheim, Norway.
    Jensen, B.B.
    Health Promotion, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
    Juvinya Canal, D.
    University of Girona, Faculty of Nursing, Girona, Spain.
    Lindström, B.
    Norwegian University of Science and Technology, Center for Health Promotion Research, Trondheim, Norway.
    Mittelmark, M.B.
    University of Bergen, Department of Health Promotion and Development, Bergen, Norway.
    Morgan, A.R.
    Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK.
    Pelikan, J.M.
    University of Vienna, Institute of Sociology, Vienna, Austria.
    Saboga-Nunes, L.
    University of Education Freiburg, Institute of Sociology,Freiburg, Germany.
    Sagy, S.
    Norwegian University of Science and Technology, Center for Health Promotion Research, Trondheim, Norway.
    Shorey, S.
    Alice Lee Center for Nursing Studies, Yong Lo Lin School of Medicine, Singapore .
    Vaandrager, L.
    Wageningen University, Department of Social Sciences, Health and Society, Wageningen, The Netherlands.
    Vinje, H.F.
    University College of Southeast Norway, Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, Kongsberg, Vestfold, Norway.
    Future directions for the concept of salutogenesis: A position article2019Ingår i: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, s. 1-9, artikel-id daz057Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass,San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC)VC that helps to mobilize resources to cope with stressors and manage tension successfully (determiningone's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensionalSOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about theorigin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in theinternational Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer,New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. Tostrengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal)of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis.During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky'soriginal contribution and then present suggestions for future development. These ideas will help guideGWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.

  • 25.
    Larsson, Lena
    et al.
    Umeå University, Heart Center and Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Johansson, Bengt
    Umeå University, Heart Center and Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Sandberg, Camilla
    Umeå University, Heart Center and Department of Public Health and Clinical Medicine, Umeå, Sweden; Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå, Sweden.
    Apers, Silke
    University of Leuven, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
    Kovacs, Adrienne H.
    Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, United States.
    Luyckx, Koen
    University of Leuven, School Psychology and Development in Context, KU Leuven, Leuven, Belgium.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Inselspital — Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; University of Leuven, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.
    Sluman, Maayke A.
    Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands.
    Wang, Jou-Kou
    Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
    Jackson, Jamie L.
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States.
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C.
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, United States.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden;Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; nstitute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Berghammer, Malin
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Rempel, Gwen
    University of Alberta, Northern Alberta Adult Congenital Heart Clinic, Edmonton, Canada.
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Msida, MSD 2090, Malta.
    Tomlin, Martha
    The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Fernandes, Susan M.
    Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital, Stanford Health Care, Stanford School of Medicine, Palo Alto, CA, United States.
    White, Kamila
    University of Missouri, Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, Saint Louis, MO, United States.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Università degli Studi di Milano, Department of Biomedical Sciences for Health, Milan, Italy.
    Kutty, Shelby
    University of Nebraska Medical Center, Division of Pediatric Cardiology, Children's Hospital & Medical Center, Omaha, NE, United States.
    Moons, Philip
    University of Leuven, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
    Geographical variation and predictors of physical activity level in adults with congenital heart disease2019Ingår i: International Journal of Cardiology : Heart & Vasculature, ISSN 2352-9067, Vol. 22, s. 20-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease(CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin.

    Methods

    3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models.

    Results

    On average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%–Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52–2.08), NYHA-class I (OR 3.10, 95%CI 1.71–5.62) and less complex disease (OR 1.46, 95%CI 1.16–1.83). In contrast, older age (OR 0.97, 95%CI 0.96–0.98), lower educational level (OR 0.41, 95%CI 0.26–0.64) and being unemployed (OR 0.57, 95%CI 0.42–0.77) were negatively associated with reaching WHO recommendations.

    Conclusions

    A significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions.

  • 26. Lindström, Bengt
    et al.
    Eriksson, Monica
    Högskolan Väst, Institutionen för hälsovetenskap.
    Grundlagen der Salutogenese: Von der Anatomie der Gesundheit zur Architektur des Lebens - Salutugene Wege der Gesundheitsförderung2019Ingår i: Salutogenese kennen und verstehen: Konzept, Stellenwert, Forschung und praktische Anwendung / [ed] Meier Magistretti, Claudia, Bern: Hogrefe , 2019, s. 25-107Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [de]

    Salutogenese ist die Wissenschaft von den Bedingungen, die Gesundheit ermöglichen, aufrechterhalten und wiederherstellen. Im Unterschied zur Pathogenese, die sich mit Ursachen von Krankheit beschäftigt, fokussiert Salutogenese die Ursachen von Gesundheit. Als Teilgebiet der Gesundheitswissenschaften gründet Salutogenese auf einer empirisch validierten Theorie von Aaron Antonovsky und verfügt über eine mittlerweile 40-jährige weltweite Forschungstradition. Mit der globalen Arbeitsgruppe zur Salutogenese innerhalb der internationalen Gesellschaft für Gesundheitsförderung (IUHPE) hat sich das Wissensgebiet zu einem Schwerpunkt in Public Health entwickelt.In diesem Werk wird die Komplexität des vorhandenen Wissens zur Salutogenese in kurzen, gut illustrierten Kapiteln dargestellt, die für verschiedene Anspruchsgruppen anschlussfähig sind und einen kompakten Überblick zu den relevanten Themen Gesundheitspolitik, Lebensqualität, Gesundheitserziehung oder psychische Gesundheit geben. Eine kurze Einführung zu den Thesen des Begründers der Salutgenese, Aaron Antonovsky, sowie ein abschließendes Kapitel zum aktuellen deutsche Forschungsstand runden das Werk ab.

  • 27.
    Holbein, Christina E.
    et al.
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, United States.
    Peugh, James
    Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, United States.
    Veldtman, Gruschen
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
    Apers, Silke
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
    Luyckx, Koen
    KU Leuven - University of Leuven, School Psychology and Child and Adolescent Development,Leuven, Belgium.
    Kovacs, Adrienne H
    University Health Network, University of Toronto, Peter Munk Cardiac Centre, Toronto, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium..
    Enomoto, Junko
    Department of Adult Congenital Heart Disease,Cardiovascular Center, Chiba, Chiba, Japan.
    Sluman, Maayke A
    University of Amsterdam, Coronel Institute of Occupational Health, Netherlands; dam, Netherlands n.
    Lu, Chun-Wei
    National Taiwan University Children’s Hospital, Adult Congenital Heart Center, Taiwan.
    Jackson, Jamie L
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.
    Chidambarathanu, Shanthi
    Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden; University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Berghammer, Malin
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Mackie, Andrew S
    University of Alberta, Division of Cardiology, Stollery Children's Hospital, Edmonton, Canada.
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Fernandes, Susan M
    Adult Congenital Heart Program at Stanford, Lucile Packard Children’s Hospital and Stanford Health Care, USA.
    White, Kamila S
    Washington University, Adult Congenital Heart Disease Center, USA: University of Missouri, Barnes Jewish Heart and Vascular Center,USA.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, Italy ;Universita degli Studi di Milano,Department of Biomedical Sciences for Health, Italy.
    Kutty, Shelby
    University of Nebraska Medical Center, Adult Congenital Heart Disease Center, USA;Taussig Heart Center, Johns Hopkins School of Medicine, USA.
    Moons, Philip
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Sweden;University of Cape Town, Department of Paediatrics and Child Health, South Africa.
    Health behaviours reported by adults with congenital heart disease across 15 countries2019Ingår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Health behaviours are essential to maintain optimal health and reduce the risk of cardiovascular complications in adults with congenital heart disease. This study aimed to describe health behaviours in adults with congenital heart disease in 15 countries and to identify patient characteristics associated with optimal health behaviours in the international sample. Design: This was a cross-sectional observational study. Methods: Adults with congenital heart disease (n = 4028, median age = 32 years, interquartile range 25–42 years) completed self-report measures as part of the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS). Participants reported on seven health behaviours using the Health Behaviors Scale-Congenital Heart Disease. Demographic and medical characteristics were assessed via medical chart review and self-report. Multivariate path analyses with inverse sampling weights were used to investigate study aims. Results: Health behaviour rates for the full sample were 10% binge drinking, 12% cigarette smoking, 6% recreational drug use, 72% annual dental visit, 69% twice daily tooth brushing, 27% daily dental flossing and 43% sport participation. Pairwise comparisons indicated that rates differed between countries. Rates of substance use behaviours were higher in younger, male participants. Optimal dental health behaviours were more common among older, female participants with higher educational attainment while sports participation was more frequent among participants who were younger, male, married, employed/students, with higher educational attainment, less complex anatomical defects and better functional status. Conclusions: Health behaviour rates vary by country. Predictors of health behaviours may reflect larger geographic trends. Our findings have implications for the development and implementation of programmes for the assessment and promotion of optimal health behaviours in adults with congenital heart disease. © The European Society of Cardiology 2019.

  • 28.
    Lundström, Sofia
    et al.
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Hedman Ahlström, Britt
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Health-related lifestyle and perceived health among people with severe mental illness: Gender differences and degree of sense of coherence.2019Ingår i: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 33, nr 2, s. 182-188Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    People with severe mental illness (SMI) experience an increased risk of physical ill health and premature death, which appears to be partly related to unhealthy lifestyle habits. The aim of this study was to describe the distribution of health-related lifestyle habits and perceived health among people with severe mental illness. A further aim was to explore if there were any gender differences or differences based on degree of sense of coherence. The study adopted a cross-sectional design based on data from 65 people with SMI. The results show that degree of Sense of Coherence (SOC) does have relevance for perceived health and for dimensions of Quality of Life (QOL). Furthermore, among the participants with strong SOC, there were less daily smokers and they seemed to have less sedentary leisure time than those with low SOC. Men reported more anxiety/depression than women and women ate fruit more often than men, otherwise there were no gender differences. In comparison with the general population, people with SMI show a higher Body Mass Index are more sedentary, more often daily smokers, have lower SOC and perceive a lower QOL. This emphasizes the importance of health-promotion support that focuses on lifestyle changes, and support for strengthening SOC and QOL for people with SMI. © 2018 Elsevier Inc.

  • 29.
    Dahlborg, Elisabeth
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    I backspegeln: en historisk återblick2019Ingår i: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] Dahlborg, Elisabeth, Lund: Studentlitteratur AB, 2019, 3., s. 43-68Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 30.
    Arakelian, Erebouni
    et al.
    Uppsala University, Department of Surgical Sciences, Uppsala, Sweden.
    Rudolfsson, Gudrun
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Rask-Andersen, Anna
    Uppsala University, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, Sweden.
    Runeson-Broberg, Roma
    Uppsala University, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, Sweden.
    Wålinder, Robert
    Uppsala University, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, Sweden.
    I Stay: Swedish Specialist Nurses in the Perioperative Context and Their Reasons to Stay at Their Workplace2019Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, nr 3, s. 633-644Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose To investigate why nurse anesthetists and operating room nurses choose to stay in the same workplace.

    Design Qualitative design.

    Methods Individual interviews were conducted with 15 nurse specialists from four hospitals in Sweden. Two men and 13 women aged between 43 and 63 participated. Data were analyzed with systematic text condensation according to Malterud.

    Findings Three themes were identified. (1) Organizational stability contributed to low staff turnover, with good spirits between colleagues, representing everyone’s equal value and resulting in a feeling of homelikeness. (2) Sustained development in one’s own profession. (3) A humane head nurse who was at hand, who was a facilitator, who knew staff members, and eliminated obstacles for them.

    Conclusions In a nonhierarchical and stable organization with a head nurse with caritative leadership skills, a welcoming working environment with opportunities for professional development is created. Thus, nurse specialists choose to stay, contributing to organizational development.

  • 31.
    Kerekes, Nora
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Brändström, Sven
    Washington University School of Medicine, Clinical Associate of the Center for Well-Being, St. Louis, MO, United States.
    Nilsson, Thomas
    University of Gothenburg, Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Gothenburg, Sweden.
    Imprisoning Yoga: Yoga Practice May Increase the Character Maturity of Male Prison Inmates.2019Ingår i: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 10, artikel-id 406Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A specific personality profile, characterized by low character maturity (low scores on the self-directedness and cooperativeness character dimensions) and high scores on the novelty seeking temperament dimension of the temperament and character inventory (TCI), has been associated with aggressive antisocial behavior in male prison inmates. It has also been shown that yoga practiced in Swedish correctional facilities has positive effects on the inmates' well-being and on risk factors associated with criminal recidivism (e.g., antisocial behavior). In this study, we aimed to investigate whether the positive effect of yoga practice on inmates' behaviors could be extended to include eventual changes in their personality profile. Methods: Male prison inmates (N = 111) in Sweden participated in a randomized controlled 10-week long yoga intervention trial. Participants were randomly assigned to either a yoga group (one class a week; n = 57) or a control group (free of choice weekly physical activity; n = 54). All the inmates completed the TCI questionnaire before and after the intervention period as part of an assessment battery. Results: After the 10-week-long intervention period male inmates scored significantly lower on the novelty seeking and the harm avoidance and significantly higher on the self-directedness dimensions of the TCI. There was a significant medium strong interaction effect between time and group belonging for the self-directedness dimension of character favoring the yoga group. Conclusion: A 10-week-long yoga practice intervention among male inmates in Swedish correctional facilities increased the inmates' character maturity, improving such abilities as their capability to take responsibility, feel more purposeful, and being more self-acceptant-features that previously were found to be associated with decreased aggressive antisocial behavior.

  • 32.
    Rudolfsson, Gudrun
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Nord University, Faculty of Nursing and Health Sciences, Bodø, Norway.
    Karlsson, Veronika
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Interacting with parents in Sweden who hesitate or refrain from vaccinating their child2019Ingår i: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, artikel-id 1367493519867170Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to explore nurses' experiences of encountering parents who are hesitant about or refrain from vaccinating their child. A qualitative approach was chosen and data collected through individual, semi-structured interviews with 12 nurses. The text was analyzed using thematic analysis. Three themes emerged from the interviews: giving room and time for acknowledging parents' insecurity concerning vaccination, striving to approach the parents' position with tact, and a struggle between feelings of failure and respect for the parents' view. The findings indicate that it was crucial to give time, be tactful when meeting parents, as well as to appear credible and up-to-date. The nurses wanted to be open and respect the parents' views on vaccination but found it difficult and frustrating to be unable to reach out with their message because their quest was to protect the child.

  • 33.
    Hoppe, Michael
    et al.
    Department of Gastroenterology and Hepatology , Clinical Nutrition Unit , Sahlgrenska University Hospital , Gothenburg , Sweden.
    Hulthén, Lena
    University of Gothenburg , Department of Internal Medicine and Clinical Nutrition , Sahlgrenska Academy , Gothenburg , Sweden.
    Samuelson, Gösta
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Uppsala University , Department of Clinical Sciences/Clinical Physiology , Uppsala , Sweden..
    Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery?: A small-scale longitudinal study2019Ingår i: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 32, nr 13, s. 2166-2172Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To measure serum hepcidin in late pregnancy and in cord blood, and to analyze relationship between hepcidin, interleukin-6 and biomarkers of fetal iron status.

    MATERIALS AND METHODS: Data from 15 uncomplicated singleton pregnancies were analyzed longitudinally in trimester 3 (T3) and at birth.

    RESULTS: In T3, S-ferritin (median 14 µg/L) and transferrin (median 4.0 g/L) indicated low iron status, whereas the median soluble transferrin receptor (sTfR) was 4.0 mg/L, ie within the reference interval. Median T3 S-hepcidin was 7.8 ng/mL. Later on in cord blood, ferritin concentration (180 µg/L) were significantly higher, transferrin concentration (1.8 g/L) were significantly lower, and both sTfR (4.7 mg/L) and S-hepcidin concentrations (30.5 ng/mL) were significantly higher than maternal T3 concentrations. At the same time, cord blood interleukin-6 indicated an activated acute-phase reaction. In T3, after logarithmic transformation, there was a significant correlation between S-hepcidin and both S-ferritin (r = 0.691) and sTfR (r = -0.825). There was also a significant correlation between S-ferritin and both sTfR (r = -0.729) and transferrin (r = 0.549) in T3.

    CONCLUSIONS: Although S-ferritin, S-hepcidin, and sTfR were correlated during pregnancy, these relationships were not apparent in umbilical cord blood. Further, cord blood interleukin-6 indicated an activated acute-phase response, and sTfR, which is known to be unaffected by inflammation, indicated a low iron status in cord blood. Thus, instead of representing an enhanced iron status, the data appear to suggest that hepcidin and ferritin in cord blood may be influenced by the low-grade acute-phase response that occurs during delivery.

  • 34.
    Pennbrant, Sandra
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Nunstedt, Håkan
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Bernhardsson, Lennarth
    Högskolan Väst, Institutionen för ekonomi och it, Avd för medier och design.
    Learning Through Reflection: The Portfolio Method As A Tool To Promote Work-Integrated Learning In Higher Education2019Ingår i: INTED2019 Proceedings / [ed] L. Gómez Chova, A. López Martínez, I. Candel Torres, Valencia: The International Academy of Technology, Education and Development, 2019, s. 729-739Konferensbidrag (Refereegranskat)
    Abstract [en]

    Students need to develop meta-reflection to strengthen their learning process and to be able to manage the continuous changes encountered both higher education and in workplaces. Reflection is the most important for achieving progress within work integrated learning. For students to develop meta-reflection and achieve progression within work integrated learning, they need a systematic structure and conscious tools. The Portfolio method can be one of those tools.In this article we are going to discuss, from a theoretical standpoint, how teachers can develop a better structure for students so that they can strengthen their learning-process and progression of work integrated learning in higher education during internships which in turn promote lifelong learning. This progression of work integrated learning will be discussed in relation to the “WIL4U” model together with examples of reflection questions, learning outcomes, learning activities and examination forms. The “WIL4U” model was developed from the “AIL 4E (DUCATION)” model created by Bernhardsson, Gellerstedt and Svensson.The purpose of this conceptual discussion article is to highlight the portfolio method as a structure and tool for progress work integrated learning by reflection.With support of the portfolio method, the students can develop their ability to make well-balanced, and reflected choices in planning actions for work integrated learning. This requires well-developed self-regulation and the ability to meta-cognition and systematic meta-reflection to evaluate the effects of various actions. The portfolio method can also improve the reflection-process to develop the student's ability to emphasize strengths and increase the ability to achieve the learning outcomes in higher education.

  • 35.
    Larsson, Inga
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Leda patientnära omvårdnadsarbete2019Ingår i: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] Elisabeth Dahlborg, Lund: Studentlitteratur AB, 2019, 3, s. 247-279Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 36.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Agriculture (SLU), Uppsala, Sweden.
    Ekström-Bergström, Anette
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Skövde, School of Health and Education, Skövde, Sweden.
    Berg, Marie
    University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Buckley, Sarah
    The University of Queensland, School of Public Health, Brisbane, Australia..
    Pajalic, Zada
    Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences Oslo, Norway.
    Hadjigeorgiou, Eleni
    University of Technology, Faculty of Health Sciences, Cyprus, Limassol, Cyprus.
    Kotłowska, Alicja
    Medical University of Gdańsk, Faculty of Health Sciences with Subfaculty of Nursing and Institute of Maritime and Tropical Medicine, Gdańsk, Poland.
    Lengler, Luise
    Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany.
    Kielbratowska, Bogumila
    Medical University of Gdańsk, Faculty of Medical Sciences, Gdańsk, Poland.
    Leon-Larios, Fatima
    University of Seville, Faculty of Nursing, Physiotherapy and Podiatry, Seville, Spain.
    Magistretti, Claudia Meier
    Lucerne University of Applied Sciences and Arts, Department of Social Work Center for Health Promotion and Social Participation, Luzern, Switzerland.
    Downe, Soo
    University of Central Lancashire, Research in Childbirth and Health (ReaCH) group, Preston, UK.
    Lindström, Bengt
    Norwegian University of Science and Technology, Trondheim, Norway.
    Dencker, Anna
    University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden .
    Maternal plasma levels of oxytocin during physiological childbirth: a systematic review with implications for uterine contractions and central actions of oxytocin2019Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, nr 1, artikel-id 285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.

    METHODS: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.

    RESULTS: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.

    CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.

  • 37.
    Wennerberg, Mia M.T.
    et al.
    University of Gothenburg, Department of Homecare Health and Nursing, Municipality of Orust , Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg , Sweden.
    Lundgren, Solveig M.
    University of Gothenburg , Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg , Sweden.
    Eriksson, Monica
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Danielson, Ella
    University of Gothenburg, Department of Nursing , Mid Sweden University, Östersund, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg , Sweden.
    Me and You in Caregivinghood: Dyadic resistance resources and deficits out of the informal caregiver's perspective2019Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 23, nr 8, s. 1041-1048Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:To present Specific and Generalized Resistance Resources (SRRs/GRRs) and Deficits (SRDs/GRDs) described by 32 informal caregivers as originating from themselves and their older adult carerecipients as dyads.METHOD:Salutogenic interviewing was used to assemble data from caregivers. A theory-driven, memo-guided and comparative analysis using within- and across- case analysis was applied to unravel resources and deficits influencing the outcomes when they managed tension associated with caregiving.FINDINGS:Living in fellowship in a well-functioning dyad unites the essence of having access to dyadic SRRs/GRRs. Such access enables dyads to use their specific dyadic tension management to resolve challenges through cooperation, derives 'positive' life-experiences and preserves dyad functioning. Struggling alone in a malfunctioning dyad indicates the presence of dyadic SRDs/GRDs counteracting such a development. If these SRDs/GRDs accumulate, the dyad become less able to resolve challenges, 'negative' life-experiences accumulates, the carerecipient's capability to cooperate decreases, caregiver's workload increases, the dyad becomes increasingly malfunctioning and moves towards the point where caregiving ends due to lack of usable SRRs/GRRs.CONCLUSIONS:Findings reveals the complex duality of caregiving and the necessity to assess all available SRRs/GRRs and SRDs/GRDs for caregiving dyads, including out of the carerecipient's perspective. Appropriate 'salutogenic' support reduces SRDs/GRDs, makes available SRRs/GRRs usable or provides alternative SRRs/GRRs, thereby dyadic tension management and dyadic functionality is preserved during this phase of life labelled Caregivinghood. The study adds new knowledge to the salutogenic framework regarding central, theoretical concepts and suggests how data for health promoting initiatives conducted the 'salutogenic way' may be acquired.

  • 38.
    Lundström, Sofie
    et al.
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Hedman Ahlström, Britt
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Mental health nurses' experience of physical health care and health promotion initiatives for people with severe mental illness2019Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Health care for people with severe mental illness is often divided into physical health care and mental health care despite the importance of a holistic approach to caring for the whole person. Mental health nurses have an important role not only in preventing ill health, but also in promoting health, to improve the overall health among people with severe mental illness and to develop a more person-centred, integrated physical and mental health care. Thus, the aim of this study was to describe mental health nurses' experiences of facilitating aspects that promote physical health and support a healthy lifestyle for people with severe mental illness. Interviews were conducted with mental health nurses (n = 15), and a qualitative content analysis was used to capture the nurse's experiences. Analysis of the interviews generated three categories: (i) to have a health promotion focus in every encounter, (ii) to support with each person's unique prerequisites in mind and (iii) to take responsibility for health promotion in every level of the organization. The results show the importance of a health promotion focus that permeates the entire organization of mental health care. Shared responsibility for health and health promotion activities should exist at all levels: in the person-centred care in the relation with the patient, embedded in a joint vision within the working unit, and in decisions at management level.

  • 39.
    Tengelin, Ellinor
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Bülow, Pia H
    University of the Free State, Department of Social Work, Bloemfontein, South Africa.Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Dahlborg Lyckhage, Elisabeth
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Norm-Critical Potential in Undergraduate Nursing Education Curricula: A Document Analysis2019Ingår i: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 42, nr 2, s. E24-E37Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The documents and literature that regulate nursing education are based on certain values and knowledge, and the underlying power in the curriculum raises the question of how health care professionals are molded during the course of their education. Norm criticism is a concept with its roots in critical pedagogy and gender and queer studies, emphasizing the origins as well as the consequences of marginalization, power, and knowledge of what is generally accepted as "normal" and "true." Norm criticism is used in this article to analyze the documents and literature underlying a nursing program in Sweden, which are shown to include a sometimes politically correct rhetoric, but one lacking a firm basis in social justice values.

  • 40.
    Berndtsson, Ina
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Karlsson, Margareta
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå.
    Rejnö, Åsa
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Stroke Unit, Skaraborg Hospital Skövde, Sweden.
    Nursing students' attitudes toward care of dying patients: A pre- and post-palliative course study2019Ingår i: Heliyon, ISSN 2405-8440, Vol. 5, nr 10, artikel-id e02578Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Many nursing students are not prepared to encounter death and care for patients who are at the end of life as newly educated nurses. The Frommelt Attitude Toward Care of Dying Scale (FATCOD) has been used to assess nursing students' attitudes during their education and changes have been noted.

    Objective: To examine nursing students' attitudes towards care of dying patients before and after a course in palliative care.

    Design: A descriptive study with a pre and post design.

    Settings & participants: Nursing students (n = 73) enrolled in a mandatory palliative course in the nursing programme at a Swedish university.

    Methods: Data were collected before and after a palliative care course using FATCOD and qualitative open-ended questions. Data from FATCOD were analysed using descriptive and analytical statistics. The open-ended questions were analysed with qualitative content analysis.

    Results: The students' mean scores showed a statistically significant change toward a more positive attitude toward care of dying. Students with the lowest pre-course scores showed the highest mean change. The qualitative analysis showed that the students had gained additional knowledge, deepened understanding, and increased feelings of security through the course.

    Conclusions: A course in palliative care could help to change nursing students' attitudes towards care of patients who are dying and their relatives, in a positive direction. A course in palliative care is suggested to be mandatory in nursing education, and in addition to theoretical lectures include learning activities such as reflection in small groups, simulation training and taking care of the dead body.

  • 41.
    Löve, J
    et al.
    University of Gothenburg, Department of Public Health and Community Medicine, Gothenburg, Sweden.
    Mehlig, K
    University of Gothenburg, Department of Public Health and Community Medicine, Gothenburg, Sweden.
    Källström, Å
    Örebro University, School of Law, Psychology and Social Work, Örebro,Sweden.
    Hensing, G
    University of Gothenburg, Department of Public Health and Community Medicine, Gothenburg, Sweden.
    Gunnarsdottir, Hrafnhildur
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Gothenburg, Department of Public Health and Community Medicine, Gothenburg, Sweden.
    Parents' socioeconomic position, psychological problems, and emotional neglect in childhood2019Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, nr Supplement_4, s. 365-366, artikel-id ckz187.182Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Despite high prevalence and severe consequences for health and wellbeing, emotional neglect (EN) in childhood is a neglected topic in epidemiological research. To enable prevention of neglect knowledge is important about conditions related to EN such as parental individual characteristics and social/economic situation. Aim to investigate the relationship between parental socioeconomic position (SEP), psychological problems, and EN in childhood.The sample comprised Swedish women, N = 976, mean age 22. EN was assessed by five indicators: maternal/paternal rejection, maternal/paternal lack of time, and occurrence of domestic violence. The associations between parental SEP/psychological problems and EN were examined by logistic regressions.The odds of experiencing domestic violence in childhood was higher among women with parents with low (OR 3.1 95% CI 1.1-8.5) or medium SEP (OR 3.4 95% CI 1.7-6.9). Women who reported maternal psychological problems had higher odds of maternal rejection (OR 6.8 95% CI 3.5-13.0), maternal lack of time (OR 2.4 95% CI 1.2-5.0) and paternal rejection (OR 1.9 95% CI 1.1-3.5). Women who reported paternal psychological problems had higher odds of perceiving their father as rejecting (OR 4.0 95% CI 2.1-7.7), not having enough time for them (OR 4.9 95% CI 2.3-10.6), and experiencing domestic violence (OR 4.9 95% CI 2.1-11.6).Lower SES was not related to EN in form of parental rejection or lack of time but to the occurrence of domestic violence. Parental psychological problems were related to all indicators of EN but differently among mothers and fathers. Public health initiatives aiming at supporting parents should also embrace parental psychological wellbeing.Emotional neglect was clearly related to parental psychological problems but not parental socioeconomic status.Gendered structures need to be considered in studies of emotional neglect.

  • 42.
    Van Bulck, Lisbet
    et al.
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium.
    Luyckx, Koen
    KU Leuven – University of Leuven, School Psychology and Development in Context, Belgium; UNIBS, University of the Free State, South Africa.
    Goossens, Eva
    KU Leuven – University of Leuven, Department of Public Health and Primary Care,Belgium; Research Foundation Flanders (FWO), Belgium; Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium .
    Apers, Silke
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium.
    Kovacs, Adrienne. H.
    University of Toronto, Peter Munk Cardiac Centre, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, USA .
    Thomet, Corina
    Center for Congenital Heart Disease, Bern University Hospital, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium ; KU Leuven – University of Leuven, Department of Cardiovascular Sciences,Belgium .
    Sluman, Maayke A.
    Department of Cardiology, Academic Medical Center, The Netherlands; Department of Cardiology, Jeroen Bosch Hospital, The Netherlands; Coronel Institute for Occupational Health, Academic Medical Centre, The Netherlands.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital – Rikshospitalet, Norway.
    Dellborg, Mikael
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden; Adult Congenital Heart Unit, Sahlgrenska University Hospital, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Berghammer, Malin
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Sweden.
    Caruana, Mayanne
    Department of Cardiology, Mater Dei Hospital, Malta.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, France.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, Italy; Università degli Studi di Milano, Department of Biomedical Sciences for Health, Italy .
    Moons, Philip
    KU Leuven – University of Leuven, Department of Public Health and Primary Care, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Sweden; Department of Paediatrics and Child Health, University of Cape Town, South Africa .
    Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance2019Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, nr 6, s. 465-473Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries' healthcare system performance are of importance for patient-reported outcomes.

    Aims: The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease.

    Methods: A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.

    Results: Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes.

    Conclusion: Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.

  • 43.
    Lindgren, Britt-Marie
    et al.
    Umeå University, Department of Nursing, Umeå, Sweden.
    Ringnér, Anders
    Umeå University, Department of Nursing, Umeå, Sweden. Umeå University, Department of Paediatrics, Umeå, Sweden..
    Molin, Jenny
    Umeå University, Department of Nursing, Umeå, Sweden.
    Hällgren Graneheim, Ulla
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Umeå University, Department of Nursing, Umeå, Sweden.
    Patients' experiences of isolation in psychiatric inpatient care: Insights from a meta-ethnographic study.2019Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, nr 1, s. 7-21Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Historically, people with mental ill-health have been isolated from society. Although mental health care has moved from closed to more open forms of care, in many societies care is still provided in locked wards, and people with mental ill-health are sometimes secluded from their fellow patients, families, friends, and visitors. The aim of this study was to illuminate patients' experiences of isolation in psychiatric inpatient care. A systematic review of qualitative research was conducted, and the key findings were subjected to meta-ethnographic synthesis. The findings were twofold: 'being admitted to prison' and 'having access to shelter'. The experience of isolated care as prison-like symbolizes patients' longing for freedom and feeling restricted and limited by rules, stripped of rights, abandoned, controlled, powerless, and unsupported. In contrast, the experience of isolation as shelter symbolizes safety and the opportunity to regain control over one's own situation. A stigmatizing public view holds that people with mental ill-health are dangerous and unpredictable and, therefore, unsafe to themselves and others. Being placed in isolation because these fears contribute to self-stigma among patients. Promoting a sheltered experience in which isolation is used with respect for patients and the reasons are made explicit may encourage recovery. A shift in emphasis in ward culture from observation to engagement is needed to reduce blame, shift patient experiences from prison to shelter, and to support autonomy as a therapeutic intervention.

  • 44.
    Holbein, Christina E
    et al.
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
    Veldtman, Gruschen R
    King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
    Moons, Philip
    KU Leuven – University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden; University of Cape Town, Department of Paediatrics and Child Health, Cape Town, South Africa.
    Kovacs, Adrienne H
    University of Toronto, Peter Munk Cardiac Centre, University Health Network,Toronto, Canada; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA.
    Luyckx, Koen
    KU Leuven - University of Leuven, School Psychology and Development in Context, Leuven, Belgium ;UNIBS, University of the Free State Bloemfontein, Bloemfontein, South Africa.
    Apers, Silke
    KU Leuven – University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
    Chidambarathanu, Shanti
    Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Eriksen, Katrine
    Adult Congenital Heart Disease Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
    Jackson, Jamie L
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio, USA.
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.
    Fernandes, Susan M
    Stanford University School of Medicine, Department of Pediatrics and Medicine, Division of Pediatric Cardiology and Cardiovascular Medicine, Palo Alto, California, USA.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine,Umeå, Sweden.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Dellborg, Mikael
    Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden .
    Berghammer, Malin
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Menahem, Samuel
    Monash Heart, Monash Medical Centre, Monash University, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Birkirkara, Malta.
    Kutty, Shelby
    University of Nebraska Medical Center/ Children's Hospital and Medical Center, Adult Congenital Heart Disease Center, Omaha, Nebraska.
    Mackie, Andrew S
    University of Alberta, Division of Cardiology, Stollery Children's Hospital,Edmonton, Canada.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Department of Cardiology, Inselspital - Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium.
    White, Kamila
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
    Sluman, Maayke A
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA: KU Leuven – University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
    Callus, Edward
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden .
    Cook, Stephen C
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Cape Town, Cape Town, Department of Paediatrics and Child Health, South Africa .
    Khairy, Paul
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; University of Toronto, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada.
    Cedars, Ari
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Oregon Health & Science University, Knight Cardiovascular Institute, Portland, Oregon.
    Perceived Health Mediates Effects of Physical Activity on Quality of Life in Patients With a Fontan Circulation2019Ingår i: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 124, nr 1, s. 144-150Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patients with a Fontan circulation are at risk of a sedentary lifestyle. Given the direct relationship between physical activity and health, promotion of physical activity has the potential to improve outcomes, including quality of life (QOL). This study aimed to describe self-reported physical activity levels in adult Fontan patients and examine associations between physical activity, perceived health status and QOL. The sample consisted of 177 Fontan patients (Mage = 27.5 ± 7.6 years, 52% male) who reported their physical activity, perceived health status, and QOL as part of the cross-sectional Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study. Descriptive statistics and univariate analyses of variance with planned contrasts were computed to describe physical activity characteristics. Mediation analyses tested whether perceived health status variables mediated the association between physical activity and QOL. Forty-six percent of patients were sedentary while only 40% met international physical activity guidelines. Higher physical activity was associated with younger age, lower NYHA class, higher perceived general health, and greater QOL. Patients who commuted by walking and engaged in sports reported better perceived health and QOL. Mediation analyses revealed that perceived general health but not NYHA functional class mediated the association between physical activity and QOL (αβ = 0.22, 95% confidence interval = 0.04 to 0.49). In conclusion, Fontan patients likely benefit from regular physical activity, having both higher perceived general health and functional capacity; greater perceived health status may contribute to enhanced QOL. In conclusion, these data support the pivotal role of regular physical activity for Fontan patients.

  • 45.
    Alabaf, Setareh
    et al.
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Gothenburg, Sweden.
    Gillberg, Christopher
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Gothenburg, Sweden.
    Lundström, Sebastian
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Gothenburg, Sweden. Center for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Lichtenstein, Paul
    Karolinska Institute, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Kerekes, Nora
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Råstam, Maria
    University of Gothenburg, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Gothenburg, Sweden. Lund University, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden.
    Anckarsäter, Henrik
    University of Gothenburg, Center for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, Gothenburg, Sweden.
    Physical health in children with neurodevelopmental disorders2019Ingår i: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 49, nr 1, s. 83-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    With increasing numbers of children being diagnosed with neurodevelopmental disorders (NDDs) attention has been drawn to these children's physical health. We aimed to identify the prevalence of defined physical problems (epilepsy, migraine, asthma, cancer, diabetes, psoriasis, lactose intolerance, celiac disease, diarrhea, constipation, daytime enuresis, encopresis) in a nationwide population of 9- and 12-year-old twins subdivided into those with and without indications of NDDs. Parents of 28,058 twins participated in a well-validated telephone interview regarding their children's mental health and answered questions about their physical problems. The results indicate a high rate of physical problems in children with NDDs, particularly in those with indications of the presence of combinations of several NDDs.

  • 46.
    Björck, Ville
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Johansson, Kristina
    Högskolan Väst, Institutionen för individ och samhälle, Avdelningen för psykologi, pedagogik och sociologi.
    Problematising the theory€-practice terminology: a discourse analysis of students'€™ statements on Work-integrated Learning2019Ingår i: Journal of Further and Higher Education, ISSN 0309-877X, E-ISSN 0013-1326, Vol. 43, nr 10, s. 1363-1375Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study uses a Foucault-inspired discourse analysis to examine two ideas about learning which reinforce the terminology whereby theory means campus-based training and practice means work placements. The purpose is to problematise this theory–practice terminology and provide scope for a non-dualistic alternative. The ideas examined are the idea of theory vs. practice as the point of departure for learning and the idea of theory and practice as harmonious points of departure for learning. These ideas were voiced by interviewed students who discussed the usual design of Work-integrated Learning (WIL) whereby students go to university to learn ‘theory’ and into working life to learn ‘practice’. The analysis shows how the ideas are formed by different ranking orders between theory and practice which are mutually exclusive, while also working together to reinforce the theory–practice terminology. The discussion on how a non-dualistic terminology can emerge highlights how the usual WIL design forms a dualistic setting where the theory–practice terminology thrives and how designing WIL at a third place between university and working life can provide scope for the terminology we seek.

  • 47.
    Arveklev Höglund, Susanna
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Gunnarsdottir, Hrafnhildur
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Eriksson, Monica
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Relations and interrelations between Sense of Coherence, socioeconomic status and health behaviour: A systematic review2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background/Objectives

    Previous research shows that the stronger the sense of coherence (SOC) the healthier behaviour. A strong SOC seems to be related to lower consumption of drugs and smoking, more frequent physical exercises and healthier food choices. Further it is established by previous research that there is a difference in health behaviour between socioeconomic groups. Individuals with lower socioeconomic status (SES) smoke to greater extent, have more sedentary lifestyle and make unhealthier food choices than individual with higher SES. The evidence regarding the interactive relations of SOC and SES to health behaviour or the potential mediating role of SOC in the relationship between SES and health behaviour is more unclear. In order to explore this, there is a need of systematic reviews of the evidence concerning SOC and health behaviour and interactions with SES.

    Thus, the objective of this study is to explore and synthesize empirical findings on the relationship between SOC and health behaviour among adults. Further the aim is to explore to what extent interactions with SES is considered in the studies of SOC and health behaviour.

     Methods

    The study is descriptive and analytical with a systematic integration of the contemporary knowledge base on the salutogenic research focusing on the relationship between sense of coherence and health behaviour among adults and interrelations with socioeconomic status. The review covers scientific publications as well as doctoral theses published 2008–2018. The review is systematic in the sense that all the included papers will be critically examined and analyzed according to (1) the study objective, (2) the study designs and methods for analysis and, (3) the applicability and practical use of the results.

     Results

    Expected outcomes of this study will be established state of the art regarding the relationship between sense of coherence and health behavior and interrelations with socioeconomic status. Further the results will identify knowledge gaps important to address in future research.

    Discussion

    The potential contribution of the synthesized knowledge to achieve a sustainable and equal development of health will be discussed as well as to what extent health inequalities can be explained or understood by SOC.

     

     

     

  • 48.
    Emilsson, Maria
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Berndtsson, Ina
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping , Sweden..
    Horne, Robert
    University College London, Centre for Behavioural Medicine, UCL School of Pharmacy, London , UK.
    Marteinsdottir, Ina
    Linnæus University, Department of Medicine and Optometry Faculty of Health and Life Sciences, , Kalmar , Sweden.
    Reliability and validation of Swedish translation of Beliefs about Medication Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with attention-deficit hyperactivity disorder.2019Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The purpose of this study was to assess the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Methods: Forward and backward translations of the BMQ-Specific and B-IPQ scales to Swedish were conducted and reviewed by adolescents with ADHD and professionals. The validity and reliability of both questionnaires were investigated in a cross-sectional study of 101 adolescents (13-17 years) on a long-term prescription of ADHD medication recruited from two child and adolescent psychiatric outpatient clinics in Sweden. Results: Regarding the BMQ-Specific, principal component analysis (PCA) loadings confirmed the previously defined components of Specific-Necessity and Specific-Concern. The PCA for B-IPQ revealed two components, the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the capability to manage the ADHD disorder (items 3, 4 and 7). The Cronbach alpha coefficients for BMQ-Specific-Necessity scale was α = 0.80, for BMQ-Specific-Concern scale α = 0.75, B-IPQ Consequences α = 0.74 and for B-IPQ-Control α = 0.44. Conclusions: The present results prove the Swedish translation of BMQ-Specific and B-IPQ to be valid and reliable for utilization in adolescents with ADHD. The PCA confirmed the original components for BMQ-Specific and the recent findings of two main B-IPQ components describing emotional and cognitive implications versus the capability for self-care maintenance of ADHD.

  • 49.
    Mjøsund, Nina Helen
    et al.
    Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway.
    Eriksson, Monica
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen for hälsopromotion och vårdvetenskap.
    Norheim, Irene
    Norwegian University of Science and Technology, NTNU Center for Health Promotion Research, Department of Public Health and Nursing, Trondheim, Norway.
    Espnes, Geir Arild
    Norwegian University of Science and Technology, NTNU Center for Health Promotion Research, Department of Public Health and Nursing, Trondheim, Norway.
    Forbech Vinje, Hege
    University College of Southeast Norway, Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Reorienting Norwegian mental healthcare services: listening to patients' learning appetite2019Ingår i: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 34, nr 3, s. 541-551Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Reorientation of healthcare services towards more efficient health promotion interventions is an urgent matter. Despite policies and guidelines being in place, it is the least developed key action area of the Ottawa charter. User involvement, or the voice of the patient, is missing from the knowledge base of health promotion in the mental healthcare services. The aim of this study was to add experiential knowledge from former patients. We explored the lived experience of 12 former inpatients at a mental healthcare hospital. We describe what they perceive as mental health promoting efforts. A salutogenic theoretical framework and the methodology of interpretative phenomenological analysis were used. The analysis revealed an appetite for learning in order to develop an in depth understanding of their former experiences. This was motivated by a desire to master daily life despite living with an illness and to increase health and well-being. The participants perceived the learning processes within the healthcare setting as mental health promoting. This craving for a better life is compatible with health promotion. It may turn out to be an opportunity to complement the curative activity of healthcare services with health promotion educational activities.

  • 50.
    Rönnerhag, Maria
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - grundnivå. University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.
    Berggren, Ingela
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Risk Management: evaluation of healthcare professionals reasoning about and understanding of maternity care2019Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, nr 6, s. 1098-1278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To evaluate healthcare professionals' explanations of the prerequisites for safe maternity care and understanding of risk management, including the underlying reasons for decision‐making intended to ensure safe care.Background: Risk management focuses on maintaining and promoting safe care by identifying circumstances that place childbearing women at risk of harm, thus reducing risks.Methods: A hermeneutic action research approach was chosen. Through a series of focus group sessions we uncovered healthcare professionals' explanations of risk management.Results: One overriding theme emerged; The consequences of what managers do or fail to do constitute the meaning of taking responsibility for team collaboration to provide safe care. Inadequate support, resources and staff shortages have consequences, such as inability to concentrate on team communication and collaboration, leading to the risk of unsafe care.Conclusion: Communication constitutes a prerequisite for both team collaboration and risk management. Thus, communication is linked to the ability of managers and healthcare professionals to provide safe care.Implications for Nursing Management: In terms of safety management, nurse managers have a significant role in and responsibility for supporting communication training, developing guidelines and providing the prerequisites for interprofessional team reflection.

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