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  • 151.
    Berg, Karin
    University West, Department of Nursing, Health and Culture.
    Transkulturell omvårdnad: att bemöta patienters kulturella behov : en litteraturstudie2004Independent thesis Advanced level (professional degree)Student thesis
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  • 152.
    Bergehall, Anna-Karin
    et al.
    University West, Department of Nursing, Health and Culture.
    Sjöberg, Pernilla
    University West, Department of Nursing, Health and Culture.
    Främjande faktorer för anknytning mellan mor och barn under det första levnadsåret2006Independent thesis Advanced level (professional degree)Student thesis
    Abstract [sv]

    Background: The early relations are the most important relationship. The child is totally dependent of caring. A child being neglected during the early years suffers consequences for the rest of their life. Aim: The aim of this study was to find out about the promoting factors for mother and child attachment during the first year. Methods: A literature review was chosen for this study. The search of literature was carried out from the two databases Academic Search Elite and Cinahl. Nine articles were selected, studied and analysed by the authors. Results: The results of the study showed that one of the most important promoting factors for attachment between mother and child during the first year is the mother´s self-esteem. Other promotion factors are the support of the spouse, relatives and friends. The temperament of the child is important, an easy child makes the mother feel competent. A difficult child makes the mother feel incompetent and inadequate. The affirmation support from the nurse at the child welfare centre has a great importance for the mother`s self-esteem.

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  • 153.
    Berggren, Caroline
    et al.
    Institutionen för pedagogik och specialpedagogik, utbildningsvetenskapliga fakulteten, Göteborgs universitet.
    Cliffordson, Christina
    University West, Department of Nursing, Health and Culture.
    Widening participation trends in Sweden: Regulations and their effects, intended and unintended2012In: Widening Participation in Higher Education: casting the net wide? / [ed] Hinton-Smith, Tamsin, London: Palgrave Macmillan, 2012, p. 197-212Chapter in book (Other academic)
    Abstract [en]

    Widening Participation in Higher Education: Casting the Net Wide? offers an authoritative up-to-date commentary on the challenges facing higher education today, through the perspectives of experts representing universities across the UK, Europe, Africa and the USA. Contributors draw on recent empirical research as well as analysis of historical developments and emerging policy to provide an understanding of these issues of widening participation to educational practitioners, policy makers and academics alike. Up-to-date insights chart the impact of global economic trends and recent policy developments for students, academics, providers and changing course provision. Contributions from emerging and established experts address a broad range of relevant issues, from the question of grade inflation through to the effectiveness of peer outreach programmes. The book provides insight into how the effects of trends including marketization and globalization will continue to impact pivotally on the extent to which higher education is able to act as a force for social equalization or exclusion of opportunities.

  • 154.
    Berggren, Göran
    et al.
    University West, Department of Nursing, Health and Culture.
    Lawson, Marcus
    University West, Department of Nursing, Health and Culture.
    Solberg, Per
    University West, Department of Nursing, Health and Culture.
    En grupp sjuksköterskors upplevelser av att dokumentera elektronisk patientjournal2004Independent thesis Advanced level (professional degree)Student thesis
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  • 155.
    Berggren, Hanna
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Nygren, Emma
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Kvinnors upplevelse av sexualitet efter avslutad behandling av gynekologisk cancer: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background; Gynecological cancer is a common term for cancer in the female genitals and 2013 there were about 2800 women in Sweden that was diagnosed. This form of cancer and the treatment that is used, affects the sexuality and also the fertility of the women.

    Aim; The purpose with the essay was to illustrate the experience of the sexuality after the treatment of gynecological cancer.

    Method; The method used in the essay was a systematic translation of different literature. Of all the articles used there were eight that was qualitative, two quantitative and one was a combination of both methods. The analytic process was accomplish with the support of the Friberg (2006) analytic method.

    Results; The analysis resulted in two categories; Physical changes after the treatment and the treatments impact on the sexuality of the women. The physical changes that occurred because of the treatment was recurring and it showed that it was primarily surgery that hurt the woman body. It was also shown that the biggest impact that the treatment had on sexuality was pain and reduced desire for sex. And it also showed that sexuality got a new meaning for the women and they found new ways to express their feelings towards their partner.

    Conclusion; It was showed that the sexual experience primarily was affected by the physical consequences that the treatment had and not only because of the cancer itself. And it can because of this conclution be of significance that the nurse focus on the effects of the treatment, like vaginal anatomy and physical and psychological effects to be able to support the womans sexual well-being

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  • 156.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Etisk undran i omvårdnadshandledning2014In: Hermeneutik i vårdpraxis: det nära, det flyktiga, det dolda / [ed] Erna Lassenius & Elisabeth Severinsson, Malmö: Gleerups Utbildning AB, 2014, p. 187-196Chapter in book (Other academic)
  • 157.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Etiska kärnbegrepp i omvårdnadshandledning2009In: Omvårdnadshandledning: ur etiskt och tvärdisciplinärt perspektiv / [ed] Barbosa da Silva, António, Berggren, Ingela Nunstedt, Håkan, Lund: Studentlitteratur , 2009, 1., p. 193-209Chapter in book (Other academic)
  • 158.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Omvårdnadshandledning i teori och praktik2009In: Omvårdnadshandledning: ur etiskt och tvärdisciplinärt perspektiv / [ed] Barbosa da Silva, António,Berggren, Ingela, Nunstedt, Håkan, Lund: Studentlitteratur , 2009, 1., p. 23-43Chapter in book (Other academic)
  • 159.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Vårdandets etik2010In: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] Dahlborg Lyckhage, Elisabeth, Lund: Studentlitteratur , 2010, 1, p. 125-144Chapter in book (Other academic)
  • 160.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Barbosa da Silva, António
    University of Stavanger.
    Severinsson, Elisabeth
    University of Stavanger, Department of Health Studies.
    Core ethical issues of clinical nursing supervision2005In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 7, no 1, p. 21-8Article in journal (Refereed)
    Abstract [en]

    Clinical nursing supervision enables supervisees to reflect on ethically difficult caring situations, thereby strengthening their professional identity, integrating nursing theory and practice, and leading to the development of ethical competence. The aim of this study was to develop an understanding of the core ethical issues of clinical nursing supervision, using previous research as well as philosophical analysis of the theories of three moral philosophers: Harald Ofstad, Richard Hare and Carol Gilligan. The ultimate aim of this study was to develop a general model for ethical decision-making and to establish its relevance for clinical nursing supervision. The findings highlight four important values for the development of a basis for ethical decision-making. These values are caring, dignity, responsibility and virtue.

  • 161.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Carlstrom, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Decision making within a community provider organization2010In: British Journal of Community Nursing, ISSN 1462-4753, E-ISSN 2052-2215, Vol. 15, no 12, p. 611-617Article in journal (Refereed)
    Abstract [en]

    Aim: To explore community nurses' experiences of decision making within the community provider organization. Background: Recent changes in health care with an increasing number of patients being cared for outside of institutions can put considerable pressure on the nurse with respect to decision making. Methods: In-depth interviews were performed with 6 registered nurses in two communities. The interviews were analysed by means of phenomenological hermeneutics. Results: The community nurses' experiences of decision making were interpreted as spiders or octopuses, consultants and troubleshooters. The subthemes were; networking and structuring, responsibility, availability and knowledge, assessment power, information selection, avoiding rules and bypassing managers. In accordance with hermeneutical phenomenology, the findings were discussed and explained with reference to Ofstad's philosophy of freedom to make decisions. Conclusion: In their decision making, community nurses are committed to finding administrative solutions that satisfy patient needs.

  • 162.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Ho, Agnes Yin Kwan
    Diabetes empowerment related to Pender's Health Promotion Model: A meta-synthesis2010In: Nursing & Health Sciences, ISSN 1441-0745, Vol. 12, no 2, p. 259-267Article in journal (Refereed)
    Abstract [en]

    Diabetes self-management is a challenge for both clients and health-care professionals. Empowerment plays a vital role in helping clients to achieve successful self-management. This study adopted a meta-ethnographic approach. Nine qualitative studies were synthesized in order to contribute to a deeper understanding of what clients perceive as being important in an effective empowerment strategy for diabetes self-management. Four central metaphors that influenced empowerment were identified: trust in nurses' competence and awareness, striving for control, a desire to share experiences, and nurses' attitudes and ability to personalize. The lines-of-argument synthesis suggested the need for an evaluation system to appraise clients' diabetes knowledge, health beliefs, and negative emotions, as well as the outcome of interventions. Based on Pender's Health Promotion Model, this study emphasizes the fact that health-care professionals need to understand and address modifiable behavior-specific variables. The study suggests that an effective empowerment strategy would be to use activity-related affect, as well as interpersonal and situational influences, as a means of facilitating and enhancing clients' health-promoting behaviors.

  • 163.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Severinsson, Elisabeth
    University of Oslo.
    The influence of clinical supervision on nurses' moral decision making.2000In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 7, no 2, p. 124--133Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the influence of clinical supervision on nurses´

    moral decision making. The sample consisted of 15 registered nurses who took part in

    clinical supervision sessions. Data were obtained from interviews and analysed by a

    hermeneutic transformative process. The hermeneutic interpretation revealed four

    themes: increased self-assurance, an increased ability to support the patient, an increased

    ability to be in a relationship with the patient, and an increased ability to take responsibility.

    In conclusion, it seems that clinical supervision enhances nurses´ ability to provide

    care on the basis of their decision making. However, the qualitative and structural aspects

    of clinical supervision have to be investigated further in order to develop professional

    insight into the way that nurses think and react. 

  • 164.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Severinsson, Elisabeth
    University of Stavanger, Faculty of Social Sciences.
    The significance of nurse supervisors' different ethical decision-making styles2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 8, p. 637-43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The role of the nurse supervisor is very important, because of his/her ability to influence the atmosphere within the clinical nursing supervision group. AIM: To present and interpret nurse supervisors' different ethical decision-making styles. METHOD: A hermeneutic interpretation of three studies on nurse supervisors' different ethical decision-making styles. RESULTS: The significance of the nurse supervisor's ethical decision-making style is reflected in the awareness of their responsibility for creating a relationship with the supervisee. The supervisors focus on ensuring safety, integrating theoretical knowledge and clinical practice, willingness and preparedness to supervise on the substance of nursing, sharing the supervisees' feelings and challenging them, reflecting on the content of clinical nursing supervision as well as promoting justice and integrity in clinical nursing supervision. CONCLUSIONS: The interpretation highlights the importance of the nurse supervisor's style for the outcome of clinical nursing supervision, as they are role models for the supervisees. There is a need for further research to explore the advantages and disadvantages of nurse supervisors' different ethical decision-making styles, especially in relation to the influence of clinical nursing supervision on the quality of care and various support systems.

  • 165.
    Berggren, Ingela
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Severinsson, Elisabeth
    Vestfold University College, Tönsberg, Norway.
    The State of the Science of Clinical Supervision in Europe 2010In: Routledge handbook of clinical supervision : fundamental international themes   / [ed] Cutcliffe, John, Hyrkäs, Kristiina, Milton Park, Abingdon, Oxon. UK: Routledge , 2010, p. 327-337Chapter in book (Other academic)
  • 166.
    Bergh, Anne-Louise
    et al.
    University of Borås.
    Friberg, Febe
    University of Stavanger.
    Persson, Eva
    Lund University.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Perpetuating ‘New Public Management’ at the expense of nurses’ patient education: a discourse analysis2015In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 22, no 3, p. 190-201Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore the conditions for nurses’ daily patient education work by focusing on managers’ way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their role as a supporter of the patient education provided by nurses, nor their role in the development of nurses’ pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses’ provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost-effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses’ patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice.

  • 167.
    Bergh, Madeleine
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Sjuksköterskans pedagogiska funktion och kompetens i mötet med närståeden2012In: Pedagogik inom vård och handledning / [ed] Pilhammar Andersson, Ewa, Lund: Studentlitteratur, 2012, 2., [rev.] uppl, , p. 172 s.p. 65-88Chapter in book (Other academic)
  • 168.
    Bergh, Madeleine
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Carlson, Elisabeth
    Malmö högskola. Fakulteten Hälsa och samhälle.
    Friberg, Febe
    Sahlgrenska akademin vid Göteborgs universitet.
    Gedda, Birgitta
    University West, Department of Nursing, Health and Culture.
    Häggström, Eva
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Pilhammar, Ewa
    Sahlgrenska akademin vid Göteborgs universitet.
    Pedagogik inom vård och handledning2012 (ed. 2., [rev.] uppl.)Book (Other academic)
  • 169.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Sahlgrenska Academy, Institute of Medicine.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Rydberg, Annika M.
    University of Umeå, Department of Clinical Sciences, Pediatrics.
    Dellborg, Mikael
    Sahlgrenska Academy, Institute of Medicine.
    Ekman, Inger
    University of Gothenburg, Centre for Person-Centred Care.
    Committed to Life: Adolescents’ and Young Adults’ Experiences of Living with Fontan Circulation2015In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 10, no 5, p. 403-412Article in journal (Refereed)
    Abstract [en]

    Background Single ventricle defects are among the most complex congenital heart defects and the development of advanced surgical procedures in recent decades has created the first generation of adolescents and young adults living with this condition. Yet little is known about how these individuals experience life and what impact the heart defect has on their life in general. Objective The aim was to illuminate and gain a deeper understanding of adolescents’ and young adults’ experiences of living with a surgically palliated univentricular heart. Design Seven open-ended in-depth interviews were conducted, transcribed, and analyzed according to the henomenological hermeneutical method. All adolescents and young adults operated before 1995 according to the Fontan procedure or the total cavo-pulmonary connection procedure at one pediatric cardiology unit were included in the study. They were 17–32 years of age (median age 22 years). Results The interpretation of the interview transcripts showed that the participants experienced living with a surgically palliated univentricular heart in terms of feeling exceptional, strong, and healthy. This was supported by two structural analyses, where three themes emerged: happiness over being me, focusing on possibilities, and being committed to life. Conclusion Living with a Fontan circulation included negative experiences but the analyses clearly demonstrated a feeling of being strong and healthy. An appreciation of having survived and being committed to life was found to be an integral part of the development of the interviewees’ existential growth. This probably strengthens them further in their ability to balance expectations and hurdles in life. This study provides valuable insights into the experience of patients after the Fontan procedure and the importance of a positive health care environment throughout their lives.

  • 170.
    Bergholm, Daniel
    et al.
    University West, Department of Nursing, Health and Culture.
    Möller, Hannes
    University West, Department of Nursing, Health and Culture.
    Mer liv till åren och inte enbart fler år till livet: Kan en ökad fysisk styrka och explosivitet bidra till en ökad livskvalitet?2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research on Sarcopenia shows that muscle atrophy affects the physical functioning during aging and can be prevented by various forms of strength training. Research on muscle atrophy aroused our interest in strength training for older adults and also the strength training effects on quality of life.

    Aim: The aim of this study is to investigate whether an increase in physical strength and explosiveness contributes to a better quality of life in people aged between 55 and 65 years.

    Method: This has been explored with inspiration from action research in a group of fifteen participants. Data was collected with the instruments MuscleLab, SF-36v2 and memos.

    Results: Nine participants showed an increase in power development and six participants showed a decrease. Quality of life has increased in all eight categories for the group as a whole, meaning that both the physical and mental health has increased in the group.

    Conclusion: Increased strength and explosiveness does not, in our case, necessarily mean a better quality of life, but we consider that the change in quality of life rather depends on a higher level of activity in itself. This is because the strength of the group as a whole increased only marginally, but that quality of life has increased all the more.

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    Examensarbete - Mer liv till åren och inte enbart fler år till livet
  • 171.
    Berglind, Betty
    University West, Department of Nursing, Health and Culture.
    Sjuksköterskans omvårdnad av patienter med myelomatos och associerad kronisk smärta: en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Multiple myeloma is a malignant incurable cancer disease associated with severe chronic pain. The nurse has several important roles in the management of patients with multiple myeloma. This study focuses on nurse´s roles including the caring of pain relief.

    Aim: The aim of this study was to elucidate the nurse’s role in giving care to patients with multiple myeloma and associated chronic pain.

    Method: This literature study was based on scientific articles.

    Results: The nurse is in a key position to facilitate ongoing adequate pain and psychosocial assessment of patients with multiple myeloma. The study presents ways of relieving pain and suffering via different ways of caring management. Five themes emerged: communication, support, distraction, information and education, pain assessment and evaluation. The nurse´s roles are acknowledged, and associated ethical dilemmas are presented. Knowledge about how to decrease pain and suffering by non-pharmacological means, improves the nurse´s possibility to manage difficult situations in patients with incurable cancer.

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  • 172.
    Berglund, Britta
    et al.
    Karolinska University Hospital, Nursing Division, Department of Medical and Surgical Gastroenterology.
    Mattiasson, Anne-Cathrine
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Randers, Ingrid
    Sophiahemmet University College.
    Dignity not fully upheld when seeking health care: Experiences expressed by individuals suffering from EhlersDanlos syndrome2010In: Disability and Rehabilitation, ISSN 0963-8288, Vol. 32, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    AIM: The principle of human dignity has assumed importance in ethics and constitutional law throughout the 20th century in the Western world. It calls for respect of each individual as unique, and of treating him or her as a subject, never as a mere object. As such, the principle constitutes an ethical cornerstone in health care. Patients suffering from Ehlers-Danlos syndrome (EDS) challenge medical care and knowledge in health-care professionals' as symptoms sometimes are vague. Individuals with this disorder have reported not being respected when seeking health care.

    PURPOSE: To describe encounters in health-care situations when individuals suffering from EDS experienced that their dignity was not fully upheld. A further aim was to describe the long-term consequences of these experiences.

    METHOD: A study-specific questionnaire was designed, where individuals with EDS described their encounters with health care from a personal perspective.

    RESULTS: After qualitative content analysis, the following five categories were identified: 'Being ignored and belittled by health-care professionals,' 'Being assigned psychological and/or psychiatric explanations', 'Being treated and considered merely as an object', 'Being trespassed in one's personal sphere' and 'Being suspected of family violence'. Consequences of these encounters were 'Mistrusting the physician' and 'Risking bad health'.

    CONCLUSIONS: The memory of not being respected is substantial for individuals with EDS and can last for years. As a result, lack of trust for the health-care system is created and they may experience difficulties in future encounters with health care. Therefore, health-care professionals should base their actions on norms that protect human dignity and confirm each patient as a unique human being with resources and abilities to master their own life.

  • 173.
    Berglund, Christin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Stake, Emma
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Tillsammans kämpar vi mot cancer som en familj: En litteraturbaserad studie om barns erfarenheter av att ha en förälder med diagnostiserad cancer2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Every year 3000-4000 children in Sweden loses a parent due to accident and illness which means that every day nine children suffer from losing one of the most important person in their life. Cancer is expected to increase from 14 million to 22 million over the next two decades, in the future it will become increasingly common for nurses to meet a child whose parent has cancer. Aim: The aim of this study was to illuminate children's experiences of having a parent diagnosed with cancer. Method: A literature-based study based on eight articles from the databases Cinahl and ProQuest was chosen, read, reviewed and analyzed according to Friberg's analyzing model. Results: Five themes with 11 sub-themes emerged; "Feeling need of support", "The world turns upside down", "Cancer is equal to death", "Changed outlook on life" and "Putting words into feelings". According to young people's perspective the crisis resulted in a positive way of life. Conclusion: Children's anxiety and fear is the greatest when the parent get the diagnosis and future forecast. It is important to provide a safe support since the children's world is turned upside down.

  • 174.
    Bergman, Annika
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Våga välja lämna ifrån sig makten: att möjliggöra ökad delaktighet för patienter som behndlas med dialys2013Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
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  • 175.
    Bergman, Annika
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Gustavsson, Anna-Lena
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Ökad kunskap hos sjuksköterskor om orsaker till bristande följsamhet förbättrar patienters delaktighet2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In today’s health care it’s most common to treat an illness with a kind of pharmaceutical preparation. But lack of resources, given information and bad communication and collaboration between the patient and the nursing staff can lead to a patient unwilling to follow the doctor’s prescription. This does not just affect the individual patient’s health but it can also result in consequences for other people and the whole society. The purpose of this study was to analyse studies about the concepts compliance and concordance in order to illustrate why patients with chronic illnesses fail to follow their prescriptions. Our method has been to read and analyse the methods and results of articles out of the perspective similarities and differences of the concepts compliance and concordance. It was hard to keep the concepts separated because of their similar meanings. Our result shows that the method used was interviews with questionnaires which has been analysed on the basis of the qualitative studies’ themes and categories. The quantitative articles’ data were displayed statistically. Our analyse showed that patients often lack knowledge about their medical treatment which affects their attitudes and can lead to bad compliance and concordance. As a nurse it’s therefore important to identify the cause that affects the patient. The nursing staff’s goal ought thus to be to get the patient involved as much as possible in their self-care. If the patient is involved in hers/his treatment, it’s more likely that they feel a responsibility towards themselves and therefore gets a better quality of life.

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  • 176.
    Bergqvist Boström, Ewa
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Nilsson Wicke, Lena
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Att lyssna är att stödja: Sjuksköterskors erfarenheter av patienter med utmattningssyndrom2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness where fatigue syndrome is one of the diagnoses is an increasing problem. Many persons with fatigue syndrome experience abandonment and do not achieve the help they need and are entitled to. Time for conversation and self-care is an important part of rehabilitation where primary healthcare and occupational healthcare have a prominent role Aim: This study's purpose was to explore what experience that nurses in primary and occupational healthcare had of patients with fatigue syndrome. Method: Eight nurses from primary and occupational healthcare were interviewed using semi-structured questions. The interview material was analyzed using content analysis. Results: A theme listening and two categories gatekeeper and create comprehensibility emerged. All nurses had initially long conversations with the patients, but their experience differed. Some of the nurses told that they were important to the patients and others indicated that they were not working with this patient group. Conclusion: All nurses describes that what they do means that they are listening to the patients at the same time that several of them not explicit express it as a support. That can be interpreted as the relation part of nursing are invisible for the nurses who does not perceive their listening valuable for the patients.

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  • 177.
    Bergqvist, Karin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Johansson, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Att arbeta med tolk vid bedömningar: sjuksköterskors upplevelser av kvalitén2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Studies show that when nurses are experiencing problems in the care of non-Swedish speaking patients, it is often due to obstacles in the communication. Studies also show that a prerequisite for adequate care is that there is a basis for a direct communication. Nurses perceive interpreters as an important link to the patient when they do not share a mutual language, the nurses perceive interpreters as a bridge in the conversation.

    Aim:

    The purpose of the study is to describe nurses' experiences of the quality of assessments done with the help of an interpreter.

    Method:

    The study was conducted through interviews with ten nurses, working at psychiatric clinics. Qualitative content analysis was used for the analysis, which resulted in five categories.

    Results:

    The analysis resulted in one theme: "it´s the interpreter who tells me and have not the feeling that the patient has" and five categories: "shades of the language", "conversation structure", "the interpreter's competence", "interpreting implementing" and "the interpreter's gender and origin". The nurses experience working with interpreters as a challenge. The difficulty of working with the help of an interpreter is that the nurse cannot see the spoken word in connection with the patient's body language. Communication through an interpreter also felt unnatural and the interpreter's participation is perceived as a filter.

    Conclusion:

    The quality of the assessments were not perceived as good with the interpreter as without, however, there was no risk to patient safety.

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  • 178.
    Bergström, Emma
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Davallius, Johanna
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Upptäckt av kvinnomisshandel: Hinder och möjligheter i vården2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Domestic violence is a growing problem. Nurses in emergency departments often meet abused women when seeking healthcare for injuries. The woman often concealed the true reason for seeking medical attention and nurses also avoided asking. Consequently many failed to be discovered and further abuse were at risk. The aim of this literary review was to illuminate the hindrance and possibilities in health care to discover domestic violence. Eleven articles were analyzed. Hindrance to discover domestic violence was attitudes among nurses, lack of knowledge concerning the importance of communication skills and risk factors for domestic violence when enhanced attention was needed. The presence of the partner, feelings of shame and insecurity were also hindrance for the women to tell. There were cultural differences what was considered as domestic violence. There were also lack of resources and time. Guidelines and screening were often absent even though it was an efficient way to discover domestic violence. Education was requested by nurses and improved their sense of security when meeting abused women. Nurses and health care organizations have both an obligation to be updated about and using best practice. In a time of lacking resources it is even more important. Then there are increasing possibilities to discover abused women and be able to give them proper attention. This decreases the risk of further discrimination of abused women in health care.

  • 179.
    Bergström, Ola
    et al.
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Strömvall, Johan
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Elever från samma klass?: En studie av hur elever i en skolklass på Komvux tolkar filmen Crash.2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I den här uppsatsen har vi studerat hur en film aktiverar människors sociala och kulturella positioner. Vi visade filmen Crash för åtta komvuxelever, vilket följdes av en kvalitativ intervju med dem. Eleverna fick svara på frågor om sin egen bakgrund, filmens budskap och rollfigurer, hur de uppfattade filmen och den föreslagna verkligheten i filmen, samt frågor kring sin egen framtid. Informanternas svar har hjälpt oss att synliggöra hur det görs över- och underordningar i filmen. Med hjälp av vår bakgrund och analytiska verktyg har vi interagerat med våra informanter och de har bidragit med perspektiv som vi aldrig hade kunnat se med tillämpning av enbart teorier. Något som blev framträdande var att de applicerade problematiken som den amerikansktillverkade filmen tar upp, på ett svenskt samhälle. Vi kom fram till att filmen som populärkulturellt medel hjälper till att reproducera gamla maktordningar och fördomar. Trots att detta inte var filmskaparens intention, blir det här till fördomar och stereotypa föreställningar om att det finns rasskillnader. Med den här studien har vi synliggjort att filmen medverkar till att reproducera maktordningar. Film och dess folkliga inflytande, skulle kunna bli ett redskap för nytänkande runt klass, kön och etnicitet med mera.

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  • 180.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Blåljusorganisationer på olycksplatsen: om samverkansminimering2009In: Offentlig sektor och komplexitet: om hantering av mål, strategier och professioner / [ed] Adolfsson, Petra & Solli, Rolf, Lund: Studentlitteratur , 2009, p. 59-79Chapter in book (Other academic)
  • 181.
    Berlin, Johan
    et al.
    Institutionen för vårdvetenskap och hälsa, Göteborgs universitet.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Christensen, Tom (2005). Organisationsteori för offentlig sektor. 1. uppl. Malmö: Liber2007In: Statsvetenskaplig Tidskrift, ISSN 0039-0747, Vol. 109, no 4, p. 94-96Article, book review (Other (popular science, discussion, etc.))
  • 182.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Dolda artefakters betydelse: -En kritisk studie av kulturella uttryck inom psykiatrin2010In: Nordiske organisasjonsstudier, ISSN 1501-8237, Vol. 12, no 2, p. 27-44Article in journal (Refereed)
  • 183.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    From artefact to effect: the organising effects of artefacts on teams2010In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 24, no 4, p. 412-427Article in journal (Refereed)
    Abstract [en]

    Purpose – Earlier studies have identified artefacts, but have only to a lesser degree looked at theireffects. The purpose of this paper is to investigate how artefacts contribute to organisation. Design/methodology/approach – A trauma team at a university hospital has been observed andits members interviewed. Findings – The trauma team showed itself to be rich on artefacts since it had strong internal drivingforces, high legitimacy, and tried to live up to high expectations from the outside. Its members were motivated to be in the forefront of trauma care. Through renewal, the team succeeded in maintaining demarcation. It also succeeded in systemising internal work tasks and made for itself a position in relation to the outside. The team's capacity, however, came to be limited by internal conflicts and battles for prestige. Practical implications – The study shows that informal logic has a strong influence on teams.Teamwork contributed to the development of organisational structure and motivation for the personnel. Originality/value – Earlier studies advocate the important role of artefacts in order to communicate, collaborate, negotiate or coordinate activities. The conclusion is that artefacts also have an organising and developing effect on teams in a fragmented and differentiated healthcare.

  • 184.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan mellan blåljusorganisationer2011 (ed. 1)Book (Other academic)
    Abstract [sv]

    Samverkan mellan olika yrkesprofessioner på en olycksplats är komplicerat. Mycket på grund av att förväntningarna inte alltid överensstämmer med förutsättningarna. I boken problematiseras agerandet på olycksplatsen. Friktionen mellan yrkesprofessioner lyfts fram och olika beteendemönster diskuteras.I boken tar författarna samverkan från retorik till ett praktiskt redskap, något som är möjligt att konkretisera och utföra praktiskt i det dagliga arbetet. Boken utgör samtidigt en introduktion till övningstekniken 3-nivåsamverkan (3-NS).I den här boken bjuds på flera närgångna beskrivningar. Medarbetare från fältet berättar om sina erfarenheter av samverkan, hur den tillämpas, om vilka möjligheter som finns och vilka svårigheter som behöver hanteras.Boken riktar sig till alla som arbetar i eller i anslutning till blåljusorganisationer. Den kan med fördel användas som lärobok för universitets- och högskolestuderande som läser till yrken inom polis, räddningstjänst eller ambulanssjukvård. Boken passar också för vidareutbildning av redan yrkesverksamma. Den kan även med fördel läsas av forskare, tjänstemän och politiker med intresse för hur framtidens blåljusorganisationer ska ledas, organiseras och styras.

  • 185.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Samverkan på olycksplatsen: om organisatoriska barriäreffekter2009Book (Other academic)
  • 186.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska akademin.
    Samverkansövningar: Om lärande och nytta2015 (ed. 1)Book (Other academic)
    Abstract [en]

    This study relates to collaboration exercises, with particular focus on the full-scale exercises between the police, rescue services and ambulance. To succeed in a complex situation, it requires that the personnel’s ability to collaborate across organisations be developed and refined.

    The overall aim of this study was to examine how collaboration is practised and how exercises lead to learning and usefulness. A research summary was initially done in this study. Based on that, a number of key concepts were developed that proved helpful when we followed the Swedish collaboration exercises through interviews and observations. The collected analysis has since been the basis for the design of a new exercise model, 3LC, three-level collaboration. It is based on the experiences we have had in studies of traditional exercises.

    The 3LC exercises that were conducted consisted of two practical sessions and three seminars. Each session was followed by an evaluative seminar with the aim that participants themselves would reflect and develop their patterns of behaviour. The two practical sessions were identical. It gave the participants the opportunity to rehearse and methodically try new approaches. The first exercise session was carried out according to the procedures that normally apply and govern the actions at an actual event. The second exercise session was preceded by a self-critical seminar where participants themselves identified what could be improved for the next exercise session.

    The research project was carried out from 2011 to 2014. A total of 19 collaboration exercises were studied, including 16 full-scale exercises. A total of 97 interviews and 125 hours of observation were carried out in this study. A questionnaire (CLU instrument) was developed, which was answered by 272 exercise participants.

    The study shows that collaborative sessions in the exercises contributed to the participants learning more and having greater usefulness from the exercises. 3LC exercises were perceived to enhance learning by 26 per cent and usefulness by 17 per cent, compared with traditional exercises. Collaborative exercises are benefitted when participants analyse their weaknesses themselves. Repetitive elements where participants try out alternative strategies improve preparedness prior to actual events.

  • 187.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The yellow line:  a critical study of the symbolic value of artefacts in health care teams2010In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 12, no 4, p. 251-261Article in journal (Refereed)
    Abstract [en]

    Artefacts reveal an organisation's ''inner life'' and they contribute to its image and reputation. They also play a decisive role for an organisation's development. In this article, similar artefacts from two different health care teams—a trauma team and a psychiatric team—in the same hospital, are compared. The team members were interviewed and their work observed over the course of several years. It was demonstrated that identical pieces of equipment in a trauma team and a psychiatric team signalled opposite values. The psychiatric team was backwardlooking, conservative and contradictory. Modern technology and pieces of equipment were associated with an abandoned and previously criticised activity. The corresponding equipment in the trauma team, on the other hand, signalled a forward looking, developing and unified culture. The trauma team was a relatively new and powerfully idealised phenomenon, which attracted attention. The analysis points out how the symbolic values signal that one activity is attractive and pleasing while another has a low external legitimacy. 

  • 188.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Traumateam - förenklat flöde eller försvårande hinder?2006In: Hälso- och sjukvårdens ekonomi och logistik (HEL), Göteborg: Sahlgrenska akademin vid Göteborgs universitet , 2006, p. 202-209Chapter in book (Other academic)
  • 189.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin. University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Vad övas vid samverkansövningar: - om första initiativeffekt och parallellitet2008In: Nordiske organisasjonsstudier, ISSN 1501-8237, no 4, p. 23-39Article in journal (Other academic)
  • 190.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture.
    Why is collaboration minimised at the accident scene?: A critical study of a hidden phenomenon2011In: Disaster Prevention and Management, ISSN 0965-3562, E-ISSN 1758-6100, Vol. 20, no 2, p. 159-171Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to study why collaboration among police, fire, and ambulance services is minimised at accident scenes. Design/methodology/approach - Observations and semi-structured interviews were carried out during 2007-2008. The data material comprises a total of 248 hours of observations on 20 occasions and 57 interviews with 80 people.Findings - The study identifies the difference between rhetoric and practice in connection with accident work. Collaboration is seen as a rhetorical ideal rather than something that is carried out in normal practice. Asymmetry, uncertainty and lack of incentives are important explanations as to why only limited forms of collaboration are actually implemented.Research limitations/implications - The paper shows a distinction between collaboration as rhetoric and practical collaboration at accident scenes. Practical implications The article proposes a multi-faceted collaboration concept. In this way, collaboration can be developed and refined.Originality/value - The results of the study show that police, fire, and ambulance services want to develop excellent forms of collaboration at the accident scene, but avoid this as it leads to uncertainty and asymmetries and because of a lack of incentives. However, simpler forms of collaboration may be realistic in the organisation of everyday work at accident scenes. 

  • 191.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Blåljusövningar och lärande: - en ny typ av samverkansövning2011Conference paper (Refereed)
  • 192.
    Berlin, Johan
    et al.
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Göteborgs universitet, Sahlgrenska Akademin, Institute of Health and Care Sciences.
    The Three-Level Collaboration Exercise: Impact of Learning and Usefulness2015In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 23, no 4, p. 257-265Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to examine the emergency personnel’s perception of the effects of exercises, with regard to learning and usefulness. The exercises were quasi-experimental and constructed in such a way that employees from different organizations overlapped each other’s tasks. This was accomplished by: having asymmetries included in the scenarios, repeating exercise procedures and testing different strategies, which were discussed at joint seminars. The exercises were compared to a similar study, published in this journal, of nonquasi-experimental but merely traditional exercises. Surveys were distributed and collected from emergency personnel in connection with seven exercises. At the exercises, 94.3% of the personnel thought that the exercises had a focus on collaboration (traditional exercises, 75.6%).

  • 193.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sandberg, Håkan S.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Typifiering eller normering?: En kritisk studie av teamteoretiska modeller2009In: Företagsekonomisk ämneskonferens 2009: Företagsekonomin i samhället: forskning, ulbildning, relevans 11-12 november 2009, 2009, p. 1-15Conference paper (Refereed)
    Abstract [sv]

    I den här studien fokuseras den starka passion som finns för typologier inom teamforskningen. Det finns typologier av teamprocesser, strukturella teamtyper och modeller för implementering av teamarbete. Vid första anblicken kan man i vissa fall få intrycket av att modellerna utvecklats utan att vara baserade på empiriska fynd och i andra fall att modeller blir en sorts självuppfyllande profetior som döljer möjligheten att urskilja variationer ur empiriska fynd.

    Syftet med denna artikel är att granska samband mellan ett antal typologier och diskutera varför teamarbete uttrycks som stegvisa utvecklingsmodeller. Speciellt fokus läggs på trestegsmodeller, så kallade triader.

    Vi har identifierat och analyserat fem teoretiska triader som beskriver teamarbete. Forskningsfrågan för denna artikel är: Är teamtypologierna värderande på så sätt att de särskiljer excellenta team från mindre framgångsrika, eller klassificerar de utan att värdera teamens grad av excellens? Är de teoretiska modellerna sorterande eller värderande?

  • 194.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sandberg, Håkan
    Mälardalens högskola.
    Team i vård, behandling och omsorg: erfarenheter och reflektioner2009In: Team i vård, behandling och omsorg: erfarenheter och reflektioner / [ed] Johan Berlin, Eric Carlström, Håkan Sandberg, Lund: Studentlitteratur , 2009, p. 15-24Chapter in book (Other academic)
  • 195. Berlin, Johan
    et al.
    Carlström, EricUniversity West, Department of Nursing, Health and Culture, Division of Nursing.Sandberg, Håkan
    Team i vård, behandling och omsorg: erfarenheter och reflektioner2009Collection (editor) (Other academic)
  • 196.
    Berlin, Johan
    et al.
    Göteborgs universitet / Sahlgrenska akademin.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sandberg, Håkan
    Varför team?2009In: Team i vård, behandling och omsorg: erfarenheter och reflektioner / [ed] Johan Berlin, Eric Carlström, Håkan Sandberg, Lund: Studentlitteratur , 2009, p. 263-276Chapter in book (Other academic)
  • 197.
    Berlin, Johan M
    et al.
    Göteborg University, School of Public Administration,.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The 20-minute team: a critical case study from the emergency room2008In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 14, no 4, p. 569-576Article in journal (Refereed)
  • 198.
    Berlin, Johan M.
    et al.
    Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    The 90-Second Collaboration: A Critical Study of Collaboration Exercises at Extensive Accident Sites2008In: Journal of Contingencies and Crisis Management, ISSN 0966-0879, E-ISSN 1468-5973, Vol. 16, no 4, p. 177-185Article in journal (Refereed)
  • 199.
    Berndtsson, Ina
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Bukaortascreening in och ut på fem minuter: Hur upplevs undersökningsförfarandet av de screenade och av personalen2010Conference paper (Refereed)
    Abstract [sv]

    Etiska aspekter vid screening av bukaortaaneurysm - en delutvärdering vid införandet i Västra Götaland

     

    Regionstyrelsen har beslutat om införande av screening av 65-åriga män för buk-aortaaneurysm (fortsättningsvis benämnt AAA) i Västra Götalandsregionen. Syftet är, i likhet med andra screeningundersökningar, att ställa diagnos i ett tidigt skede, redan innan sjukdomen har börjat ge symtom. Utvärderarna, liksom den helt övervägande delen av de kallade och intervjuade medarbetarna, anser att detta är en riktig satsning. Utvärderingsgruppen ställer sig således bakom införandet och huvuddragen i genomförandet av AAA screening i Västra Götalandsregionen. De kunskaper vi har om screening i allmänhet och AAA i synnerhet indikerar helt enkelt att det vore oetiskt att inte screena denna grupp personer. Det finns dock en risk för oro och ångest i samband med förfarandet. Det är därför viktigt att minimera negativa upplevelser hos de kallade. Utvärderingen är gjord med detta som utgångspunkt och har således ansatsen att finna förbättringsmöjligheter i det framväxande förfarandet.

     

    Under 2009 kallades 10 361 män och av dessa avstod 14,5 % . Till SU/Östra och SU/Mölndal avstod ca 20 % att komma medan de som kallades till SÄS, SKAS och NU avstod i mindre utsträckning (ca 11 %).

     

    Förbättringsförslagen i rapporten bygger på enkätsvar, telefonintervjuer från såväl de som kom som de som uteblev. Det genomfördes också fokusgruppsintervjuer med den personalen som undersökte de kallade (ST-läkare, sjuksköterskor och biomedicinska analytiker) på de kliniskt fysiologiska mottagningarna vid Sahlgrenska universitetssjukhuset Mölndal och Östra, Kungälvs sjukhus (röntgen), Södra Älvsborgs sjukhus (SÄS), Norra Älvsborgs sjukhus (NÄL) och Skaraborgs sjukhus (SkaS).

    Kort om resultaten

    De kallade och personalen var i allmänhet positiva till att sjukvården gjorde screeningundersökning av 65-åriga män. Kallelse och informationsbrev upplevdes av de flesta som bra. Avståndet till screeningorten påverkade inte deltagandet i screeningen negativt trots kommentarer om lång resväg. De som hade längst resväg undersöktes på NÄL och SkaS. Att få ett påminnelsebrev gjorde att flera som glömt eller var bortresta kunde undersökas. Egenavgiften (100 kr) hade inte betydelse för deltagandet. Undersökningen medförde inga obehag och gick snabbt (5 min). Undersökningens korta tid kunde dock vara ett besvär för den som behövde mer omfattande information eller omhändertagande. Informationen om undersökningen var bra men besked om hur vanligt tillståndet var och normalgränserna saknades av de undersökta.

     

    Av dem som avstod från undersökning förekom fysisk psykisk sjukdom eller handikapp som orsak till att det var svårt eller omöjligt att undersökas. Flera hade negativa attityder till massundersökningar och som exempel angavs svininfluensa-vaccinationen för inställningen. Andra orsaker till att man avstod var inställningen ”det drabbar inte mig”. Några hade dålig erfarenhet av sjukvård eller läkarskräck. Det förekom också transportproblem, som att man inte hade egen bil. Den största andel som avstod bodde i Göteborgsregionen (22 %).

     

    Screeningpersonalen upplevde att de flesta var positiva och nöjda med informationen i kallelsen, förutom att man trodde att hela bukaortaavsnittet skulle undersökas. Personalen fick påpekanden från män att egenavgiften (100 kr) utgjorde ett problem för dem som inte hade internet då en betalningsavgift tillkommer. Speciell tid var avsatt för undersökningarna, på två ställen på kvällstid för att det skulle vara lättare med parkering. Ofta räckte undersökningstiden till (5 min) men ibland, om undersökningen var mer komplicerad eller om någon hade svårt att röra sig eller behövde prata, upplevdes tiden för kort.  Principen var att det skulle ges besked om bukaorta var normal eller förstorad, men beskedet gavs på olika sätt, en del fick muntligt besked, andra också skriftligt. Några fick reda på måttet när det var normalt men inte om det var förstorat. Vid upptäckt av vidgad aorta skulle personalen faxa uppgifter till kärlkirurgen i Göteborg. Personalen upplevde att de inte hade klara besked på hur informationen till patienten skulle ges om vidgad aorta upptäcktes. Det var även osäkert om och när patienten skulle bli omhändertagen både beroende på tillgång till mottagningstid till kärlkirurg och beroende på hur stor vidgning aorta hade.

     

    Utvärderingsgruppen har reflekterat över de etiska aspekterna av screeningen. Gruppen anser att tillvägagångssättet visat sig vara hållbart och föreslår endast förbättringar av förfarandet och rekommendationer om alternativa förhållningssätt.

    Sammanfattning av etiska reflektioner vid bukaortascreeningen i Västra    Götaland

    • Information och undersökning byggde på ett rationalistiskt perspektiv där 65-åriga män ansågs vara friska, svensktalande och utan hjälpbehov.
    • Vid komplicerad undersökning eller vidgad aorta var det brist på tidsmarginal vilket innebar att kravet på ett fullgott omhändertagande riskerade att inte kunna uppfyllas.
    • Förfarandet vid beskedet av mätresultat, både skriftligt och muntligt, var inte samstämmiga mellan screeningorterna.
    • Yrkeskategori som inte var utbildad för eller hade erfarenhet av omhändertagande vid besked kunde skapa oro och ångest.
    • Beskeden till männen om och när läkarkontakt skulle fås varierade.
    • Osäkerhet och frustration över att inte ha tillgång till läkare/psykolog fanns bland screeningpersonalen.
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    Bukaortascreening
  • 200.
    Berndtsson, Ina
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Livskvalitet och sexualitet efter stomioperation2010Conference paper (Refereed)
    Abstract [sv]

    Fysiska och psykiska besvär kan påverka hälsan och i förlängningen sexualiteten. Ett exempel är patienten som har diarréer, ont i magen och förlorar vikt och energi orsakat av en inflammatorisk tarmsjukdom.  Medan att ha en cancer i colon eller rektum ger oftast inga besvärliga symtom, inte i början. Men för patienten med cancer påverkar behandlingen i form av strålning, kirurgi och cytostatika bla. sexualiteten.

    Det är viktigt att sjuksköterskan är medveten om patienten påverkas även sexuellt. Sjuksköterskan kan vanligtvis prata med patienten om privata saker som tex. avföringsvanor och om döden. Sjuksköterskan skall även ges information om sexualiteten, och frågor skall kunna ställas av patienten och eventuell partner. Sexualiteten betyder olika mycket för olika personer och vid olika tidpunkter i livet. Att negligera patientens behov om att prata om detta eller resonera som att de får någon annan ta upp om (läkaren) är inte rätt. Människan är en sexuell varelse.

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