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  • 151.
    Nordstrand, Linda
    et al.
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Holmefur, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kits, Annika
    Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
    Eliasson, Ann-Christin
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Improvements in bimanual hand function after baby-CIMT in two-year old children with unilateral cerebral palsy: a retrospective study2015In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 41-42, p. 86-93Article in journal (Refereed)
    Abstract [en]

    The common assumption that early-onset intensive intervention positively affects motor development has rarely been investigated for hand function in children with unilateral cerebral palsy (CP). This retrospective study explored the possible impact of baby constraint-induced movement therapy (baby-CIMT) on hand function at two years of age. We hypothesized that baby-CIMT in the first year of life would lead to better bimanual hand use at two years of age than would not receiving baby-CIMT. The Assisting Hand Assessment (AHA) was administered at age 21 months (SD 2.4 months) in 72 children with unilateral CP, 31 of who received baby-CIMT. When dividing the children into four functional levels based on AHA, the proportional distribution differed between the groups in favour of baby-CIMT. Logistic regression analysis indicated that children in the baby-CIMT group were more likely than were children in the no baby-CIMT group to have a high functional level, even when controlling for the effect of brain lesion type (OR 5.83, 95% CI 1.44-23.56, p = 0.001). However, no difference was found between groups in the odds of having a very low functional level (OR 0.31, 95% CI 0.08-1.17, p = 0.084). The result shows that baby-CIMT at early age can have a positive effect. Children who received baby-CIMT were six times more likely to have a high functional level at two years of age than were children in the no baby-CIMT group.

  • 152.
    Norlén, Tobias
    et al.
    Örebro University, School of Health Sciences.
    Stridsman, Andrea
    Örebro University, School of Health Sciences.
    Orsaker till ljudkänslighet hos personer med autism - en systematisk litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 153.
    Pavli, Antonia
    Örebro University, School of Health Sciences.
    Creative Disability Classification Systems: The case of Greece, 1990-20152017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Disability classification systems belong to the core of states’ social/disability policies through which persons with disabilities are classified as eligible or ineligible for having access to disability allowances. The study of disability classification systems has stimulated the interest of several scholars from the broader area of disability studies. Either by conducting comparative studies between different states and describing the similarities and differences of these systems around the world or by conducting studies focusing on the politics and semantics in the development of disability classification systems in specific states, all studies have shown a pluralism in the systems for assessing and certifying disability. In Greece, the development of disability classification systems for social welfare reasons emerged as a controversy that lasted for almost twenty years. One factor that strengthened the controversy was the outbreak of the economic crisis late in 2009 followed by the announcement by the governmental authorities of the enactment of a new system for assessing and certifying disability as part of the austeritydriven policies that the Greek state would enact for facing the consequences of the economic crisis. Drawing on an interdisciplinary approach, the overall aim of this study is to describe and analyze the enactment of disability classification systems in the context of Greek social policy from 1990 to 2015. For the collection of empirical material, a qualitative research method was employed, consisting of interviews, written material, and newspaper articles. The main findings of this thesis are: I) the involvement of the political parties in the development of the systems for certifying and assessing disability; II) the involvement of the disability movement in policymaking; III) the “creative” use of statistics by governmental authorities for the enactment of disability/social policies; IV) how the concept of “disability fraud” has been constructed as a “threat” to the society; and V) the vulnerability of disability classification systems in times of austerity.

  • 154.
    Pettersson, Cecilia
    Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden.
    Powered Mobility Device Use: Participation and Accessibility2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis elucidates the use of powered mobility devices in a Swedish context. The overall aim was to increase and deepen the knowledge on powered mobility device use in relation to participation and accessibility in different environments and among different user groups, with a specific focus on independence and autonomy. An additional aim was to contribute to the knowledge base regarding the optimization of use of such devices. The thesis is based on four studies in which different research approaches were applied through the combination of different types of data in order to interpret the complexity of powered mobility device use. Quantitative, qualitative and mixed methods were utilized. The first study was a prospective cohort study in which data was collected using structured interviews at baseline and two follow-ups. The second study was an exploratory multiple longitudinal case study. A focusgroup methodology with a descriptive design was used in the third study. The fourth study was a cross-sectional study based on survey data collected from people with spinal cord injury. The main contribution of the studies that constitute the empirical basis of this thesis is that the purpose of providing people with powered mobility devices is mostly fulfilled in that such devices provide their users’ with greater opportunities for participation. Nevertheless, there are also problems in terms of accessibility in various environmental arenas that have an impact on mobility. An additional important contribution is that the results show that the experiences of users of powered mobility devices should be taken seriously as they convey different aspects of how the use of such devices could be optimized. In conclusion, this thesis contributes to our understanding of the use of powered mobility devices and has the potential to optimize independence in terms of mobility and participation among users of such devices. Finally, the results have practical implications for occupational therapy in the provision of powered mobility devices. Likewise, this new knowledge about the needs of powered mobility device users in terms of accessibility are of importance to politicians, professionals and other stakeholders engaged in housing provision and physical planning.

  • 155.
    Pettersson, Cecilia
    et al.
    Örebro University, School of Health Sciences.
    Hedvall, Per-Olof
    Department of Design Sciences, Faculty of Engineering (LTH), Lund University, Lund, Sweden.
    Alienating design – the oppressive face of an inaccessible societyManuscript (preprint) (Other academic)
  • 156.
    Pettersson, Cecilia
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Iwarsson, Susanne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Brandt, Åse
    The National Board of Social Services, Odense, Denmark.
    Norin, Lizette
    Department of Health Sciences, Lund University, Lund, Sweden.
    Månsson Lexell, Eva
    Department of Health Sciences, Lund University, Lund, Sweden; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
    Men's and women's perspectives on using a powered mobility device: benefits and societal challenges2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 6, p. 438-446Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe how men and women experience their use of powered wheelchairs (PW) and powered scooters (PS) in everyday occupations, in the home and in society at large.

    METHODS: A qualitative research approach with focus-group methodology was used. Four focus groups were created, with men and women as well as PW and PS users in different groups. Applying a descriptive approach, data were analysed according to the principles described by Krueger.

    FINDINGS: Three categories emerged and revealed that even though use of PW and PS increased independence and enabled everyday occupations, participants struggled to be independent powered mobility device (PMD) users. They experienced many accessibility problems in dwellings and in society, described similarly by users of PW and PS. Men and women experienced their use of (PMD) differently, especially in relation to the service delivery process.

    CONCLUSIONS: The study contributes with new knowledge on accessibility for PW and PS users and related service delivery processes, stating that gender differences regarding provision and training must be taken into account. Occupational therapists can contribute to an enhanced understanding of PMD users' challenges in person-environment-occupation transactions in the home and society, and thereby promote occupational justice for PMD users.

  • 157.
    Ranjbar, Parivash
    et al.
    Örebro University, School of Science and Technology.
    Anderzén-Carlsson, Agneta
    Örebro University, Department of Health Sciences.
    Neovius, Lennart
    Saven Hitech AB.
    Johansson, Camilla
    Audiologiska forskningscentrum.
    Borg, Erik
    Audiologiska forskningscentrum, USÖ.
    Vibrotactile detection, identification and directional perception of signal-processed sounds from environmental events: a pilot field evaluation in five cases2009In: Iranian Rehabilitation Journal, ISSN 1735-3602, Vol. 6, no 7-8, p. 89-107Article in journal (Refereed)
    Abstract [en]

    Objective: Conducting field tests of a vibrotactile aid for deaf/deafblind persons for detection, identification and directional perception of environmental sounds.

    Method: Five deaf (3F/2M, 22–36 years) individuals tested the aid separately in a home environment (kitchen) and in a traffic environment. Their eyes were blindfolded and they wore a headband and holding a vibrator for sound identification. In the headband, three microphones were mounted and two vibrators for signalling direction of the sound source. The sounds originated from events typical for the home environment and traffic. The subjects were inexperienced (events unknown) and experienced (events known). They identified the events in a home and traffic environment, but perceived sound source direction only in traffic.

    Results: The detection scores were higher than 98% both in the home and in the traffic environment. In the home environment, identification scores varied between 25%-58% when the subjects were inexperienced and between 33%-83% when they were experienced. In traffic, identification scores varied between 20%-40% when the subjects were inexperienced and between 22%-56% when they were experienced. The directional perception scores varied between 30%-60% when inexperienced and between 61%-83% when experienced.

    Conclusion: The vibratory aid consistently improved all participants’ detection, identification and directional perception ability.

  • 158.
    Ranjbar, Parivash
    et al.
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Stranneby, Dag
    Örebro University, School of Science and Technology.
    Borg, Erik
    Ready-Ride: A tactile communications aid to improve the mobility of persons with deafblindness in a riding arena2018In: International Journal of Engineering Technology and Scientific Innovation, ISSN 2456-1851, Vol. 3, no 1, p. 56-62Article in journal (Other academic)
    Abstract [en]

    Persons with severe visual impairment (VI), blindness (B) and deafblindness (DB) have difficulties in mobility and thereby poor leisure time. Activities as horseback riding become difficult especially for persons with DB who communicate with an assistant/instructor via tactile sign language and need to stop and get information/feedback.

    Ready-Ride, a tactile communications system can improve the mobility of the persons with B and DB by making distance communication possible. It consists of transmitter with four buttons which communicates via Bluetooth with a receiver connected to four vibrators via cables. The button(s) are used to activate the specific vibrator(s). The messages can consist of simple "right" or "left" or more complex codes for any needed instruction.

    Ready-Ride has been evaluated in the riding arena by persons with B and DB who consider it as mobile, easy to use and no need for long introduction or installation of any software/hardware. The vibrations are intuitive, easy to detect and distinguish. The system gives the rider information tactually without disturbing other persons or horses nearby. Using Ready-Ride they got more time to ride and the quality was increased since they could communicate while riding and get immediate feedback directly.

    One of the riders with DB has been using the system during a long period, in average one lesson a week and participated in different competitions with good results. She says that the use of Ready- Ride is crucial for continued riding, "Ready-Ride is a MUST BEE".

  • 159.
    Rasoal, Dara
    Örebro University, School of Health Sciences.
    Perspectives on clinical ethics support and ethically difficult situations: reflections and experiences2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Healthcare personnel encounter ethically difficult situations in their everyday work and clinical ethics support might be important to support healthcare personnel to deal with these situations. The overall aim of this thesis was to describe perspectives on clinical ethics support, experiences of being in ethically difficult situations and experiences of facilitating ethics reflection. Methods. Study I had a descriptive design in which research articles were reviewed (n=54). In study II audio-recorded moral case deliberation (n=70) in 10 Swedish workplaces in hospitals and community care were analysed. In study III interviews were conducted with facilitators (n=11) of moral case deliberation. Study IV used non-participant observation during three weeks as well as informal conversations with healthcare personnel (n=12) in community home healthcare. Results and conclusion. In study I, two perspectives emerged on clinical ethics support, a “Top-down” perspective, where an individual or a group of “experts” in ethics could recommend the best course of action and a “Bottom-up” perspective that allows healthcare personnel to manage ethically difficult situations through ethical reflections led by a facilitator. Studies II and IV showed how ethically difficult situations on different levels are often connected with emotions and uncertainties. Study III showed the role of the facilitator to be fundamental in creating a space for self-reflection among healthcare personnel. Study IV showed that healthcare personnel face complex demands and expectations from the healthcare organization regarding the provision of care as well as having to meet the needs of patients and their next-of-kin. To conclude, healthcare personnel needed to find a balance among demands and expectations in order to satisfy those stakeholders involved and they had to seek compromise. There is a need for clinical ethics support that helps healthcare personnel reflect individually and collectively on ethically difficult situations they encounter in their everyday clinical practice. From this standpoint, a “Bottom-up” perspective may reduce the risk of moral distress among healthcare personnel and promote care based on person-centred values.

    List of papers
    1. Clinical ethics support for healthcare personnel: An integrative literature review
    Open this publication in new window or tab >>Clinical ethics support for healthcare personnel: An integrative literature review
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57636 (URN)
    Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2017-10-18Bibliographically approved
    2. What healthcare teams find ethically difficult: Captured in 70 moral case deliberations
    Open this publication in new window or tab >>What healthcare teams find ethically difficult: Captured in 70 moral case deliberations
    2016 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, no 8, p. 825-837Article in journal (Refereed) Published
    Abstract [en]

    Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss.

    Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation.

    Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis.

    Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation.

    Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient's/next-of-kin's emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient's autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have.

    Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders.

    Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective.

    Place, publisher, year, edition, pages
    London, United Kingdom: Sage Publications, 2016
    Keywords
    Clinical ethics, ethically difficult situations, ethics consultation, healthcare professionals, moral case deliberation
    National Category
    Nursing
    Research subject
    Ethics
    Identifiers
    urn:nbn:se:oru:diva-44848 (URN)10.1177/0969733015583928 (DOI)000391461900002 ()25991657 (PubMedID)2-s2.0-85007109749 (Scopus ID)
    Note

    Funding Agency:

    Stiftelsen Olle Engqvist Byggmästare 

    Available from: 2015-06-05 Created: 2015-06-05 Last updated: 2019-04-09Bibliographically approved
    3. ‘It’s like sailing’- experiences of the role as facilitator during moral case deliberation
    Open this publication in new window or tab >>‘It’s like sailing’- experiences of the role as facilitator during moral case deliberation
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57637 (URN)
    Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2017-10-18Bibliographically approved
    4. Balancing different expectations in ethically difficult situations while providing community home health care services: A focused ethnographic approach
    Open this publication in new window or tab >>Balancing different expectations in ethically difficult situations while providing community home health care services: A focused ethnographic approach
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57639 (URN)
    Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2017-10-18Bibliographically approved
  • 160.
    Rasoal, Dara
    et al.
    Örebro University, School of Health Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Skovdahl, Kirsti
    Department of Nursing and Health Sciences, University College in Southeast Norway, Campus Drammen, Norway.
    Balancing different expectations in ethically difficult situations while providing community home health care services: A focused ethnographic approachManuscript (preprint) (Other academic)
  • 161.
    Rasoal, Dara
    et al.
    Örebro University, School of Health Sciences.
    Skovdahl, Kirsti
    Department of Nursing and Health Sciences, University College in Southeast Norway, Campus Drammen, Norway.
    Gifford, Mervyn
    Örebro University, School of Health Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Clinical ethics support for healthcare personnel: An integrative literature reviewManuscript (preprint) (Other academic)
  • 162.
    Rasoal, Dara
    et al.
    Örebro University, School of Health Sciences.
    Svantesson, Mia
    Örebro University, School of Health Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    ‘It’s like sailing’- experiences of the role as facilitator during moral case deliberationManuscript (preprint) (Other academic)
  • 163.
    Rossen, Jenny
    et al.
    Sophiahemmet University, Stockholm, Sweden; Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Sophiahemmet University, Stockholm, Sweden.
    Hagströmer, Maria
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
    Brismar, Kerstin
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
    Ainsworth, Barbara E
    School of Nutrition and Health Promotion, Arizona State University, Phoenix AZ, United States.
    Iskull, Christina
    Sophiahemmet Hospital, Stockholm, Sweden.
    Möller, Peter
    Sophiahemmet Hospital, Stockholm, Sweden.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT2015In: BMC public health, ISSN 1471-2458, Vol. 15, article id 647Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity prevents or delays progression of impaired glucose tolerance in high-risk individuals. Physical activity promotion should serve as a basis in diabetes care. It is necessary to develop and evaluate health-promoting methods that are feasible as well as cost-effective within diabetes care. The aim of Sophia Step Study is to evaluate the impact of a multi-component and a single component physical activity intervention aiming at improving HbA1c (primary outcome) and other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes.

    METHODS/DESIGN: Sophia Step Study is a randomized controlled trial and participants are randomly assigned to either a multi-component intervention group (A), a pedometer group (B) or a control group (C). In total, 310 patients will be included and followed for 24 months. Group A participants are offered pedometers and a website to register steps, physical activity on prescription with yearly follow-ups, motivational interviewing (10 occasions) and group consultations (including walks, 12 occasions). Group B participants are offered pedometers and a website to register steps. Group C are offered usual care. The theoretical framework underpinning the interventions is the Health Belief Model, the Stages of Change Model, and the Social Cognitive Theory. Both the multi-component intervention (group A) and the pedometer intervention (group B) are using several techniques for behavior change such as self-monitoring, goal setting, feedback and relapse prevention. Measurements are made at week 0, 8, 12, 16, month 6, 9, 12, 18 and 24, including metabolic and cardiovascular biomarkers (HbA1c as primary health outcome), accelerometry and daily steps. Furthermore, questionnaires were used to evaluate dietary intake, physical activity, perceived ability to perform physical activity, perceived support for being active, quality of life, anxiety, depression, well-being, perceived treatment, perceived stress and diabetes self- efficacy.

    DISCUSSION: This study will show if a multi-component intervention using pedometers with group- and individual consultations is more effective than a single- component intervention using pedometers alone, in increasing physical activity and improving HbA1c, other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes.

    TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02374788 . Registered 28 January 2015.

  • 164.
    Rönnåsen, Berit
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Aspekter på lärande vid dövblindhet: möjligheter och begränsningar för personer med Alström syndrom2015Licentiate thesis, comprehensive summary (Other academic)
    List of papers
    1. Auditory and vestibular pathology in Alström syndrome
    Open this publication in new window or tab >>Auditory and vestibular pathology in Alström syndrome
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Learning Other Medical Sciences not elsewhere specified
    Research subject
    Disability Research
    Identifiers
    urn:nbn:se:oru:diva-44681 (URN)
    Available from: 2015-05-22 Created: 2015-05-22 Last updated: 2017-10-17Bibliographically approved
    2. Aspects of Learning from the Perspective of People With Alström Syndrome
    Open this publication in new window or tab >>Aspects of Learning from the Perspective of People With Alström Syndrome
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Keywords
    Alström syndrome (AS), deafblindness, dual sensory loss, learning, sensoneural progressive hearing loss, vision loss
    National Category
    Learning Other Health Sciences
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-44682 (URN)
    Available from: 2015-05-22 Created: 2015-05-22 Last updated: 2017-10-17Bibliographically approved
  • 165.
    Rönnåsen, Berit
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research, Linköping, Sweden; Audiological Research Centre, Örebro University Hospital.
    Möller, Kerstin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research, Linköping, Sweden; Audiological Research Centre, Örebro University Hospital.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research, Linköping, Sweden; Audiological Research Centre, Örebro University Hospital; Department of Behavioural Science and Learning, Linköping University.
    Lyxell, Björn
    Department of Behavioural Science and Learning, Linköping University.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research, Linköping, Sweden; Audiological Research Centre, Örebro University Hospital.
    Aspects of Learning from the Perspective of People With Alström SyndromeManuscript (preprint) (Other academic)
  • 166.
    Rönnåsen, Berit
    et al.
    School of Health and Medical Sciences, Örebro University, The Swedish Institute for Disability Research, Örebro, Sweden; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Möller, Kerstin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Lyxell, Björn
    Department of Behavioural Science and Learning, Linköping University, Linköping, Sweden.
    Anderzén Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Aspects of learning from the perspective of people with Alström syndrome2016In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 38, no 7, p. 644-652Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to explore aspects of learning, from a lifelong perspective, in individuals with Alstro ̈m syndrome (AS). AS is an autosomal recessive disorder causing early blindness, progressive sensorineural hearing loss, cardiomyopathy, endocrine disorders, metabolic dysfunction, and abbreviated lifespan.

    Method: Eleven individuals with AS participated. The study had a qualitative explorative design, giving voice to the participants’ perspectives on their situation. Data were collected using semi-structured interviews, which were subjected to conventional (inductive) qualitative content analysis.

    Results: The analysis revealed in the participants a quest for independence and an image of themselves as capable people willing to learn, but in constant need of support to continue learning throughout their lives to be as independent as possible.

    Conclusion: Based on the levels of functioning, i.e. personal resources, revealed in the interviews, supervisors, caregivers, and teachers are encouraged to allow people with AS to be their own advocates, as they know best how, what, and with whom they learn, and what type of sensory material – tactile, auditory, visual, or a combination – is most helpful. Implications for RehabilitationIndividuals with AS strive for independence, and to be independent they need to continue to learn throughout their lives.Individuals with AS know best how they learn, and should be asked what modalities are the most effective for them.The tactile modality for learning will continue throughout life and should be emphasized early in the individual's education and rehabilitation.

  • 167.
    Sjöberg, Jessica
    et al.
    Örebro University, School of Health Sciences.
    Tidman Elme, Fredrika
    Örebro University, School of Health Sciences.
    Attityder och vanor – en studie om ungdomars förhållningssätt till höga ljudnivåer2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 168.
    Sjöberg, Lis
    et al.
    Örebro University, School of Health Sciences.
    Lindner, Helen Y.
    Örebro University, School of Health Sciences.
    Hermansson, Liselotte
    Örebro University Hospital. Örebro University, School of Health Sciences. Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Long-term results of early myoelectric prosthesis fittings: A prospective case-control study2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 527-533Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Different recommendations exist regarding what age is best for first-time fitting of myoelectric hand prostheses in children.

    OBJECTIVES: To compare prosthetic skill, prosthetic use and risk for rejection over time between children fitted with myoelectric hand prostheses before or after 2½ years of age.

    STUDY DESIGN: Prospective case-control design.

    METHODS: The cases were nine children fitted with myoelectric hand prostheses before the age of 2½ years, whereas the controls were 27 children who were fitted with myoelectric hand prostheses after the age of 2½ years. The Skills Index Ranking Scale was used to classify prosthetic skill, and prosthetic use was categorised based on wearing time and pattern. Independent samples tests were used to compare data between groups. To estimate and compare the risk of prosthesis rejection between groups and over time, survival analysis was used.

    RESULTS: Cases showed prosthetic skill early, but controls had caught up by the age of 3½ years. Cases had a significant ( p = 0.046) decrease in prosthetic use at the age of 9 years. In the long term, cases had a higher percentage of prosthesis rejection.

    CONCLUSIONS: Considering young children's development of prosthetic skill and prosthetic use over time, this study shows no additional advantages from fitting a myoelectric hand prosthesis before 2½ years of age. Clinical relevance Children may be fitted with myoelectric hand prostheses to assist in daily tasks and to prevent future over-use problems. Most children fitted with myoelectric hand prostheses before 4 years of age become regular users. No advantages of fitting myoelectric hand prostheses before 2½ years of age were observed.

  • 169.
    Skagerstrand, Åsa
    Örebro University, School of Health Sciences.
    Perception of disturbing sounds: Investigations of people with hearing loss and normal hearing2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The present thesis concerns the daily sound environment and the human perception of the same. The sound environment affects the possibility to be active in a communication. With background noise, it may be harder to hear desired signals, and when suffering from a hearing loss, negative effects of the background noise increase. Previous research has explored, that persons with hearing loss benefit from hearing aid usage, but there is a risk of non-usage due to low sound quality. The non-usage of hearing aids has furthermore been described as a cause of isolation and social withdrawal for persons with hearing loss.

    The general aim of the present thesis is to explore the concept of disturbing sounds in a daily sound environment and to examine the influence of hearing loss and hearing aid usage. Disturbing sounds were investigated in means of perception of loudness and annoyance, where loudness concerned the acoustical properties, mainly sound level, whereas annoyance concerned the psychological phenomenon, defined as an individual adverse reaction to noise. The results of studies I and II showed, that hearing aid users experience disturbing sounds more or less daily, and that those sounds resulted in a decreased usage of hearing aids. The effect of disturbing sounds seemed to rely on several factors, acoustical as well as psychological, and there was not one single factor providing a full explanation of disturbance. In study III and IV, the perception of sounds in normal hearing and hearing impaired persons were thoroughly examined and revealed that hearing thresholds affect the perceived loudness and annoyance. Furthermore, the effect of hearing aids on loudness and annoyance perception was investigated. The results showed that hearing aids restored the loudness and annoyance to levels comparable to people with normal hearing function. The results of the studies stress that additional research should focus on the implementation of knowledge of disturbing sounds in audiological rehabilitation, in order to increase the benefit of hearing aid usage.

    List of papers
    1. Sounds perceived as annoying by hearing-aid users in their daily soundscape
    Open this publication in new window or tab >>Sounds perceived as annoying by hearing-aid users in their daily soundscape
    2014 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 4, p. 259-269Article in journal (Refereed) Published
    Abstract [en]

    Background: The noises in modern soundscapes continue to increase and are a major origin for annoyance. For a hearing-impaired person, a hearing aid is often beneficial, but noise and annoying sounds can result in non-use of the hearing aid, temporary or permanently.

    Objective: The purpose of this study was to identify annoying sounds in a daily soundscape for hearing-aid users.

    Design: A diary was used to collect data where the participants answered four questions per day about annoying sounds in the daily soundscape over a two-week period.

    Study sample: Sixty adult hearing-aid users. Results: Of the 60 participants 91% experienced annoying sounds daily when using hearing aids. The annoying sound mentioned by most users, was verbal human sounds, followed by other daily sound sources categorized into 17 groups such as TV/radio, vehicles, and machine tools. When the hearing-aid users were grouped in relation to age, hearing loss, gender, hearing-aid experience, and type of signal processing used in their hearing aids, small and only few significant differences were found when comparing their experience of annoying sounds.

    Conclusions: The results indicate that hearing-aid users often experience annoying sounds and improved clinical fitting routines may reduce the problem.

    Place, publisher, year, edition, pages
    London: Informa Healthcare, 2014
    Keywords
    Soundscape, annoying sounds, hearing aid, hearing-aid fitting
    National Category
    Otorhinolaryngology
    Identifiers
    urn:nbn:se:oru:diva-34849 (URN)10.3109/14992027.2013.876108 (DOI)000332867100007 ()24495276 (PubMedID)2-s2.0-84896353214 (Scopus ID)
    Available from: 2014-04-28 Created: 2014-04-25 Last updated: 2018-06-05Bibliographically approved
    2. Acoustic analysis of real-life sounds that affect hearing aid usage
    Open this publication in new window or tab >>Acoustic analysis of real-life sounds that affect hearing aid usage
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-65013 (URN)
    Available from: 2018-02-15 Created: 2018-02-15 Last updated: 2018-02-15Bibliographically approved
    3. Loudness and annoyance of disturbing sounds: perception by normal hearing subjects
    Open this publication in new window or tab >>Loudness and annoyance of disturbing sounds: perception by normal hearing subjects
    2017 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 10, p. 775-783Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: Sounds in the daily environment may cause loudness and annoyance. The present study investigated the perception of loudness and annoyance for eight different sounds present in a daily sound environment and at nine different levels varying by ±20 dB around the recorded level. The outcomes were related to tests of participants' auditory and cognitive abilities.

    DESIGN: The participants undertook auditory and working memory (WM) tests prior to ratings of everyday sounds previously shown to be disturbing for persons with hearing impairment (hearing aid users).

    STUDY SAMPLE: Twenty-one participants aged between 24 and 71 years, with normal hearing threshold levels.

    RESULTS: Both perceived loudness and annoyance were primarily driven by the sound level. Sounds emitted from paper were rated as having greater loudness and being more annoying than the other sound sources at the same sound level. Auditory and cognitive abilities did not influence the perception of loudness and annoyance.

    CONCLUSIONS: Loudness and annoyance ratings were mainly driven by sound level. Expectations of a sound seemed to influence the assessment of loudness and annoyance while auditory performance and WM capacity showed no influence on the ratings.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2017
    Keywords
    Psychoacoustics/hearing science; noise; psycho-social/emotional; behavioural measures
    National Category
    Otorhinolaryngology Other Medical Sciences not elsewhere specified
    Identifiers
    urn:nbn:se:oru:diva-60890 (URN)10.1080/14992027.2017.1321790 (DOI)000416642900009 ()28485649 (PubMedID)2-s2.0-85019114085 (Scopus ID)
    Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2018-08-06Bibliographically approved
    4. Loudness and annoyance of disturbing sounds: Perception by people with hearing loss
    Open this publication in new window or tab >>Loudness and annoyance of disturbing sounds: Perception by people with hearing loss
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Research subject
    Disability Science
    Identifiers
    urn:nbn:se:oru:diva-65014 (URN)
    Available from: 2018-02-15 Created: 2018-02-15 Last updated: 2018-02-15Bibliographically approved
  • 170.
    Skagerstrand, Åsa
    et al.
    Örebro University, School of Health Sciences. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Sweden .
    Köbler, Susanne
    Örebro University, School of Health Sciences. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Sweden .
    Stenfelt, Stefan
    Linnaeus Centre HEAD, Swedish Institute for Disability Research, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden .
    Acoustic analysis of real-life sounds that affect hearing aid usageManuscript (preprint) (Other academic)
  • 171.
    Skagerstrand, Åsa
    et al.
    Örebro University, School of Health Sciences. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden .
    Köbler, Susanne
    Örebro University, School of Health Sciences. Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden .
    Stenfelt, Stefan
    Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping Sweden.
    Loudness and annoyance of disturbing sounds: Perception by people with hearing lossManuscript (preprint) (Other academic)
  • 172.
    Sparr, Sara
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Whalstedt, Carolina
    Hörapparatsutprovning i ett urval av europeiska länder: En litteraturstudie med fokus på kvalifikationskrav för professionella involverade i hörseldiagnostik och hörapparatsutprovning samt finansieringen av hörapparater2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Hörapparatsutprovning är en stor del av audiologisk rehabilitering. Flera intresseorganisationer inom hörselområdet har dock påtalat att det förekommer skillnader rörande utbildningsnivån hos hörselvårdpersonal inom Europa samt att tillhandahållen hörselvård i vissa fall är bristande.

    Syfte: Att jämföra hörapparatsutprovningsprocessen i ett urval av Europeiska länder. Fokus ligger på att belysa vilka yrkesgrupper som är involverade i hörseldiagnostik och hörapparatsutprovning samt vilken utbildningsnivå dessa har. Utöver detta kommer ländernas finansiering av hörapparater undersökas. Eventuella likheter och skillnader mellan länderna kommer sedan diskuteras ur ett patient perspektiv.Metod: En integrativ litteraturstudie har genomförts.

    Resultat: En jämförande beskrivning av de yrkesgrupper som patienter träffar under hörapparatsutprovningsprocessen i de studerade länderna samt vad hörapparaterna där kostar patienterna. Resultaten visar vidare att audiologiutbildningar varierar i omfattning mellan länderna, från 11-månaders yrkesutbildningar till 5-åriga universitetsutbildningar. Finansieringen av hörapparater i respektive land varierar också från gratis offentlig hörselvård till att patienten själv får betala hela kostnaden hos privata hörselkliniker.

    Slutsats: De skillnader i audiologiutbildning och finansiering av hörapparater som observerats motiverar fortsatt utvecklingsarbete inom området för att uppnå en likvärdigare hörselvård inom hela Europa.

  • 173.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Case-management – rehabilitation support for people with Acquired Brain Injury2018Conference paper (Refereed)
    Abstract [en]

    Approximately 70 000 acquire a brain injury yearly in Sweden which often result in disabilities. Acquired brain injury (ABI) can be caused by trauma, stroke or disease. The rehabilitation process is divided into acute and subacute phase and the late stage. Studies shows that clients with moderate and severe injuries have difficulties in coordinating rehabilitation and societal support. Rehabilitation can be a long-term process and clients with ABI are often referred to next of kin for coordinating societal support, e.g. rehabilitation and social services. Case-management have since 1980’s been a rehabilitation support in an international perspective, but in a Swedish context it is a relatively new form of support.

    The aim is to describe, based on a book chapter (Strandberg 2018), how this form of support has been developed in Sweden, as well as putting the form of support in relation to the client’s empowerment.

    The results show that there are different theoretical models for how Case-management can be organized, the support is designed differently in different countries and context. Furthermore, it is demonstrated that the support may be helpful to the client as well as the next of kin in terms of participation.

    Although, Case-management has been known since 1980s, the scientific studies are limited and there is no evidence for the clinical significance using this support. Research is therefore necessary to demonstrate its clinical significance.

  • 174.
    Strandberg, Thomas
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Möller, Kerstin
    Örebro University, School of Health Sciences.
    Widén, Stephen
    Örebro University, School of Health Sciences.
    Doctoral theses within the Swedish Institute for Disability Research 2000-2012: A review of content and interdisciplinarity2017In: International Journal of Health Sciences, ISSN 2372-5060, Vol. 5, no 2, p. 1-10Article in journal (Refereed)
    Abstract [en]

    The Swedish Institute for Disability Research (SIDR) was founded in 2000. The SIDR graduate programmedis a leading research programmedin disability science. The scientific method at SIDR is based on an interdisciplinary approach.The aim of this study is to describe content of doctoral theses presented within SIDR, and to analyzethe occurrence of interdisciplinarywithin the theses published between 2000 and 2012. Forty-one theses were included in the study. First, the manifest data was categorized in a matrix, and second, the latent content was analyzedwithin a scheme. The scheme included seven criteria within interdisciplinary theory, namely: Is the phenomenon multi-dimensional? Does the aim reflect an interdisciplinary approach? Are the studies non-reductionist? Have multiple methods been used? Is the knowledge integrated? Are the results discussed as a whole?Do they explicitly show an interdisciplinaryknowledge?Findings show a variety of disability groups studied within SIDR, but the main disabilities are hearing impairment or deafness, and cognitive and communication difficulties. Different theoretical perspectives are used within the theses. To different extents, an interdisciplinary approach is used as an overall meta-theory.

  • 175.
    Sundqvist, Ann-Sofie
    Örebro University, School of Health Sciences.
    Perioperative patient advocacy: having the patient's best interests at heart2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patient advocacy implies taking action on someone else’s behalf, and has been described as a key element of nurses’ professional care. In the perioperative setting, it involves not only critical decision making, but also all the small things that the nurses do for the sake of the patients during their working day. Since previous research on the advocacy role of a registered nurse anesthetist (RNA) is sparse, and has not been conducted in a Swedish context, this thesis was intended to contribute to a greater understanding of advocacy in the perioperative context. The overall aim was therefore to explore the characteristics and consequences of perioperative patient advocacy (Study I), and to describe RNAs’ views of advocacy in anesthetic nursing through interviews (Study II), a questionnaire (Study III), and observations (Study IV).

    The synthesis of the characteristics and consequences of perioperative patient advocacy was interpreted in this thesis as the RNAs having the patient’s best interests at heart, in that they (1) had control of the situation, (2) preserved human values, and finally (3) were emotionally affected, as the results from the four studies suggested this as the core of perioperative patient advocacy.

    Perioperative patient advocacy is not always perceived as easy. In praxis, it is linked to the code of ethics outlined by the International Council of Nurses, which states that all registered nurses, regardless of their working context, shall respect human rights, promote health, prevent illness, and ensure that the individual receives accurate and sufficient information. This thesis elaborates on how this is done by describing how RNAs exert perioperative patient advocacy and how they interact in order to facilitate the best possible care for the patient. The results deepen the understanding of perioperative patient advocacy from the RNA’s perspective and contribute to a new insight in the RNA’s professional role.

    List of papers
    1. Perioperative Patient Advocacy: An Integrative Review
    Open this publication in new window or tab >>Perioperative Patient Advocacy: An Integrative Review
    2016 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 5, p. 422-433Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The purpose of this review was to identify the characteristics and consequences of perioperative patient advocacy.

    Design: An integrative review method was employed.

    Methods: A database search to identify peer-reviewed articles that focused on perioperative patient advocacy was conducted in PubMed and CINAHL, followed by a manual search for additional articles. Studies were selected if they reported original empirical research findings with regard to perioperative patient advocacy. The data abstraction and synthesis were achieved with an inductive qualitative content analysis.

    Finding: The analysis resulted in seven categories, two subthemes, and one main theme. The main theme, “Doing good for another human being—a balancing act between philanthropy and personal gratification,” was the core of perioperative patient advocacy.

    Conclusion: Perioperative patient advocacy is part of the professional role of the perioperative nurse, and it affects the perioperative nurse emotionally. This advocacy shares similarities with descriptions of patient advocacy in general nursing.

    Place, publisher, year, edition, pages
    New York, USA: Elsevier, 2016
    Keywords
    Advocacy, integrative review, perioperative nursing
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-49820 (URN)10.1016/j.jopan.2014.12.001 (DOI)000385340100010 ()27667349 (PubMedID)2-s2.0-84962502652 (Scopus ID)
    Projects
    Anestesisjuksköterskan, patientens advokat
    Note

    Funding Agencies:

    Örebro University

    Research Committee at Örebro County Council, Örebro, Sweden OLL-426621

    Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2017-11-30Bibliographically approved
    2. Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy
    Open this publication in new window or tab >>Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy
    2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 2, p. 281-288Article in journal (Refereed) Published
    Abstract [en]

    Background: Anaesthesia often induces a state of unconsciousness that includes inability to communicate and influence the situation. The patient has to rely on the nurse anaesthetist to speak up for her/him as well as maintain her/his dignity and safety. Consequently, the nurse anaesthetist can be likened to the patient's advocate.

    Aim: The aim of the study was to describe advocacy in anaesthesia care during the perioperative phase from the perspective of the registered nurse anaesthetist.

    Method: Data for this qualitative descriptive study were collected during March and April, 2011. Individual interviews were conducted with a purposive sample of 20 nurse anaesthetists from two hospitals in Sweden. The audio-taped interviews were transcribed verbatim and analysed by means of qualitative content analysis.

    Findings: The main theme, Holding the patient's life in my hands, described the nurse anaesthetists' perception of advocacy and comprised three subthemes: providing dignified care, providing safe care and a moral commitment.

    Conclusion: Acting as the patient's advocate includes important health and well-being issues and could be stressful for the nurse anaesthetists'. A work environment where the nurse anaesthetists' can make their voices heard and feel that their opinion regarding the patient's best interests is taken seriously would be desirable, as all health professionals should ideally focus on those in their care.

    Place, publisher, year, edition, pages
    Hoboken: Wiley-Blackwell, 2014
    Keywords
    advanced practice nursing, nurse anaesthetist, advocacy, content analysis, nursing
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-34993 (URN)10.1111/scs.12057 (DOI)000334503400009 ()23713584 (PubMedID)2-s2.0-84898893862 (Scopus ID)
    Available from: 2014-05-09 Created: 2014-05-09 Last updated: 2018-06-07Bibliographically approved
    3. Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions
    Open this publication in new window or tab >>Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions
    2018 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 58-68Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective.

    Design: A cross-sectional design was used.

    Methods: First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy.

    Finding: The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions.

    Conclusions: The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies.

    Place, publisher, year, edition, pages
    WB Saunders, 2018
    Keywords
    nursing advocacy, Protective Nursing Advocacy Scale, psychometrics, Rasch analysis
    National Category
    Nursing
    Research subject
    Caring Sciences w. Medical Focus
    Identifiers
    urn:nbn:se:oru:diva-57127 (URN)10.1016/j.jopan.2016.10.002 (DOI)000425223700009 ()29362048 (PubMedID)2-s2.0-85011295515 (Scopus ID)
    Note

    Funding Agencies:

    Örebro University  

    Research Committee at Region Örebro County 

    Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2018-03-06Bibliographically approved
    4. Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational study
    Open this publication in new window or tab >>Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational study
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57177 (URN)
    Available from: 2017-04-24 Created: 2017-04-24 Last updated: 2017-10-18Bibliographically approved
  • 176.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational studyManuscript (preprint) (Other academic)
  • 177.
    Svensson, Margita
    Örebro University, School of Health Sciences.
    Patients´ experiences of mood while waiting for day surgery2016Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Preoperative psychological state is a major issue in day surgery; especially as patients have a short hospital stay. Except for preoperative anxiety, knowledge is sparse about how patients’ experience mood during waiting for day surgery.

    The overall aim of this thesis was to describe preoperative moods, persons’ experiences of preoperative mood, and the experiences persons´ describe as having an influence on their preoperative waiting.

    In study І, mixed methods were used. Data from 163 participants were collected through a study-specific questionnaire. In study ІІ, a qualitative method was used. Data from 20 participants were collected through semi-structured interviews. All participants (n=183) were waiting for small or medium surgery within four different specialties’ (I, II). Data were analysed with descriptive statistics and thematic content analysis (І) and inductive content analysis (ІІ).

    The main finding was that preoperative patients experience a variety of moods, besides anxiety patients may experience a positive mood. Moodinfluencing factors while waiting for day surgery were found. Patients may experience a shifting mood or to not feel calm, while other patients may feel calm, and experience a harmonious mood. Nearly half of the participants felt calm before surgery, as seventy persons (43 %) stated that they felt calm, whereas 91 persons (57%) stated that they did not feel calm (І). Previous negative experiences from health care were confirmed as a trigger for anxiety. Earlier positive experiences, feelings of trust and expectations contribute to a harmonious mood and to feel calm. Regard-less of mood, patients´ experienced feeling hope about regaining health as a help to balance mood (I-II).

    The findings contribute to knowledge about different preoperative moods and may have implications in improving preoperative care with support strategies that benefits patients’ during waiting for day surgery regardless of psychological state

    List of papers
    1. Calm or not calm: the question of anxiety in the perianesthesia patient
    Open this publication in new window or tab >>Calm or not calm: the question of anxiety in the perianesthesia patient
    2008 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 23, no 4, p. 237-246Article in journal (Refereed) Published
    Abstract [en]

    Preoperative anxiety can be a major problem for the patient. Three distinct dimensions of preoperative anxiety are known: fear of the unknown, fear of feeling ill, and fear for life. The aim of this study was to investigate whether patients feel anxiety (calm or not calm) preoperatively before undergoing an elective day care surgery and also to elucidate the factors contributing to a patient's current state of mind. A prospective study with 161 American Society of Anesthesiologists I-II outpatients scheduled for elective surgery was conducted. In a questionnaire the patients were asked to state if they were feeling calm or not and to describe factors contributing to their current mood. If responding that they did not feel calm, the participants were asked to rate the level of anxiety on a Numeric Rating Scale, 1-10. The results showed that 57% (n = 91) of the participants stated that they did not feel calm. A significantly higher proportion of women did not feel calm (65%), P < .05. Significantly more participants with a previous experience of surgery felt calm (90%), P < .01. In all, 190 statements were submitted. The results show that nearly half of the participants felt calm before surgery. The reasons were earlier positive experiences, feeling of security and caring, being well-informed, and having positive expectations. Furthermore, a higher proportion of women did not feel calm preoperatively. This indicates a need before surgery to routinely document and evaluate the individual patient's state of mind and reasons for the state of mind. This individual preoperative care can make it possible to provide emotional support, decrease anxiety, and give the patient a more positive surgical experience.

    Place, publisher, year, edition, pages
    Amsterdam: Elsevier, 2008
    Keywords
    anxiety, calm, day care surgery, nursing, ambulatory surgery
    National Category
    Medical and Health Sciences Anesthesiology and Intensive Care Nursing Social Sciences Interdisciplinary
    Research subject
    Caring Sciences w. Medical Focus
    Identifiers
    urn:nbn:se:oru:diva-6996 (URN)10.1016/j.jopan.2008.05.002 (DOI)18657759 (PubMedID)2-s2.0-47649096452 (Scopus ID)
    Available from: 2009-05-28 Created: 2009-05-28 Last updated: 2018-01-13Bibliographically approved
    2. Patients’ experience of mood while waiting for day surgery
    Open this publication in new window or tab >>Patients’ experience of mood while waiting for day surgery
    2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 17-18, p. 2600-2608Article in journal (Refereed) Published
    Abstract [en]

    Aims and objectives: The aim was to describe the moods experienced by people waiting for day surgery.

    Background: Except for anxiety, there is a lack of knowledge about the moods experienced by patients while waiting for day surgery, as well as the impact of mood during the perioperative period. Preoperative anxiety is common and has multiple negative effects. A deeper knowledge of preoperative moods and how they are experienced is needed and may be useful for improving perioperative care.

    Design: Qualitative descriptive design.

    Methods: Qualitative semi-structured interviews (n = 20) with adults waiting for day surgery in a Swedish university hospital. Data were analysed with inductive content analysis.

    Results: The informants described a variety of moods and mood-influencing reasons. The main category that emerged was, ‘feeling hope about regaining health as a help to balance mood’ regardless of mood. This category was abstracted from the generic categories ‘experiencing a harmonious mood’ and ‘experiencing a shifting mood’. The subcategories were ‘feeling calm and at ease despite concerns and fear’, ‘experiencing expectation’, ‘feeling trust and confidence’, ‘shifting between expectancy and anxiety’, ‘feeling vulnerable and exposed, and ‘feeling uncertainty’.

    Conclusions: The findings contribute to the knowledge about that regardless of mood, feeling hope about regaining health may help patients to balance their mood during the waiting period.

    Relevance to clinical practice: The results can have implications with respect to developing and improving preoperative care, such as having clinicians extend offers of individual assistance and information during the waiting period to patients experiencing shifting mood. Instilling hopefulness in patients who are waiting for day surgery by means of clinical staff attitudes and interactions may help patients to develop healthy coping strategies and thereby improve their physical and emotional well-being.

    Place, publisher, year, edition, pages
    Wiley-Blackwell Publishing Inc., 2016
    Keywords
    Affect, anxiety, calm, expressed emotion, hope, nursing care, preoperative care, state of mood
    National Category
    Medical and Health Sciences Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-51934 (URN)10.1111/jocn.13304 (DOI)000388920400022 ()27349201 (PubMedID)2-s2.0-84987941984 (Scopus ID)
    Note

    Funding Agencies:

    Research Committee of Orebro County, Sweden

    Department of Health and Medicine, Orebro University

    Available from: 2016-09-01 Created: 2016-09-01 Last updated: 2017-11-21Bibliographically approved
  • 178. Thurin, Anders
    et al.
    Wennberg, Mats
    Antonov, Karolina
    Klein, Gunnar O
    Örebro University, Örebro University School of Business. Karolinska institute, Stockholm, Sweden.
    Shallow linguistic analysis of a large corpus of drug prescriptions.2002In: Health data in the information society: proceedings of MIE2002 / [ed] Surján, György; Engelbrecht, Rolf ; McNair, Peter, Amsterdam: IOS Press, 2002, Vol. 90, p. 411-415Conference paper (Refereed)
    Abstract [en]

    We report on first experiences from linguistic analyses of patient instructions from 19,8404 actual drug prescriptions regarding seven pharmaceutical products frequently prescribed in Sweden. The analysis includes expressions for amount, dose unit, dose interval, mode of administration, purpose and a few further details. Even simple processing seems useful to extract information from these short, rather formal text strings. We estimate the potential for calculation of prescribed dose from this material, and collected material gives a good starting point for more advanced linguistic analyses.

  • 179.
    Warnicke, Camilla
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Delade arenor vid förmedlade samtal via bildtelefoni.net2018In: Abstractsamling OFTI 36: Tema: Tal – Interaktion – Multimodalitet, 2018, p. 19-19Conference paper (Refereed)
    Abstract [sv]

    Bildtelefoni.net är en statlig service där en tolk förmedlar samtal mellan en person som använder svenskt teckenspråk via bildtelefon och en person som talar i "vanlig" telefon. Tolken och personen som ringer via bildtelefon delar den visuella arenan, medan tolken och personen som använder telefon delar den auditiva arenan. Vid tjänsten framhålls att användarna är de som primärt skall tala till, och med var-andra. Tolken är dock den enda som står i direkt kontakt med de båda användarna och som förmedlar samtalet. Fokus vid denna datasession kommer vara vad sam-talsdeltagarna gör relevant för varandra relaterat till de delade arenorna: den visuella arenan och den auditiva arenan i kombination, och vad som åstadkoms genom dessa praktiker.

  • 180.
    Warnicke, Camilla
    Örebro University, School of Health Sciences. University Health Care Research Centre.
    Equal Access to Make Emergency Calls: A Case for Equal Rights for Deaf Citizens in Norway and Sweden2019In: Social Inclusion, ISSN 2183-2803, E-ISSN 2183-2803, Vol. 7, no 1, p. 173-179Article in journal (Refereed)
    Abstract [en]

    It is stipulated that deaf citizens have equal right to use social services as other citizens. One social service is the access to make an emergency call. Deaf citizens who cannot hear and use a signed language to communicate have to make emergency calls in another way rather than relying on listening and speaking via a telephone. However, the possible ways to call are not the same for deaf citizens in all countries. This commentary shows that there are options dedicated for deaf citizens to make emergency alarms in both Norway and Sweden: via telephone typewriters, Short Message Service, and Video Relay Service, although the design of the respective options differs between the countries. However, it is argued that deaf citizens in Norway do not have equal access to make emergency alarms as other citizens in Norway, whereas the situation for deaf citizens in Sweden may be seen as equal compared to other citizens in Sweden, although there still are limitations.

  • 181.
    Warnicke, Camilla
    Örebro University, School of Health Sciences. Örebro University Hospital.
    När det oförutsedda händer: Dövas möjlighet att larma SOS2019Conference paper (Other academic)
  • 182.
    Warnicke, Camilla
    Örebro University, School of Health Sciences. Örebro University Hospital.
    The co-creation of communicative projects within the Swedish Video Relay Service (VRS)Manuscript (preprint) (Other academic)
  • 183.
    Warnicke, Camilla
    Örebro University, School of Health Sciences. Örebro University Hospital.
    The headset as an interactional resource in a Video Relay Interpreting (VRI) service settingManuscript (preprint) (Other academic)
  • 184.
    Warnicke, Camilla
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Tolkaspekter av interaktionen vid förmedlade samtal via bildtelefoni.net2015Conference paper (Other (popular science, discussion, etc.))
  • 185.
    Warnicke, Camilla
    Örebro University, School of Health Sciences.
    Tolkning vid förmedlade samtal via Bildtelefoni.net: interaktion och gemensamt meningsskapande2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The Swedish Bildtelefoni.net is a service that people who use Swedish Sign Language (SSL) through a video phone can call in order to get in touch with people who speak through a telephone, or vice versa. In relayed calls via the Swedish video relay service (FBT), the interlocutors have different access to the visual arena and the auditive space. They are also physically separated from each other. An interpreter, working in a studio, enables the interaction across the different media, and the interpreter is the only person who has direct contact with both users of the service. FBT has been provided in Sweden since 1996, and is administrated by The Swedish Post and Telecom Authority (PTS).

    The overall aim of the dissertation is to describe, analyse and discuss participants’ interaction and their joint construction of meaning within FBT. The theoretical and methodological frameworks for the dissertation are dialogism and Conversation Analysis (CA). The dissertation is based on twenty-five authentic calls from FBT, recorded during two periods of time: in the years 2009–2010, and in 2013. One stimulated recall is also made with one interpreter, concerning a call from the second collection. The project has been ethically approved by the Swedish Ethical Review Board.

    The interaction within FBT is dynamic and dependent on different media, modalities, resources, and also related to several conventions specific for the setting. All this influences the interlocutors, their actions as well as the entire activity. This kind of complexity has not previously been studied in the regular service. Analysis of the recordings focuses on the actions and activities of the participants who interact in the FBT, on a moment-to-moment basis. As results of the research, four phenomena are addressed, and presented as papers: I: the organisation of turns; II: the headset as an interactional resource; III: positioning and bimodal mediation with a focus on the interpreter; IV: the co-creation of communicative projects among the interlocutors. A main conclusion of the results is that the interaction is a joint construction of meaning among all of the interlocutors, although, the interpreter has a key function.

    Further research of interaction within FBT needs to be conducted, since investigations on this institutional interaction are rare despite the fact that this kind of service is widespread all over the world.

    List of papers
    1. Turn-organisation in mediated phone interaction using Video Relay Service (VRS)
    Open this publication in new window or tab >>Turn-organisation in mediated phone interaction using Video Relay Service (VRS)
    2012 (English)In: Journal of Pragmatics, ISSN 0378-2166, E-ISSN 1879-1387, Vol. 44, no 10, p. 1313-1334Article in journal (Refereed) Published
    Abstract [en]

    Technical development has created new arenas of communication for people. One such arena is the Video Relay Service (VRS). The VRS facilitates interaction between people who use visual/gestual sign language on a video phone, and people who use verbal/auditive language on the telephone/mobile phone. The interaction is mediated by a sign language interpreter. The interpreter is the only person in the setting who is directly linked to the others, and all participants are physically separated fromeach other. The interpreter plays a key role in the interaction, administratingandco-ordinatingthe talk. In order to doso, the interpreter usesarange of different techniques andstrategies. It is the purpose of the current article to describe, analyse and discuss the turn-organisation of the VRS. The article demonstrates how the interpreter is a power figure, who may sanction or not sanction an utterance. The interpreter also manages the turn-taking machinery by means of visible and audible techniques, as well as rendition strategies. The interpreter is not only a mediator, but a co-creator of the interaction; a part that relates dynamically, and makes the participants relate dynamically, to the specific setting of the service.

    Place, publisher, year, edition, pages
    Amsterdam, Netherlands: Elsevier, 2012
    Keywords
    Sign language interpreting, turn-organisation, turn-taking, computer-mediated communication, language and technology, video relay service (VRS)
    National Category
    Humanities Communication Studies
    Research subject
    Linguistics
    Identifiers
    urn:nbn:se:oru:diva-40311 (URN)10.1016/j.pragma.2012.06.004 (DOI)000307686200012 ()
    Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2018-05-14Bibliographically approved
    2. The headset as an interactional resource in a Video Relay Interpreting (VRI) service setting
    Open this publication in new window or tab >>The headset as an interactional resource in a Video Relay Interpreting (VRI) service setting
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57833 (URN)
    Available from: 2017-05-24 Created: 2017-05-24 Last updated: 2017-10-18Bibliographically approved
    3. The positioning and bimodal mediation of the interpreter in a Video Relay Interpreting (VRI) service setting
    Open this publication in new window or tab >>The positioning and bimodal mediation of the interpreter in a Video Relay Interpreting (VRI) service setting
    2016 (English)In: Interpreting, ISSN 1384-6647, E-ISSN 1569-982X, Vol. 18, no 2, p. 198-230Article in journal (Refereed) Published
    Abstract [en]

    This study explores the interpreter’s positioning in a Video Relay Interpreting (VRI) service that offers bimodal mediation between people using Swedish Sign Language (SSL) and people using spoken Swedish. Positioning subsumes the ways in which interpreters orient themselves to the contingencies of the setting on a moment-by-moment basis, in relation to the impact of technology, participants’ knowledge asymmetries (e.g., prior experience of VRI), their physical separation, and the need for two arenas (visual and auditive). The interpreting is bimodal, each of the two users being in direct contact with the interpreter through a different medium (telephone for one, videophone for the other). Nine excerpts from two calls within the VRI service serve as examples to show how the interpreter’s positioning emerges dynamically in relation to contingent variables of the setting, such as the initial importance of briefing users on the service, temporary loss of sound and image, the perceived need to inform either user of extralinguistic items, or situational awareness that it is time to conclude the interaction. This new research perspective on VRI can afford a better understanding of its moment-by-moment complexity and specificities, thus helping improve it and train interpreters better for it.

    Place, publisher, year, edition, pages
    Amsterdam, Netherlands: John Benjamins Publishing Company, 2016
    Keywords
    Video Relay Service (VRS), positioning, signed language, role, Video Relay Interpreting (VRI)
    National Category
    Media and Communications
    Identifiers
    urn:nbn:se:oru:diva-53659 (URN)10.1075/intp.18.2.03war (DOI)000392926700003 ()2-s2.0-84992747290 (Scopus ID)
    Note

    Funding Agencies:

    bildtelefoni.net Region Örebro County

    University Health Care Research Center, Region Örebro County

    Available from: 2016-11-28 Created: 2016-11-28 Last updated: 2017-11-29Bibliographically approved
    4. The co-creation of communicative projects within the Swedish Video Relay Service (VRS)
    Open this publication in new window or tab >>The co-creation of communicative projects within the Swedish Video Relay Service (VRS)
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57834 (URN)
    Available from: 2017-05-24 Created: 2017-05-24 Last updated: 2017-10-18Bibliographically approved
  • 186.
    Warnicke, Camilla
    Örebro University, School of Health Sciences.
    Tolkning vid förmedlade samtal via Bildtelefoni.net: Interaktion och gemensamt meningsskapande2018Other (Other (popular science, discussion, etc.))
  • 187.
    Wennberg, Pär
    Örebro University, School of Health Sciences.
    Pain management in older persons with hip fractures2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to evaluate the preoperative management of pain from the perspectives of a literature overview, emergency medical service pain management, an intervention with a fascia iliaca compartment block and the association between cognitive status and the treatment of pain. Paper 1 is an integrative review of the literature on emergency care in patients with hip fractures or suspected hip fractures. Pain is a major problem for patients suffering a hip fracture when waiting for surgery and it is challenging for health care to provide sufficient pain relief. Listening to the patient’s narrative and the mandatory use of pain scales and pain documentation are necessary to deepen our understanding of individual patients’ needs. Paper 2 is a prospective observational study that explored the prehospital pain levels in 1,426 patients with suspected hip fractures. Furthermore, this study evaluated prehospital pain management. At the site of the injury, patients with hip fractures are often in substantial pain. Seventy-five per cent of the patients received pain relief from the emergency medical service (EMS) care providers and the pain relief was often effective. Several of the patients that did not receive prehospital pain relief had moderate to severe pain. Paper 3 is a randomised placebo-controlled double-blind trial (RCT) of 127 patients waiting for surgery. This RCT evaluated the effect of fascia iliaca compartment blocks (FICB) in relation to pain and medical pain relief, when added to regular preoperative analgesia. FICB improved pain relief when compared with regular analgesia alone (p=0.002). Paper 4 examined whether preoperative pain management with FICB could have an effect on cognitive status in the same 127 patients that were included in Paper 3. No impact on cognitive impairment was proven in this study. Patients with severe cognitive impairment received significantly lower doses of prehospital morphine than patients with higher cognitive status. Prehospital and hospital pain management need to improve. Pain management is especially challenging in persons with cognitive impairment.

    List of papers
    1. Patients with suspected hip fracture in the chain of emergency care: An integrative review of the literature
    Open this publication in new window or tab >>Patients with suspected hip fracture in the chain of emergency care: An integrative review of the literature
    2018 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 29, p. 16-31Article, review/survey (Refereed) Published
    Place, publisher, year, edition, pages
    Elsevier, 2018
    Keywords
    Hip fractures, Pain, Pain assessment, Pain management, Cognitive impairment, Emergency care
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy Nursing
    Identifiers
    urn:nbn:se:oru:diva-67032 (URN)10.1016/j.ijotn.2017.11.002 (DOI)000432461300004 ()29631852 (PubMedID)2-s2.0-85046756618 (Scopus ID)
    Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2019-09-25Bibliographically approved
    2. Evaluation of the intensity and management of pain before arrival in hospital among 3 patients with suspected hip fractures
    Open this publication in new window or tab >>Evaluation of the intensity and management of pain before arrival in hospital among 3 patients with suspected hip fractures
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-76738 (URN)
    Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2019-09-25Bibliographically approved
    3. Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial
    Open this publication in new window or tab >>Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial
    Show others...
    2019 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 33, p. 35-43Article in journal (Refereed) Published
    Abstract [en]

    Introduction: Pain management in patients with hip fractures is a major challenge for emergency care. The objective of this study was to evaluate whether the supplementation of pre-operative analgesia with low-dose fascia iliaca compartment block (FICB) compared with placebo would improve pain relief in patients with hip fractures.

    Methods: A double-blind, randomized, controlled trial was conducted on 127 patients. At hospital admission, a low-dose FICB was administered to patients with hip fractures as a supplement to regular pre-operative analgesia. Patients with and without cognitive impairment were included. The instruments used were a visual analogue scale (VAS), a numerical rating scale and a tool for behavior related pain assessment. The primary endpoint was the change in reported pain on movement from hospital admission to two hours after FICB.

    Results: The intervention group showed improved pain management by mean VAS score for pain on movement compared with the control group (p = 0.002).

    Conclusions: Our results support the use of low-dose FICB as a pain-relieving adjuvant to other analgesics when administered to patients with a hip fracture.

    Place, publisher, year, edition, pages
    Elsevier, 2019
    Keywords
    Hip fractures, Pain, Nerve block, Pain management, Fascia iliaca compartment block, Analgesia
    National Category
    Nursing
    Identifiers
    urn:nbn:se:oru:diva-74410 (URN)10.1016/j.ijotn.2018.11.003 (DOI)000467622900006 ()30876869 (PubMedID)2-s2.0-85065780869 (Scopus ID)
    Note

    Funding Agency:

    Skaraborg Hospital - Örebro County Council

    Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-09-25Bibliographically approved
    4. Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures: effects on cognition
    Open this publication in new window or tab >>Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures: effects on cognition
    2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, no 1, article id 252Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period.

    METHODS: One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire.

    RESULTS: Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures.

    CONCLUSION: Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies.

    TRIAL REGISTRATION: EudraCT number 2008-004303-59 date of registration: 2008-10-24.

    Place, publisher, year, edition, pages
    BioMed Central, 2019
    Keywords
    Cognitive impairment, Cognitive status, Hip fractures, Nerve block, Pain, Pain management, Perioperative care
    National Category
    Orthopaedics Geriatrics
    Identifiers
    urn:nbn:se:oru:diva-76426 (URN)10.1186/s12877-019-1266-0 (DOI)000485322000002 ()31510918 (PubMedID)2-s2.0-85072099268 (Scopus ID)
    Note

    Funding Agencies:

    Region Örebro County  

    Skaraborg Hospital 

    Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-10-02Bibliographically approved
  • 188.
    Wennberg, Pär
    et al.
    Örebro University, School of Health Sciences.
    Möller, Margareta
    Örebro University, School of Health Sciences.
    Sarenmalm, E.K.
    Herlitz, J.
    Evaluation of the intensity and management of pain before arrival in hospital among 3 patients with suspected hip fracturesManuscript (preprint) (Other academic)
  • 189.
    Widehammar, Cathrine
    et al.
    Örebro University, School of Health Sciences. Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Lidström, Helene
    Department of Social and Welfare Studies, Faculty of Medicine, Linköping University, Linköping, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Environmental barriers to participation and facilitators for use of three types of assistive technology devices2017In: MEC 2017 - A Sense of What´s to Come: Myoelectric Controls and Upper Limb Prosthetics Symposium, Fredericton, New Brunswick, Canada: University of New Brunswick , 2017, p. 36-36Conference paper (Refereed)
  • 190.
    Widehammar, Cathrine
    et al.
    Örebro University, School of Health Sciences. Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Lidström, Helene
    Department of Social and Welfare Studies, Faculty of Medicine, Linköping University, Linköping, Sweden.
    Hermansson, Liselotte
    Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Department of Prosthetics and Orthotics, Örebro University Hospital, Örebro, Sweden.
    Environmental barriers to participation and facilitators for use of three types of assistive technology devices2017In: Nobelday Festivities Orebro University, 2017Conference paper (Refereed)
    Abstract [en]

    Background: In rehabilitation, assistive technology (AT) is prescribed in order to improve activity and participation for individuals with disability. Research shows that many devices are not used to the extent or to the benefits expected. The aim of this study was to compare the presence of environmental barriers to participation and facilitators for AT use and study the relation between barriers and AT use in three different types of AT devices.

    Methods: A cross-sectional survey was conducted. Inclusion criteria were: ≥1 year experience as user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. The survey contained the Swedish version of Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire focusing on facilitating factors. Overall, 156 participants answered the survey. Non-parametric tests were used for comparisons.

    Results: Barriers to participation were significantly lowest in MEP users (md=0.12; p<0.001), and highest in ATC users (md=1.56; p<0.001-p=0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r=0.30, p=0.038). Compared to the other groups, users of ATC with more use reported more barriers for participation. The greatest barriers to participation were: Natural environment, Surroundings, and, Information. Most support came from Relatives and Professionals.

    Conclusions: There is a difference in how users of different AT devices experience the environment in terms of barriers for participation and facilitators for use. The environment may facilitate AT use but barriers in the environment can still restrict participation in AT users. Future research should comprise the influence of AT use on participation.

  • 191.
    Widehammar, Cathrine
    et al.
    Örebro University, School of Health Sciences. Department of Pediatrics, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden; University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Lidström, Helene
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Department of Prosthetics and Orthotics , Örebro University , Örebro , Sweden.
    Environmental barriers to participation and facilitators for use of three types of assistive technology devices2019In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 31, no 2, p. 68-76Article in journal (Refereed)
    Abstract [en]

    The aim was to compare the presence of environmental barriers to participation and facilitators for assistive technology (AT) use and study the relation between barriers and AT use in three different AT devices. A cross-sectional survey was conducted. Inclusion criteria were ?one year of experience as a user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. Overall, 156 participants answered the Swedish version of the Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire on facilitating factors. Non-parametric tests were used for comparisons. Barriers to participation were lowest in MEP users (md = 0.12; p < 0.001), and highest in ATC users (md = 1.56; p < 0.001) with the least support for AT use (p < 0.001 - p = 0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r = 0.30, p = 0.038). The greatest barriers to participation were Natural environment, Surroundings and Information, and the most support came from Relatives and Professionals. Support, training and education are vital in the use of AT. These factors may lead to a more sustained and prolonged use of AT and may enable increased participation. Future research should focus on interventions that meet the needs of people with cognitive disabilities.

  • 192.
    Widehammar, Cathrine
    et al.
    Örebro University, School of Health Sciences. Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre.
    Pettersson, Ingvor
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Attitudes is the most important environmental factor for use of powered mobility devices - users' perspectives2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed)
    Abstract [en]

    Introduction: Different factors in the environment influence the use of powered wheelchairs or powered scooters, i.e. powered mobility devices (PMDs), but there is limited knowledge about how these factors interact and if any factor has a greater impact. According to the ICF the environment consists of five areas.

    Aim: To describe users' experiences of how environmental factors from all ICF areas influence the use of PMDs.

    Methods: Descriptive qualitative design including 14 interviews with PMD users, analyzed using inductive qualitative content analysis.

    Findings: Use of PMDs means a conditional freedom depending on the interaction of several environmental factors. Regardless of environmental factor the societal attitudes were always present, directly or indirectly, and influenced the participants' feeling of being included and involved in society. The environmental factors and how they influence PMD use are described in four categories, comprising the following subjects: societal attitudes, the service delivery process, accessibility to the physical environment and financial resources.

    Conclusion: The findings show that societal attitudes influence all other factors, directly by others people's attitudes, or indirectly by how legislation and guidelines are formulated, interpreted and applied. Therefore, a change of societal attitudes seems necessary to increase accessibility and participation for PMD users.

  • 193.
    Wijk, Helle
    et al.
    Chalmers University of Technology, Gothenburg, Sweden.
    Malmqvist, Inga
    Chalmers University of Technology, Gothenburg, Sweden.
    Pettersson, Cecilia
    Chalmers University of Technology, Gothenburg, Sweden.
    Space for housing and care: a study protocol2017In: Proceedings of the International Conference on Advances on Sustainable Cities and Buildings Development, Green Lines Institute, 2017Conference paper (Refereed)
  • 194.
    Wistrand, Camilla
    Örebro University, School of Health Sciences.
    Swedish operating room nurses preventive interventions to reduce bacterial growth, surgical site infections, and increase comfort in patients undergoing surgery2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Surgical site infection is a major postoperative complication that causes patient suffering and is costly for society. The general aim of this thesis was to test and describe interventions performed by operating room (OR) nurses to prevent bacterial growth in surgical patients, with the intent to prevent surgical site infections (SSIs) whilst increase patients comfort.

    In studies I and II, 220 pacemaker patients were tested to compare pre-heated skin disinfection with room-temperature skin disinfection regard-ing bacterial growth, skin temperature and patient experience. Preheated skin disinfection was not less effective compared to room-temperature skin disinfection in reducing bacterial growth after skin disinfection and there were no differences regarding SSIs three month postoperatively. Preheated skin disinfection reduces skin heat loss and was perceived as more pleas-ant compared to room-temperature skin disinfection.

    In study III, 12 OR nurses were examined regarding bacterial growth on their hands and at the sterile glove cuff end after surgical hand disinfec-tion and again after wearing sterile surgical gloves during surgery. They were compared with a control group of 13 non-health care workers. OR nurses’ hands had higher amounts of bacterial growth at two of three culture sites after surgical hand disinfection compared with the control group, and the bacterial growth increased in both groups with time during surgery. There seems to be a risk of bacterial growth at the glove cuff end during surgery, involving the same type of bacteria as isolated from the hands.

    In study IV, 890 OR nurses answered an online questionnaire describ-ing OR nurses interventions guided by national guidelines to reduce SSIs, such as preparation of the patient skin, patient temperature, and OR ma-terials used. The proportion of the OR nurses who complied with the national guidelines preventive interventions was high: skin disinfection solution (93.5%), drapes (97.4%) and gowns (83.8%), and double gloves (73%). However, when guidelines were lacking the interventions differed.

    List of papers
    1. The effect of preheated versus room-temperature skin disinfection on bacterial colonization during pacemaker device implantation: a randomized controlled non-inferiority trial
    Open this publication in new window or tab >>The effect of preheated versus room-temperature skin disinfection on bacterial colonization during pacemaker device implantation: a randomized controlled non-inferiority trial
    2015 (English)In: Antimicrobial Resistance and Infection Control, ISSN 2047-2994, E-ISSN 2047-2994, Vol. 4, article id 44Article in journal (Refereed) Published
    Abstract [en]

    Background: In clinical practice, patients who are awake often comment that cold surgical skin disinfectant is unpleasant. This is not only a problem of patients’ experience; heat loss during the disinfection process is a problem that can result in hypothermia. Evidence for the efficacy of preheated disinfection is scarce. We tested whether preheated skin disinfectant was non-inferior to room-temperature skin disinfectant on reducing bacterial colonization during pacemaker implantation.

    Methods: This randomized, controlled, non-inferiority trial included 220 patients allocated to skin disinfection with preheated (36 °C) or room-temperature (20 °C) chlorhexidine solution in 70 % ethanol. Cultures were obtained by swabbing at 4 time-points; 1) before skin disinfection (skin surface), 2) after skin disinfection (skin surface), 3) after the incision (subcutaneously in the wound), and 4) before suturing (subcutaneously in the wound).

    Results: The absolute difference in growth between patients treated with preheated versus room-temperature skin disinfectant was zero (90 % CI −0.101 to 0.101; preheated: 30 of 105 [28.6 %] vs. room-temperature: 32 of 112 [28.6 %]). The pre-specified margin for statistical non-inferiority in the protocol was set at 10 % for the preheated disinfectant. There were no significant differences between groups regarding SSIs three month postoperatively, which occurred in 0.9 % (1 of 108) treated with preheated and 1.8 % (2 of 112) treated with room-temperature skin disinfectant.

    Conclusion: Preheated skin disinfection is non-inferior to room-temperature disinfection in bacterial reduction. We therefore suggest that preheated skin disinfection become routine in clean surgery.

    Place, publisher, year, edition, pages
    London, United Kingdom: BioMed Central, 2015
    Keywords
    Perioperative, Skin disinfection, Bacterial growth, Non-inferiority
    National Category
    Medical and Health Sciences Nursing
    Research subject
    Caring Sciences w. Medical Focus
    Identifiers
    urn:nbn:se:oru:diva-46423 (URN)10.1186/s13756-015-0084-1 (DOI)000367371700001 ()26539295 (PubMedID)2-s2.0-85006223174 (Scopus ID)
    Note

    Funding Agencies:

    Örebro County Council Research Committee, Örebro, Sweden

    Örebro University

    Available from: 2015-11-04 Created: 2015-11-04 Last updated: 2018-09-04Bibliographically approved
    2. Positive impact on heat loss and patient experience of preheated skin disinfection: a randomised controlled trial
    Open this publication in new window or tab >>Positive impact on heat loss and patient experience of preheated skin disinfection: a randomised controlled trial
    2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 21-22, p. 3144-3151Article in journal (Refereed) Published
    Abstract [en]

    Aims and objectives: The aim of this study was to compare the effect of preheated (36 °C) and room-temperature (20 °C) skin disinfectant solution on skin temperature and patients' experience of the skin disinfection process.

    Background: To prevent surgical site infections, it is important to disinfect skin prior to invasive surgery. In clinical practice, conscious patients often comment on the coldness of the preoperative skin disinfection solution. Evidence is lacking, as to whether preheated skin disinfectant has any positive effects during preoperative skin disinfection.

    Design: Randomised controlled trial.

    Methods: A total of 220 patients undergoing pacemaker, implantable cardioverter-defibrillator, or cardiac resynchronisation therapy under local anaesthesia were included and randomly allocated to preheated or room-temperature skin disinfection. Skin temperature was assessed before and after skin disinfection at the planned incision site; in addition, three study-specific questions were used to assess how patients experienced the temperature.

    Results: Patients experienced the skin disinfection process with preheated disinfectant as significantly more pleasant. They felt less cold and reported increased satisfaction with the temperature of the solution compared to patients who were disinfected with room-temperature solution. Skin disinfection with preheated solution also yielded a significantly higher mean skin temperature compared to room-temperature solution.

    Conclusions: Preoperative skin disinfection with preheated disinfectant may prevent heat loss and contributes to a more pleasant experience for patients.

    Relevance to clinical practice: Skin disinfection with preheated skin disinfectant is an easy and inexpensive nursing intervention that has a positive impact on heat loss and on patients' experience of the disinfection process.

    Place, publisher, year, edition, pages
    Wiley-Blackwell Publishing Inc., 2016
    Keywords
    Experience, intraoperative, perioperative, randomised controlled trial, skin disinfection, temperature
    National Category
    Dermatology and Venereal Diseases Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-50606 (URN)10.1111/jocn.13263 (DOI)000388922700006 ()27256458 (PubMedID)2-s2.0-84973308967 (Scopus ID)
    Note

    Funding Agency:

    Örebro County Council

    Available from: 2016-06-08 Created: 2016-06-08 Last updated: 2017-11-30Bibliographically approved
    3. Bacterial growth and recolonization after preoperative hand disinfection and surgery: a pilot study
    Open this publication in new window or tab >>Bacterial growth and recolonization after preoperative hand disinfection and surgery: a pilot study
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-61555 (URN)
    Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2017-10-16Bibliographically approved
    4. National survey of operating room nurses’ aseptic techniques and interventions to reduce surgical site infections
    Open this publication in new window or tab >>National survey of operating room nurses’ aseptic techniques and interventions to reduce surgical site infections
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-61556 (URN)
    Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2017-10-16Bibliographically approved
  • 195.
    Wistrand, Camilla
    et al.
    Örebro University, School of Health Sciences.
    Falk-Brynhildsen, Karin
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    National survey of operating room nurses’ aseptic techniques and interventions to reduce surgical site infectionsManuscript (preprint) (Other academic)
  • 196.
    Wistrand, Camilla
    et al.
    Örebro University, School of Health Sciences.
    Söderquist, Bo
    Örebro University, School of Medical Sciences.
    Falk-Brynhildsen, Karin
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Bacterial growth and recolonization after preoperative hand disinfection and surgery: a pilot studyManuscript (preprint) (Other academic)
  • 197.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Beyond foodscapes – the importance of health geography and the built environment: Part of symposium called Food Systems for nutrition and health: Growing, shopping, cooking and eating2013Conference paper (Refereed)
  • 198.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Debate Public Health Nutrition vs Personalized Nutrition2013Conference paper (Refereed)
1234 151 - 198 of 198
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