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  • 1.
    Adam, Christina
    et al.
    1 St. Savvas Anticancer Hospital, Athens, Greece.
    Patiraki, Elisabeth
    National and Kapodistrian University of Athens, Athens, Greec.
    Lemonidou, Chryssoula
    National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
    Radwin, Laurel
    Research Health Scientist, Center for Health Care Organization and Implementation Research, Boston VA Health Care System, Boston, MA USA.
    Charalambouss, Andreas
    Cyprus University of Technology, Department of Nursing Studies, Limassol, Cyprus and Docent, University of Turku, Department of Nursing Science, Finland.
    Charalambous, Melanie
    Cyprus Ministry of Health, Nursing Services, Educational Sector, Nicosia, Cyprus.
    Berg, Agneta
    University West, Department of Health Sciences, Section for nursing - graduate level. Kristianstad University, Kristianstad.
    Sjövall, Katarina
    Skane University Hospital and Medical faculty, Lund University, Sweden.
    Katajisto, Jouko
    Statistician University of Turku, Department of Mathematics and Statistics, Turku, Finland.
    Stolti, Minna
    University of Turku, Department of Nursing Science, Turku, Finland.
    Suhonen, Riitta
    University of Turku, Department of Nursing Science/Turku University Hospital and City of Turku, Welfare Division, Turku, Finland.
    Quality of nursing care as perceived by cancer patients: A cross-sectional survey in four European countries2017In: Balkan Union of Oncology. Journal, ISSN 1107-0625, Vol. 22, no 3, p. 777-782Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore and compare cancer patients’ perceptions on the quality of nursing care in four European countries. Methods: Data were collected in Cyprus, Finland, Greece and Sweden. The sample comprised 596 hospitalized cancer patients. The quality of nursing care was measured using the “Oncology Patients’ Perceptions of the Quality of Nursing Care Scale” (OPPQNCS). Patient characteristics were also collected. Analysis of variance was used to examine the effects of country on the perceptions of the quality of nursing care. Results: Patients’ age ranged from 18 to 86 years, and 58% were male. The comparison of cancer patients’ perceptions regarding the quality of nursing care between the four countries showed a statistically significant difference in the total OPPQNCS scores (p <0.001) as well as in the subscales responsiveness (p <0.001), individualization (p<0.001), co ordination (p<0.001) and proficiency (p<0.001). The Cronbach’s alpha coefficient for the OPPQNCS ranged between 0.89 and 0.95. A multivariate analysis of variance for the OPPQNCS controlled by respondents’ demographic characteristics revealed that only the patient’s country was significantly related with the patients’ perceptions of quality care. Conclusion: Quality of nursing care as perceived by cancer patients was high, but differed between the four countries. The impact of the clinical status of cancer patients on the quality of nursing care and managerial factors such as staffing/nursing care delivery models that influence the ability of nurses to offer high quality care should also be explored by more focused studies.

  • 2.
    Ahlström, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Vahtera Eliasson, Katarina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors tillvägagångssätt för att stödja flickor i grundskolan vars vårdnadshavare begränsar deltagande i hälsofrämjande insatser2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background According to the Swedish law "skollagen" the school shall encourage all children’s development and strive to mitigate differences in pupils individual conditions to utilize their education. The role of the school nurse is to proactively prevent illness amongst the pupils. With some girls, absence is high in physical exercises and their presence in other activities that aim for increased health is limited. This absence affects these pupils’ ratings and limits their chances of having physical activities, but it also reduces their possibilities to interact in social activities within and outside school.

    Aim The aim of this study was to describe school nurses’ approach to strengthen girls who are in a situation where their guardians restrict their participation in health promotive activities.

    Method This is a qualitative, descriptive study based on individual semi-structured interviews with nine school nurses. The transcribed interviews were subjected to qualitative content analysis.

    Results The school nurses had an active approach to create a mutual understanding between the girls, their guardians and the school. This was conducted by strengthening of democratic appraisals, finding new ways to reach girls and their guardians and finally building and widening the school nurses’ own competence in the situation.

    Conclusions: The studie shows that school nurses make use of the steering documents that exists within the school system in order to strengthen girls’ equality rights. A prerequisite for the school nurse to influence guardians and girls was to create a good relation for all of them. The school nurses were interested in understanding the family’s situation and their life experiences as well as inform about the core values of the school in order to create mutual understanding and build a foundation for further work based on each family’s situation. In the role of a school nurse it was not found viable to reach results only by informing the guardians and girls. Instead the school nurses tried to reach an open discussion with respect for both parties.

    Only through such a dialogue the school nurses argued that they could reach out and create the right conditions for a positive change to support the girls’ equality rights.

  • 3.
    Ali, Tara
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gustavsson, Anna-Lena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Distriktssköterskans erfarenhet av sin arbetssituation på vårdcentral2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The work done by the nurse at the primary health care center includes meeting with people of different ages and with different health problems and diseases. It is important that the work is carried out in a good environment. Former studies show that the workload for the district nurse has increased and become more stressful with threats and violence from patients who expect more treatment.

    Aim: To describe the district nurse's experiences of their work situation.

    Method: A qualitative interview study with eight district nurses working in primary health care in Sweden were interviewed. The data was analysed using a qualitative content analysis with an inductive approach.

    Results: Three main categories and nine subcategories were generated by the authors. The categories included: The content of a good day is when all the colleagues are present, and the timetable is good planned with enough work containing good meetings. When planning fails is the change of planning because of more patients and obstacles in communication skills. Experience of their environment is the impact of the physical environment such as good working environment and threatening environment.

    Conclusion: There was negative employment in the district nurses' work situation, but despite that, the experience was positive to work independently, make decisions and use their resources. They felt collegial support and it was important to know where to turn when things went wrong.

  • 4.
    Alsen, Pia
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Thörn, Susanna
    Primary Health Care, Sollentuna, Sweden.
    Nordqvist, Linnea
    Primary Health Care, Munkedal, Sweden.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Men’s Experience of Difficulties during First Year Following Myocardial Infarction: Not OnlyFatigue2016In: Health, ISSN 1949-4998, Vol. 8, p. 1654-1667Article in journal (Refereed)
    Abstract [en]

    Recovery from a myocardial infarction (MI) can be a very difficult process and some patients are also stricken by fatigue. The aim of the study was to describe the difficulties experienced by men with fatigue during the first year following their MI. The study was conducted using qualitative content analysis of semi-structured interviews with nine men in working age (mean age: 55 years) with verified fatigue (≥12 of 20 on the Multidimensional Fatigue Scale with a mean of 17) one year after their MI. During the first year after the MI the men suffering from fatigue experienced various difficulties in terms of both themselves and the care received. The analysis generated three themes with difficulties described by the interviewed men. 1) Going through involuntary change: not recognizing their body and the inability to recognize themselves. 2) Lacking individualized care: To be denied satisfactory health care treatment and to be denied respectful treatment. 3) Not being seen in the light of the social context: The MI affects the whole family and caregivers do not pay attention to the family. In order to make both the patient and relatives feel secure and cared for, it is essential that caregivers be aware of the importance of providing individualized care over time with particular attention for the patient’s social context.

  • 5.
    Alsén, Pia
    et al.
    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.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Fatigue after myocardial infarction - a two-year follow-up study2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 11-12, p. 1647-1652Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To investigate changes in self-reported fatigue and depression from four months to two years following a myocardial infarction, as well as to explore gender differences, identify the incidence of fatigue without coexisting depression and finally predict health-related quality of life at a two-year follow-up. Background: Depression and fatigue are associated with decreased health-related quality of life after myocardial infarction. Although there is a close relationship between fatigue and depression, it has been shown that symptoms of fatigue can occur without coexisting depression. Design: Quantitative and longitudinal design. Methods: Participants (n = 155) were asked to complete the following questionnaires: the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory-20 (MFI-20) and the Short Form Survey (SF-36) following myocardial infarction (after four months and two years). Descriptive statistics, paired t-tests and multiple regressions were carried out. Results: In the entire group, self-reported fatigue had decreased from four months to two years after myocardial infarction. After two years, 18% of respondents reported depression together with fatigue and 30% reported fatigued without depression. Women scored higher than men on the fatigue dimensions reduced activity, reduced motivation and mental fatigue. Moreover, the physical dimension of health-related quality of life two years after myocardial infarction was predicted by experienced general fatigue at four months. Conclusion: Fatigue with or without coexisting possible/probable depression remains as a significant symptom two years after myocardial infarction in nearly half of the entire group. Relevance to clinical practice: Fatigue is a problem following myocardial infarction. Therefore, systematic screening and early identification of patients experiencing symptoms of depression and fatigue after myocardial infarction are important for suitable care planning. In contemporary coronary care, strategies aimed at relieving fatigue should be developed. ᅵ 2013 Blackwell Publishing Ltd.

  • 6.
    Andelin, Mervi
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Uppfattningen av typ 2 diabetes hos personer från Mellanöstern som lever i Sverige: en beskrivande kvantitativ pilotstudie2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research shows that persons from the Middle East are at higher risk to develop type 2 diabetes which increases the risk of diabetic complications and early death. Both illness perception and self care are significant factors for the disease process. The diabetes nurse needs to search for knowledge of illness perception thus they have a central role in strengthening the individuals' ability to handle treatment, symptoms, emotional, cognitive and physical consequences as well as lifestyle changes.

    Aim: The aim of this study was to investigate illness perception of type 2 diabetes among persons from The Middle East living in Sweden.

    Method: A descriptive analysis of a pilot study was conducted in the region of VästraGötaland during spring 2019. 27 individuals answered the Brief Illness Perception Questionnaire about their illness perception of type 2 diabetes.

    Results: The participants perceived type 2 diabetes to be a chronic disease and reported a very high degree of coherence of the disease. They also perceived that type 2 diabetes can be controlled by both treatment and themselves to a very high degree and to a relatively high degree. Trust in treatment was greater than in their own control. The study shows a significant difference in coherence of type 2 diabetes between women and men in the study, where women experienced a higher degree of coherence than men. Identity and consequences were the dimensions of illness perception with the lowest median.

    Conclusion: Illness perception affects the degree of self care and disease progress. The results can be used to give an increased understanding of illness perception of type 2 diabetes among persons from the Middle East living in Sweden.

  • 7.
    Andersson, Ann-Christine
    et al.
    Jönköping University,The Jönköping Academy for Improvement of Health and Welfare, Jönköping.
    Ainalem, Ingrid
    Centre for Innovation and Improvement (CII), Region Skane, Malmo.
    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, Kristianstad.
    Janlöv, Ann-Christin
    Kristianstad University, Kristianstad.
    Challenges to Improve Inter-Professional Care and Service Collaboration for People Living With Psychiatric Disabilities in Ordinary Housing.2016In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, no 1, p. 44-52Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back-evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

  • 8.
    Andersson, Erika
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ett vårdverksamhetsperspektiv på samverkan i sjuksköterskeprogrammets verksamhetsförlagda utbildning2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Society is constantly evolving and changes are taking place, which creates the opportunity to collaborate around several different areas. Working for a work-integrated learning (WIL) could mean that you work structured together with healthcare and college with common goals and collaborative issues. The content of the study deals with healthcare representatives´ perceptions of the importance of collaboration, the possibility of nursing education's vocational education. Method used in the study is qualitative method with focus group interviews. In the study, three focus groups and one interview were interviewed. Interviewees consisted of managers, supervisors and supervisors. The care activities that the informants represented were somatic care in emergency medical care, psychiatric care and home care. A qualitative content analysis was made by the interviews that were themed by interpretation of the interviews. Healthcare representatives wanted a collaborative perspective in various areas, such as development and collaboration of teaching models, assessment and evaluation. Working together with work-integrated learning as a model can be a way of interacting. There is a hope that the healthcare and higher education institutions will find development pathways in the future to ensure the knowledge of nursing students and their future occupational role, as to ensure the quality of care.

  • 9.
    Andersson, Marina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Individuell anpassning och uppföljning av fysisk aktivitet på recept (FaR): en kvalitativ studie med fokus på patienters erfarenheter2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Physical activity on prescription, so-called FaR is an important task for the district nurse in order to promote the individual´s health. Physical activity can relieve pain and symptoms as well as lead to reduced medication. The purpose of this study was to examine adult patients’ experiences of having been prescribed FaR. An interview study using an inductive qualitative approach was set up and ten patients were interviewed. The interviews were analyzed using content analysis according to Graneheim and Lundman’s description of the method. The results show that those who received tailored FaR had, in different ways, been offered, given to reason and discuss, agree and given the choice of activity and degree of activity the following individual condition and disease. To be asked to increase activity was almost as common as getting tailored FaR. Monitoring and support varied from close contacts if necessary to no follow-up at all. Those who had close contact described they had been met with a motivational interview. Some patients had no need of frequent follow-ups and were pleased to have received encouragement to the increased activity. The medical staff need ongoing training in motivational interviewing and in being flexible when there is a prescribed FaR to be consistent in patients undergoing treatment. To get repeated encouragement at follow-ups was one of the main categories that made the patients motivated progressively, increased activity and reduced resistance.

  • 10.
    Andersson, Sarah
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Faktorer som hindrar patienter med diabetes typ 2 att genomföra livsstilsförändringar.2019Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is the most common form of diabetes, 90% of all people living with diabetes have type 2 diabetes. The reason for obtaining type 2 diabetes is rising age, obesity, physical inactivity and genetic factors. Symptoms from the disease are fatigue, thirst and increased amounts of urine. Lifestyle changes can be explained as an act performed to change lifestyle, such as diet and physical activity. Treatment of type 2 diabetes is dietary changes and increased physical activity in combination with medications.

    The aim of this literature study was to identify factors that prevent patients with type 2 diabetes from performing lifestyle changes.

    The method was a systematic literature study where seven qualitative articles were analyzed and the result was based on. Six articles were found through searches in databases Cinahl and PubMed, one article via manual search.

    Results: Two categories and six subcategories emerged from content analysis of the included articles, the categories were; Internal factors and external factors. Subcategories were; lack of inner motivation, lack of support, lack of knowledge/information, attitude/expectations to lifestyle changes, physical barriers and surrounding obstacles.

    Conclusions: Interpretation of the result could be that patients need different types of support to be able to implement the lifestyle changes required by them. It can be assumed that each patient needs an individualized counseling/information about type 2 diabetes and how obstacles to carrying out lifestyle changes could be eliminated. More research and increased knowledge are required for specialist nursing in diabetes regarding obstacles to the implementation of lifestyle changes.

  • 11.
    Andrén, Ulla
    et al.
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Hedman Ahlström, Britt
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Kinnander, Monica
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Skyvell Nilsson, Maria
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nunstedt, Håkan
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Utveckling av ett nytt yrke inom socialpsykiatrisk vård2019Report (Other academic)
    Abstract [en]

    The program in Social Psychiatric Care is a three-year program at the university level leading to a vocational qualification in social psychiatric care and a bachelor's degree in the field of Health Sciences. Until the spring of 2018, six litters have graduated. Students in the social psychiatric care program often have personal interest, previous professional experience from the business areas or inspiration from related friends working in the field of activity. Personal experiences of problems in the fields of activity are also prominent among the students. Students believe that personal experience, willingness and ability is important in order to work within the profession. Characteristics of the students are also an interest and a clear empathetic willingness to work with people and they consider that the profession primarily requires characteristics such as altruism, empathy, social skills and deeper knowledge and understanding in the field. Upon completion of education, students want a career role where they can help other people, feel motivated, or they aim for specific positions or areas of activity. Both managers and alumni from the Social Psychiatric Care program value the broad professional competence that the program leads to. Psychiatric competence is emphasized as particularly valuable by both alumni and managers. This competence means that they also complement the other professions in the activities. Students consider themselves possessed a professional identity that involves introducing psychiatric and custody skills to organizations that previously lacked these perspectives. Something that also brings new approaches to patients, users and clients. Being able to use knowledge from several disciplines are considered to be a strength and competence that are well-needed in environments where people with mental ill health are cared for. The alumni perceive their knowledge as both interdisciplinary and interprofessional.

  • 12.
    Antonsson, Helena
    et al.
    University of Umeå , Department of Nursing , Umeå , Sweden.
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Umeå , Department of Nursing , Umeå , Sweden.
    Isaksson, Ulf
    University of Umeå , Department of Nursing , Umeå , Sweden.
    Åström, Sture
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Umeå , Department of Nursing , Umeå , Sweden.
    Lundström, Mats O
    University of Umeå , Department of Nursing , Umeå , Swede.
    Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design.2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 734-743Article in journal (Refereed)
    Abstract [en]

    The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.

  • 13.
    Arakelian, Erebouni
    et al.
    Uppsala University, Department of Surgical Sciences, Uppsala, Sweden.
    Rudolfsson, Gudrun
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rask-Andersen, Anna
    Uppsala University, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, Sweden.
    Runeson-Broberg, Roma
    Uppsala University, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, Sweden.
    Wålinder, Robert
    Uppsala University, Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala, Sweden.
    I Stay: Swedish Specialist Nurses in the Perioperative Context and Their Reasons to Stay at Their Workplace2019In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, no 3, p. 633-644Article in journal (Refereed)
    Abstract [en]

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

    Design Qualitative design.

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

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

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

  • 14.
    Arakelian, Erebouni
    et al.
    Uppsala University Hospital,Department of Surgical Sciences, Entrance 70, SE-751 28..
    Swenne, Christine Leo
    Uppsala University, Department of Public Health and Caring Sciences, Box 564, SE-751 22, Uppsala, Sweden.
    Lindberg, Susan
    Skaraborg Hospital, Department of Anaesthesia, SE-541 85, Skövde, Swede.
    Rudolfsson, Gudrun
    University West, Department of Health Sciences, Section for nursing - graduate level. Faculty of Professional Studies, University of Nordland, 8049, Bodø, Norway..
    von Vogelsang, Ann-Christin
    Karolinska Institutet, Department of Clinical Neuroscience,Stockholm, Sweden..
    The meaning of person-centred care in the perioperative nursing context from the patient's perspective: an integrative review2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 17-18, p. 2527-2544Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To determine the meaning of person-centred care from the patient's perspective and in the context of perioperative nursing. BACKGROUND: Person-centred care (PCC) is used but not defined in the perioperative context. The concept indicates an interest in the patient's own experience of health, illness, needs and preferences. As with many terms that are frequently used, there is a tendency for person-centred care to mean different things to different people in different contexts. METHODS: A two-part search strategy was employed; firstly, a computerized database search of PubMed and CINAHL, using Medical Subject Headings and free terms to search articles dating from 2004 to 2014, and secondly, a hand-search of those articles' reference lists was performed. Twenty-three articles were selected and an integrative review was conducted. RESULTS: Four themes were discovered: 'Being recognized as a unique entity and being allowed to be the person you are', 'Being considered important by having one's personal wishes taken into account', 'The presence of a perioperative nurse is calming; prevents feelings of loneliness and promotes wellbeing, which may speed up recovery', and 'Being close to and being touched by the perioperative nurse during surgery'. CONCLUSIONS: PCC means respecting the patient as a unique individual, considering the patient's particularities and wishes, and involving the patient in their own care. PCC also implies having access to one's own nurse who is present both physically and emotionally through the entire perioperative process and who guides the patient and follows up postoperatively, guaranteeing that the patient is not alone. RELEVANCE TO CLINICAL PRACTICE: By having a common understanding of the concept of PCC, the nurse anaesthetists' and theatre nurses' caring actions or concerns will be directed towards the patient', resulting in personalization of care rather than simply defining the concept. This article is protected by copyright. All rights reserved.

  • 15.
    Arifaj, Fitore
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Larsson, Kerstin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lågaffektivt bemötande: ett verktyg för den psykiatriska slutenvården? En studie av sjuksköterskors erfarenheter.2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A low arousal approach is defined as a working method that focus on the interaction between the patient and the caregiver. The approach is one of the most important tools in psychiatric inpatient care, which focus on getting the patient to maintain control over their emotions. The work method has been well-evaluated in other contexts outside psychiatry but sparingly evaluated in psychiatric inpatient care. The aim of the study has been to increase knowledge about low arousal approach and its effect in psychiatric inpatient care.

    Aim: The aim of the study was to describe registered nurses' experiences of low arousal approach in psychiatric inpatient care.

    Method: The study is a descriptive qualitative study in which interviews were conducted with ten registered nurses in child- and adult psychiatric inpatient care. The data was analyzed by a qualitative content analysis. An inductive approach was used where similarities and differences in the collected material were described.

    Result: The analysis resulted in three categories. Low arousal approach: Gives an inner and outer strength, Gives a feeling of uncertainty and Put the patient in the center. The result of the study shows both a strength in the low arousal approach experiences, but at the same time it can give the registered nurse a feeling of uncertainty when there are a knowledge gap both in herself or in the staff group. The registered nurses in the study find that the low arousal approachmeans that the patient is seen as a person regardless of diagnosis.

    Conclusion: When the registered nurse feels safe in his or her knowledge and the working group works on a staff-common way with low arousal approach, can this create a calmer careenvironment and a good working climate. The registered nurses also feel that the working method gives the patient an increased opportunity to control his or her feelings and this increases the patient's sense of empowerment.

  • 16.
    Arveklev Höglund, Susanna
    et al.
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Gunnarsdottir, Hrafnhildur
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Eriksson, Monica
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Relations and interrelations between Sense of Coherence, socioeconomic status and health behaviour: A systematic review2019Conference paper (Refereed)
    Abstract [en]

    Background/Objectives

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

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

     Methods

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

     Results

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

    Discussion

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

     

     

     

  • 17.
    Askland, Daniel
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ahmad Sadik, Nawsaid
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Patientutbildning för personer med bipolär sjukdom: Upplägg och innehåll av utbildningar inom psykiatrisk öppenvård2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    To suffer from bipolar disorder can cause significant distress. Bipolar disorder causes severe shifts in mood. The person can, apart from having a normal mood, experience depressive episodes or a highly elevated mood – hypomania or mania. Psychoeducation as a complement to medicine treatment can help persons manage their disorder and reduce severe changes in mood. Little is known about psychoeducation programs in the country as a whole. Knowledge about these programs can be useful for evaluation and can contribute to valuable insights. The aim of this study was to survey the setup and content of psychoeducation programs for people with bipolar disorder in outpatient care in the country. To accomplish this a cross-sectional study was made through a web-based questionnaire sent to staff involved in outpatient psychoeducation. The Swedish National Quality Register for Bipolar Disorder – BipoläR contributed with contact information to the outpatient clinics. All 234 clinics involved were linked to BipoläR, 56 answers were returned resulting in the following information: Most of the psychoeducation programs were group-based. The major part used programs designed by themselves. Nurses were the most frequently staff involved. The mean amount of time for education delivery was 12 hours. The psychoeducation content was rich in important aspects related to the disorder. The programs were delivered through lectures and discussion. The conclusion of this study was the emphasis on group-based programs developed at the clinics, the quality content of programs and the possible need for more evidence-based programs.

  • 18.
    Asplund, Charlotta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Hallgren, Magdalena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    "En tickande bomb": Sjuksköterskors upplevelser av att vårda hotfulla och våldsamma patienter i psykiatrisk slutenvård2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Inpatient aggression is common as a phenomenon in psychiatric inpatient care. Inpatient aggression arises for several reasons. It disturbs the nurses in their work assignments and causes negative emotions, which can be reflected in the interaction with the patients.

    Aim: To describe nurse's experiences of caring for aggressive patients in psychiatric inpatient care

    Method: An interview study was conducted with eight nurses at two psychiatric clinics at a hospital in a big town in Western Sweden. The material was analysed through qualitative content analysis.

    Results: The analysis resulted in four main categories. The first category is uneasiness, with subcategories: to feel anxiety, to feel stress, to feel sad and to feel offended. The second category is fear, with subcategories: to feel fear for the aggressive patient and to feel fear for others sake. The third category is powerlessness, with subcategories: to lose control, to feel frustration and to work with a ticking time bomb. The fourth category is work to create security policies with subcategories: understanding the patients' situation and courage to remain in an aggressive encounter.

    Conclusion: Inpatient aggression is often associated to symtoms and/or drug abuse, which also was confirmed in our study. In most scenarios the nurses had a deeper understanding for the patients behavior and thereby a higher tolerance towards inpatient aggresion. The nurses claimed that beeing available to the patients was very important, since that created an atmosphere of security for both parties and it was assumed a presumtion for a good caring relationship.

  • 19.
    Ax Hansson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Derdziak, Anna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Närståendes behov av stöd då de vårdar eller stödjer en person med långvarig psykisk sjukdom2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To illuminate relatives need of support when caring for or supporting a person suffering from mental illness

    Background: Relatives of a person suffering from mental illness have different needs. It has for the past few years merely been little improvements in the relative's situation.

    Methods: Focus group interviews with fourteen relatives. Data were analyzed through manifest content analysis.

    Findings: Three categories were found: Functioning contact channels to the psychiatric health care organization, Need of an active support from the psychiatric health care organization and Need of support from community resources.

    Conclusion: The relatives need more attention and understanding for their situation. The support of relatives must be designed and monitored individually. A collaboration or a well-functioning relation with the psychiatric nurses, other professionals working in the health care organisation and social services gives a mutual respect and trust which in turn leads to that the relative is confirmed as an important resource in the care of the mentally ill person. The relatives need an increased support and understanding from the community.

  • 20.
    Axelsson, Madeleine
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Olsson, Susanne
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ensamhet. En begreppsanalys: Den ensamhet som råder i den djupaste skog2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Loneliness can be experienced in different ways. By visualizing the dimensions of loneliness, healthcare professionals have a deeper understanding of what the concept of loneliness is. The purpose of this study was to analyze the meaning of the word loneliness through a concept analysis. The method used in this study was a concept analysis according to Peep Koort´s semantic method. Loneliness was defined according to etymological dictionaries as in the relationship to be lonely, for example,”A frozen trail that disappears in the loneliness of the forest”. In the definition of loneliness the analysis of the dictionaries resulted in several synonyms, three of which were chosen for further analysis. The most prominent synonyms was ”ödslighet” (desolation),” enslighet” (solitude) and ”isolering” (isolation). The theoretical definition of the outcome was discussed in a philosophical and health science perspective. The result showed both positive and negative aspects of loneliness. Loneliness can be a time of silence and reflection, but can also mean human suffering. From a scientific perspective, it is important to pay attention to the experiences of loneliness in patients and relatives in order to be able to provide appropiate support as a heathcare professional. In summary, loneliness can be illustrated by the metaphor ” The loneliness that exists in the deepest forest”.

  • 21.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet.
    Recent educational interventions for improvement of asthma medication adherence.2012In: Asia Pacific allergy, ISSN 2233-8276, Vol. 2, no 1, p. 67-75Article in journal (Refereed)
    Abstract [en]

    Poor adherence to asthma medication treatment is a dilemma as it decreases the chance of achieving and maintaining a proper asthma control. Another dilemma is that there seems to be a small range of functional interventions that enhance adherence to long-term medication treatments. The aim was to review the last five years of published educational interventions for improving adherence to asthma medication. Through systematic database searches 20 articles were identified, which matched the inclusion criteria and described educational interventions to improve asthma self-management including adherence. The current review showed that addressing unintentional non-adherence in terms of incorrect inhaler technique by recurrent education improved the technique among many patients, but not among all. Phoning patients, as a means to remove medication beliefs as adherence barriers, seemed to be an effective educational strategy, shown as increased adherence. Involving patients in treatment decisions and individualising or tailoring educational support also seemed to have favourable effect on adherence. To conclude, addressing specific adherence barriers such as poor inhaler technique or medication beliefs could favour adherence. To change adherence behavior, the current review proposes that educational adherence support should be a collaborative effort between the patient and the health-care professional based on each individual patient's needs and patient factors, including elements such as personality traits.

  • 22.
    Baatz Asplund, Catarina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lundgren Andersson, Ann-Katrin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors attityder och erfarenheter av att arbeta med patienter med en ohälsosam alkoholkonsumtion: En empirisk studie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year 3.3 million people die in the world due to harmful use of alcohol. Alcohol is a public health problem in Sweden as well, where one in ten people considered having risky drinking habits. Research shows that excessive alcohol consumption leads to the development of alcohol-related illnesses. Nurses' dialog with patients is important to support them to change unhealthy habits. What experiences have nurses about discussion concerning the patients' drinking habits?

    Aim: The purpose of this study was to investigate nurses' attitudes to, and experiences of, dialog with patients about their alcohol use habits.

    Method: A descriptive cross-sectional study was conducted with the help of a questionnaire.

    Results: Most nurses felt that they have a good knowledge and were secure in their work with patients who have unhealthy alcohol consumption. They asked the patients about their drinking habits and used the AUDIT screening form for mapping unhealthy consumption.

    Conclusion: Nurses in specialist psychiatric services have a good knowledge of the causes of alcohol problems and can provide consultative support. Their experience of success helping patients with alcohol problems varies.

  • 23.
    Baldock, Karina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Anhörigas upplevelser av bemötande inom psykiatrisk vård: Den utfrysta anhöriggruppen2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Making people feel safe and secure in health care is one of the most importanttasks of nursing. A good response is not only important to patients but also to their relatives. Previously, for most of last century, relatives were not welcome to the psychiatric health care. But research show they are in need of information and support from the health care. It istherefore important that nursing staff learn what kind of response the relatives require.

    Aim: To investigate how relatives experience the response from nursing staff within thepsychiatric care.

    Method: Qualitative interviews with eight respondents, where the answers were transcribedand analysed to learn how they had experienced the response from nursing staff. In theanalysis the text was condensed and abstracted into subcategories and categories.

    Result: The analysis resulted in twelve subcategories and three categories; Feeling valued andmaking a difference, Feeling left out and not wanted, Response improvement suggestions.

    Conclusion: This study shows that relatives still to a large extent are left out fromparticipation in psychiatric care, although society has placed the main responsibility on themto support their next of kin. The result shows that relatives require more information andparticipation to be able to support their next of kin. Getting a good response from nursing caremeans for them to be seen, listened to and getting information and support. They don´t wantto be left out any more.

  • 24.
    Bancks, Ann-Sofie
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ivarsson, Karin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Förutsättningar som behövs för att implementera personcentrerad vård inom Kommunal Hemsjukvård: En kvalitativ intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background According to the Swedish Association of Local Authorities and Regions should all healthcare professionals within the regions, municipalities and county councils work for an introduction of person-centered care, which will aim to promote good and equitable health care and to enhance patients and users as co-creators in their own care process.

    Aim The aim of this study was to describe the district nurses' perception of person-centered care and the conditions required to implement person-centered care in home care.

    Method A qualitative study was conducted using eleven face-to face interviews.

    Results The analysis showed that the district nurses perceive person-centered care was to have the person at the center when it comes to planning and implementation of health care. To achieve this goal the nurses declared the need for certain conditions. These are reported to be team work, support from the organization and patient involvement in their care.

    Conclusion All nurses in the study were positive to a person-centered care approach and basically they were aware of the meaning of the term. The district nurses who had recently undergone specialized training focusing on district nursing had a more scientifically based definition of what person-centered mean In relation to those with older training. The former appeared more likely to work on a basies of a person-centred approach and were more positive to develop such approach in health care.

  • 25.
    Bardhi, Razije
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Björling, Sonja
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Distriktsköterskors och diabetessköterskors erfarenheter av att möta patienter med diabetes som riskerar att få fotsår2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:  Diabetes is one of the most common chronic diseases in the world and according to studies, the disease has a rapid development, especially type 2 diabetes that may be similar to an epidemic. Foot complications are among the most risky and costly late complications of diabetes mellitus. Neuropathy is the commonest complication and affects about half of all with diabetes. An important part of the preventive work of diabetes-related foot ulcers to provide both patient and family with knowledge, information and self-care education. Aim:  The aim of this study was to describe district nurse's and diabetic nurse's experience of meeting patients with diabetes who are at risk of foot ulcers Method:  The study had a qualitative approach. The study was based on individual interviews, with nine participants. Data analysis was then done using qualitative content analysis. Results:   The study resulted in four categories: conditions for a good start of a long-term relationship, different care depending on where the patient lives, the nurse as a mediator of knowledge and difficulties in preventive work. Conclusion:  This study shows that a large part of the preventive work is about self-care. It also appears that it is a challenge for nurses when patients do not want to take care of the advice and information they receive.

  • 26.
    Bay, Annika
    et al.
    Umeå University, Public Health and Clinical Medicine, Umeå, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lamas, K
    Umeå University, Nursing, Umeå, Sweden.
    Sandberg, Camilla
    Umeå University, Public Health and Clinical Medicine, Umeå, Sweden.
    Johansson, Bengt
    Umeå University, Public Health and Clinical Medicine, Umeå, Sweden.
    Facilitators and barriers for physical activity in adults with congenital heart disease2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no suppl_1, p. 1120-1121, article id ehy566.P5433Article in journal (Refereed)
    Abstract [en]

    Background: A majority of adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and counteract acquired cardiovascular disease. This study illuminates aspects that may be relevant for performing physical activity.Purpose: To describe facilitators and barriers for physical activity in adults with CHD.Methods: Semi-structured interviews were performed individually with fourteen adults (age 19–68 years, women=7) with complex CHD. The interviews were analyzed using qualitative content analysis.Results: Aspects that may enable or inhibit physical activity were found in two domains; Facilitators and Barriers, which both consisted of four categories physical, psychological, psychosocial and environmental aspects (Table 1).

  • 27.
    Bay, Annika
    et al.
    Umeå University, Department of Public Health and Clinical Medicine, Umeå University, Sweden; Department of Nursing, Sweden.
    Dellborg, Mikael
    Gothenburg University, Institute of Medicine, The Sahlgrenska Academy, Sweden..
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden.
    Sandberg, Camilla
    Umeå University, Department of Public Health and Clinical Medicine, Sweden.
    Engström, Gunnar
    Umeå University, Department of Surgical and Perioperative Science, Cardiothoracic Surgery Division,.
    Moons, Philip
    KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Sweden..
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Sweden..
    Patient reported outcomes are associated with physical activity level in adults with congenital heart disease.2017In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 243, p. 174-179Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO).

    METHODS: Patients with CHD (n=471) were randomly selected from the national register on CHD and categorized according to complexity of lesions - simple (n=172, 39.1±14.6years), moderate (n=212, 39±14.1years), and severe (n=87, 31.7±10.7years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression.

    RESULTS: PAL was categorized into high (≥3 METs ≥2.5h/week, n=192) and low (≥3 METs <2.5h/week, n=279). Patients with low PAL were older (42.6 vs. 35.8years, p≤0.001), had more prescribed medications (51% vs. 39%, p=0.009), more symptoms (25% vs. 16%, p=0.02) and comorbidity (45% vs. 34% p=0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p<0.001), satisfaction with life (25.6 vs. 27.3, p=0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p<0.001) and Mental Component Summary score (MCS) (73.5 vs. 79.5, p<0.001). Complexity of heart lesion was not associated with PAL. The included PROs - separately tested in the model, together with age were associated with PAL.

    CONCLUSIONS: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.

  • 28.
    Bay, Annika
    et al.
    Umeå University, Department of Public Health and Clinical Medicine Department of Nursing.
    Lämås, Kristina
    Umeå University, Department of Nursing, .
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sandberg, Camilla
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy, Sweden.
    Johansson, Bengt
    Department of Public Health and Clinical Medicine.
    It's like balancing on a slackline: A description of how adults with congenital heart disease describe themselves in relation to physical activity2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 15-16, p. 3131-3138Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To illuminate how adults with CHD describe themselves in relation to physical activity.

    BACKGROUND: Several studies have shown that adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.

    DESIGN: Qualitative study with semi-structured interviews analysed with qualitative content analysis.

    METHODS: Semi-structured interviews were individually performed with fourteen adults (women=7, age 19-68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow-up and diagnosis.

    RESULTS: The overall theme, It's like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (1) Being an adventurer- enjoying the challenges of physical activity; (2) Being a realist- adapting to physical ability; (3) Being a non-doer- lacking prerequisites for physical activity; and (4) Being an outsider- feeling excluded depending on physical ability.

    CONCLUSIONS: Adults with CHD seem to have a diverse relationship to physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active in order to get a deeper understanding of how to support adults with CHD to be physically active.

    RELEVANCE TO CLINICAL PRACTICE: Given the diverse relationship to physical activity, nurses have to further investigate the patients' relationship to physical activity, in order to support a healthy lifestyle. Nurses and allied health professionals should offer individualized exercise prescriptions and education about suitable physical activities in relation to physical ability. This article is protected by copyright. All rights reserved.

  • 29.
    Bengtsson, Emma
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nielsen, Ida
    University West, Department of Health Sciences, Section for nursing - graduate level.
    ”Att göra det bästa av situationen”: En kvalitativ studie om sjuksköterskors erfarenhet av vårdmiljöns betydelse för psykiatrisk omvårdnad2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The mental illness in society are increasing both nationally and internationally. In Sweden, about 40 percent of the population has at some point been affected by mental illness. Lack of nurses as well as savings in health and medical care with reduced hospital beds within the psychiatric inpatient care affect the healthcare environment in which staff and patients resides. Knowledge is needed about how nurses experience their care environment in order to continuously improve the possibilities of providing good care within the psychiatric inpatient care. Aim The aim of this study was to illuminate nurses' experiences of the care environment's importance in psychiatric care. Method The study was performed at a psychiatric clinic in southern Sweden. Ten nurses were interviewed individually about their experiences of the importance of the care environment with semi-structured interview questions. The data material was analyzed using qualitative content analysis. Results Two domains emerged, The ward's physical care environment with categories: The design of the premises, Locked doors and Surroundings outside the ward. The ward´s psychosocial care environment with categories: Ward atmosphere, Protocol, Structure and rules, Work group, Stress and Nursing. Conclusion The healthcare environment are important for nurses' ability to provide good care in psychiatric inpatient care. Both positive and negative factors emerged during the analysis. The nurses described that their care environment was not designed to the care that was given, but that they did the best they could with the conditions that existed

  • 30.
    Bengtsson, Victoria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bloom, Emelia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Det är inte bara att ge en spruta...: barnhälsovårdssjuksköterskors upplevelser av att vaccinera barn2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In child health care immunization is a common task for the child health nurse. Often children are unprepared, afraid and preoccupied with pain in the vaccination situation. Most children experience the presence of the parents as important during the procedure. Parents who prepare their child reduce the child's stress during the vaccination situation. An interaction occurs between the child health nurse and the child where participation is a prerequisite for the experience to be a positive outcome. Aim: The aim of the study was to describe the child health nurses' experiences of vaccinating children aged 0-6 years.Method: Semi-structured qualitative interviews were performed with twelve child health nurses. Data was analyzed using a content analysis focusing in manifest content. Results: Child health nurses' experiences of vaccinating commuted between the sense of power and confident. The crucial experience was the support and cooperation that the child health nurses experienced with the parents. It emerged a theme: Participation, three main categories: Sense of power, sense of confidence and cooperation with parents and six subcategories: Abuse, powerlessness, experiences, strategies, common goals and approaches and different goals and approaches. Conclusion: The result indicates that the parents have a dominant role in the vaccination situations with the ability to affect the health nurse's experience. Child health nurse, child and parents must cooperate to vaccinations to be carried out and be perceived in a positive way

  • 31.
    Berg, Ann
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Fohlin Johansson, Leone
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Äldre personer med diabetes mellitus och deras upplevelse av egenvård: En litteraturöversikt2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Diabetes is a growing health problem and the risk of getting diabetes is increasing with age. Beside diabetes, older persons often have several diseases which makes their situation complex. Self-care is an important part of treatment and how the older persons experience this is relatively unknown. The aim of the literature review was to investigate how older persons with diabetes experience self-care to find out how support for self-care can be developed. Systematic searches were made in the databases Cinahl, Pub/Medline and PsychInfo for the period 2007-2017. Fifteen articles were found and analysed using a descriptive synthesis. Three themes were identified: 1) To be responsive to the body's signals, 2) To be able to understand the life situation, and 3) To participate creates security. Older persons with diabetes usually had good knowledge of self-care but had difficulty to perform it. The result indicates that to support older people with diabetes to self-care, nurses need more knowledge how to involve and support older people in their care, create support-groups and meeting others with the same diagnosis, and develop a person-centred action plan.

  • 32.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Is being physically active the key to a good quality of life for patients living with Fontan circulation?2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 11, p. 1257-1258Article in journal (Other academic)
  • 33.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Sahlgrenska Academy, Institute of Medicine.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Rydberg, Annika M.
    University of Umeå, Department of Clinical Sciences, Pediatrics.
    Dellborg, Mikael
    Sahlgrenska Academy, Institute of Medicine.
    Ekman, Inger
    University of Gothenburg, Centre for Person-Centred Care.
    Committed to Life: Adolescents’ and Young Adults’ Experiences of Living with Fontan Circulation2015In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 10, no 5, p. 403-412Article in journal (Refereed)
    Abstract [en]

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

  • 34.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, B.
    Umea University, Department of Public Health and Clinical Medicine, Umea, Sweden.
    Mattson, E.
    Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden.
    Moons, P.
    The Sahlgrenska Academy at Gothenburg University, Institute of health and caring sciences, Gothenburg, Sweden;.
    Dellborg, M.
    University of Gothenburg, Institute of medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Exploration of disagreement between the patient’s self reported limitations and limitations assessed by caregivers in adults with congenital heart disease2018In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, no Suppl 1, article id 2406Article in journal (Refereed)
    Abstract [en]

    Background: The New York Heart Association (NYHA) classification is applied in a wide spectrum of heart diseases including adult patients with congenital heart disease (ACHD). The NYHA-class assessment is often based on the evaluation by the caregiver, but to what extent it correlates with the patient's view of their function is not fully known.Purpose: To investigate the relation between the patient's self-reported physical limitations, symptoms, other heart defect related factors and NYHA-class assessed by the caregiver.Methods: Eligible patients (n=333, age 39.2±13.6 years) were identified and randomly selected from the national registry for CHD. All of the patients completed a standardized questionnaire measuring different PRO-domains. By combing self-reported data with registry data including NYHA-class, analyses of agreement of physical limitations were performed.Results: Almost 30% of the patients rated their limitations higher compared to the NYHA-class estimated by the caregiver. Patients with self-reported limitations and their NYHA-class underestimated by caregivers, more often reported symptoms, anxiety, lower health and worked fewer hours/week compared to other patients with CHD. There were no differences regarding sex, type of symptoms, prescribed medications, or complexity of cardiac lesion. In patients without self-reported limitations agreement with NYHA-class estimated by caregivers was 97%.Conclusion: Adult patients with CHD and self-reported limitations may not be correctly identified by the care-giver. Instruments for patient reported outcomes might improve the assessment of physical limitations and could further improve the correctness in evaluating the patient's status.

  • 35.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
    Mattsson, Eva
    Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Moons, Philip
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Dellborg, M.
    The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
    Comparison of participants and non-participants in patient-reported outcome surveys: the case of Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study2017In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 27, no 3, p. 427-434Article in journal (Refereed)
    Abstract [en]

    Background: The last decade has seen a vast increase in the use of patient-reported outcomes. As patient-reported outcomes are used in order to capture patients’ perspectives of their health and illness, it is a prerequisite for accurate patient-reported outcome evaluations to use representative samples. In order to evaluate representativeness, the present study focussed on the comparison between participants and non-participants in the Swedish branch of the international study APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study), regarding demographic, clinical, and health status characteristics. Methods: Eligible patients for APPROACH-IS were identified and selected from SWEDCON, the Swedish registry for congenital heart disease (CHD). Overall, 912 eligible patients were identified, of whom 471 participated, 398 did not participate, and 43 were either unreachable or declined to participate in APPROACH-IS. The participants and non-participants were compared in terms of statistical significance and effect sizes. Results: Significant differences were observed between participants and non-participants for sex, age, primary diagnosis, number of cardiac operations, and fatigue; however, the effect sizes were in general small, except for the difference in primary diagnosis. No differences between the two groups were found in number of catheterisations, implanted device, the distribution of NYHA functional class, or health status and symptoms. Conclusions: This study shows that participants and non-participants are relatively comparable groups, which confirms the representativeness of the participants. The Swedish data from APPROACH-IS can therefore be reliably generalised to the population of adults with CHD in Sweden. © Cambridge University Press 2016

  • 36.
    Berglöv, Louise
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Söderqvist, Anna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Personcentrerad vård inom BVC2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Person centered care (PCC) is about understanding the totality of individuals' lives and what context they are in. Therefore, flexibility can be seen as an important feature in specialist nurses work with PCC at the child health center (CHC). Today, PCC is recognized in healthcare and shows good results, however, there is a resistance among the professionals. Research on PCC in child health care is deficient, while at the same time studies show that children do not feel respected.

    Aim: The aim of the study was to describe child health nurses view of person centered care with focus on the child in relation to the parents.

    Method: Nine individual semistructured interviews with specialist nurses were conducted and data analyzed through qualitative content analysis.

    Results: The specialist nurses all agreed that PCC was about seeing the child and the parents, meeting them here and now and always having the child in focus. Allowing the child to participate and to share their stories was a prerequisite for working person centered. The specialist nurses also considered that their own professional experience played a crucial role. There were also obstacles and difficulties, the reasons for that were several, but most often was it about ignorance and uncertainty.

    Conclusion: The fact that the focus always on the child and that the specialist nurse always assumes the best interests of the child is the most important when it comes to PCC at the CHC. Family focused care and person centered care complement each other where it is up to the specialist nurse to decide which of them who is the most important in the current situation.

  • 37.
    Bergqvist, Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tingberg, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    En fråga med dolda svar: en registerstudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since 2008 there is a law stating that patients who do not require institutional forensic psychiatric care may be moved to non-institutional forensic care, with special conditions. RättspsyK is a national quality register where all of the 25 forensic care units in Sweden collect information about their patients and their care. Previous analysis showed that a considerable amount of patients continue to receive institutional forensic psychiatric care despite they are assessed and found ready to move onto non-institutional forensic care. Aim: The objective of this study was to identify factors affecting why patients were still in institutional forensic care despite assessed to be ready for non-institutional forensic care.Method: First, yearly assessment of each patient between 2009 and 2014 was drawn from the RättspsyK register. Answers to the specific question, Question 10, were analyzed with descriptive statistics and were planned to be used in regression analyses as dependent variable. Result: 1900 patients were included. During analyses the fact that answers to this question were not trustable was found, therefore no exact prevalence of inpatients kept in institutional forensic care despite assessed ready for non-institutional care could be determined. Other information revealed that lack of housing and lack of collaboration were the most frequent reasons for this phenomenon. Conclusion: The present study could not give answer to the original question, but pointed out avalidity problem in the Swedish Forensic Psychiatry Register. The result calls for caution and for the need of validation of RättspsyK register.

  • 38.
    Berholt, Camilla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lilienberg, Ann-Charlotte
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Psykisk ohälsa hos intagna med självriktad aggressivitet: Effekt av 10 veckors yoga2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental ill-health is common among prisons inmates. More than half of inmates in Swedish prisons suffer from different psychiatric problems that untreated can contribute to aggressive behaviors, including self-directed aggressive behaviors such as self-harm, suicide attempt or completed suicide. Evidence shows that participation in yoga exercise may improve mental health in the general but even in prison inmates population. The effect of yoga on self-directed aggressive behavior in prison inmates population has not yet been specifically studied, according to our knowledge.

    Aim: To examine the self-reported prevalence of psychiatric diagnoses by gender among prison inmates, and to study the effect of 10 weeks yoga on the prevalence and severity of self-directed aggression in this population.

    Method/Study population: From nine prisons in Sweden, 211 inmates participated voluntarily in the 10 weeks of study. They were randomized into two groups, one yoga group in which inmates participated in 90 minutes of hatha yoga once every week and a control group including those who were placed into a waiting list for yoga and asked to participate in 90 minutes of physical activity of free choice, once a week during the study.

    Results: Major depression, substance use disorder, anxiety disorder, and attention deficit hyperactivity disorder were the most common psychiatric diagnoses among inmates. The prevalence of many psychiatric diagnoses was significantly higher in female inmates than in male inmates. Both yoga and freely chosen physical activity reduced self-directed aggression during incarceration, but the improvement was better in the group that preformed yoga.

    Conclusion: The study provides evidence that yoga made on a regular basis have a positive effect on reducing self-directed aggression. Since no side effects of yoga exercise have previously or in this study detected, it can be concluded that yoga can be effective measure to increase inmates well-being.

  • 39.
    Bern, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Saltell, Mikaela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Motivation till livsstilsförändringar: en utmaning för distriktssköterskan2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Hypertension increases all over the world and with the disease there is a risk för complications and personal suffering. The treatment involves lifestyle changes and pharmacological treatment. The district nurse has an important role in care of patients with hypertension and through health interviews, the district nurse can create possibilities for lifestyle changes. Motivation plays an essential role in implementing lifestyle changes and it varies in between individuals.

    Aim: The aim of the study was to examine district nurse's perceptions of what motivates and what creates obstacles and holds back patients with hypertension to implement lifestyle changes.

    Method: Eight district nurses who on daily bases worked with patients with hypertension and lifestyle changes were interviewed. The interviews were analyzed by qualitative content analysis with an inductive approach to reach the aim of the study.

    Results: The district nurses experienced that both positive as well as negative factors were found to have an impact on a patient's motivation for lifestyle changes. These factors were both found in the district nurse and in the patient. The patient's inner drive force and the district nurse's professionalism created conditions for patients to implement lifestyle changes while as a patient's own negative attitude and a district nurse's lack of commitment and understanding created barriers for patients to implement lifestyle changes.

    Conclusion: The district nurses experienced that both the district nurse and the patient's involvement in health interviews influenced the patient's motivation for lifestyle changes.

  • 40.
    Bernling, Sigrid
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kucukcelik, Nadire
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Medias konstruktioner av flyktingar och hur dessa kan påverka distriktssköterskor i deras möte med flyktingar2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In 2015, the increased number of refugees arriving in Sweden was covered in media. Public health nurses may in their encounter with immigrants be influenced by discourses arising from medial constructions of refugees. The aim of this study was to examine mass medial constructions of and discourses about refugees, since preconceptions can influence district nurses in encounters with these persons. It is a matter of importance to discuss how this can manifest itself, in order to make public health nurses encounters with refugees as well-functioning as possible. Person-centred care has been uses as a theoretical frame of reference in this study. A qualitative approach was chosen. The methods used were corpus analysis and discourse analysis.  Data was collected from three daily newspapers: Dagens Nyheter, Sydsvenskan and Svenska Dagbladet, published in September, October and November 2015. During this time the concept refugee occurred in 4022 articles. The result shows that refugees in media are contoured as a homogenous group. Four discourses based on thirteen constructions were identified. The four discourses were a crisis discourse, a helplessness discourse, a political discourse, and an economical discourse. From the discourses, it is assumed that public health nurses reading of medial texts about refugees influences their view, and therefore their care, of refugees. Hence, it is important to illuminate the constructions of refugees in media

  • 41.
    Berntsson, Shala Ghaderi
    et al.
    Uppsala University, Department of Neuroscience, Neurology, University Hospital, Uppsala, Sweden.
    Landtblom, Anne-Marie
    Uppsala University, Department of Neuroscience, Neurology, University Hospital, Uppsala, Sweden, Department of Clinical and Experimental Medicine, Neurology, Medical Faculty, University of Linköping, Linköping, Sweden.
    Flensner, Gullvi
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Cerebellar ataxia and intrathecal baclofen therapy: Focus on patients´ experiences2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 2, no 6, article id e0180054Article in journal (Refereed)
    Abstract [en]

    Elucidating patients´ experiences of living with chronic progressive hereditary ataxia and the symptomatic treatment with intrathecal baclofen (ITB) is the objective of the current study. A multicenter qualitative study with four patients included due to the rare combination of hereditary ataxia and ITB therapy was designed to elucidate participants' experiences through semi-structured interviews. The transcribed text was analyzed according to content analysis guidelines. Overall we identified living in the present/ taking one day at a time as the main theme covering the following categories: 1) Uncertainty about the future as a consequence of living with a hereditary disease; The disease; 2) Impact on life as a whole, 3) Influence on personal life in terms of feeling forced to terminate employment, 4) Limiting daily activities, and 5) ITB therapy, advantages, and disadvantages. Uncertainty about the future was the category that affected participants' personal life, employment, and daily activities. The participants' experience of receiving ITB therapy was expressed in terms of improved quality of life due to better body position and movement as well as better sleep and pain relief.

  • 42.
    Björk, Theres
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Torstensson, Annalena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Erfarenheter av att vara närstående till en anhörig med palliativ vård i hemmet2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: More and more patients with terminal illness choose to die in their own home. Next of kin play a central role in the care of their loved one. They are entitled to the support of health care, both in the relative´s illness and after the death in the form of survivor calls.

    Aim: To describe the experience of being closely related to a loved one in palliative home care.

    Method: A qualitative inductive approach was used. Eight relatives to patients who had received palliative home care were interviewed. The interviews were analyzed using content analysis.

    Results: The results are presented in three categories: "Not having a life of its own", "Feeling safe" and "Losing trust in caregivers". These are based on 11 subcategories that affect the experience of being related to a loved one with palliative home care. Next of kin described the responsibility for the loved one which affected their entire life situation with lack of rest and recovery as a result. When caregivers gave the help they were in need of, it created a sense of security. It could mean that they came quickly to urgent situations or that they met the next of kin's need for relief. When the care could not meet the needs of family members, or when they perceived shortcomings in care, this led to a loss of confidence for caregivers.

    Conclusion: Next of kin are in an emotional and stressful situation, and caregivers needs to be better at ensuring their needs and offer bereavement support.

  • 43.
    Bodri, Titti
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Karlsson, Maja-Stina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Evidensbaserad vård för personer med KOL: En journalgranskning utifrån Socialstyrelsens riktlinjer/indikatorer på en primärvårdsenhet2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sufferers of COPD do not always receive the healthcare which guidelines and evidence suggest they should be given. In November 2015, The National Board of Health and Welfare issued new guidelines and indicators for care administered to sufferers of COPD. Aim: To investigate documentation of indicators and vaccination administered to COPD sufferers at a primary care unit.Method:The method was a retrospective journal review of total of n=118 journals. Aquantitative analysis with deductive approach was performed using a review template based on indicators for COPD care.Results: According to the documentation, 89% of subjects had their COPD diagnosis confirmed through spirometry and 90% were offered assistance with smoking cessation. The journals indicated that 8.5% of subjects had been vaccinated against influenza and pneumococcus, 15.3% of subjects had received structured patient education, the health status of 10.2% of subjects had been documented through CAT, 34.6% of subjects received nutritional treatment for those with a BMI under 22, 3.4% of subjects had their physical activity measured, 3.4% had been diagnosed cardiovascular exercise and/or weight training and the patient's next appointment had been documented in 80.5% of cases. None of the subjects involved in the study had received a written treatment plan or documented mMRCsymptom assessment. Conclusion: The primary care unit neither documents nor administers evidence-based care to COPD sufferers to a satisfactory degree in line with The National Board of Health andWelfare's domestic guidelines.

  • 44.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Learning by supporting others: experienced parents' development process when supporting other parents with a child with Type 1 diabetes2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. E1171-E1178Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: This study's purpose was to describe and analyze coach-parents' development process when supporting parents of children recently diagnosed with Type 1 Diabetes Mellitus (T1DM).

    BACKGROUND: It has been found repeatedly that providing social support for families with a child diagnosed with T1DM promotes health and wellbeing for both the child and the parents. Less explored are the processes experienced by those who provide this support. However, research has found that acting as a provider of social support promotes personal development, strengthens communication skills, and increases self-confidence.

    METHODS: The study design was based on Constructivist Grounded Theory and data were collected, through Repeated Focus Group Discussions, from eight coach-parents at a Swedish hospital from 2012-2015.

    RESULTS: The core category in the data was identified as a learning process where coach-parents emphasized their own learning in the dyad supporter - supported, and in the interaction with other parents in the Repeated Focus Group Discussions. The coach-parents' motivation for participation was a wish to learn more and to help other parents in a life-changing situation. They also pointed out hindrances and their frustration when unable to provide support.

    CONCLUSIONS: This study leads to the conclusion that people who provide support benefit from doing so. Encountering people with similar experiences in a supportive situation promotes a reciprocal learning process, based on the supporter's wish to help people in a situation they recognize. A further conclusion is that social support is not only essential initially, but is also important over a longer period and that it follows various life stages.

    RELEVANCE TO CLINICAL PRACTICE: Setting up repeated focus group discussions might be a relevant and effective tool for pediatric diabetes nurses to use in promoting health and wellbeing for both families with a newly diagnosed child and experienced families. This article is protected by copyright. All rights reserved.

  • 45.
    Boman, Åse
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bohlin, Margareta
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Eklöf, Mats
    University of Gothenburg, Department of Psychology, Gothenburg, Sweden.
    Forsander, Gun
    The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Munthe, Christian
    University of Gothenburg, Department of Philosophy, Linguistics and Theory of Science, Gothenburg, Sweden.
    Törner, Marianne
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background2017In: SAGE Open Medicine, E-ISSN 2050-3121, Vol. 5, article id 2050312117700056Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not.

    OBJECTIVE: The aim of this study was to identify elements in the patient-pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus.

    METHODS: A total of 12 pediatrician-adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background.

    RESULTS: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent's experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration.

    CONCLUSION: An extended person-centered approach with focus on the adolescent's experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician-adolescent consultations may increase integration of the disease.

  • 46.
    Brandt, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rosell, Emma
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Erfarenheter av att främja barns delaktighet i vårdmötet med skolsköterskan: En kvalitativ intervjustudie2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It is obligatory for children in Sweden to go to primary school and all meet the school nurse on some occasion. The mission of the school nurse is to work for health, preventive care and according to the overall equal public health. For the school nurse to connect with every individual student in the encounters it is essential that the student is participating. Participation creates meaningfulness that, together with understandability and manageability, is perceived as a sense of coherence which promotes health.

    Aim: The purpose of the study is to describe the school nurses experience of promoting children´s participation in the encounters.

    Method: A qualitative interview study with inductive reasoning was performed. Eight schoolnurses in Västra Götaland, Sweden participated in the study. The interviews were transcribed literally. The transcribed text was analyzed using qualitative content analysis.

    Result: The result of the study of how school nurses promote participation among students showed three categories. To inspire confidence and create a reliable relationship, adaptation of the communication according to the needs of the student and being aware of obstacles and resistances.

    Conclusion: Previous research is further strengthened, and many earlier studies can be confirmed with this study. The school nurses experience and ways of working with and around the encounters to promote participation in the encounter is signified by the ability to inspire confidence and to build a reliable relationship, to adapt communication after the needs of the student and being aware of obstacles and resistance. An important observation is that there can be an ethical dilemma when the obligations of the school nurse need to be fulfilled which can interfere with the desire to maintain a relationship based on trust with the student. This can pose an obstacle to promote children´s participation.

  • 47.
    Bratt, Ewa-Lena
    et al.
    University of Gothenburg, Institution of Health and Care Sciences, Gothenburg, Sweden..
    Burström, Å
    Karolinska Institute, Institution for Women's and Children's Health, Stockholm, Sweden..
    Hanseus, K
    Department of Pediatric Cardiology, Skåne University Hospital, Lund, Sweden.
    Rydberg, A
    Umeå University, Department of Clinical Sciences, Pediatrics, Umeå, Sweden..
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. Department of Pediatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
    Do not forget the parents: Parents' concerns during transition to adult care for adolescents with congenital heart disease2018In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 44, no 2, p. 278-284Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Growing up with congenital heart disease (CHD) often means transfer to adult care and lifelong medical follow-up. An optimal transition process usually involves a multipart collaboration between the patient, their parents and other family members, and the healthcare providers. Taking an active role while knowing when it is time to step aside can be difficult for all the concerned parties, even the healthcare professionals. The aim of the present study therefore, was to explore parents' expectations and needs during their adolescent's transition to adult care.

    METHOD: Semi-structured interviews were conducted with 18 parents of 16 adolescents (aged 13-18 years) with CHD in 4 pediatric cardiology settings in Sweden. The interviews were analysed with qualitative content analysis.

    RESULTS: The analysis resulted in 2 main themes: (a) Feeling secure-the importance of being prepared and informed. This theme focused on the need to be prepared and informed about transition and future transfer to adult care. (b) Recognizing when to hand over at the right time. This theme addressed the process of handing over the responsibility from the parent to the adolescents and contained handing over from pediatric care to adult care.

    CONCLUSION: Being prepared and informed about the upcoming transition process was essential. The parents underlined the importance of being involved in the transition planning for gradually handing over responsibility to the adolescent. They also considered establishing contact with the adult healthcare team before transfer as important and needed to be assured that CHD-related information of importance for the young person's daily life would be given.

  • 48. Bratteby, L E
    et al.
    Sandhagen, B
    Lötborn, M
    Samuelson, Gösta
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Daily energy expenditure and physical activity assessed by an activity diary in 374 randomly selected 15-year-old adolescents.1997In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 51, no 9, p. 592-600Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the average daily levels of physical activity, energy expenditure and the time and energy spent a different activities in two cohorts of Swedish adolescents.

    DESIGN: Total energy expenditure (TEE) and physical activity level (PAL = TEE/basal metabolic rate (BMR)) were estimated in 374 randomly selected healthy adolescents living with two different regions of Sweden on the basis of a seven-day activity diary (AD) and predicted BMR. A validation of the estimates from the AD with the doubly labelled water (DLW) method in a randomly selected subsample of 50 of these subjects is presented elsewhere.

    SETTING: The Unit of Paediatric of the Department of Clinical Physiology, University Hospital, Uppsala and the Department of Paediatrics, Northern Alvsborg Hospital, Trollhättan, Sweden.

    RESULTS: No significant differences in TEE and PAL were found between the adolescents of the two regions. High levels of TEE (14.2 and 10.9 MJ/d in boys and girls, respectively) and PAL (1.95 and 1.80) were observed. There was a close association between the PAL and the adolescents and their reported time spent sitting. Those with the lowest PAL values spent 3-6 h longer each day sitting compared to those with the highest PAL values. The results also indicate that everyday activities such as walking and bicycling have a crucial impact on the PAL values.

    CONCLUSIONS: In the 15 y old adolescents of the two studied regions of Sweden, high and concordant levels of energy expenditure and physical activity were found.

  • 49. Bratteby, L-E
    et al.
    Samuelson, Gösta
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tid ägnad olika aktivitetstyper hos ungdomar med varierande grad av fysisk aktivetet1997Conference paper (Other academic)
  • 50.
    Brauer, Josefin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pettersson, Lisa
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors erfarenheter av att samtala med barn med övervikt: Det krävs fingertoppskänsla2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Almost every fifth child in Sweden has overweight or obesity. In school all children meets the school nurse and through their work they can support and guide children with overweight, and they have a great opportunity to help these children. Working with children with overweight is seen as a demanding part of the school nurses work, among other things because of lack of knowledge in how conversations with children with overweight should take place. Aim: The aim of the study is to describe School nurses experiences of bringing a conversation to children with overweight. Method: A qualitative method was used. Ten school nurses were interviewed with semistructured questions. The material from those interviews were analyzed with a qualitative content analysis according to Graneheim and Lundman (2004). Result: The analysis of the material resulted in three categories: To create the conditions for a successful conversation, To meet challenges, Using strategies in the conversation. During the work, a theme has emerged: dialogue that requires compliance. School nurses considered that children with overweight were a difficult and emotional topic to talk about. The School nurses experienced difficulties when the pupils lacked of motivation and when support from the parents was missing. Even lack of time and how the conversations were best adapted to each individual pupil were further challenges for the school nurses. To be compliant in the conversation and building a bond was seen as a major part of getting a positive conversation and a good continuing work with these children. Conclusion: School nurses experiences of having a dialogue with children with overweight shows that it is a complex and sensitive topic. Difficulties considered to be cooperation with the parents and to work with children who has a lack of motivation. Differences also emerged about how school nurses work with templates.

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