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  • 151.
    Hofbrink, Carolina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Jidetoft Thoresson, Sofie
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskans arbete med barns sömnvanor: En kvalitativ intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The sleeping habits amongst children have changed and bad sleeping habits often have a negative impact on the health. The school nurse have the opportunity to early identify the risk of illness amongst children as well as promoting health and offer support in good sleeping habits. Aim: To describe the school nurse experience of sleeping habits amongst children between the age 10 -16 years. Methods: Nine school nurses from three different municipalities´ were interviewed using semi-structured questions. A qualitative content analysis with an inductive approach was exercised. Results: The school nurse described that the majority of all children generally had good sleeping habits, although they had changed in recent years. They could see a connection between lifestyle, sleep and health. The school nurse worked on identifying children with sleeping disorders and to offer them support. The school nurse experienced that the general knowledge about sleep needed improving amongst both children and guardians´. Through good relationships with children and their guardians´ the school nurse could offer both support and useful tools in the working process. A fluctuation within the school nurses´ health promoting work was discovered and was restricted by the lack of cooperation and time. The majority of the organisations lacked common routines in health promoting work. The school nurses´ had a wish to develop health promotion further to counteract bad sleeping habits and to give the children best possible conditions to stay healthy. Conclusion: The rapid development of our society along with changed lifestyles create challenges and have an impact on children's sleeping habits. Children and their guardians´ need to widen their general knowledge about sleep and health. Extended health promotion work is demanded to be able to meet the requirements needed. A well organised student health with clear described routines and effective cooperation with educators are believed to be a success in health promotion.

  • 152.
    Holbein, Christina E.
    et al.
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    Fogleman, Nicholas D.
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    Hommel, Kevin
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    Apers, Silke
    KU Leuven, Leuven, Belgium.
    Rassart, Jessica
    KU Leuven, Leuven, Belgium.
    Moons, Philip
    KU Leuven, Leuven, Belgium & University of Gothenburg, Gothenburg, Sweden..
    Luyckx, Koen
    KU Leuven, Leuven, Belgium.
    Sluman, Maayke A.
    Amsterdam Medical Center, Amsterdam, The Netherlands.
    Enomoto, Junko
    Chiba Cardiovascular Center, Chiba, Japan.
    Johansson, Bengt
    Umeå University, Umeå, Sweden.
    Yang, Hsiao-Ling
    National Taiwan University, Taipei, Taiwan.
    Dellborg, Mikael
    University of Gothenburg, Gothenburg, Sweden.
    Subramanyan, Raghavan
    Frontier Lifeline Hospital, Dr. K. M. Cherian Heart Foundation, Chennai, India..
    Jackson, Jamie L.
    Nationwide Children's Hospital, Columbus, Ohio, USA.
    Budts, Werner
    University Hospitals Leuven and Department of Cardiovascular Sciences, Leuven, Belgium..
    Kovacs, Adrienne H.
    Oregon Health & Science University, Portland, Oregon, USA.
    Morrison, Stacey
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    Tomlin, Martha
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    Gosney, Kathy
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    Soufi, Alexandra
    Hospital Louis Pradel, Lyon, France.
    Eriksen, Katrine
    Oslo University Hospital, Oslo, Norway.
    Thomet, Corina
    KU Leuven, Leuven, Belgium.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Gothenburg, Sweden.
    Alday, Luis
    Hospital de Niños, Córdoba, Argentina.
    Callus, Edward
    IRCCS Policlinico San Donato Hospital, Milan, Italy.
    Fernandes, Susan M
    Stanford University, Palo Alto, California, USA.
    Caruana, Maryanne
    Mater Dei Hospital, Msida, Malta.
    Menahem, Samuel
    Monash Medical Center, Melbourne, Australia.
    Cook, Stephen C.
    Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA.
    Rempel, Gwen R.
    University of Alberta, Edmonton, Canada.
    White, Kamila
    Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, Missouri, USA.
    Khairy, Paul
    Montreal Heart Institute, Montreal, Canada.
    Kutty, Shelby
    Children's Hospital & Medical Center, Omaha, Nebraska, USA.
    Veldtman, Gruschen
    Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
    A multinational observational investigation of illness perceptions and quality of life among patients with a Fontan circulation2018In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 13, no 3, p. 392-400Article in journal (Refereed)
    Abstract [en]

    Objective First, to compare QOL and illness perceptions between patients with a Fontan circulation and patients with anatomically simple defects (ie, atrial septal defects [ASD] or ventricular septal defects [VSD]). Second, to explore illness perceptions as a mediator of the association between congenital heart disease (CHD) diagnosis and QOL. Design Cross-sectional observational study. Setting Twenty-four cardiology centers from 15 countries across five continents. Patients Four hundred thirty-five adult patients with congenital heart disease (177 Fontan and 258 ASD/VSD) ages 18-83 years. Outcome Measures QOL and illness perceptions were assessed by the Satisfaction With Life Scale and the Brief Illness Perceptions Questionnaire, respectively. Results Patients with a Fontan circulation reported lower QOL (Wald Z = −3.59, p = <.001) and more negative perceptions of their CHD (Wald Z = −7.66, p < .001) compared with patients with ASD/VSD. After controlling for demographics, anxiety, depressive symptoms, and New York Heart Association functional class, path analyses revealed a significant mediation model, αβ = 0.15, p = .002, 95% CI = 0.06-0.25, such that CHD diagnosis was indirectly related to QOL through illness perceptions. Conclusions The Fontan sample’s more negative perceptions of CHD were likely a reflection of life with a more complex defect. Illness perceptions appear to account for unique differences in QOL between groups of varying CHD complexity. Psychosocial screening and interventions may be important treatment components for patients with CHD, particularly those with Fontan circulations.

  • 153.
    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
    University West, Department of Health Sciences, Section for nursing - graduate level.
    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 countries2019In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881Article in journal (Refereed)
    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.

  • 154.
    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
    University West, Department of Health Sciences, Section for nursing - graduate level.
    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 Circulation2019In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 124, no 1, p. 144-150Article in journal (Refereed)
    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.

  • 155.
    Holgersson, Ida
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Distraktion som smärtlindring vid venpunktion på barn: en systematisk litteraturöversikt2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Background: Despite increased knowledge of pain relief in children during the recent decades, children are still exposed of many painful procedures in healthcare without sufficient painrelief. This may cause the child pain and anxiety as at a later stage leads to them avoiding or refusing these procedures completely. This can lead to an unvaccinated population and long expensive care time related to an unwillingness to undergo treatments. Painrelief during venipuncture in children today is oftenly given as a topical anesthesia. It is an expensive method and it also comes with side effects and takes time to use. Distraction is a painreliefing method commonly used in todays healthcare. It is a quick and simple method without side effects wich has proven to be effective in the past during painful procedures in children.

    Aim: Examine the painreliefing effect of distraction during venipuncture in children.

    Methods: A systematic literature review of papers published from 2007 to 2017 were conducted in the databases PubMed, CINAHL. Studies that examined the painrelifing effects of distraction in children undergoing venipuncture were included. These studies were then assessed in quality by the author of this study. Seven of the studies were finally included in this review. They were compiled in a tabel regarding contence and quality.

    Results: Three of five studies implicate that distraction during venipuncture in children has a painrelieving effect. Three of five studies noticed a lower level of anxiety when distraction was used during venipuncture in children.

    Conclusions: The studies included indicates that distraction as painrelief during venipuncture in children is effective. They also indicate that the use of distraction reduces there anxiety during the procedure. Concluded distraction during venipuncture in children may be effective. However, the evidence of this study is low due to the small size of the scientific material existed. Further studies is recommended to determine the effect of distraction during venipuncture in children.

  • 156.
    Holmgren, Daniel
    et al.
    Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden / Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Skyvell Nilsson, Maria
    University West, Department of Health Sciences, Section for nursing - graduate level.
    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 programme2019In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, article id 28Article in journal (Refereed)
    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.

  • 157.
    Holmén, Grazyna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Brandt, Thomas
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av att vårda suicidnära patienter inom psykiatrisk öppenvård2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year, about 800,000 people die in the world through suicide, making it an international public health problem. The underlying cause is mainly different forms of mental illness. People suffering from depression, bipolar disorder, schizophrenia, psychosis, post-traumatic stress disorder or substance abuse are at most suicide risk. This means a great personal suffering and great socio-economic costs for society. It is crucial that suicide-close persons are offered adequate nursing care, and that nurses working with them have specialist competence and in-depth knowledge of the subject. Nurses experience the work as demanding, complex and responsible as they independently assess the risk of suicide and take measures to ensure the care of patients with suicide.

    Aim: The aim of the study was to describe the nurses´ experiences of caring for suicidal patients in psychiatric outpatient care.

    Method: The study was based on interviews with nine nurses who described their experience of caring for suicidal patients in psychiatric outpatient care. Qualitative content analysis with an inductive approach was used as a method.

    Results: The analysis showed different experiences that could be divided into three categories; Create a safe caring relationship, An alliance as the foundation for development and change and Manage the responsibility for the patient's life and safety. In the first two categories, experiences of describing, based on a person-centered approach, building safe caring relationships and creating an alliance with the patient are described. It was emphasized that the patient's participation was a prerequisite for jointly developing strategies for problem solving and for starting up constructive health processes. Under the last category, experiences of how the nurses interacted with colleagues, how they dealt with concerns about patient safety and the importance of the experience-based knowledge emerged.

    Conclusion: It takes a holistic, salutogenic and person-centered way to reach and nurture suicidal patients. Good quality of care and sustainable care can only be designed in collaboration with the patient. This requires that the nurse possesses qualities such as empathy, patience and a personal maturity to show humility before every person she meets.

  • 158.
    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
    University West, Department of Health Sciences, Section for nursing - graduate level. 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 study2019In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 32, no 13, p. 2166-2172Article in journal (Refereed)
    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.

  • 159.
    Hrybanova, Yana
    University West, Department of Health Sciences, Section for nursing - graduate level.
    First-time fathers' experiences of professional support from child health nurses2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background. 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 the father in the family can be challenging, especially for the first-time fathers. Child health nurses' support is an important factor for the fathers to manage difficulties of their fathership. It is important to provide the support, corresponding to the fathers needs and expectations of parental support in order to empower fathers to be confident caregivers. The Father Perceived Professional Support scale can be used in nursing practice to better understand the father's needs of professional support.

    Aim. The aim of the study is to describe first-time fathers' experiences of the professional support offered by child health nurses and to validate the instrument: "Father-Perceived-Professionals-Support scale (FaPPS scale)".

    Method. A qualitative design with inductive and deductive approaches was used in conduction of the study. Twelve first time fathers participated in the semi-structured interviews of the study thereafter grading the FaPPS scale items and commenting on them.

    Result. Fathers experienced nurses' support positively when nurses provided useful practical information and stimulated them to be involved practically and emotionally in care of their children. Fathers lacked nurses' commitment and nurses' support to be adapted to their needs as well as to be available for them. Some fathers also experienced inequality in nurses' treatment. However, the fathers also perceived the mothers to be in a greater need of nurses' support and they also wished to be advised about how to support the mother. Fathers expect nurses to actively offer support to them and supervise them in a childcare. Fathers also expressed that they would like to meet the parents in the same situations in parental groups.

    Conclusion. Nurses' support to the first -time fathers should be more available for fathers and more adapted to their father role. When meeting fathers' needs of support, the nurses need to be aware of their supportive skills. The FaPPS scale can be used both in research and clinical practice, though still needing development.

  • 160.
    Hrybanova, Yana
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ekström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Thorstensson, Stina
    School of Health and Education, University of Skövde, Sweden.
    First-time fathers' experiences of professional support from child health nurses2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 4, p. 921-930Article in journal (Refereed)
    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.

  • 161.
    Huusko, Linda
    et al.
    Narhälsan Skövde Women’s Health Clinic, Skövde, Sweden.
    Sjöberg, S.
    Women’s Health Clinic, Umeå, Sweden.
    Ekström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Skövde, School of Health and Education,Skövde, Sweden.
    Hertfelt Wahn, Elisabeth
    University of Skövde, School of Health and Education,Skövde, Sweden.
    Thorstensson, Stina
    University of Skövde, School of Health and Education,Skövde, Sweden.
    First-Time Fathers´ Experience of Support from Midwives in Maternity Clinics: An Interview Study2018In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, article id 9618036Article in journal (Refereed)
    Abstract [en]

    Background.

    Research shows that first-time fathers want to take part in preparation for birth and parenthood but they describe being excluded by health professionals. Aim. The aim of this study was to illustrate first-time fathers' experiences of support from midwives in maternity clinics as a step in the validation of "The Father Perceived-Professional-Support" (The FaPPS) scale.

    Methods.

    A qualitative content analysis with an inductive and deductive approach was used; seven first-time fathers were strategically selected and interviewed. In the inductive part the following open question was asked: "How did you perceive the support from the antenatal midwife/midwives?" In the deductive part, the fathers were asked to respond to the FaPPS scale, in order to receive their thoughts and understanding of the scale, inspired by the "Think-aloud" method. Findings. The inductive results showed two main categories: Experience of not knowing what support they needed and Experience of being excluded. The fathers found support from other fathers in parental education classes, but they lack time to discuss. Overall it seems as if the fathers answered both from their own perspective and from the mothers' perspective. This was not evident in the deductive results. The FaPPs scale should therefore include professionals' ability to strengthen social support from other first-time fathers and professionals' ability to offer support to the mother.

    Conclusion and Clinical Implications.

    The fathers experienced exclusion both by themselves and also by midwives. Midwives should offer both parents the opportunity to pose questions. It is important for expectant fathers that time for discussion is planned in parental education classes. The FaPPS scale is useful but needs further development. Parts of our result are in line with earlier research, for decades; therefore it is necessary to focus more on support for fathers.

  • 162.
    Hällgren Graneheim, Ulla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lindgren, Britt-Marie
    Umeå University, Department of Nursing, Umeå, Sweden.
    Lundman, Berit
    Umeå University, Department of Nursing, Umeå, Sweden.
    Methodological challenges in qualitative content analysis: A discussion paper.2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 56, p. 29-34Article in journal (Refereed)
    Abstract [en]

    This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation.

  • 163.
    Hällgren Graneheim, Ulla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Åström, Sture
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Until Death Do Us Part: Adult Relatives' Experiences of Everyday Life Close to Persons with Mental Ill-Health2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 8, p. 602-608Article in journal (Refereed)
    Abstract [en]

    This study illuminates adult relatives' experiences of everyday life close to a person with mental ill-health. The study was based on nine diaries and four narrative interviews with relatives of people with mental ill-health. Data were subjected to qualitative content analysis. The participants experienced everyday life as a constant fight, for better and for worse, with psychiatric care. They were fighting for the mentally ill person's right to care; sometimes they felt resigned, but yet they had a confidence in the care. Their mission in life was to sacrifice themselves, meaning that they felt indispensable and became lonely and socially isolated. They considered their mission to last until death set them apart because they were keeping a family secret, and had great worries about the future. We conclude that relatives experience a two-folded stigma in living close to a person with mental ill-health and in becoming lonely and socially isolated.

  • 164.
    Högfors, Linda
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Liselott
    University West, Department of Health Sciences, Section for nursing - graduate level.
    En begreppsanalys av begreppet lidande2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BackgroundIn advanced homecare specialist nurses often encounters patients who are suffering in their final stage of life. The concept suffering can have different dimensions. The aim of this study is to reveal the concept of suffering on order to get a deeper understanding of patients suffering in end of life care.

    Aim The aim is to unveil the concept of suffering in order to get a deeper understanding of the patient's suffering in end of life care.

    Method The concept analysis method developed by Koort and the content analysis developed by Graneheim & Lundman was used.

    Results The concept of suffering reveal several dimensins of the concept suffering. The concepts that were considered meaningsful in end of life context was tolerate, endure and agony. The result of the analysis from the biography was withheld a end of life context and was interpreted using a content analysis. The resultat of testanalysis show that the dimensions tolerate, endure and agony formed a line of argument through the autobiography and formed the main theme of suffering.

    Conclusion To be in the final stages of life usually means a great deal of suffering for the patient. As seen in this study the concept of suffering portrays so many different dimensions; body, soul and spirit. These different dimensions will be an important tool for the specialist nurse when whom is to alleviate the suffering of patients in end of life.

  • 165.
    Jacobsson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Svensson, Eva
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Att identifiera föräldrar som "mår dåligt" och skapa stöd för familjen: En kvalitativ studie med fokus på BVC-sjuksköterskans arbete med postpartumdepressioner2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: To identify parents who "feel bad" and create support for the family. A study focusing on the child health nurse working with postpartum depression Background: Postpartum depression (PPD) affects about 13% of new mothers. It's common that fathers develop PPD as well if the mothers has suffered from it. The child health care nurse should work with the hole family with the little child´s best interest in focus. If the family´s wellbeing is not good it could have a negative impact on the child and the connection could be disturbed. In Sweden new mothers are screened for PPD.Aim: The aim of the study was to illustrate child health care nurses work to identify and support families where as someone suffered of PPD. Method: The study was based on interviews with child health care nurses. The text was processed and analyzed with qualitative content analysis. Results: The study resulted in two categories: To identify parents who´s wellbeing is not good and To create support for the family. Conclusion: Child health care nurses experiences PPD as unusual, no one had identified any fathers with PPD. To support a family affected of PPD it was important to find their own resources to overcome the problem. Family center and vicinity to other care givers were important for the child healthcare nurse in her work to support the family

  • 166.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University, Health and Social Sciences, Kristianstad, Sweden.
    Granskär, Monica
    Kristianstad University, Health and Social Sciences, Kristianstad, Sweden.
    Berg, Agneta
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level. Kristianstad University, Health and Social Sciences, Kristianstad, Sweden.
    Challenges Highlighted During Peer Supervision by Mental Health Nurses and Social Workers Recently Trained as Case Managers in Sweden2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 10, p. 809-816Article in journal (Refereed)
    Abstract [en]

    This study looked at 13 mental health nurses and social workers who were recently trained as case managers (CMs) and the work-related challenges they faced in community mental health services. Data were collected during ten peer supervisions sessions. Participants expressed pride and enthusiasm about their new function as CMs, but they also acknowledged that their new position meant they had to confront existing systems and posed several challenges, including organizational hindrances, economic prerequisites, nominated administrators, role function, and model fidelity. We conclude that the existing organizations seemed to be unprepared to hold and facilitate more person-centered approaches, such as designating CMs. The model fidelity is important, but has to be flexible according to clients' daily state.

  • 167.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University.
    Persson, Irené
    Kristianstad University.
    Berg, Agneta
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 1, p. 42-50Article in journal (Refereed)
    Abstract [en]

    This study illuminates nine psychiatric disabled per-sons’ lived experience of a newly established community based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenologicalhermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.

  • 168.
    Jansson, Helena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors hälsofrämjande arbete: en litteraturöversikt2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of health promotion is to increase student´s physical and mental health. The mental health among children and young people has increased, above all among girls. There is correlation between student´s health and their school results. School nurse´s health function is considered to be unclear and needs to be made visible. The aim of this study is to describe the school nurses' health promoting work. The method was a systematic literature search according to the SBU. Thirteen scholarly articles were included and analyzed according to Polit and Beck. The result showed that the school nurses through health promotion can identify and strengthen the students' internal and external forces and also the sense of coherence and ability to deal with stress. The school nurse is seen as a trustful person to talk to about health. The professional secrecy helps the student to feel confident that their problems are not passed on without their consent. There is a requirement for the school nurse to always be present. This can be a hinder for developing their professional skills. The uncertainty and lack of evidence-based practices can lead to misunderstandings and wrong expectations at the school nurse's health-promoting work. It is therefore important to clarify the health-promoting work and use evidence-based methods and theories that can be evaluated.

  • 169.
    Jansson, Leila
    et al.
    Umeå University, Department of Nursing , Umeå , Sweden..
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nurses' Experiences of Assessing Suicide Risk in Specialised Mental Health Outpatient Care in Rural Areas2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 554-560Article in journal (Refereed)
    Abstract [en]

    This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress. Consequently, in order to prevent ill health among these nurses, there is a need for a tolerant work climate and an organisation that provides support to its employees. Assessing suicide risk is a demanding task within mental health outpatient care. Further, nurses operating in rural areas have to initiate and conduct assessments on their own, and they are, together with the physician in charge, also held individually responsible for their assessments. Consequently, it is important to describe nurses' experiences of how they deal with questions concerning suicide risk. Their experiences can foster awareness of the responsibility and the ethical standpoints related to assessing suicide risk, can help outline the need for further education and supervision, and can improve support from co-workers and management.

  • 170.
    Jensen, Charlotte
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Svensson, Jennie
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Dialog: en begreppsanalys2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Well analyzed generally accepted concepts can help the nurse identify and solve complex care situations and thus more easily communicate with patients and ascertain their needs, develop nursing diagnoses and choose the appropriate nursing interventions.AimThe aim of this study was to unveil the concept of dialogue and elucidate its meaning. Method The concept analysis method developed by Koort was used. Results The analysis revealed that the word dialogue was first mentioned in the early 1200s and is derived from the old French word "dialoge". The concept of dialogue is described as a conversation between two people. When dictionaries and encyclopedias were reviewed we found twenty eight synonyms for the concept of dialogue, on further examination it emerged that many of the words were not relevant to nursing science. Conclusion Dialogue is an attitude characterized by proximity, a mutual exchange takes place between two or more people. The relationship between a health professional and a patient should be characterized by both seeing themselves as free and by recognizing that both of them have the knowledge needed for the patient to regain health. Both parts have obligations, rights and responsibilities towards each other.

  • 171.
    Jepsen, Linda
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Toresdotter, Elin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    ”Men visst känner man glädje när föräldrar beslutat sig för en vaccination som de varit tveksamma till”: Föräldrar som väljer att tacka nej till att vaccinera sina barn – Sjuksköterskans upplevelser och strategier i mötet2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In the mid-20th century, vaccines began to be routinely administered to children in order to prevent illness. This is seen as the foremost medical effort made for public health. The vaccination coverage in Sweden is high, but some parents choose to refuse the Swedish childhood vaccination program. Previous research shows that meeting with parents who refuse vaccination is perceived as difficult for nurses. In order to understand why parent´s refuse and how nurses best can meet them more knowledge is needed. Aim: To describe the nurse's idea of why parents refuse to vaccinate their children and how the nurse responds to these parents. Method: Web-based questionnaire with 15 questions, both open-ended and closed, was used and sent to nurses working in the child health care sector and in primary school. The questionnaire was analyzed with qualitative content analysis and descriptive statistics. Results: In the result, three main categories emerged: Influence on the child, Mistrust of vaccination and The specialist nurse's strategies. The main categories are made up of a total 10 subcategories. Conclusion: The result showed that nurses felt insecure meeting parents who refuse vaccinations. In order to reduce insecurity, nurses highlighted the importance of asking about the cause of the parents' decision and make time for these conversations. Finding a structure for the conversation was important and one example was motivational conversations. Individualizing the conversation and the questions after each parent created a safe environment and an approach of a person-centered care.

  • 172.
    Joelsson, Britta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Linnéa
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Samverkan mellan primärvård och specialistpsykiatri: Två sidor av samma mynt2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is increasing in society. Collaboration between primary care and specialist psychiatry is ongoing. The experience is that many people with mental illness refer to different activities and being left without treatment. Good interaction is important for persons seeking mental health care to get the right help.

    Aim: to describe the primary care nurse's experience of collaboration with specialist psychiatry.

    Method: a qualitative study based on semistructured interviews of primary care nurses. The material was analyzed by qualitative content analysis.

    Results: appeared in the following categories; Collaboration characterized by differences with the subcategories Good collaboration for emergency transfers and poor accessibility and inadequate feedback between the activities. Unclear division of responsibilities with the subcategories care different assessments of the same person, Inadequate knowledge on the division of responsibilities between the professions and gray zone patient - primary care or specialist psychiatry. Last category are resource shortage and low interest in mental health with the subcategories Inadequacy and Interest and respect for psychiatry.

    Conclusion: Working according to the division of responsibilities can be an obstacle to cooperation in such a way that the nurse expires blindly from the division of responsibilities without knowing what he/she refers to. Resource shortage, in turn, leads to experiences of insufficiency of nurses. Increased knowledge of each other's activities could lead to closer cooperation and understanding of each other. The person-centered care would benefit from the fact that both instances took care of more people than they actually consider to be part of their area of responsibility.

  • 173.
    Johansson, Ann-Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö, Sweden.
    Grankvist, Gunne
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Brink, Eva
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 9, p. 591-604Article in journal (Refereed)
    Abstract [en]

    Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

  • 174.
    Johansson, Ann-Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Brink, Eva
    University West, Department of Health Sciences. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Cliffordson, Christina
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö.
    The function of fatigue and illness perceptions as mediators between self-efficacy and health-related quality of life during the first year after surgery in persons treated for colorectal cancer.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1537-E1548Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the present study was twofold: 1) to measure changes in health-related quality of life (HRQoL), two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for CRC during the first year after surgical treatment, and 2) to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect HRQoL at 12 months post-surgery.

    BACKGROUND: There are fluctuations in HRQoL during the first year after treatment for colorectal cancer (CRC), and fatigue may negatively influence HRQoL. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with HRQoL in other cancer diagnoses. Concerning CRC, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to HRQoL at 12 months.

    DESIGN: A prospective longitudinal design.

    METHODS: Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostoma, participated. HRQoL, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used.

    RESULTS: No changes were reported in levels of HRQoL, fatigue, or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on HRQoL at 12 months.

    CONCLUSION: Persons treated for CRC who have lower self-efficacy 3 months post-surgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue.

    RELEVANCE TO CLINICAL PRACTICE: Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, i.e., carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy. This article is protected by copyright. All rights reserved.

  • 175.
    Johansson, Carina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Äsplöf Bergsten, Jenny
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tonåringar med attention deficit hyperactivity disorder: Kartläggning av register2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Attention deficit hyperactivity disorder (ADHD) is a disability and affected executive functions and working memory, which requires changed in the classroom. Integrated healing process included the patient, the family, the structures and the systems. Psychiatric nursing care integrated physical and spiritual health and participation in society. The improwement of nursing was a neverending process.

    The registerstudy mapped registrations in the quality register, which was responsible for follow up treatment of secured ADHD. This study was a quantitative method with a cross sectional study. The population was boys and girls between 13 to 17,5 years old. There where 1956 boys and 796 girls. The mainly inattention is a symptom of ADHD. About the boys , 19,5 % of these had mainly inattention. About the girls, 25 % of these, had mainly inattention.

    The main common form of schooling without additional support is one sort of schooling in the study. About the boys, 44,1 % of the boys, were in the main common schoolform without additional support. About the girls, 47, 5 % of the girls, were in the main common schoolform without additional support. About the parparticipants in the main common schoolform without additional support, there were 18,9 o% of these who had psychosocial problems.

    The custom of studies is another sort of schooling in the study. About this schooling there were 41,8 % of the participants who had psychosocial problems. This could be perceived as ADHD diagnosis effect of executive functions and gave varying severity.

  • 176.
    Johansson, Caroline
    University West, Department of Health Sciences, Section for nursing - graduate level.
    BVC-sjuksköterskors upplevelser av språkbedömningssituationen för barn som inte har svenska som modersmål2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background One of the functions in child health care is to observe language development. Research shows that language delays which are not treated can cause difficulties in learning and socialization. When the child does not have Swedish as their mother tongue it may be difficult for the child health care nurses (CHC nurses) to make language assessment. The aim of this study is to illuminate the CHC nurses experiences of the language assessment situation among children who do not have Swedish as their mother tongue.

    Method Then the aim of this study was to illuminate experiences a qualitative inductive method was chosen. Multistage focus groups were used, where the CHC nurses who worked in a multicultural area were interviewed on two occasions. When analyzing the transcribed text qualitative content analysis were used.

    Result The analysis culminated into three categories; The interpretation situation, Importance of parents, The own competence in the language assessment situation and the theme; Feelings of doubt and uncertainty in the language assessment situation. The results showed that it is varied quality of the interpreters. The language assessment takes longer when an interpreter is present and it is not for the benefit if an interpreter and family are familiar with each other. Many times CHC nurses rely on parental assessment of the language development. It is felt by the CHC nurses to be cultural differences whether parents stimulate language development. CHC nurses feel themselves that they have a lack of cultural competence.

    Conclusion CHC nurses strives to be responsive and have the child in focus during the assessment but they experience feelings of doubt and uncertainty whether their assessment is correct or not. There are factors that are important for proper assessment; interpreter quality and parents' sincerity. The lack of cultural competence can do a risk of not understanding the child's situation.

  • 177. Johansson, Caroline
    et al.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Nursing. University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    Child health nurses' experiences of language assessment in children: A Swedish study2017In: Journal of Health Visiting, ISSN 2050-8719, Vol. 5, no 4, p. 187-195Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to discover Swedish child healthcare (CHC) nurses' experiences of language assessment in children who do not have Swedish as their mother tongue. A CHC nurse has qualifications in child health, and their role is to promote good health and prevent illness. As immigration to Sweden is at the highest level ever recorded (Statistics Sweden, 2014), there is an increasing need for language assessment. In this study, ‘mother tongue’ is defined as the language a child learns first, which is synonymous with the term ‘first language’ (Oxford Learner's Dictionaries, 2016). The CHC nurses in this study were Swedish-speaking, but conducted speech and language assessments among children who did not speak Swedish; for example, who had a mother tongue other than Swedish. It is important to acquire knowledge of CHC nurses' experiences of language assessment.

  • 178.
    Johansson, Catrin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Daily Life Dialogue Assessment in Psychiatric Care—Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health2013In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 6, p. 306-311Article in journal (Refereed)
    Abstract [en]

    This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases.

  • 179.
    Johansson, Catrin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    Helldin, Lars
    The NU Health Care, Department of Psychiatry, SE-461 85 Trollhättan.
    Carlström, Eric D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Culture as a predictor of resistance to change: A study of competing values in a psychiatric nursing context.2014In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 114, no 2-3, p. 156-162Article in journal (Refereed)
    Abstract [en]

    It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.

  • 180.
    Johansson, Marie-Louise
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Simberg, Jenny
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Barnhälsovårdssjuksköterskans erfarenheter av barn med funktionell förstoppning2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Many children suffer from functional constipation. In case of functional constipation there is no underlying disease. In Sweden, functional constipation is very common in children. Risk factors include lack of physical activity, irregular toilet habits and insufficient intake of fibers and fluids. Child health nurse has the knowledge and skills to advise and treat children in functional constipation and to support and reduce the suffering. Aim: The aim of the study was to illuminate child health nurses' experiences in the care of children with functional constipation. Method: Ten child health nurses were interviewed during a semi structured interview used openended questions. The interviews were recorded as digital files and transcribed verbatim and then analyzed according to a qualitative content analysis. Results: The child health nurses described experiences in the care of children with functional constipation. There were two categories from the analyzed data: "to base on the child`s needs" and "the child´s physical and psychosocial environment". Conclusion: This study shows the child health nurses experiences in the care of children with functional constipation. The care is based on the childs neeeds and the environment around the child in terms of physical and psychosocial environment is taken into account. The child health nurses should be aware of the reason why parents seek care, how to find the cause of functional constipation and how to relieve the child's suffering. She creates a health promotion meeting with children and parents seeking care for functional constipation.

  • 181.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Sweden.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Voices used by nurses when communicating with patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1640-E1650Article in journal (Refereed)
    Abstract [en]

    AIM: To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Communication is an essential tool for nurses when working with older patients and their relatives but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome.

    DESIGN: An ethnographic design informed by the sociocultural perspective was applied.

    METHOD: Forty participatory observations were conducted and analyzed during the period October 2015 to September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semi-structured follow-up interviews were conducted with five nurses.

    RESULTS: In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualized, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices this indicates a shift in the orientation or situation.

    CONCLUSION: The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved.

    RELEVANCE TO CLINICAL PRACTICE: Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. This article is protected by copyright. All rights reserved.

  • 182.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Striving to establish a care relationship -Mission possible or impossible?: Triad encounters between patients, relatives and nurses2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, no 6, p. 1304-1313Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction.

    OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people.

    DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective.

    METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis.

    RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view.

    CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible.

  • 183.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    What are they talking about? Content of the communication exchanges between nurses, patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1651-E1659Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore and describe the content of the communication exchanges between nurses, patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Information, messages and knowledge are constantly being communicated between nurses, older patients and relatives in the healthcare sector. The quality of communication between them has a major influence on patient outcomes. A prerequisite for good care to be given and received is that there is mutual understanding between the parties involved.

    DESIGN: An ethnographic study was informed by a sociocultural perspective.

    METHOD: Data were collected through 40 participatory observations of meetings between nurses and older patients and/or relatives which covered 135 hours of nurse-patient-relative interaction, field notes, 40 field conversations with 24 nurses and 40 field conversations with patients (n=40) and relatives (n=26). Five semi-structured interviews were conducted with nurses. An ethnographic analysis was performed.

    RESULTS: The analysis identified three categories of content of the communication exchanges: medical content focusing on the patient's medical condition, personal content focusing on the patient's life story, and explanatory content focusing on the patient's health and nursing needs. The content is influenced by the situation and context.

    CONCLUSIONS: Nurses would benefit from more awareness and understanding of the importance of the communication content and of the value of asking the didactic questions (how, when, what and why) in order to improve the patients' and relatives' understanding of the information exchanges and to increase patient safety.

    RELEVANCE TO CLINICAL PRACTICE: Nurses can use the communication content to create conditions enabling them to obtain a holistic view of the patient's life history and to develop an appropriate person-centered care plan. This article is protected by copyright. All rights reserved.

  • 184.
    Jonsson, Bosse
    et al.
    Mälardalen University.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Work Integrated Learning and Learning Integrated Work: An Approach to Unite Theory and Practice to Praxis2016In: Handbook of Research on Quality Assurance and Value Management in Higher Education / [ed] Nuninger, Walter & Châtelet, Jean-Marie, Hersey, PA: IGI Global , 2016, p. 139-159Chapter in book (Refereed)
    Abstract [en]

    The difference between the professional competence conveyed during education and the competence demanded in working life is substantial and needs to be taken seriously. In this chapter where the case is nursing education, Work Integrated Learning (WIL) and Learning Integrated Work (LIW), are suggested as pedagogical approaches in Higher Education aiming to integrate scientific knowledge and with practical knowledge, and to provide an analytical perspective where students have the opportunity to develop metacognitive skills and praxis by learning through experiences during internship. One way to achieve this in vocational education to learn from the knowledge and skills used when performing inpractice. By integrating scientific and practical vocational knowledge, one promotes professionalization that is exhibited as Learning Integrated Work (LIW), i.e. the capability to perform the expected tasks and learn at work by using a critical and development-oriented attitude in daily work and actively participate in renewals of work assignments.

  • 185.
    Jungevik Edvinsson, Carola
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lund Petersen, Hannah
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av att vårda patienter med samsjuklighet inom psykiatrisk vård2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Co-morbidity between mental illness and addiction is a common occurrence in psychiatric care. Such co-morbidity affects the illness and the prognosis of the treatment as well as the caregiving needs of the patient. International studies show that nurses experience certain impediments in caring for patients with co-morbidity. There is, however, a lack of national research in the same regard.

    Aim: The aim of the study was to describe nurses' experience in caring for patients with co-morbidity in psychiatric care

    Method: Ten semi-structured interviews were conducted with nurses working in either psychiatric in-patient, or out-patient care. The interview-data was analyzed using qualitative content analysis.

    Results: The result is presented in three categories; To meet and to treat, To identify caregiving-needs and To devise and execute care. Nurses described the importance of creating a trusting relationship free from bias, in order to explore the patients´ complex of problems and plan caregiving efforts accordingly.

    Conclusion: The result of the study emphasizes the importance of the therapeutic relationship between nurse and patient in order to meet patients´ needs and develop the care of patients with co-morbidity. A therapeutic relationship takes time to develop and constitutes the frame within which the nurse can identify the caregiving needs of the patient and devise and execute care. The nurses in the study felt that they lacked time and resources to adequately meet the caregiving needs of patients with co-morbidity, and there is room for development within the organization.

  • 186.
    Jämtén, Sofia
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Möller Ranch, Matilda
    University West, Department of Health Sciences, Section for nursing - graduate level.
    First-time mothers' experiences of professional breastfeeding support and evaluation of the Mother-Perceived-Professional-Support scale2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Breastfeeding has decreased all over the world. World health organisation recommends exclusive breastfeeding for six months. Even though it's the natural way of feeding the baby it has to be learnt. It´s not unusual that problems occur and supporting breastfeeding is important. In Sweden most children under the age of six are on regular check-ups at child health care centres, where they meet a pediatric nurse who is supposed to support and help the family.

    The aim of the study was to explore first time mothers' personal experiences of professional breastfeeding support from the pediatric nurse and to evaluate and develop the scale "The Mother Perceived Support from Professionals" (MoPPS).

    Methods A qualitative design with both inductive and deductive approaches was chosen. Nine first time mothers were interviewed about their experience of professional breastfeeding support from the pediatric nurse. Semi structured interviews were used. There after the mothers were asked to grade their experience of breastfeeding support on the MoPPS-scale and commented their answers. Qualitative content analysis were used when analysing the data, both on the inductive (interviews) and deductive (the scale) part.

    Results The result reveals that the mothers felt a desire to breastfeed and they all experienced some difficulties. They wanted the pediatric nurse to give them professional support from their own experience and wanted her to be perceptive and understanding to their will. When the pediatric nurse gave time and booked extra appointments the mothers felt supported. The theme was: When having a desire to breastfeed, the mothers need to walk on a path of professional breastfeeding-support from the pediatric nurse. Three main categories were identified; Need of support, Lack of support and Received support. The result from the MoPPS-scale showed similar result as the interviews and the questions on the scale were seen as relevant to the aim. Comparing the result from the inductive and deductive analyses it was found that the mothers found it important that the pediatric nurse had enough knowledge about breastfeeding. It was also seen as important that the pediatric nurse involved the partner in the breastfeeding support.

    Conclusion There might be a benefit for pediatric nurses to have good knowledge about breastfeeding to be able to support mothers in a good way. The MoPPS-scale can be used as an easy way for the pediatric nurse to evaluate a mother´s experience of breastfeeding-support.

  • 187.
    Jörgensen, Lorena
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Zanders, Karin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Abandoning inpatient care: Reasons why psychiatric nurse specialists choose to leave psychiatric inpatient care2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to describe reasons why psychiatric nurse specialists choose to leave psychiatric inpatient care. In this study psychiatric nurse specialists were interviewed about their reasons for leaving psychiatric inpatient care. A total of nine semi-structured interviews were completed from within a Swedish psychiatric specialist health care setting. Interviews were transcribed verbatim and subjected to qualitative content analysis. Four themes emerged; 'wanting to use newly gained competence and develop advanced nursing care'; 'dissatisfaction with labour management'; 'lack of resources for advanced nursing care' and; 'the lack of personal balance between work and private life'. This study described the psychiatric nurse specialists' strong commitment to their former workplace, and to the patients they cared for in inpatient psychiatric care. This study also showed that the reasons why psychiatric nurse specialists choose to leave psychiatric inpatient care are multidimensional. The psychiatric nurse specialists want to use their newly gained competence and develop advanced nursing care, but, a lack of resources to perform advanced nursing care and dissatisfaction with labour management in combination with the lack of balance between work and their private lives may cause psychiatric nurse specialists to leave psychiatric inpatient care.

  • 188.
    Karlsson, Henrik
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kemell, Ida
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Föräldrars tillfredsställelse med vården efter att deras barn vårdats på intensivvårdsavdelning2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It is known from earlier research that family's closeness and involvement is significant when their child is hospitalized in an intensive care unit. In order to decrease parent's perception of stress and anxiety about the circumstances, they need information and support in whatever way suits their situation. Trust in their own self-efficacy may have meaning as to how parents handle the situation when their child is cared for at an intensive care unit.

    Aim: To map parents' satisfaction with the child's care and treatment and find out if there is a connection between the satisfaction with care and treatment and the faith in one's self-efficacy in handling strenuous situations.

    Method: A quantitative method with an online questionnaire where the data was analyzed in SPSS with descriptive statistics and correlation analysis.

    Results: 70 participants started the questionnaire, 56 finished it. Response rate 80%. Over all many of the participants were satisfied with the care, but least satisfied with the process of getting discharged. Correlation was found between self-efficacy and the satisfaction with care.

    Conclusion: Most parents are satisfied, but there is a room for improvements. They mainly wished for clearer information from the doctors, and better preparation before getting discharged. More research is needed for a more general view of parental satisfaction of intensive care.

  • 189.
    Karlsson, Ida
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Karlsson, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av att vårda patienter som gjort suicidförsök2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: About 1100 people commit suicide in Sweden in the year of 2015, but there is a larger number of people that makes suicide attempt. Many of this people are treated in psychiatric care. The nurses have a great responsibility in the care of these patients. Caring for these patients can bring out a lot of feelings and emotions among nurses.

    Aim: The aim of this study was to describe nurses' experiences of caring for patients who committed suicide attempts in a psychiatric care context.

    Method: Two focus group interviews where used to collect data. The data was transcribed and analyzed using qualitative content analysis.

    Results: The analysis revealed four categories and nine subcategories. The categorize in the result are "to assess the suicide risk" "to create a caring relationship" "to feel frustration" and "to handle emotions". In the suicide-assessment the nurses use their experiences, clinical look and intuition. The nurses could feel frustration in the work with the patient and towards the organization. To work with patients who has made a suicide attempt caused many emotions in nurses. These emotions had to be processed.

    Conclusion: It is a complex work to care for patients whom has made a suicide attempt. The nurses needed guidance and tutoring to process their emotions and to strengthen their role in the nursing. This also lead to increased health and less frustration.

  • 190.
    Karlsson, Ingrid
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tillsyn hos personer som är äldre och multisjuka vid hemkomst från sjukhus2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Elderly patients older than 65 years with multimorbidity and an increased need of healthcare are at risk of being readmitted to the hospital several times after discharge. By offering a supervised home visit and follow up after hospitalisation, the district nurse can      provide comfort for the elderly patient. This in turn may prevent rehospitalisation and patient suffering. Aim: To describe district nurses’ experiences with supervision of a newly homecoming hospitalised elderly patient with multimorbidity. Method: A qualitative interview study of 10 half structured interviews were conducted. The material was transcribed and analysed according to a qualitative content analysis. Results: The results are presented in two categories: Relieve worry at home and Create trust at home. The category Relieve worry at home was generated by using sub-categories; To be prepared and Respond to patient’s thoughts. To be prepared the district nurses had to plan and prepare the supervision. Routines were absent so the district nurses had to take part of information available from discharge notes, informing why the patient had been hospitalised. In general, the district nurse experienced that patients had many unanswered questions, and the district nurse had to respond to patients thoughts to their hospital stay and their medicine, which needed to be discussed and solved. The category Create trust at home was achieved by using sub-categories; To have the overall responsibility and State of health follow up. The district nurse’s experience of supervision was that it created trust at home and comfort in the nursepatient relationship. By implementing a state of health follow up, the district nurse could have an overall responsibility and make an own impression of the patient’s health condition and wellbeing, hence being able to see if the patient was in need for further help and support.  Conclusion: The results show that a home supervision by the district nurse prevented illness, created comfort and reduced the risk of impairment for elderly patients with multimorbidity.  

  • 191.
    Karlsson, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rydberg, Magdalena
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Äldre sköra personer söker främst akutvård?: erfarenheter av kontakt med akutmottagningen.2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Two million of Sweden’s population is 65 years of age or older and the number is increasing. Elderly patients are more frequent users of the emergency department. Forty percent of the visitors in the emergency department are represented by this patient category. Nurses need to understand how individual experiences of care might affect the next visit for the patient. Frail elderly has limited resources to spare and the emergency department is not suited for them. Nurses need to see how they can change and/or adapt to fulfil the needs of this group. The need for knowledge is always a requirement for nurses.

    Aim The purpose of this study was to describe frail elderly person´s experiences of the emergency department.

    Method The method was a literature-based study based on the analysis of nine qualitative studies.

    Results Three main themes emerged in the results; accessibility of the emergency department, experiences leading to seek care in the emergency department and moments that has affected the experience of the emergency department. Experience of the emergency department was also affected by the patient’s health-literacy.

    Conclusion The quality of care, the past experience of care and the accessibility to comprehensive care were factors that influenced why frail elderly choose to seek non urgent treatment in the emergency department, even though they knew they would have to wait. The main reason for seeking care in the emergency department was based on the experience of convenience.

  • 192.
    Karlsson, Margareta
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Åbo Academi University.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kasén, Anne
    Åbo Academi University.
    Wärnå-Furu, Carola
    Åbo Academi University.
    Söderlund, Maud
    University of Gävle, Åbo Academi University.
    A Qualitative Metasynthesis From Nurses’ Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care2015In: International journal for human caring, ISSN 1091-5710, Vol. 19, no 1, p. 40-48Article in journal (Refereed)
    Abstract [en]

    This metasynthesis aimed to translate, interpret, and present a synthesis of qualitative studies from nurses' perspectives dealing with ethical dilemmas and ethical problems in end-of-life care and to gain a deeper understanding of the phenomena. Nurses and other care professionals need to gain a deeper understanding and alleviate the suffering of patients through evidence-based practice end-of-life care. The metasynthesis, inspired by Noblit and Hare, generated an overarching metaphor, The Loving Eye. The Loving Eye illustrates how nurses are deeply involved with patients as human beings and connotes an inner responsibility to struggle for patients' best interests and wishes at the end of life. With The Loving Eye, nurses can see and feel patients' need to be confirmed, comforted, and healed approaching the end of life.

  • 193.
    Karlsson, Margareta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hedemalm, Azar
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Assessment and decision-making of Swedish primary care nurses in relation to the use of interpreters2017In: Journal of Health Visiting, ISSN 2050-8719, Vol. 5, no 9, p. 454-460Article in journal (Refereed)
    Abstract [en]

    Communicating with immigrants in primary care can be a challenge for nurses who must assess language proficiency and decide whether to use an interpreter. The aim of this study was to examine primary care nurses’ experiences of assessment and decision-making in relation to the use of interpreters. A qualitative inductive research design was chosen and nurses with experience of professional interpreters were recruited for focus group interviews. The study results showed that primary care nurses respected immigrants as human beings and recognised their right to decline an interpreter in sensitive situations. The purpose of primary care nurses’ experiences of assessment and decision-making in relation to the use of interpreters was ensuring patient safety, the importance of reciprocal information and respect for patient autonomy.

  • 194.
    Kauffeldt, Anders
    et al.
    University West, Department of Nursing, Health and Culture. University West, Department of Health Sciences, Section for nursing - graduate level.
    Velander, Eva
    University West, Department of Nursing, Health and Culture.
    Att handleda handledare: ett led i arbetsintegrerat lärande2004Report (Other (popular science, discussion, etc.))
  • 195.
    Kauffeldt, Anders
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Velander-Sundin, Eva
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sjuksköterskors uppfattningar av klinisk handledning utifrån organisations-, kompetens- och utbildningsperspektiv2009Report (Other academic)
    Abstract [sv]

    Verksamhetsförlagda studier i sjuksköterskeprogrammen på såväl grund- som specialistnivå är att betrakta som en form av arbetsintegrerat lärande. En viktig del i detta är den kliniska handledning som studenterna möter i sin utbildning. Högskolan Väst och Västra Götalandsregionen har i samverkan utvecklat en handledningsmodell där bas- huvudhandledare och högskolans lärare tillsammans är resurser för studenterna under verksamhetsförlagda studier. I anslutning till dessa intentioner erbjuds kliniskt verksamma sjuksköterskor handledarutbildning. Syftet med denna studie var att beskriva en grupp sjuksköterskors uppfattningar av klinisk handledning utifrån organisations-, kompetens och utbildningsperspektiv. I en enkätundersökning som besvarades av 199 sjuksköterskor som genomgått handledarutbildning framkom att den föreskrivna handledarmodellen fortfarande var i en utvecklingsfas. Huvudhandledarfunktion och handledarnas akademiska kompetens var inte i fas med intentionerna i handledarmodellen. I undersökningen framkom också indikationer på att samarbetet mellan kliniska handledare och högskolans lärare behöver utvecklas. När det gällde innehåll i den kliniska handledningen beskrevs att praktiska perspektiv har en dominerande funktion i handledningen och att arbetsledning och samarbete var det område där informanterna upplevde att de hade lägst kompetens att handleda i. Överlag skattade sjuksköterskorna sin handledande kompetens som hög. Informanterna var positiva till handledarutbildningens effekter i förhållande till integration av och reflektion kring teori, etik och praktik. Utbildningen hade också stärkt självkänslan i rollen som handledare vilket också hade ett positivt samband med i vilken utsträckning man uppfattade att studenterna uppnådde kursplanernas studiemål. Med utgångspunkt från arbetsintegrerat lärande diskuteras fortsatt utveckling av den föreskrivna handledarmodellen och handledarnas kompetens. Vidare diskuteras utveckling av handledarutbildningen och möjligheter till vidareutbildning i handledning. 

  • 196.
    Kauffeldt, Anders
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    "Formuleringarna blev professionella": upplevelser av omvårdnadsplanering med stöd av ICF ipsykiatrisk vård2012Report (Refereed)
  • 197.
    Kihlberg, Pernilla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Österberg, Sophia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Upplevelser av den egna arbetsmiljön hos sjuksköterskor inom kommunal hälso- och sjukvård i Fyrbodal och Lilla Edet: en enkätundersökning2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Working as a nurse today can be stressful and studies show that many nurses tend to leave their work. The nurse can be described as a spider that pull in many threads at the same time. The nurse in the community setting is working in the patient's home without many of the resources you can find in hospital, which is challenging.

    Aim: The aim of this study was to investigate nurses' in community settings in Fyrbodal and Lilla Edet experiences of their work environment.

    Method: A cross- sectional quantitative study with questionaries and a qualitative part with one open question.

    Results: The result showed that nurses over all thrive at work and have good relations with their colleagues. Further nurses found their work meaningful to a great extent. Whether the nurses could finish their work at time it seemed to be diverse meanings about and also about nurse's experiences of their first line manager. The result also showed that nurses in small community's experiences that their leader was fair when work is distributed. Nurses in small communities were also statistically significantly more positive to changes in work for example that nurses were able to be involved in the change process.

    Conclusion: Nurses are proud of their profession. They believe that the work they are performing has a meaning. The spirit among colleagues is good and the nurses support and care for each other. At the same time nurses ask for more participation, improved leadership and more time to do their work.

  • 198.
    Kjellberg, Carl
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Peci, Indira
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Psykiatrisjuksköterskors erfarenheter av självmordsriskbedömning i det vardagliga arbetet inom psykiatrisk slutenvård: En kvalitativ intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this study is to illuminate psychiatric nurses' experiences of suicide assessment in their daily work of a psychiatric inpatient ward.

    Background: The majority of all suicides are committed by people with some kind of psychiatric diagnosis and suicides within psychiatric hospital departments are increasing. In more than half of the cases where patients have committed suicide in the psychiatric hospital, the patient's suicidal risk assessment has failed and the patient has been able to leave the department and commit suicide. Previous research suggests that suicide risk assessments are important and nurses need more skills and time to be able to pay attention to patients' behavior.

    Design: This is a qualitative descriptive study based on eight individual semi-structured interviews that have been analyzed using qualitative content analysis by Lundman and Hällgren Graneheim (2012).

    Method: Data analysis was based on Lundman and Hällgren Graneheim (2012) description of qualitative content analysis. Semi-structured interviews with the addition of narrative questions was conducted. The participants were eight registered psychiatric nurses from four different psychiatric departments at a hospital in Västra Götaland. A male psychiatric nurse and seven female psychiatric nurses participated with at least one years of experience participated.

    Results: The results showed that the psychiatric nurses had difficulties defining a general suicide behavior. On the other hand, different behavior patterns were identified as more suicidal. Such patterns could be rapid twists in emotional state, strong anxiety, impulsivity and backwardness. Three categories emerged during the analysis process: Clinical Glance, Alliance Work and Experiences Collaboration and Knowledge, and all three had three related subcategories.

    Conclusion: The suicidal process is complex and the difficulty lies in identifying where in the process the patient is. Psychiatric nurses have responsibility identifying early signs considered by psychiatric nurses to be an important part of suicide assessment. Experience about the patient and knowledge of suicide is something that psychiatric nurses experience as significant to be able to make good suicide risk assessments.

  • 199.
    Kjellberg, Mimmi
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Therese
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Föräldrars erfarenhet av BVC-sjuksköterskans första hembesök2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background shows how the child health care is established in Sweden, which laws and convention that controls the nurses work with the families. It describes different ways for the nurse to support the families in their parenthood, how the parents can connect to their child and support the parents in trusting their ability to raise their child. The aim of the study was to illuminate parents' first experience of the first home visit from the nurse from the child health clinic and through interviews with first time parents gain an understanding of what their needs might be. The method was an empirical qualitative study with descriptive design. The study was performed by two focus groups and three phone interviews. Total ten parents were selected through convenient sampling. The interviews were recorded, transcribed and analyzed according to qualitative content analysis. The analysis resulted in three main categories; Parents' expectations and feelings, Parents need of support and the interaction is important for the experiences. The conclusion is that first time parents are in need of support in their parenthood, that they are in need of information and they really appreciated when the nurses managed to involve both the mother and the father in the conversation that took place in the first home visit. The first time parents looked forward to the home visit despite their concern that the nurse would supervise their home.

  • 200.
    Kjellsdotter, Anna
    et al.
    Skaraborg Hospital Skövde, Research and Development Centre, Skövde, Sweden; Skövde University, School of Health Sciences, Skövde, Sweden .
    Berglund, Mia
    Skövde University, School of Health Sciences, Skövde, Sweden .
    Jebens, Elisabeth
    Primary Health Care Center, Stenstorp, Sweden.
    Kvick, Jennie
    Primary Health Care Center Mösseberg, Falköping, Sweden.
    Andersson, Susanne
    University West, Department of Health Sciences, Section for nursing - graduate level.
    To take charge of one's life: group-based education for patients with type 2 diabetes in primary care - a lifeworld approach2020In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 15, no 1, article id 1726856Article in journal (Refereed)
    Abstract [en]

    Background: The number of people suffering from diabetes worldwide, including Sweden, has increased. To strengthen the patient's empowerment and thus improve their ability to take care of their own health, patient education in self-care management plays a central role in diabetes care.Purpose: The specific aim in this study was to describe patients' experiences of group-based education using the Taking charge of one's life with type 2 diabetes model.Methods: A qualitative approach with a phenomenological lifeworld perspective was used. The study was based on group and individual interviews and reflection books.Results: The group-based education model made it possible for the patients to learn through reflection concerning their own and others' experiences. The learning that occurred with support from the group reflections and the reflection books contributed to the understanding of the complexity of the illness. This increased the motivation and desire to be responsible for the treatment and implementation of habits. The group contributed to a sense of belonging and community that inspired a continued and active learning.Conclusion: The results showed that from the patients' perspective, this didactic model was both suitable and appreciated, supporting and facilitating learning.

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