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  • 1. Adolfsson, Annsofie
    et al.
    Larsson, Per-Göran
    Translation of the short version of the Perinatal Grief Scale into Swedish2006Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, nr 3, s. 269-273Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Women's emotions and grief after miscarriage are influenced not only by the context in which the miscarriage occurred but also by their past experience, the circumstances around the miscarriage and their future prospects. Their emotions therefore express a specific form of grief. Normally the time needed to work through the loss varies. A number of different scales, measuring women's emotions and grief after miscarriage have been published. One instrument that measures the specific grief, such as the grief after miscarriage is the Perinatal Grief Scale (PGS) that was designed to measure grief after perinatal loss and has good reliability and validity.

    AIMS: The purpose of this study was to translate the PGS into Swedish and to use the translation in a small pilot study.

    MATERIAL AND METHOD: The original short version of the PGS was first translated from English into Swedish and then back-translated into English, using different translators. During translation and back-translation, not only the linguistic and grammatical aspects were considered but also cultural differences. The Likert 5-point and a 10-point scale were tested in a pilot study where 12 volunteers anonymously answered the PGS twice. The intra-personal correlations were compared and analysed with weighted kappa-coefficient.

    FINDINGS: In all, five different versions were tested before the final Swedish version was established. The weighted kappa-coefficient for the volunteers was 0.58, which is regarded as representing good reproducibility.

    CONCLUSION: The PGS was translated successfully into Swedish and could be used in a Swedish population. As this work is rather time-consuming we therefore wish to publish the Swedish version so that it may be used by other researchers.

  • 2.
    Andersen, Randi Dovland
    et al.
    Department of Child and Adolescent Health Services, Telemark Hospital, Skien, Norway; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Munsters, Josanne M. A.
    Department of Women’s and Children’s Health, University Children’s Hospital Uppsala, Uppsala, Sweden.
    Vederhus, Bente Johanne
    Department of Pediatrics, Haukeland University Hospital, Bergen, Norway and.
    Gradin, Maria
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Pain assessment practices in Swedish and Norwegian neonatal care units2018Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, nr 3, s. 1074-1082Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The use of measurement scales to assess pain in neonates is considered a prerequisite for effective management of pain, but these scales are still underutilised in clinical practice.

    AIM: The aim of this study was to describe and compare pain assessment practices including the use of pain measurement scales in Norwegian and Swedish neonatal care units.

    METHODS: A unit survey investigating practices regarding pain assessment and the use of pain measurement scales was sent to all neonatal units in Sweden and Norway (n = 55). All Norwegian and 92% of Swedish units responded.

    RESULTS: A majority of the participating units (86.5%) assessed pain. Swedish units assessed and documented pain and used pain measurement scales more frequently than Norwegian units. The most frequently used scales were different versions of Astrid Lindgren's Pain Scale (ALPS) in Sweden and Echelle Douleur Inconfort Noveau-Ne (EDIN), ALPS and Premature Infant Pain Profile (PIPP) in Norway. Norwegian head nurses had more confidence in their pain assessment method and found the use of pain measurement scales more important than their Swedish colleagues.

    CONCLUSION: The persisting difference between Swedish and Norwegian units in pain assessment and the use of pain measurement scales are not easily explained. However, the reported increased availability and reported use of pain measurement scales in neonatal care units in both countries may be seen as a contribution towards better awareness and recognition of pain, better pain management and potentially less suffering for vulnerable neonates.

  • 3.
    Andershed, Birgitta
    et al.
    Örebro universitet, Hälsoakademin.
    Olsson, Kristina
    Review of research related to Kristen Swanson's middle-range theory of caring2009Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, nr 3, s. 598-610Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to identify and describe how Kristen Swanson's middle-range theory has been used in nursing practice/research presented in international journals. A total of 120 studies were included in the review and 23 were analysed further. An overview of the studies is presented, followed by four categories of how the theory has been used: referring to the theory (97 papers), applications of the theory to practice/research and/or theoretical discussions (nine papers), relating findings to and/or validation of the theory (eight papers), and development of measurements from and/or testing of the theory (six papers). The use of the theory and conclusions of the studies related to criteria for evaluation of theories were discussed.

  • 4.
    Andershed, Birgitta
    et al.
    Örebro universitet, Hälsovetenskapliga institutionen.
    Ternestedt, Britt-Marie
    Örebro universitet, Hälsovetenskapliga institutionen.
    Patterns of care for patients with cancer before and after the establishment of a hospice ward1997Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 11, nr 1, s. 42-50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A majority of people die in acute hospital care, in a culture of quickness primary aimed at curing. There are indications that hospice care in various forms will spread during the present decade in Sweden. The hospice philosophy contributes to a culture of slowness, where the patient is not only allowed but is encouraged to live at his own pace. As a first step in establishing for whom hospice inpatient care is the best alternative, patient flow to a newly started hospice ward was studied. All patients (n = 1464) who died at the Medical Centre Hospital with a primary diagnosis of cancer during the period of study were compared regarding place of death, diagnosis, gender, age and length of the last period of care. The year before the ward was established, 82% of patients died in acute hospital care compared with 59% during the hospice ward's third year of operation. A total of 315 patients (22%) died in the hospice ward during the study period. The percentage of these patients over the age of 80 was significantly higher (p = 0.0001), and they also had a longer continuous final period of care. More women (57%) than men (43%) were cared for at the hospice ward. The hospice ward has in this way influenced the pattern of care in the hospital.

  • 5.
    Andersson, Ida-Maria
    et al.
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Nilsson, Sandra
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Adolfsson, Annsofie
    School of Life Sciences, University of Skövde, Skövde, Sweden; Department of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, Sweden.
    How women who have experienced one or more miscarriages manage their feelings and emotions when they become pregnant again: a qualitative interview study2012Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, nr 2, s. 262-270Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to investigate how women who have experienced one or more miscarriages manage their feelings when they become pregnant again.

    Method: Individual qualitative interviews were conducted with 16 women who were pregnant again after experiencing one or more miscarriages. The interviews were analysed using qualitative content analysis with an inductive approach.

    Results: The analysis of the material ended up in five categories: distancing herself from her pregnancy, focusing on her pregnancy symptoms, searching for confirming information, asking for ultrasound examination and asking for professional and social support. Because of their past experience with miscarriage, it could be painful to have another pregnancy terminate in disappointment. Therefore, the women manage their feelings by distancing themselves from their pregnancies. Simultaneously, they are managing their emotions by seeking affirmation that their current pregnancy is normal.

    Conclusion: Generally speaking, women manage their emotions by themselves. They feel isolated with their worries and concerns, and they are in need of the support provided from their intimate circle of friends and family as well as from the staff of the maternity health care ward. Unfortunately, the women do not feel that they get the support they need from the staff, instead they have to rely on their friends, family and partners to help them manage their emotions.

  • 6.
    Bergh, Anne-Louise
    et al.
    Sch Hlth Sci, Univ Borås, Borås, Sweden.
    Persson, Eva
    Sch Hlth Sci, Univ Borås, Borås, Sweden; Dept Hlth Sci, Fac Med, Lund Univ, Lund, Sweden.
    Karlsson, Jan
    Region Örebro län. Inst Hlth & Care Sci, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Friberg, Febe
    Dept Hlth Studies, Fac Social Sci, Univ Stavanger, Stavanger, Norway.
    Registered nurses' perceptions of conditions for patient education - focusing on aspects of competence2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 523-536Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: It is important to clarify nurses' perceptions of conditions for patient education in daily work as research findings are ambiguous. There is a gap between societal regulations on nurses' competence in accomplishment/achievement of patient education and research findings. Aim: The aim was to describe nurses' perceptions of conditions for patient education, focusing on aspects of competence. The aim was also to describe differences in conditions for nurses working in primary, municipal and hospital care. Methods: The study is a cross-sectional survey and is part of a project about nurses' patient-education. A randomized selection of nurses (842) received a questionnaire comprising 47 items concerning factual experience and attitudes to patient education and 13 background items. Questionnaires were returned by 83% of participants. Descriptive statistics, non-parametric tests and content analysis for open-ended items were used. Results: Nurses' perceptions of conditions for patient education differ between health-care settings. Primary care nurses are at an advantage in following research in patient education, perception of their own competence (prioritizing and knowing their mandate in patient teaching), pedagogical education and post graduate specializations. Conclusions: Nurses' patient education must be more visualized and appropriate conditions created at each workplace. In this change process, managers' support is considered vital.

  • 7.
    Bratt, Annika
    et al.
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Allvin, Renée
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden.
    Wann-Hansson, Christine
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Modifying a generic postoperative recovery profile instrument to an instrument specifically targeting coronary artery bypass grafting2017Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, nr 3, s. 475-486Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Patients may suffer from a wide range of postoperative symptoms after coronary artery bypass grafting. In-depth knowledge of the recovery process is a prerequisite for nursing interventions. However, we found no specific instrument covering the entire range and duration of postoperative symptoms related to this procedure. We therefore modified and extended the 19 items, generic Postoperative Recovery Profile questionnaire for the specific evaluation of the recovery after coronary artery bypass grafting. We here report on the development process of the new questionnaire. Procedure-specific symptoms were identified by a literature review and by experts. The content validity was assessed by healthcare professionals (n = 15), inpatients (n = 12) and outpatients (n = 4). A test run was done with inpatients (n = 10), which was followed by a test-retest reliability evaluation with inpatients (n = 24). We identified 15 new symptoms in the literature review and six in the content validity assessment. Only three of the 35 items had an acceptable content validity index, but all 35 items in the test run were reported by at least two patients. The questionnaire took 4-9 minutes to complete and was considered easy to use. The final instrument used in the reliability test included 22 new items, and 25 of the 35 items were satisfactory stable. To conclude, we developed a 35 items, procedure-specific questionnaire that was easy to use and may aid systematic assessment of the recovery after coronary artery bypass grafting.

  • 8.
    Brobeck, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Research, Development and Education, Halmstad, Sweden.
    Bergh, Håkan
    Department of Research, Development and Education, Varberg, Sweden;.
    Odencrants, Sigrid
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Hildingh, Cathrine
    School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
    Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education?2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 1, s. 118-125Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change.

  • 9.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Social Medicine, Uppsala University, Uppsala.
    Nursing documentation practice on 153 hospital wards in Sweden as described by nurses1993Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 7, nr 4, s. 201-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    According to Swedish laws and regulations, registered nurses are required to document nursing care in the patient's record. In this exploratory study, nurses were asked to describe how they made their nursing records. The nursing process model was used as a framework. The findings show that a system for admission assessment was fairly common, regarding objectives and a nursing care plan together with a nursing discharge note; more than half of the wards studied recorded these aspects at least occasionally. Nursing diagnoses were seldom recorded in practice. The results reveal serious limitations and deficiencies in the practice of nursing documentation and the implementation of current laws and regulations. This underlines the importance of emphasizing nursing knowledge and nursing documentation in nursing training and practice.

  • 10.
    Ehnfors, Margareta
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Social Medicine, Uppsala University, Uppsala.
    Smedby, Björn
    Department of Social Medicine, Uppsala University, Uppsala.
    Nursing care as documented in patient records1993Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 7, nr 4, s. 209-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A review of 106 nursing records from 12 wards was conducted to categorize and quantify the content of the documentation and to consider the comprehensiveness of the recording for individual nursing problems. Audit instruments, based on a model for nursing documentation were developed and applied. The results show that admission assessment was missing in slightly less than half of all records, two-thirds had no nursing care plan and about one-third had no documentation on nursing outcome. About 90% of the records had no nursing diagnosis, no objective or no nursing discharge note. Notes on nursing status and nursing interventions were most common. Only one-third of the nursing problems identified had recording that gave information about the progress of the patient's problem. The analyses performed give information on the quality of nursing records which may be used to evaluate the quality of nursing care.

  • 11.
    Ehrenberg, Anna
    et al.
    Department of Social Medicine, Uppsala University, Uppsala; Falun College of Health and Caring Sciences, Falun.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Patient records in nursing homes: Effects of training on content and comprehensiveness1999Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 13, nr 2, s. 72-82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to describe the effects on the contents and comprehensiveness of the nursing-care documentation in the patient records at nursing homes following an educational intervention. A review was made of records (n = 120) from nursing homes in six Swedish municipalities, allocated to a study group and a reference group. All the nursing home nurses in three municipalities received education concerning the nursing process and how to document according to the VIPS model. A retrospective audit of all nursing notes in the records from the nursing homes was made before and after the intervention. Improvements were found in the contents of the records in the study group. The number of notes on nursing history more than doubled. The occurrence of the recording of nursing diagnoses, goals and discharge notes increased. No corresponding changes were observed in the reference group. In the study group, an increase in the number of acceptable notes with contents on nursing history, status, nursing diagnosis, planned and implemented interventions, and nursing discharge notes was found. This increase was significant. The comprehensiveness in the documentation of single nursing problems was only slightly improved in the study group. No record met the requirements of the national regulations on nursing documentation or followed the nursing process thoroughly.

  • 12.
    Ehrenberg, Anna
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala; Health and Caring Sciences, Dalarna University, Falun.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Public Health and Caring Sciences, Uppsala University, Uppsala; Swedish Society of Nursing, Stockholm.
    The accuracy of patient records in Swedish nursing homes: congruence of record content and nurses' and patients' descriptions2001Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, nr 4, s. 303-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Data from patient records will increasingly be used for care planning, quality assessment, research, health planning and allocation of resources. Knowledge about the accuracy of such secondary data, however, is limited and only a few studies have been conducted on the accuracy of nursing recording. The aim of this study was to analyse the concordance between the nursing documentation in nursing homes and descriptions of some specific problems of nurses and patients. Comparisons were made between wards where nurses had received training in structured recording based on the nursing process (study group) and wards where no intervention had taken place (reference group). Data were collected from the patient records of randomly selected nursing home residents (n=85). The methods used were audits of patient records and structured interviews with residents and nurses. The study revealed considerable deficiencies in the accuracy of the patient records when the records were compared with the reports from nurses and residents. The overall agreement between the interview data from nurses and from the patient records was low. Concordance was better in the study group as compared with the reference group in which the recorded data were structured only following chronological order. The study unequivocally demonstrates that there are major limitations in using records as a data source for the evaluation, planning and development of care.

  • 13.
    Ehrenberg, Anna
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala; School of Health and Caring Sciences, University College of Dalarna, Falun.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Public Health and Caring Sciences, Uppsala University, Uppsala; Swedish Society of Nursing, Stockholm.
    Smedby, Björn
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala.
    Auditing nursing content in patient records2001Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, nr 2, s. 133-41Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this paper is twofold: (a) to explore different approaches in reviewing records based on a literature review of studies of audits of patient records and (b) to apply these approaches on a sample of records to illuminate consequences of their application. The method used was a literature review of papers on recording of nursing care (n = 56). Based on our findings, an audit of a stratified sample of records (n = 298) from Swedish community health care and nursing homes was performed, applying the different approaches for auditing previously described in the literature. The review showed that audits of patient records were performed using four different approaches with varying aims. The focus of the four approaches can be described as formal structure, process comprehensiveness, knowledge-based and concordance with actual care. The results of this study suggest that audits of patient records should not be solely limited to encompass the formal structure of recording. To avoid a superficial picture or a false sense of high quality and to obtain a more complete and reliable portrait of the quality of recording, we suggest the process comprehensiveness approach in combination with a critical review of the knowledge base for the assessment, diagnosis and interventions of patient records.

  • 14.
    Ekman, Inger
    et al.
    Department of Nursing, Umeå University, Umeå; Department of Nursing, University of Göteborg, Göteborg.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Norberg, Astrid
    Department of Nursing, Umeå University, Umeå.
    The meaning of living with severe chronic heart failure as narrated by elderly people2000Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, nr 2, s. 130-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The meaning of elderly patients' experiences of living with chronic heart failure was studied. Narrative interviews were analysed using a phenomenological hermeneutic approach. 'Feeling imprisoned in illness' and 'feeling free despite illness' constituted the themes. These themes were interpreted as describing variations in awareness of the relationship between the self and the body. In theme 'feeling imprisoned in illness' the body's illness and disability hindered the subjects from being themselves. In the theme 'feeling free despite illness' the disabled body was not experienced as limiting, but rather as a part of the self. The patients' understanding of the illness must be interpreted by the caregiver, who also needs to be aware of different modes of communicating feeling about the illness.

  • 15.
    Eldh, Ann Catrine
    et al.
    Örebro universitet, Hälsoakademin.
    Carlsson, Eva
    Seeking a balance between employment and the care of an ageing parent2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 2, s. 285-293Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rationale: A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities. Aim: To elucidate the experience of providing informal care to an ageing parent while managing the responsibilities of a working life. Methods: Narrative interviews were performed with 11 persons with experience of the phenomenon. Transcribed interviews were analysed with phenomenological hermeneutics. Ethics: Informed consent was given prior to the interviews. The study was approved by a research ethics committee. Findings: Providing informal care to an ageing parent while also pursuing a working life implies seeking balance: a balance between providing support to the parent's needs and one's responsibilities at work. Being employed supports this balance as it provides both fulfilment and refuge. Being capable of managing both roles grants a sense of satisfaction, supporting one's sense of balance in life. The balance can be supported by sharing the responsibility of caring for the ageing parent with others. Study limitations: Despite perceived saturation and an effort to provide for the possibility to consider internal consistency, the findings should be considered as a contribution to the understanding of the phenomenon, as experienced by individuals in their life world. Conclusions: It is essential to recognise the impact that providing care for an ageing parent may have on the lives of a growing number of people, particularly if they have employment responsibilities. Acknowledgement by others supports one's ability to attain balance; as co-workers and managers, we can acknowledge the efforts of an informal caregiver and as health care staff recognise the valuable contribution made by people in mid-life who provide informal care for their ageing parents.

  • 16.
    Eriksson, Henrik
    et al.
    Mälardalens högskola, Västerås, Sweden.
    Salzmann-Erikson, Martin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Supporting a caring fatherhood in cyberspace: an analysis of communication about caring within an online forum for fathers2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 1, s. 63-69Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:  Today’s parents seek out social support on the Internet. A key motivation behind the choice to go online is the need for more experience based information. In recent years, new fathers have increasingly taken on an active parental role. Men’s support for their caring activities for infants on the Internet needs attention.

    Aim:  The aim was to describe communication about caring activities for infants among men who visited an Internet-based forum for fathers and elaborate on the dimensions of support available in the forum.

    Method:  An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online: “nethnography”. A total of 1203 pages of data from an Internet forum for fathers were gathered and analysed.

    Result:  Support for a caring fatherhood in cyberspace can be understood as fathers’ communicating encouragement, confirmation and advice. The findings show that important ways of providing support through the forum included a reciprocal sharing of concerns – how to be a better father – in relation to caring for an infant. Concerns for their child’s well-being and shared feelings of joy and distress in everyday life were recurrent supportive themes in the communication. Information gained from contacting others in similar situations is one important reason for the fathers’ use of the Internet.

    Discussion:  Support offered in this kind of forum can be considered as a complement to formal support. Professionals can use it to provide choices for fathers who are developing themselves as caregivers without downplaying the parental support offered by formal health care regimes.

    Further research:  Online support will probably be one of the main supporting strategies for fathers in Scandinavia. Caring and nursing researchers need to closely monitor support activities that develop, and over time, as these ill likely become an important source of support for people.

  • 17.
    Fahlström, Gunilla
    et al.
    University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Kamwendo, Kitty
    College of Medicine, University of Malawi, Zomba, Malawi.
    Forsberg, Jenny
    Region Örebro County, Örebro, Sweden.
    Bodin, Lennart
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial2018Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, nr 2, s. 575-585Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention.

  • 18. Flackman, Birgitta
    et al.
    Fagerberg, Ingegerd
    Haggstrom, Elisabeth
    Kihlgren, Annica
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Kihlgren, Mona
    Despite shattered expectations a willingness to care for elders remains with education and clinical supervision2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 3, s. 379-389Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to describe nursing home (NH) caregivers' work experiences while receiving education and clinical supervision for 2 years. Working in elder care seems to be losing its attraction especially with organizational changes, cutbacks and changes in work place conditions. Clinical supervision has been reported to increase job satisfaction and creativity. Semi-structured interviews from caregivers working at an NH in Sweden were conducted, at the start and again at 12 and 24 months. At about 12 months the caregivers were informed of planned cutbacks. Content analysis was the method used to analyse the interviews from seven caregivers who participated throughout the entire period. Findings show that the value of a caring milieu was one category generated by the subcategories: experiences related to work activities and changes, and experiences related to relationships. The value of knowledge was the other category that was influenced by the experiences related to the different backgrounds and the experiences related to increased knowledge gained from the support through education and clinical supervision. The categories contained positive as well as negative influences on care. The initial focus on practical duties associated with the opening of the NH shifted towards caregiver activities with the elders they spoke warmly about. After 2 years the caregivers' willingness to care continued despite their disappointment in the worsened working conditions. The main theme that resulted was: Despite shattered expectations a willingness to care for elders remained. Continued education and clinical supervision seems to be one factor behind the retained willingness. These findings demonstrate that support and caregiver involvement in educational programmes are important during times of change and when disappointments arise in the workplace.

  • 19.
    Fonad, Edit
    et al.
    Karolinska institutet.
    Emami, Azita
    Karolinska instituet.
    Robins Wahlin, Tarja-Brita
    Karolinska institutet.
    Winblad, Bengt
    Sandmark, Helene
    Örebro universitet, Hälsoakademin.
    Falls in somatic and dementia wards at Community Care Units2008Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, nr 1, s. 2-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Falls and fall injuries are common problems for patients at nursing homes in Sweden. Impaired cognitive function, a poor sense of orientation and a high intake of medicine, can lead to an increase in falls among older people. AIM: The objective of this study was to investigate the associations between falls and: fall risks, fractures, the use of physical restraints and the use of certain medications in somatic and dementia wards, respectively. METHOD: The study design is ecological, and aggregated data regarding falls, fall risk assessments, fractures, the use of physical restraints and medication were collected between 2000 and 2003. The Pearson correlation analysis and regression analyses were used to investigate associations between fall risks, medication, fractures, wheelchair-bound situations, bed rails and falls. RESULTS: The total number of reported fall incidents was 2651; of these, 737 incidents were registered in dementia wards and 1914 in somatic wards. Dementia wards and somatic wards differed regarding falls and fractures, as it was only in dementia wards that falls were associated with fractures. There was also a significant correlation between falls and assessed risk of falling, the use of certain medication, and physical restraints such as wheelchairs and bed rails in dementia wards. Falls at somatic wards were associated with the use of sleeping pills with benzodiazepines. CONCLUSION: For dementia wards there were associations between falls and fractures, physical restraints and the use of certain medications. Fractures were associated with the use of neuroleptics, sleeping pills and sleeping pills with benzodiazepines. At somatic wards, falls correlated with the use of sleeping pills with benzodiazepines, and with the use of wheelchairs and bed rails.

  • 20.
    Forsberg, Anette
    et al.
    Örebro universitet, Hälsoakademin.
    Ahlström, Gerd
    Widén Holmqvist, Lotta
    Falling ill with Guillain-Barré syndrome: patients' experiences during the initial phase2008Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, nr 2, s. 220-226Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Research describing the personal experiences of Guillain-Barré syndrome (GBS) is limited, but is important for identifying the patients' need of support. The aim of this study was to describe experiences of falling ill with GBS, with the focus on the onset of disease, the diagnosis and the illness progress during hospital care.

    Methods: The study included 35 persons, 20–78 years old. They were interviewed 2 years after the onset of GBS. The interviews were analysed using qualitative content analysis.

    Results: The onset was described as either an incomprehensible, prolonged, increasing deterioration with puzzling sensations or as a frightening, rapid onset with a sudden loss of body control. The majority of the persons relied heavily on the reassurance of a positive prognosis, and expressed immense confidence in being able to recover. During the early phase at the hospital, a rapid and steady course of improvement inspired hope in many persons. In contrast, even in this early phase of hospital care some individuals expressed doubts of a slow recovery. Feelings of fear and insecurity were evident when losing body functions, thus causing helplessness. Sensations of pain, numbness and lost body image increased their vulnerability. Half of the ventilator-treated persons expressed vivid memories of scary hallucinations.

    Conclusion: The onset is characterized by an incomprehensible bodily deterioration or a frightening, rapid paralysis. In the initial phase, there is hope for recovery, which for many individuals is reinforced by a steady recovery. In contrast, early psychosocial support may be necessary for some persons with an alarmingly slow recovery. 

  • 21.
    Gullberg, Mats
    et al.
    Faculty of Health Sciences, Dept Caring Sciences, Linköping University, Linköping, Sweden.
    Olsson, Henny
    Faculty of Health Sciences, Dept Caring Sciences, Linköping University, Linköping, Sweden.
    Alenfelt, Gunilla
    Faculty of Health Sciences, Dept Caring Sciences, Linköping University, Linköping, Sweden.
    Ivarsson, Ann-Britt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Margareta
    Faculty of Health Sciences, Dept Caring Sciences, Linköping University, Linköping, Sweden.
    Ability to solve problems, professionalism, management, empathy, and working capacity in occupational therapy: The Professional Self Description Form1994Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, nr 8, s. 173-178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The majority of occupational therapists in Sweden previously worked on large occupational therapy wards. Health care policy has changed over the years and the system has been reorganized accordingly. The employment situation for occupational therapists has also changed. This paper focuses on the perception of professional self among occupational therapists. The objective was to explore the professional self and to suggest components important to the occupational therapist profession. The Professional Self Description Form (PSDF) was used for the exploration of self. The 19 items in the PSDF cover areas relevant to professional functioning and activity. Sixty-eight employed occupational therapists participated. The results of the PSDF were subjected to factor analysis and five factors were obtained; Ability to solve problems, Professionalism, Management, Empathy, and Working capacity. We believe that these five factors can function as improving domains of the role of the professional occupational therapist in Sweden

  • 22.
    Göransson, Carina
    et al.
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden; School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Wengström, Yvonne
    Cancer Theme, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Langius-Eklöf, Ann
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Self-care ability and sense of security among older persons when using an app as a tool for support2019Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    THE STUDY'S RATIONALE: The need for home care among older persons is increasing, and mHealth is evolving to help meet the challenge. When developing an app to help maintain their health, it is essential to incorporate older persons' preferences.

    AIMS AND OBJECTIVES: To describe and evaluate the experiences of self-care support and sense of security among older persons using an interactive app to report health concerns.

    METHODOLOGICAL DESIGN AND JUSTIFICATION: The study had a descriptive and evaluative design. Qualitative and quantitative methods were applied to achieve a broader understanding.

    ETHICAL ISSUES AND APPROVAL: Ethical approval was obtained from the Regional Ethical Review Board. The older persons received verbal and oral information about the study and gave written informed consent.

    RESEARCH METHODS: Questionnaires (n = 17 older persons) answered at baseline, end of the intervention and at a 6-month follow-up were analysed with statistical analysis. Interviews (n = 17 older persons) conducted at the end of the intervention were analysed using a qualitative directed approach.

    MEASUREMENTS AND INTERVENTION: The questionnaire included the Appraisal of Self-care Agency Scale and a question concerning sense of security. For 3 months, the older persons used an app for regular reporting of health concerns. The app included self-care advice, graphs and a risk assessment model that generated alerts directly to the nurses.

    RESULTS: The older persons described how self-care and sense of security increased at the end of intervention, but statistically, it was shown to decrease afterwards.

    STUDY LIMITATIONS: The small sample size for statistical analysis.

    CONCLUSIONS: This study shows that an app can be a complementary tool to conventional home care that can increase older persons' sense of security and self-care ability. The results mirror the older persons' awareness that the support they received with the app was only temporary. Larger studies are needed for generalisation.

  • 23.
    Göransson, Katarina
    et al.
    Örebro universitet, Hälsovetenskapliga institutionen.
    Ehrenberg, Anna
    Örebro universitet, Hälsovetenskapliga institutionen.
    Marklund, Bertil
    Ehnfors, Margareta
    Örebro universitet, Hälsovetenskapliga institutionen.
    Accuracy and concordance of nurses in emergency department triage2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 4, s. 432-438Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. In Sweden, few studies on ED triage have been conducted and the organization of triage has been found to vary considerably with no common triage scale. The aim of this study was to investigate the accuracy and concordance of emergency nurses acuity ratings of patient scenarios in the ED setting. Totally, 423 RNs from 48 (62%) Swedish EDs each triaged 18 patient scenarios using the CTAS. Of the 7,550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.

  • 24.
    Henoch, Ingela
    et al.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Carlander, Ida
    Palliative Research Centre, Ersta Hospital, Ersta Sköndal University College, Stockholm, Sweden; Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Holm, Maja
    Palliative Research Centre, Ersta Hospital, Ersta Sköndal University College, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    James, Inger
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kenne-Sarenmalm, Elisabeth
    Palliative Research Centre, Ersta Hospital, Ersta Sköndal University College, Stockholm, Sweden; Research and Development Centre, Skaraborg Hospital, Skövde, Sweden.
    Lundh-Hagelin, Carina
    Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Sophiahemmet University, Stockholm, Sweden; Research and Development Unit in Palliative care, Stockholms Sjukhem Foundation, Stockholm, Sweden.
    Lindh, Susanne
    Palliative Research Centre, Ersta Hospital, Ersta Sköndal University College, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Sandgren, Anna
    School of Health Sciences, Jönköping University, Jönköping, Sweden; Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linneaus University, Kalmar/Växjö, Sweden.
    Öhlén, Joakim
    Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden; Palliative Research Centre, Ersta Hospital, Ersta Sköndal University College, Stockholm, Sweden.
    Palliative Care Research: A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 20122016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 1, s. 5-25Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: In 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci.

    Methods: A literature review was undertaken. The databases Academic search elite, Age line, Ahmed, Cinahl, PsychInfo, PubMed, Scopus, Soc abstracts, Web of science and Libris were reviewed for Swedish palliative care research studies published from 2007 to 2012, applying the search criteria 'palliative care OR palliative medicine OR end-of-life care OR terminal care OR hospice care OR dying OR death'.

    Results: A total of 263 papers met the inclusion criteria, indicating an increased volume of research compared to the 133 articles identified in the previous review. Common study foci were symptom assessment and management, experiences of illness and care planning. Targeting non-cancer-specific populations and utilisation of population-based register studies were identified as new features. There was continued domination of cross-sectional, qualitative and mono-disciplinary studies, not including ethnic minority groups, nonverbally communicable people or children <18 years of age.

    Conclusions: The trend is that Swedish palliative care research has expanded in volume from 2007 to 2012 compared to during the 1970s to 2006, with increasing participation of non-cancer-specific populations. A domination of qualitative approaches and small, cross-sectional studies with few interventions is still characteristic. Still more strategies are needed to expand the knowledge development of palliative care to respond to demographical, epidemiological, therapeutic and healthcare structure changes.

  • 25. Hjelmblink, Finn
    et al.
    Holmström, Inger
    Örebro universitet, Hälsoakademin.
    Kjeldmand, Dorte
    Stroke patients' delay of emergency treatment2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 2, s. 307-311Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Treatment of stroke victims with fibrinolysis should take place within a time limit of 3 hours. In spite of comprehensive endeavours to reduce hospital arrival time, too many patients still delay arrival beyond this time limit. This qualitative case study explored the meaning of acute stroke and treatment to four patients with more than 24-hour delayed arrival. The setting of the study was the catchment area of a university hospital. Semi-structured interviews were analysed through the empirical psychological, phenomenological method. An essence was found which was constituted by four themes. The essence of stroke symptoms and treatment was: 'Threatened control of bodily function, autonomy and integrity'. When the patients fell ill they acted as if nothing had happened. They treated their body like a defective device. In encounters with physicians they demanded to be met as a person by a person; otherwise they rejected both the physician and her or his prescriptions. They did not involve their near ones in decision-making. The conclusions were the following: Health care information about how to act in cases of early stroke symptoms may need to imbue people with an understanding of how early treatment of neurological symptoms and preserved control of life are intimately connected. Furthermore emergency care of acute stroke patients might need to take place in an organisation where patients are sure to be met by physicians as a person by a person.

  • 26.
    Holmberg, Mats
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
    Forslund, Kerstin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wahlberg, Anna Carin
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Fagerberg, Ingegerd
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    To surrender in dependence of another: the relationship with the ambulance clinicians as experienced by patients2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 544-551Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care.

  • 27.
    Hägglund, Doris
    et al.
    Örebro universitet, Hälsoakademin.
    Wadensten, Barbro
    Fear of humiliation inhibits women's care-seeking behaviour for long-term urinary incontinence2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 3, s. 305-312Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Most women with urinary incontinence (UI) do not seek professional help. Women's experiences of their behaviour when seeking care for incontinence are important to improve understanding by nurses and encourage as well as enable women to seek help. The aim of this study was to illuminate the meaning of women's lived experiences of their behaviour when seeking care for long-term UI. Thirteen women were interviewed (range 37–52 years) who had not sought professional help for incontinence. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. Three themes evolved from data: being in an affected situation, having personal beliefs about seeking care and having desired expectations about care. Being in an affected situation, means that the women were negatively affected by their long-term incontinence. Living with shame, altered sexual relationships and a need for distancing have negatively influenced their care-seeking behaviour (CSB). Having personal beliefs about seeking care means that the women had their own beliefs regarding morally acceptable behaviour for seeking care because of incontinence. This led to a toning down of their problem and a minimization of the problem associated with incontinence as it was considered to be a normal consequence of pregnancy and childbirth. Having desired expectations about care means that the women had opinions relevant to the care and felt being asked about incontinence and an understanding atmosphere should be included. The conclusion is that fear of humiliation inhibited women from seeking care for long-term UI. The findings suggest that nurses should be precise when asking about women's experiences of UI because otherwise they do not bring it up. Additionally, CSB can help nurses to explain the experience and enable women to seek help for this manageable condition.

  • 28. Hägglund, Karin M.
    et al.
    Helsing, Christer
    Sandmark, Helene
    Örebro universitet, Hälsoakademin.
    Assistant nurses working in care of older people: associations with sustainable work ability2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 2, s. 325-332Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Indicators of health have shown improvements in the Swedish working population during the past decades, but with the exception of low-skilled women. Earlier research has shown that assistant nurses belong to an occupational group, which has the lowest share of individuals with long-term health in the total Swedish workforce. Sick leave research has mostly focused on determining risk factors for the development of diseases and dysfunctions. In the process of acquiring knowledge about mechanisms for sick leave, it has become obvious that there is also a need to focus on what contributes to work ability. The aim in this study was to explore what promotes sustainable work ability in female assistant nurses working in care of older people. Associations between factors related to work, health, lifestyle and sustainable work ability were investigated in a cross-sectional nested case-control study in a cohort of 366 female assistant nurses. Data were collected in self-reports in a questionnaire. Odds ratios were calculated, and a multiple logistic regression analysis was performed with sustainable work ability as the dependent variable. Sustainable work ability was associated with good self-rated health, a BMI < 30, ability to sleep well, recuperation, low stress level, support from family and friends, being over 25 years of age at birth of the first child, and control over one's own life in the >= 50 age group. In the logistic regression analysis, the significant associations were good self-rated health, being over 25 years of age at the birth of the first child and recuperation. In conclusion, the study showed that self-rated health and factors in private life are important for assistant nurse's sustainable work ability over time. The results from this study could be applied in health promotion work for employees in the care sector to strengthen and enhance sustainable work ability.

  • 29.
    Håkanson, Cecilia
    et al.
    Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
    Sahlberg-Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Ternestedt, Britt-Marie
    Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden; Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; Stockholms Sjukhem Foundation, Research, Development and Education Unit, Stockholm, Sweden.
    Nyhlin, Henry
    Gastro Center, Karolinska University Hospital, Huddinge, Sweden.
    Learning about oneself through others: experiences of a group-based patient education programme about irritable bowel syndrome2012Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, nr 4, s. 738-746Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: People with irritable bowel syndrome (IBS) often experience severe illness-related troubles in their everyday lives. Many persons also perceive their disease-related knowledge to be insufficient, and they feel dissatisfied with their inability to improve well-being. Previous research about patient education and IBS has emphasized biomedical outcomes of symptoms, health-promoting behaviours, coping and health-related quality of life, rather than people's experiences.

    Aim: To explore people's experiences of participating in a multidisciplinary group-based patient education programme about IBS and of the influence of this programme on everyday life with illness. Methods:  Focus group interviews were performed with 31 persons after their participation in the patient education programme. Interpretive description guided the inductive analysis of data. The study was approved by the local research ethics committee.

    Findings: The analysis revealed four patterns; being part of a safe community, learning about oneself through others, understanding and controlling the body and illness as a whole, and being outside of the community. The pattern of learning about oneself through others can be described as a reciprocal activity of learning by listening to, telling and observing others. Being among similar others had created feelings among most of the focus group participants of being part of a safe community where taboo subjects related to IBS-symptoms could be outspoken. Understanding the body and illness as a whole had enhanced their ability to interpret bodily signals and to handle trouble some situations with greater self-confidence, and this regained their access to the social everyday world.

    Conclusion: The combination of reciprocal sharing of experiences and the provision of professional scientific knowledge during the patient education programme together contributed to a growing readiness to improve well-being in everyday life, for most of the participating individuals. This was based on new understandings of the body and illness as a whole and of new abilities to make knowledge-based decisions about what strategies to use in overcoming illness-related troubles.

  • 30.
    Håkanson, Cecilia
    et al.
    Ersta Hosp, Stockholm, Sweden; Dept Neurobiol Care Sci & Soc, Div Nursing, Karolinska Inst, Stockholm, Sweden.
    Sahlberg-Blom, Eva
    Örebro universitet, Hälsoakademin.
    Ternestedt, Britt-Marie
    Dept Neurobiol Care Sci & Soc, Div Nursing, Karolinska Inst, Stockholm, Sweden; Dept Palliat Care Res, Ersta Sköndal Univ Coll, Stockholm, Sweden; Res Dev & Educ Unit, Stockholms Sjukhem Fdn, Stockholm, Sweden.
    Nyhlin, Henry
    Gastro Ctr, Karolinska Univ Hosp, Huddinge, Sweden.
    Learning to live with irritabel bowel syndrome: the influence of a group-based patient education programme on peoples' ability to manage illness in everyday life2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 491-498Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Living with chronic irritable bowel syndrome sets limitations in peoples’ everyday lives. This is due to bad health and the difficulty to find strategies that will manage their problem. In encounters with health care providers, these people feel that they are not getting the appropriate support to manage their illness-related troubles, and they perceive themselves to be insufficiently informed about the disease.

    Aim: To evaluate the influence of a group-based patient education programme about irritable bowel syndrome, on people’s ability to manage their illness in everyday life.

    Methods: The study used an evaluative research design. Fifty-one individuals with irritable bowel syndrome completed the ways of coping questionnaire, and the irritable bowel syndrome severity scoring system, before and after participating in a multidisciplinary group-based patient education programme.

    Results: In the participants’ self assessments, statistical significances (p > 0.05) were found for the mean frequency of efforts used on the coping strategies distancing and escape-avoidance. Distancing was used more often after the education programme, while escape-avoidance, was used more seldom. The proportional use of the strategy self-controlling (relative score) was enhanced after the education programme. The participants’ overall severity of symptoms was significantly reduced after the education programme. The individuals with a clinically noteworthy improvement in symptom severity (decrease ≤ 50) had greater changes in relative score values than those that showed a lesser improvement in symptom severity.

    Conclusion: Coping patterns were changed and symptoms were scored significantly less severe among the participants who participated in the education programme. Controlled studies following individuals over a longer period are suggested to establish the validity and sustainability of these changes, and qualitative interview studies would provide additional understanding about the significance of the separate parts of the education programme, and about the meaning of the programme to peoples’ everyday lives as a whole.

  • 31.
    Ivarsson, Ann-Britt
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sidenvall, Birgitta
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    The factor structure of the Burden Assessment Scale and the perceived burden of caregivers for individuals with severe mental disorders2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, nr 2, s. 396-401Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims of this study were to test the construct validity and the homogeneity of the Swedish version of the Burden Assessment Scale (BAS) and study perceived burden in daily life among family caregivers of individuals with severe mental disorders. A total of 256 caregivers took part in the study. The participants completed two questionnaires. One was the BAS, a brief scale that focuses on specific subjective and objective consequences of families caring for individuals with severe mental disorders. The other one was a questionnaire constructed for the study including demographic data. A principal component analysis yielded three factors: 'activity limitation', 'feelings of worry and guilt' and 'social strain'. The internal consistency calculated by Cronbach's alpha coefficients varied between 0.73 and 0.88 for the three factors. The findings indicated that the caregivers experienced more 'activity limitation' and 'social strain' in relation to the youngest and to those who had an elementary educational level than they did for comparison groups. There were no differences found between the caregivers in relation to clients' daily occupation outside home. The results confirm that family caregiver burden is complex and includes several areas such as activities in daily life, worry and social strain. Given this knowledge about caregivers' situation, it is critical that families be given opportunities to identify what support might help. Further research is needed to identify such support.

  • 32.
    Ivarsson, Ann-Britt
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Söderback, Ingrid
    Uppsala universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndals högskola.
    The meaning and form of occupational therapy as experienced by women with psychoses: A phenomenological study2002Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, nr 1, s. 103-110Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to illuminate the experiences of occupational therapy interventions in individuals with psychoses. Repeated tape-recorded narrative interviews were conducted with six women participating in occupational therapy immediately after an intervention. The subsequent analyses followed a phenomenological approach. Key constituents integrated in two structures, are the main ®ndings. The meaning of occupational therapy as expressed in the key constituents relief, selfknowledge, belief in the future, capability, resistance and satisfaction formed one structure. The form of occupational therapy as expressed in the key constituents time, environment, guidance, voluntariness and collaboration represented the other structure. These ®ndings con®rm and give empirical support to beliefs and assumptions expressed in occupational therapy literature. The results form a conceptual base for developing an evaluative assessment instrument for individuals with psychoses participating in occupational therapy.

  • 33.
    Johansson, Anita
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Div Psychiat, Skaraborg Hosp, Skövde, Sweden.
    Andershed, Birgitta
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Enheten för forskning i palliativ vård, Ersta Sköndal högskola, Stockholm, Sweden; Ersta Hosp, Stockholm, Sweden; Sektionen för sykepleie, Högskolen, Gjövik, Norge.
    Anderzen-Carlsson, Agneta
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Conceptions of mental health care: from the perspective of parents’ of adult children suffering from mental illness2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 496-504Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe parents' conceptions of the mental health care provided to adult children suffering from mental illness. Data were collected using qualitative research interviews with a purposive sample of sixteen mothers and ten fathers. Phenomenographic analysis was used to identify conceptions and formulate descriptive categories. The first category, questioning the availability of care, describes mental health care as being unequal in terms of accessibility and lacking in continuity. The second category, disapproval of parental exclusion, illustrates conceptions that mental healthcare professionals disregard parents and do not provide them with adequate information. The third category, questioning the quality of care, encompasses conceptions of lack of trust in the professionals' competence, an unsatisfactory environment as well as inadequate cooperation with other healthcare providers and authorities. Positive aspects, such as being seen and confirmed, were mentioned as valuable by the parents.

  • 34.
    Kihlgren, Annica Larsson
    et al.
    Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden.
    Nilsson, Margareta
    Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Ersta Sköndal University College, Stockholm,Sweden.
    Skovdahl, Kirsti
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden.
    Palmblad, Bert
    Centre for Nursing Science, Örebro University Hospital, Örebro,Sweden; Department of Primary Health Care, Psychiatry and Rehabilitation, Örebro County Council, Örebro, Sweden.
    Wimo, Anders
    Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm,Sweden; Department of Family Medicine, Bergsjö, Sweden.
    Older patients awaiting emergency department treatment2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 2, s. 169-176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe, through observations and interviews with patients >/=75 years old and the relatives who accompanied them to the hospital, the conditions at the emergency department (ED) and the events that took place during the waiting period. Twenty older patients were studied, together with their relatives. A modification of a comparative design, the interpretative method 'grounded theory', was utilized. Open, nonparticipant observations were carried out; from the time patients were admitted until the time they were discharged. Patients were observed through all stages, for example, in the reception area, in the examination room, and in the X-ray department. The observations were supplemented with field notes and interviews with the older patients as they left the ED. The selective coding developed into six core-variables that were the focus of the material. These were: unpleasant waiting, unnecessary waiting, lack of good routines during the waiting stage, suffering during the waiting stage, bad feelings during the waiting stage and nursing care during the waiting stage. The way, in which nursing care was carried out, which in this context is discussed in terms of praxis and poieses, appeared to be of major importance for the older peoples' experiences when visiting the ED.

  • 35.
    Kihlgren, Annica
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wimo, Anders
    Department of Neurobiology, Caring Sciences and Society, KI-Alzheimer Disease Research Center (KI-ADRC), Karolinska Institute, Stockholm, Sweden.
    Mamhidir, Anna-Greta
    Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Older patients referred by community nurses to emergency departments - a descriptive cross-sectional follow-up study in a Swedish context2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 1, s. 97-103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    ObjectivesThe objective of this study was to examine on what extent nursing home (NH) older patients aged 75 or older, referred to hospitals by registered nurses (RNs) in the community, utilise the emergency department (ED) over a 1-year period and for what reason. A further objective was to identify factors that may explain these referrals. MethodsA cross-sectional follow-up study, examining older patients' disabilities, resources and needs, was carried out in a county in Sweden. Assessments were made using Residents Assessment Instrument/Minimum Data Set, among 719 individuals in 24 NHs and the RNs' documentation were followed. ResultsThe result showed that of 719 residents, 209 accounted for 314 referrals to an ED over the 1-year period. No gender differences were observed. The main reasons for referrals were falls (23%), cardiovascular problems (16%), gastrointestinal problems (12%) and infections (11%). Most of the referrals (65%) were made on weekdays during daytime hours. In 62% of the cases, there had been a consultation with a physician prior to the referral. The nursing documentation was poor in connection with the referral. ConclusionOlder patients with dementia diseases were significant less refereed and questions are raised whether this group is undetected and undertreated, and therefore, it is important with further investigation.

  • 36.
    Källstrand-Eriksson, Jeanette
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Baigi, Amir
    Buer, Nina
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Hildingh, Cathrine
    Perceived vision-related quality of life and risk of falling among community living elderly people2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 2, s. 433-439Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Perceived vision-related quality of life and risk of falling among community living elderly people Falls and fall injuries among the elderly population are common, since ageing is a risk factor of falling. Today, this is a major problem because the ageing population is increasing. There are predictive factors of falling and visual impairment is one of them. Usually, only visual acuity is considered when measuring visual impairment, and nothing regarding a person's functional visual ability is taken into account. Therefore, the aim of this study was to assess the perceived vision-related quality of life among the community living elderly using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and to investigate whether there was any association among vision-related quality of life and falls. There were 212 randomly selected elderly people participating in the study. Our study indicated that the participants had an impaired perceived vision-related health status. General health was the only NEI VFQ-25 variable significantly associated with falls in both men and women. However, among men, near and distance activities, vision-specific social functioning, role difficulties and dependency, color and peripheral vision were related to falls.

  • 37.
    Källström Karlsson, Inga-Lill
    et al.
    Örebro universitet, Hälsoakademin.
    Ehnfors, Margareta
    Örebro universitet, Hälsoakademin.
    Ternestedt, Britt-Marie
    Enheten för fors Department of Health Care Sciences, Ersta Skondahl, University College, Stockholm, Sweden.
    Patient characteristics of women and men cared for during the first 10 years at an inpatient hospice ward in Sweden2006Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, nr 2, s. 113-121Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The hospice philosophy with focus on the patient's autonomy and the ideal of a good death are the overall objectives of palliative care. Often-raised questions, when discussing hospice, are for which of the incurable ill inpatient hospice is the most optimal care alternative together with who are making use of hospice. The aim of the present study was to describe patient characteristics such as age, marital status, diagnosis, referral source and length of stay (LoS) in relation to gender, during the first decade at an inpatient hospice ward (1992–2001). Data, obtained from medical register, were analysed by using descriptive statistics and the chi-square test. The number of patients was 666 women and 555 men, and most of them were elderly. In some respects significant differences were observed between women and men. More women than men were single, had cancer with relatively rapid trajectory and were referred from the oncology department. Men, more often than women, were diagnosed with cancers with a somewhat longer trajectory. Despite the longer trajectory, the LoS was shorter for men (median =13 days) than for women (median = 17 days). The most frequent referral source was hospital, though men, younger men in particular, were more often referred from home-based hospice care than women. During the last 3 years self-referrals were documented. Self-referrals can be seen as one distinct expression from a standpoint of one's own active choice compared with other referrals. Altogether, self-referrals were less frequent among women than men but in relation to age, self-referrals were more common among the youngest (<60 years) and the oldest women (>85 years) than men in the same age groups. Further studies illuminating a gender perspective can broaden the understanding of what these differences may imply for women and men.

  • 38.
    Langius-Eklöf, Ann
    et al.
    Örebro universitet, Hälsoakademin.
    Samuelsson, Mats
    Sense of coherence and psychiatric morbidity in terms of anxiety and depression in patients with major depression before and after electric convulsive treatment2009Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, nr 2, s. 375-379Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The specific aim of this study was to explore if the Sense of Coherence (SOC) Scale reflects and overlaps with standardized psychiatric assessments of depression and anxiety leading to the main hypothesis that the degree of depression decreases while the SOC scores remain stable. Fifteen patients with a diagnosis of major depression according to Axis I in DSM-IV and planned electric convulsive treatment (ECT) participated in the study. The clinician-rated instruments, Montgomery Asberg Depression Rating Scale (MADRS) and Global Assessment of Function (GAF), and the self-assessment instruments such as SOC and the Comprehensive Psychopathological Rating Scale-Self Rating Scale for Affective Syndromes (CPRS-S-A) were used before and after the treatment. The patients showed statistically significant improvements in clinician-rated depression (p < 0.001) and functional status (p < 0.001), and in self-rated anxiety (p = 0.001) and depression (p = 0.003). There was no significant improvement in SOC (p = 0.213). No significant correlations were found between the SOC scores and any of the measures except for GAF after treatment (r = 0.57, p = 0.039); the lower the SOC scores the greater was the functional dysfunction. In conclusion, the SOC Scale seems not to be a measure of psychopathology in terms of depression or anxiety merely.

  • 39.
    Larson [Windahl], Jenny
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Nursing, Karolinska Institutet, Stockholm, Sweden; Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Franzén-Dahlin, Åsa
    Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Billing, Ewa
    Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Arbin, Magnus
    Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Murray, Veronica
    Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Wredling, Regina
    Department of Nursing, Karolinska Institutet, Stockholm, Sweden; Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Predictors of quality of life among spouses of stroke patients during the first year after the stroke event2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 4, s. 439-445Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Stroke, a disease with severe consequences for patients and their families, often lead to psychosocial stress, and a decline in the quality of life (QoL) among carers. Predicting the QoL is essential in the development of effective nursing support interventions.

    AIM: The aim of the present study was to identify predicting factors for the general QoL among spouses of stroke patients, and to determine whether these predictors change during the first year after the patient's stroke event.

    DESIGN: One hundred spouses were followed three times during 1 year regarding QoL, own illness, economic situation, well being, life situation, sense of coherence, social network and the patients' ability in activities of daily living (ADL). Stepwise multiple linear regression analyses were conducted for the baseline, 6- and 12-month assessments respectively, with the present QoL as the dependent variable.

    RESULTS: Over time during the first year after the patients' stroke event, there were significant differences in the spouses perceived general QoL. Life situation and economic situation were the only predictors of the spouses' QoL, which emerged during the entire year after the patient's stroke event, while well being, education, own illness, social network and ADL ability (patient) emerged at one or two occasions.

    CONCLUSION: The psychosocial factors -- life situation, well being, social network, education and economy -- are important in predicting QoL among spouses of stroke patients, and these predicting factors change over time. Determining the predictors at an early stage, and continuously over time, will help to focus clinical nursing interventions on the spouses' changing needs.

  • 40. Lindh, Marianne
    et al.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Perseius, Kent-Inge
    Factors influencing compliance to hygiene routines in community care: the viewpoint of medically responsible nurses in Sweden2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 2, s. 224-230Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Factors influencing compliance to hygiene routines in community care - the viewpoint of medically responsible nurses in Sweden Aims and objectives: The aim of the study was to describe factors influencing compliance to hygiene routines in community care in Swedish municipalities from the perspective of medically responsible nurses (MRN). Method: A web-based questionnaire was sent to all MRNs in Swedish municipalities, N=268. Beside demographical background data, the questionnaire contained two core open-ended questions generating free text data. Data were analysed with descriptive statistics and qualitative content analysis. Result: Four categories of factors were found: resources, management, staff and external factors. All four categories contained subcategories. Conclusion: To some extent, the challenges to uphold adequate compliance to hygiene routines seem different in community care than in hospitals. Resources regarding equipment and supplies seem as an uncertain asset and uneven distributed among municipalities. Home likeness was seen as a major obstacle for upholding adequate hygiene routines. To uphold sufficient hygiene routines in a person's home or in a home-like environment might be one of the major challenges for community health care in the future. The MRN's narratives suggest that Registered Nurses have a key role in upholding sufficient hygiene in community care. This report might contribute in providing them with more knowledge to take on this urgent task.

  • 41.
    Lindstedt, Helena
    et al.
    Uppsala universitet.
    Ivarsson, Ann-Britt
    Örebro universitet, Hälsovetenskapliga institutionen.
    Söderlund, Anne
    Uppsala universitet.
    Background factors related to and/or influencing occupation in mentally disordered offenders2006Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, nr 3, s. 331-338Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Knowledge of background and occupational related factors of mentally disordered offenders are missing. It is essential to understand these issues when planning discharge from forensic psychiatric hospital careto enable community dwelling. Aims: One aim was to investigate mentally disordered offenders’ background factors, confidence in and how they value occupations. Another aim was to investigate MDOs background factors’ in relation to and the influences on Occupational Performance and Social Participation. Method: Data was collected with an explorative, correlative design after informed consent, from 74 mentally disordered offenders (mean age 34,2) cared for in forensic psychiatric hospitals. Assessments were Allen Cognitive Level Screen, Capability to Perform Daily Occupations, Interview Schedule of Social Interaction, Manchester Short Assessment of Quality of Life, Self-efficacy Scale and Importance scale. Eight background factors were assembled from the individual forensic psychiatric investigation. Findings: Most of the investigated background factors relate to and half of them influence occupational performance, particular the cognitive aspect of occupational performance. The influences on occupation originate from adulthood, such as suffering from schizophrenia, psycho/social problems, and having performed violent crimes. These findings indicate that staff in forensic hospital care should initiate rehabilitation with knowledge about MDOs’ complex daily occupations. For avoiding information bias, information gathering preceding treatment planning should be performed in collaboration between caring staff and mentally disordered offenders.

  • 42.
    Lindström, Caisa
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Åman, Jan
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Anderzen Carlsson, Agneta
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Centre for Health Care Science, Örebro University Hospital, Örebro, Sweden.
    Lindahl-Norberg, Annika
    Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
    Group intervention for burnout in parents of chronically ill children: a small-scale study2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 4, s. 678-686Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Long-term stress leading to burnout symptoms is prevalent in parents of chronically ill children. The aim of the study was to evaluate the effect of a group intervention by measuring changes in self-rated clinical burnout and performance-based self-esteem. In addition, the parental perceptions of the acceptability of the intervention were explored.

    Methods: Previously, we have explored the prevalence of clinical burnout in parents of patients 1–18 years with type 1 diabetes mellitus (T1DM) and inflammatory bowel disease (IBD) in the county of Örebro. All parents who exhibited clinical burnout symptoms in accordance with the Shirom–Melamed Burnout Questionnaire (SMBQ) were then invited to participate in a group intervention, which was evaluated in the present small-scale study. The group intervention consisted of eight sessions over a 12-week period, including education about behaviour, cognition and symptoms associated with burnout, intending to help the parents to develop adequate strategies for coping with and reducing stress. We evaluated the effect of the intervention in terms of self-rated clinical burnout and performance-based self-esteem (PBSE). In addition, the acceptability of the intervention was evaluated by analyses of recruitment and retention and self-reports from parents.

    Results: Sixteen parents (13 of children with TIDM and three of children with IBD) out of 104 reporting clinical burnout participated in the intervention. All participants completed the intervention, and the mean attendance rate at all sessions was 90%. Parents’ subjective evaluations were mainly positive, and SMBQ (p = 0.01) and PBSE scale (p = 0.04) measurements were significantly reduced, which effects remained 6 months after completion of the intervention.

    Conclusions: Despite the small-scale study, we consider that this intervention for parents with clinical burnout was appreciated and well accepted. The significant reduction in clinical burnout symptoms requires further evaluation in randomised controlled studies based on larger groups of parents.

  • 43.
    Medin, Jörgen
    et al.
    Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.
    Larson [Windahl], Jenny
    Karolinska Institutet, Stockholm, Sweden.
    von Arbin, Magnus
    Sophiahemmet University College, Stockholm, Sweden.
    Wredling, Regina
    Sophiahemmet University College, Stockholm, Sweden.
    Tham, Kerstin
    Karolinska Institutet, Stockholm, Sweden.
    Striving for control in eating situations after stroke2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 4, s. 772-80Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    THE study's rationale: Eating difficulties are common after stroke. However, to better meet individuals' needs, in terms of care, support and rehabilitation after stroke, it was considered important to know more about how patients with stroke experience their eating difficulties while in process of regaining their ability.

    Aims and objectives: The aim of this study was to explore the experience of eating difficulties among patients with stroke 3 months after stroke onset.

    Methodological design and justification: A qualitative interpretive descriptive approach was used. The analysis was based on constant comparative approach, using the principles of grounded theory.

    Research methods: The study included 14 participants with stroke and eating difficulties. A semi-structured interview guide with open-ended questions and probes was used. The interview guide was gradually modified during the data collection process. The interviews were digital audio recorded and fully transcribed. Memos were documented simultaneously with the analysis. Instruments:  A structured observation of a meal verified eating difficulties, and semi-structured interviews were conducted.

    Results 'Striving for control' emerged as a tentative core category. The participants related their striving for control to 'eating safely', and 'eating properly'; they also had to analyse the consequences of their eating difficulties, being careful when eating, and/or avoiding activities. Some also felt a need of help from others. Those others could remind and provide advice in this matter.

    Conclusion: This study highlights the complexity of having eating difficulties after stroke. Aspects related to the participants' striving for control are based on different strategies to eat safely and properly. Nurses can use this knowledge to support patients in their strive for control by observing them in eating situations. In addition, nurses can also ask them to describe and make explicit the experience of eating situations after stroke.

  • 44.
    Norell [Pejner], Margaretha
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Ziegert, Kristina
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Care priorities: registered Nurses' clinical daily work in municipal elderly care settings2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 2, s. 388-95Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Care priorities- Registered Nurses' clinical daily work in municipal care settings Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. In according to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure is perceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 - 2008, using a web-based form. The nurses filled in patient's type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and were attributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in south-western Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient's gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation.

  • 45.
    Odencrants, Sigrid
    et al.
    Örebro universitet, Hälsoakademin.
    Ehnfors, Margareta
    Grobe, Susan J.
    Living with chronic obstructive pulmonary disease (COPD): Part II. RNs' experience of nursing care for patients with COPD and impaired nutritional status2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 1, s. 56-63Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study is the second part of a project with the main purpose of obtaining a deeper understanding of the consequences of living with chronic obstructive pulmonary disease (COPD) concerning meal-related situations and an impaired nutritional status. COPD is a slowly progressive lung disease that results in several complications, including malnutrition. Nutritional status is an important part of COPD treatment, and there are criteria recommended for nutritional assessment and interventions among patients with COPD. Despite this, patients with extreme malnutrition and unnoticed weight loss are reported. The aim of the study was to investigate how Registered Nurses (RNs) in primary care describe nutritional assessment practices and interventions in COPD patients with impaired nutritional status. An interview approach using semistructured questions and case vignettes was chosen. The sample included 19 RNs working specifically with COPD patients. Data from interviews were analysed using qualitative content analysis, and nine categories corresponding to the aim were identified. The RNs reported that their assessment of nutritional status was based largely on intuition. Assessment also included detection of the patients' current beliefs and being sensible about information provision - When and How. Interventions were supportive eating interventions, practical and cognitive participation, and making patients aware of the illness trajectory. An overall category that influenced nursing was respecting patients' feelings of shame and guilt about a self-inflicted disease. It seems that RNs use intuition because of a lack of knowledge of systematic methods of nutritional assessment. The findings also indicate that the RNs attempted to build a relationship of trust with the patients rather than provide early information on sensitive topics (e.g. nutritional information). The study reports areas of nursing care for COPD patients that must be improved in the future

  • 46.
    Odencrants, Sigrid
    et al.
    Örebro universitet, Hälsoakademin.
    Ehnfors, Margareta
    Grobe, Susan J.
    Living with chronic obstructive pulmonary disease: Part I. Struggling with meal-related situations: experiences among persons with COPD2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 3, s. 230-239Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Reduced nutritional intake with low and decreased body weight can be a component of normal ageing. There is, however, also a greater risk for reduced nutritional intake within certain diagnoses, especially for chronic diseases. Malnutrition in chronic obstructive pulmonary disease (COPD) is caused by many factors. The relationship between COPD and low values of body mass index (BMI) is a known independent risk for mortality. For optimal support and care with special focus on nutritional status and interventions, caregivers need more knowledge about the meal-related situations (i.e. shopping for food, cooking and eating) of COPD patients. The aim of this study was to describe experiences of meal-related situations as viewed from the individual's perspective. The sample included eight women and five men with COPD recruited from five primary health clinics. The participants' average age was 68.9 years, with values of forced expiratory volume in 1 second (FEV(1) percentage) ranging from 18 to 69 and BMI values from 15 to 40. A descriptive design with qualitative interviews and self-reported diaries were used and the data were later analysed using content analysis. Findings showed consistency between informants' COPD, nutritional status and descriptions of experiences in meal-related situations. Findings were disease-specific but were also found to be general- and age-related. Respondents described physical influences and positive and negative feelings in their meal-related situations. Feelings of dependence, level of activity, transport of food, having company or being alone, appetite, hunger and need of time were also mentioned. Most research reports reduced nutritional status from a medical perspective. To our knowledge, no study has reported the positive and negative feelings that arise when eating in persons with COPD. Malnutrition for persons with COPD is not only caused by eating difficulties: eating is an integral part of social situations as shown in this study.

  • 47.
    Olsson, Annakarin
    et al.
    Örebro universitet, Hälsoakademin. Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Engström, Maria
    Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Skovdahl, Kirsti
    Örebro universitet, Hälsoakademin.
    Lampic, Claudia
    Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    My, your and our needs for safety and security: relatives' reflections on using information and communication technology in dementia care2012Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, nr 1, s. 104-112Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The present paper reports on a study aimed at describing relatives' reflections on different kinds of information and communication technology (ICT) devices that are used or can be used in the daily care of persons with dementia.

    Background: Many persons with dementia continue living in their own homes, which requires the support of their relatives. One way to meet the needs of relatives and persons with dementia is to use ICT.

    Methods: An interview study was conducted in Sweden (2007-2008) with a purposive sample of 14 spouses of a person with dementia. Qualitative content analysis was used to identify categories and themes in the data.

    Findings: Relatives' reflections on the use of ICT were described as ICT - a support in daily life, ICT - internal and external conditions and ICT - the decision to use or not use. Based on these categories, a theme was revealed: shifting between different perspectives: my, your and our needs for safety and security.

    Conclusion: Relatives struggle to create a situation of safety and security in daily life for themselves and the persons with dementia. ICT devices with the right functionality and used at the right time are regarded as useful in solving everyday problems. In the decision to use or not use ICT, the opportunity to create a safe and secure environment overshadows potential ethical problems. Providing early information about ICT to persons with dementia and their relatives could facilitate joint decision-making regarding use of ICT.

  • 48.
    Olsson, Helen
    et al.
    Mid Sweden University, Sundsvall, Sweden.
    Strand, Susanne
    Mid Sweden University, Sundsvall, Sweden; Sundsvall Forensic Psychiatric Hospital, Sundsvall, Sweden.
    Kristiansen, Lisbeth
    Mid Sweden University, Sundsvall, Sweden.
    Reaching a turning point - how patients in forensic care describe trajectories of recovery2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 505-514Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, the duration of treatment is increasing for patients admitted to forensic psychiatric care. To reduce the length of stay, it is important for the forensic rehabilitation and recovery process to be effective and safe. Not much is known about how the process of recovery and transition begins and how it is described by the forensic patients. The purpose of this study was to explore how forensic patients with a history of high risk for violence experienced the turn towards recovery. A qualitative content analysis was used to analyse interviews with 10 patients who had decreased their assessed risk for violence on the risk assessment instrument HCR-20 and who were successfully managed a lower level of security. Three themes were identified: (i) the high-risk phase: facing intense negative emotions and feelings (ii) the turning point phase: reflecting on and approaching oneself and life in a new way (iii) the recovery phase: recognising, accepting and maturing. In the high-risk phase, chaotic and overwhelming feelings were experienced. The turning point phase was experienced as a sensitive stage, and it was marked by being forced to find a new, constructive way of being. The recovery phase was characterised by recognising personal circumstances in life, including accepting the need for structure, a feeling of maturity and a sense of responsibility for their own life. In order to ensure a successful recovery, the forensic nursing staff needs to recognise and support processes related to treatment motivation and turning points. Recommendations for best nursing practice are given accordingly.

  • 49.
    Röing, Marta
    et al.
    Uppsala University, Uppsala, Sweden.
    Rosenqvist, Urban
    Uppsala University, Uppsala, Sweden.
    Holmstrom, Inger K.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Uppsala University, Uppsala, Sweden.
    Threats to patient safety in telenursing as revealed in Swedish telenurses' reflections on their dialogues2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 4, s. 969-976Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Telenursing is a rapidly expanding actor in the Swedish healthcare system, as in other Western nations. Although rare, tragic events occur within this context, and are reminders of the importance of giving patient safety the highest priority. As telenurses' main sources of information are their dialogues with the callers, the provision of safe care can depend on the quality of this dialogue.

    The aim of this study was to identify issues that could threaten patient safety in telenurses' dialogues with callers. As part of an educational intervention, a researcher visited a sample of six telenurses five to six times at their workplace to listen to and discuss, together with the telenurses, their dialogues with callers in stimulated recall sessions. Each call and the following discussion between researcher and telenurse was tape-recorded and transcribed as text, resulting in a total of 121 calls. Qualitative content analysis of the reflections and following discussions revealed that threats to patient safety could be related to the surrounding society, to the organisation of telenursing, to the telenurse and to the caller.

    This study gives insight into significant problem areas that can affect patient safety in telenursing in Sweden. Issues that need to be focused on in telenursing educational programmes and future research are suggested, as well as the need for organisational development.

  • 50.
    Skovdahl, Kirsti
    et al.
    Örebro universitet, Hälsoakademin.
    Fahlström, Gunilla
    Regionförbundet i Örebro län.
    Horttana, Britt-Marie
    Örebro universitet, Hälsoakademin.
    Winblad, Bengt
    Kihlgren, Mona
    Centre for Nursing Science, Örebro University Hospital.
    Demanding behaviours and workload in elderly care in Sweden: occurrence at two time points within a decade2008Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, nr 3, s. 323-330Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to investigate the occurrence of demanding behaviours in persons ‡65 years receiving home care or living in sheltered accommodation at two points in time, 1993 and 2002. Another aim was to investigate whether the perceived workload in staff had changed during this period. All persons ‡65 years living at home and utilizing home care services or those who lived in some form of sheltered housing were included and assessed by staff using a three-part questionnaire, in two cross-sectional studies. The study group comprised 1187 and 1017 participants which equals 77% and 99% respectively. Symptoms and degree of behavioural and psychiatric symptoms common in dementia that were assessed with a subscale in The Gottfries-Bra°ne-Steen Scale, demonstrated an all over increase from 1993 to 2002. Items from The Multi Dimensional Dementia Assessment Scale (MDDAS) measured a decrease in ‘daily’ occurrences of dementia symptoms but an increase in ‘sometimes per week’. A mixed pattern was seen concerning behaviours where increases as well as decreases were found. The behaviours ‘constantly seeking attention’ and ‘shrieking continuously’ increased significantly. The number of individuals showing restless, aggressive or shrieking behaviours increased significantly over the decade. Two items from the MDDAS were used to measure the workload. The physical workload increased significantly over the decade whereas the rising tendencies of the psychological workload were not statistically significant. The mean age over the decade had increased from 83 to 86 years, which together with the findings make the recipients of home care and sheltered housing a very vulnerable group. The demanding problems place considerable pressure on staff.

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