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  • 51.
    Forslund, Kerstin
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden.
    Kihlgren, Annica
    Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; CECAR, Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Mona
    Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; CECAR, Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    Operators' experiences of emergency calls2004Inngår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 10, nr 5, s. 290-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, the operators at emergency dispatch centres are responsible for allocating resources (e.g. ambulances, fire brigade, police) in response to calls. We analysed situations that the emergency operators experienced as difficult and their reflections on how they managed them. Interviews were conducted with all 16 emergency operators at a centre that serves a population of 275,000 and receives about 700,000 emergency calls annually. A phenomenological-hermeneutic approach was used for the analysis. Situations that operators experienced as difficult were characterized by uncertainty, communication difficulties and insufficient resources. Skills, knowledge and experience were regarded as important in the management of these situations, as were personal qualities such as sensitivity, insight, empathy and intuition. The emergency operators stated that they needed more guidance, feedback and education in their work. This would lead to an increased sense of certainty, which would lead to decreased stress and a better outcome for those in need.

  • 52.
    Gustafsson, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Konsekvenser av en akut traumatisk handskada: en prospektiv studie av patientens situation under det första året efter olyckan2003Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of the research project was to investigate the consequences of an acute traumatic hand injury during the first year after the accident. The project involved 112 patients with acute traumatic hand injuries requiring inpatient hand-surgical treatment. The majority of the patients were men. Most of them were injured at home or at their usual place of work. The hand injuries differed in degree of severity. Nearly one third of the patients had amputations.

    The project comprised two qualitative and two quantitative studies. Data for the qualitative studies were obtained by interviews with a theoretical sample of 20 patients between 8 and 20 days after the accident. Data for the quantitative studies were obtained from a consecutive sample of patients by means of questionnaires answered 1-2 weeks, three months and one year after the accident. All 112 patients participated in the first and 91 patients in all three assessments. The questionnaires included were the Impact of Event Scale (IES) for measuring trauma-related distress, the Hospital Anxiety and Depression scale (HAD) for measuring mood disorders and study-specific questions for measuring problems experienced. Information about injuries and accidents was obtained from the patients’ medical records.

    The results of the studies showed that psychological problems were frequent the first weeks after the injury and related to consequences of both the injury and the traumatic experience. Nearly half of the patients had symptoms of traumatic stress and one third had signs of a mood disorder. Negative reactions at the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observations of the patients’ reactions when the dressing is changed might help to identify those in need of psychological support in the early stage. One third still had increased levels of traumatic stress symptoms and one out of ten had signs of a mood disorder in the one-year follow-up.

    The first weeks after the accident more than half of the patients reported substantially limited physical function and had a need for help with activities of vital importance in everyday life. Troublesome pain was felt by one third of the patients. Most patients experienced significant improvement during the first three months. One year after the accident the majority of the patients had slight or moderate physical limitations. Only one out of five experienced no limitations at all. One out of seven reported troublesome pain. Patients with amputations had more pain than others both the first weeks and one year after the accident.

    About 16 % were on the sick-list one year after the accident. Half of the patients back at work experienced a worse work-situation as a result of the injury. One third of all patients experienced a worse life-situation. A worse life-situation was experienced not only by patients at the sick-list but also by patients back at work. Patients with amputations and blue-collar workers more often experienced a worse life-situation than others.

    In sum, this project showed how important it is that the care of patients with acute traumatic hand injuries, in addition to surgical treatment and other action for restoring function in the hand, also should include preventive action and follow-up of trauma-related distress and pain.

    Delarbeid
    1. Trauma-related distress and mood disorders in the early stage of an acute traumatic hand injury
    Åpne denne publikasjonen i ny fane eller vindu >>Trauma-related distress and mood disorders in the early stage of an acute traumatic hand injury
    2003 (engelsk)Inngår i: Journal of Hand Surgery - British and European Volume, ISSN 0266-7681, E-ISSN 1532-2211, Vol. 28B, nr 4, s. 332-338Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The aim of the study was to estimate the incidence of trauma-related distress and mood disorders in the early stages after acute traumatic hand injuries and identify characteristics associated with these reactions. Data were obtained from 112 patients by means of mailed questionnaires and medical records. Nearly half of the patients had increased levels of intrusive and avoidance symptoms, indicating trauma-related distress. One-third showed signs of a mood disorder. Mood disorders were associated with the need for help with activities of daily living, pain and avoidance symptoms. The study showed that emotional problems in the early stages after injury are related to the consequences of both the injury and the traumatic experience. Negative reactions to the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observation of the reactions to the sight of the hand could help to identify patients in need of psychological support.

    Emneord
    Activities of Daily Living/psychology, Acute Disease, Adult, Aged, Amputation; Traumatic/psychology/surgery, Anxiety/*diagnosis/psychology, Avoidance Learning, Defense Mechanisms, Depression/*diagnosis/psychology, Female, Hand Injuries/*psychology/surgery, Humans, Logistic Models, Male, Middle Aged, Pain/psychology, Psychiatric Status Rating Scales, Questionnaires, Stress Disorders; Post-Traumatic/*diagnosis/psychology
    HSV kategori
    Forskningsprogram
    Omvårdnadsforskning med medicinsk inriktning
    Identifikatorer
    urn:nbn:se:oru:diva-4412 (URN)10.1016/S0266-7681(03)00138-4 (DOI)000184372900009 ()12849944 (PubMedID)2-s2.0-0042816236 (Scopus ID)
    Prosjekter
    Consequences of an acute traumatic hand injury
    Tilgjengelig fra: 2008-02-27 Laget: 2008-02-27 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    2. A qualitative study of stress factors in the early stage of acute traumatic hand injury
    Åpne denne publikasjonen i ny fane eller vindu >>A qualitative study of stress factors in the early stage of acute traumatic hand injury
    2000 (engelsk)Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 32, nr 6, s. 1333-1340Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The aim of the study reported in this paper was to identify stress factors in the early stage of acute traumatic hand injury. Stress factors were defined as circumstances which the hand-injured patients experienced as problems in the actual situation. A total of 20 patients, treated as inpatients at the Department of Hand Surgery in Orebro Medical Centre Hospital, Sweden, were interviewed 8-20 days after the day of the accident. The analyses of the interviews followed the first step in the analytical process described in a modified model of grounded theory. The trauma experience was one of the stress factors in the early stage. Single acute traumatic stress symptoms, mostly involuntary recollection and re-experience of the trauma, were found in a fourth of the hand-injured patients. All patients reported impaired functioning caused by their hand, irrespective of injury. Practical problems with daily activities and being dependent on help from others for solving practical problems were stress factors caused by functional impairment. Before the accident most of the hand-injured had been very active, also working a lot with their hands in their leisure-time. Involuntary inactivity was a big problem for some of them. Other stress factors in the early stage were uncertainty about function in the future and pain. The appearance of the hand was a minor problem before the first follow-up visit. Probably because the hand was hidden in a bandage. However, some hand-injured felt discomfort in seeing the hand when the dressing was changed at the first follow-up visit.

    sted, utgiver, år, opplag, sider
    Oxford: Blackwell Science, 2000
    Emneord
    Activities of Daily Living, Adult, Aged, Female, Freedom, Hand Injuries/complications/*psychology, Humans, Male, Middle Aged, Pain/etiology/psychology, Stress; Psychological/*etiology, Sweden
    HSV kategori
    Forskningsprogram
    Omvårdnadsforskning med medicinsk inriktning
    Identifikatorer
    urn:nbn:se:oru:diva-4411 (URN)10.1046/j.1365-2648.2000.01630.x (DOI)000166164500022 ()11136400 (PubMedID)2-s2.0-0034574114& (Scopus ID)
    Prosjekter
    Consequences of an acute traumatic hand injury
    Tilgjengelig fra: 2008-02-27 Laget: 2008-02-27 Sist oppdatert: 2019-10-08bibliografisk kontrollert
    3. A qualitative study of coping in the early stage of acute traumatic hand injury
    Åpne denne publikasjonen i ny fane eller vindu >>A qualitative study of coping in the early stage of acute traumatic hand injury
    2002 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, nr 5, s. 594-602Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Twenty patients with acute traumatic hand injury were interviewed 8-20 days after the day of the accident. The aim of the study was to identify coping strategies, defined as thoughts or actions used by the hand-injured patients to manage stress factors and resulting emotions in the early stage. Stress factors were reported in an earlier study. The analyses of the interviews followed the first steps in the analytical process described in a modified model of grounded theory. Eleven different coping strategies were identified in the interviews. By "comparing with something worse", "positive thinking", "relying on personal capacity", "distancing" and "distracting attention" the patients tried to play down the seriousness of the problem or situation. Other coping strategies used by the hand-injured were "accepting the situation", "seeking social support", "maintaining control", "solving practical problems by oneself", "pain-relieving actions" and "active processing of the trauma experience." The findings of the study show how important it is to identify the patient's own way of coping with a stressful illness situation in order to give adequate psychosocial support.

    Emneord
    Activities of Daily Living, Acute Disease, Adaptation; Psychological, Adult, Aged, Attitude to Health, Female, Follow-Up Studies, Hand Injuries/complications/*psychology, Humans, Internal-External Control, Male, Middle Aged, Nursing Methodology Research, Problem Solving, Questionnaires, Social Support, Stress; Psychological/*etiology/*prevention & control/psychology, Sweden
    HSV kategori
    Forskningsprogram
    Omvårdnadsforskning med medicinsk inriktning
    Identifikatorer
    urn:nbn:se:oru:diva-4410 (URN)10.1046/j.1365-2702.2002.00657.x (DOI)000177748800006 ()12201886 (PubMedID)2-s2.0-0036718019 (Scopus ID)
    Prosjekter
    Consequences of an acute traumatic hand injury
    Tilgjengelig fra: 2008-02-27 Laget: 2008-02-27 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    4. Problems experienced during the first year of an acute traumatic hand injury: a prospective sudy
    Åpne denne publikasjonen i ny fane eller vindu >>Problems experienced during the first year of an acute traumatic hand injury: a prospective sudy
    2004 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, nr 8, s. 986-995Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background. Evidence-based nursing of patients with acute traumatic hand injuries treated at the hand-surgical clinic calls for knowledge about long-term implications. Aims and objectives. The aim of the study was to investigate consequences of an acute traumatic hand injury during the first year after the accident. Specifically, the objectives were to investigate changes in the experience of physical and psychological problems over time, frequencies of remaining problems and the impact of the injury on work situation and life situation 1 year after the accident.

    Design. The study was prospective and followed the patients from the first weeks to 1 year after the accident. Method. Ninety-one patients were assessed three times during the year. Each time the patients answered study-specific questions, the Impact of Event Scale and the Hospital Anxiety and Depression Scale.

    Results. Problems experienced decreased during the first 3 months but tended to remain unchanged during the rest of the year. In the 1-year follow-up, the majority of the patients experienced slight or moderate functional limitations in the hand, onethird had symptoms of trauma-related distress and one out of seven had troublesome pain. Half of the patients who had returned to work reported a worse work situation and 16% were still on the sick list. One-third of all patients considered their whole life situation to be worse as a result of the injury. Patients with amputations more often experienced a worse life situation. Blue-collar workers reported functional limitations and a worse life situation more often than white-collar workers.

    Conclusions. Patients with acute traumatic hand injuries requiring surgical treatment may experience problems, such as functional limitations, trauma-related distress and troublesome pain, with long-term implications for their work situation and life situation. Relevance to clinical practice. Caring for hand-injured patients should include, not only surgical treatment and other actions for restoring the function of the hand, but also preventive action and follow-up of trauma-related distress and pain.

    Emneord
    disability, evidence-based nursing, hand injury, outcome, pain, psychological stress
    HSV kategori
    Forskningsprogram
    Omvårdnadsforskning med medicinsk inriktning
    Identifikatorer
    urn:nbn:se:oru:diva-3088 (URN)10.1111/j.1365-2702.2004.01019.x (DOI)000224922100010 ()15533105 (PubMedID)2-s2.0-9244229494 (Scopus ID)
    Prosjekter
    Consequences of an acute traumatic hand injury
    Tilgjengelig fra: 2003-11-04 Laget: 2003-11-04 Sist oppdatert: 2017-12-14bibliografisk kontrollert
  • 53.
    Gustafsson, Margareta
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ahlström, Gerd
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre for Nursing Research,Örebro University Hospital,Örebro, Sweden.
    Problems experienced during the first year of an acute traumatic hand injury: a prospective sudy2004Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, nr 8, s. 986-995Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. Evidence-based nursing of patients with acute traumatic hand injuries treated at the hand-surgical clinic calls for knowledge about long-term implications. Aims and objectives. The aim of the study was to investigate consequences of an acute traumatic hand injury during the first year after the accident. Specifically, the objectives were to investigate changes in the experience of physical and psychological problems over time, frequencies of remaining problems and the impact of the injury on work situation and life situation 1 year after the accident.

    Design. The study was prospective and followed the patients from the first weeks to 1 year after the accident. Method. Ninety-one patients were assessed three times during the year. Each time the patients answered study-specific questions, the Impact of Event Scale and the Hospital Anxiety and Depression Scale.

    Results. Problems experienced decreased during the first 3 months but tended to remain unchanged during the rest of the year. In the 1-year follow-up, the majority of the patients experienced slight or moderate functional limitations in the hand, onethird had symptoms of trauma-related distress and one out of seven had troublesome pain. Half of the patients who had returned to work reported a worse work situation and 16% were still on the sick list. One-third of all patients considered their whole life situation to be worse as a result of the injury. Patients with amputations more often experienced a worse life situation. Blue-collar workers reported functional limitations and a worse life situation more often than white-collar workers.

    Conclusions. Patients with acute traumatic hand injuries requiring surgical treatment may experience problems, such as functional limitations, trauma-related distress and troublesome pain, with long-term implications for their work situation and life situation. Relevance to clinical practice. Caring for hand-injured patients should include, not only surgical treatment and other actions for restoring the function of the hand, but also preventive action and follow-up of trauma-related distress and pain.

  • 54.
    Gustafsson, Margareta
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Hand Surgery, O.rebro University Hospital, Örebro, Sweden.
    Amilon, Anders
    Örebro University Hospital.
    Ahlström, Gerd
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Trauma-related distress and mood disorders in the early stage of an acute traumatic hand injury2003Inngår i: Journal of Hand Surgery - British and European Volume, ISSN 0266-7681, E-ISSN 1532-2211, Vol. 28B, nr 4, s. 332-338Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to estimate the incidence of trauma-related distress and mood disorders in the early stages after acute traumatic hand injuries and identify characteristics associated with these reactions. Data were obtained from 112 patients by means of mailed questionnaires and medical records. Nearly half of the patients had increased levels of intrusive and avoidance symptoms, indicating trauma-related distress. One-third showed signs of a mood disorder. Mood disorders were associated with the need for help with activities of daily living, pain and avoidance symptoms. The study showed that emotional problems in the early stages after injury are related to the consequences of both the injury and the traumatic experience. Negative reactions to the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observation of the reactions to the sight of the hand could help to identify patients in need of psychological support.

  • 55.
    Gustafsson, Margareta
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Orthopaedic Surgery, Department of Hand Surgery, Örebro University Hospital, Örebro, Sweden; Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden.
    Persson, Lars-Olof
    Associate Professor/Senior Lecturer, Department of Nursing, University of Gothenburg, Gothenburg, Sweden.
    Amilon, Anders
    Head of the Department of Hand Surgery, Örebro University Hospital, Örebro, Sweden.
    A qualitative study of coping in the early stage of acute traumatic hand injury2002Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, nr 5, s. 594-602Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Twenty patients with acute traumatic hand injury were interviewed 8-20 days after the day of the accident. The aim of the study was to identify coping strategies, defined as thoughts or actions used by the hand-injured patients to manage stress factors and resulting emotions in the early stage. Stress factors were reported in an earlier study. The analyses of the interviews followed the first steps in the analytical process described in a modified model of grounded theory. Eleven different coping strategies were identified in the interviews. By "comparing with something worse", "positive thinking", "relying on personal capacity", "distancing" and "distracting attention" the patients tried to play down the seriousness of the problem or situation. Other coping strategies used by the hand-injured were "accepting the situation", "seeking social support", "maintaining control", "solving practical problems by oneself", "pain-relieving actions" and "active processing of the trauma experience." The findings of the study show how important it is to identify the patient's own way of coping with a stressful illness situation in order to give adequate psychosocial support.

  • 56.
    Hagelin, Elisabeth
    et al.
    Department of Women's and Children's Health, Unit of Paediatrics, Uppsala University Children's Hospital, Uppsala, Sweden.
    Jackson, Karin
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Wikblad, Karin
    Falun College of Health and Caring Sciences, Falun, Sweden.
    Utilization of Child Health Services during the first 18 months of life: aspects of health surveillance in Swedish preschool children based on information in health records1998Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 87, nr 9, s. 996-1002Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to evaluate some aspects of care given within the preventive Child Health Services (CHS) during the first 18 months of Life. A national random sample performed on child health records of 172 Swedish preschool children horn between 1982 and 1987 was analysed regarding services recorded as having been provided and used within and beyond the national programme of health surveillance. Most families had mode visits within the core programme of health surveillance to an optimal or at least sufficient extent. First-time parents visited the CHS more frequently than did more experienced parents. Procedures within the programme, such as growth monitoring, hip examination and immunizations, were documented to have been optimally performed on a majority of the children. Conversely, screening for hearing impairment and assessment of developmental milestones were performed less frequently, as were health information and postnatal parental education. To improve the quality of care, national recommendations ought to be more specific regarding both the performance and the documentation of the service.

  • 57.
    Holmefur, Marie
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Krumlinde-Sundholm, Lena
    Karolinska Institutet.
    Eliasson, Ann-Christin
    Interrater and intrarater reliability of the Assisting Hand Assessment2007Inngår i: American Journal of Occupational Therapy, ISSN 0272-9490, Vol. 61, nr 1, s. 79-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate interrater and intrarater reliability for the Assisting Hand Assessment.

    METHOD: For interrater reliability, two designs were used: 2 occupational therapists rated the same 18 children, and 20 occupational therapists rated the same 8 children. For intrarater reliability, 20 raters each rated one child twice. Both English and Swedish versions of the instrument were used. Intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) were calculated.

    RESULTS: ICCs for the sum score for the interrater were 0.98 (two raters) and 0.97 (20 raters) and for the intrarater 0.99. SEM was 1.5 for interrater and 1.2 for the intrarater study, which gave an error interval of +/-3 raw scores for interrater and +/- 2.4 raw scores for intrarater.

    CONCLUSION: This study shows excellent interrater and intrarater reliability for sum scores.

  • 58.
    Hurtig Wennlöf, Anita
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Cardiovascular risk factors in children2005Doktoravhandling, med artikler (Annet vitenskapelig)
    Delarbeid
    1. Sampling procedure, participation rates and representativeness in the Swedish part of the European Youth Heart Study (EYHS)
    Åpne denne publikasjonen i ny fane eller vindu >>Sampling procedure, participation rates and representativeness in the Swedish part of the European Youth Heart Study (EYHS)
    2003 (engelsk)Inngår i: Public Health Nutrition, ISSN 1368-9800, Vol. 6, nr 3, s. 291-299Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVE:

    The European Youth Heart Study (EYHS) is a cross-sectional, school-based population study on risk factors for future cardiovascular disease in children, with an overall participation rate in Sweden of about 50%. To study the representativeness of the participants in the Swedish part of EYHS, a comprehensive non-participant follow-up study was carried out.

    DESIGN:

    A structured multilevel analysis model was developed, addressing each level in the sampling procedure. The income, educational and occupational categories of the geographical regions of the study (level I), school catchment areas (level II) and parents (level III) were compared with official data. Participating and non-participating pupils (level IV) were compared through a questionnaire.

    SETTING:

    Thirty-seven state schools in two regions of Central Sweden (Orebro and southern Stockholm) were visited during the school year 1998/1999.

    SUBJECTS:

    Boys and girls aged 9 and 15 years were randomly sampled through a multiphase sampling procedure.

    RESULTS:

    Data for socio-economic status for levels I and II corresponded well to national and regional official data. At level III, non-manually working parents were slightly over-represented among parents of participating children. At level IV, non-participating subjects corresponded in most respects to participants with a few exceptions--mainly more interest in physical exercise among participants.

    CONCLUSIONS:

    Based on the knowledge from the non-participant study, we do not foresee problems regarding interpretation of the outcomes in the EYHS, despite the low participation rate.

    Emneord
    Adolescent, Cardiovascular Diseases/*etiology, Child, Cross-Sectional Studies, Europe, Female, Follow-Up Studies, Health Surveys, Humans, Male, Population Surveillance, Risk Factors, Sample Size, Sampling Studies, Schools, Socioeconomic Factors, Sweden
    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-4206 (URN)10.1079/PHN2002425 (DOI)12740078 (PubMedID)
    Tilgjengelig fra: 2007-12-05 Laget: 2007-12-05 Sist oppdatert: 2020-01-29bibliografisk kontrollert
    2. Serum lipids, glucose and insulin levels in healthy schoolchildren aged 9 and 15 years from Central Sweden: reference values in relation to biological, social and lifestyle factors
    Åpne denne publikasjonen i ny fane eller vindu >>Serum lipids, glucose and insulin levels in healthy schoolchildren aged 9 and 15 years from Central Sweden: reference values in relation to biological, social and lifestyle factors
    2005 (engelsk)Inngår i: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 65, nr 1, s. 65-76Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    BACKGROUND:

    There is a shortage of reference values for cardiovascular risk factors such as serum lipids, glucose and insulin related to biological, social and lifestyle factors for Swedish children and adolescents. Such values are needed for planning and evaluation of public health activities, and for clinical use.

    DESIGN AND METHODS:

    Data for this cross-sectional, school-based study were collected during a school year (September to May). A random sample of 1137 girls and boys aged 9 and 15 years from two locations in central Sweden participated in the study, and blood samples were taken from 969 of them.

    METHODS:

    Fasting serum blood samples were analysed for triglycerides, total cholesterol, high-density lipoprotein cholesterol, glucose and insulin. Physical examination included measurement of height, weight and pubertal status. Questionnaires provided family background data. Total physical activity was measured by accelerometer registration.

    RESULTS:

    Serum levels differed significantly between age and gender groups and were correlated to pubertal status. Neither genetic nor socio-economic background nor smoking status influenced the serum levels. Insulin levels were elevated in subjects with a body mass index in the highest decentile, compared with the levels in the rest of the subjects. The insulin levels were inversely associated with total physical activity, and physical activity varied with season.

    CONCLUSIONS:

    Pubertal status (biological age) should to be considered in the interpretation of serum values in schoolchildren rather than chronological age. The interpretation of insulin values should include both body mass index and physical activity level, and perhaps also season. Previously described regional differences in serum lipid levels in Swedish adults seem to be present also in children.

    Emneord
    Adolescent, Blood Glucose/genetics/*metabolism, Body Mass Index, Child, Fasting, Female, Health, Humans, Insulin/*blood/genetics, Interpersonal Relations, Life Style, Lipids/*blood/genetics, Male, Motor Activity, Reference Values, Seasons, Sexual Maturation, Smoking, Socioeconomic Factors, Sweden
    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-4205 (URN)10.1080/00365510410003110 (DOI)15859028 (PubMedID)
    Tilgjengelig fra: 2007-12-05 Laget: 2007-12-05 Sist oppdatert: 2020-01-29bibliografisk kontrollert
    3. Trends in aerobic fitness in Swedish children and adolescents
    Åpne denne publikasjonen i ny fane eller vindu >>Trends in aerobic fitness in Swedish children and adolescents
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-16029 (URN)
    Tilgjengelig fra: 2011-06-20 Laget: 2011-06-20 Sist oppdatert: 2020-01-29bibliografisk kontrollert
    4. Cardiorespiratory fitness relates more strongly than physical activity to risk factors for cardiovascular disease in healthy school children
    Åpne denne publikasjonen i ny fane eller vindu >>Cardiorespiratory fitness relates more strongly than physical activity to risk factors for cardiovascular disease in healthy school children
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Forskningsprogram
    Biomedicin
    Identifikatorer
    urn:nbn:se:oru:diva-16030 (URN)
    Tilgjengelig fra: 2011-06-20 Laget: 2011-06-20 Sist oppdatert: 2017-10-17bibliografisk kontrollert
  • 59.
    Hurtig Wennlöf, Anita
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Harro, Maarike
    Sjöström, Michael
    Cardiorespiratory fitness relates more strongly than physical activity to risk factors for cardiovascular disease in healthy school childrenManuskript (preprint) (Annet vitenskapelig)
  • 60.
    Hurtig Wennlöf, Anita
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Yngve, Agneta
    Sjöström, Michael
    Trends in aerobic fitness in Swedish children and adolescentsManuskript (preprint) (Annet vitenskapelig)
  • 61.
    Hägglund, Doris
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Walker-Engström, Marie-Louise
    Larsson, Gregor
    Leppert, Jerzy
    Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study2003Inngår i: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 14, nr 5, s. 296-304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims of this study were to investigate the reasons why some women with long-term urinary incontinence (UI) seek professional help whereas others do not, their experiences and satisfactions with the healthcare services, and how women deal with their incontinence. In total, 95 women aged 23–51 years with persistent UI (median 10 years, range 6–20 years) were included in this telephone interview survey. Seventy-four percent of the women with long-term UI had not sought help. The most common reason given was that the disorder was considered a minor problem, which they felt they could cope with on their own. When women did consult professional help they did so because they were afraid of the odor of urine and that they perceived the leakage as shameful and embarrassing. These women felt that the healthcare service offered appropriate care for their condition. Pelvic floor exercises were the most commonly used management methods for all participants.

  • 62. Häggstrom, Elisabeth
    et al.
    Kihlgren, Annica
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Experiences of caregivers, and relatives in public nursing homes2007Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, nr 5, s. 691-701Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the present study was, by means of discussion highlighting ethical questions and moral reasonings, to increase understanding of the situations of caregivers and relatives of older persons living in a public nursing home in Sweden. The findings show that these circumstances can be better understood by considering two different perspectives: an individual perspective, which focuses on the direct contact that occurs among older people, caregivers and relatives; and a societal perspective, which focuses on the norms, values, rules and laws that govern a society. Relatives and caregivers thought that the politicians were sending out mixed messages: they were praising caregivers and relatives for their efforts, but at the same time the public health care sector was subjected to significant cutbacks in resources. Both caregivers and relatives were dissatisfied and frustrated with the present situation regarding the care of older persons in public nursing homes.

  • 63.
    Häggström, Elisabeth
    et al.
    University of Gävle, Gävle, Sweden; Neurotec-Department, Karolinska Institutet, Stockholm, Sweden.
    Skovdahl, Kirsti
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Neurotec-Department, Karolinska Institutet, Stockholm,Sweden; Centre of Nursing Science, Örebro University Hospital, Örebro, Sweden.
    Fläckman, Birgitta
    University of Gävle, Gävle, Sweden; Neurotec-Department, Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Annica Larsson
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Neurotec-Department, Karolinska Institutet, Stockholm, Sweden; Centre of Nursing Science, Örebro University Hospital, Örebro, Sweden.
    Kihlgren, Mona
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Neurotec-Department, Karolinska Institutet, Stockholm, Sweden: Centre of Nursing Science, Örebro University Hospital, Örebro, Sweden.
    To feel betrayed and to feel that you are betraying the older residents: caregivers' experiences at a newly opened nursing home2004Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, nr 6, s. 687-696Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: In Sweden and internationally, little research has focused on the working situation of Enrolled Nurses and Nurses' Aides who form the majority of workers in geriatric care today. With this in mind, it is important to focus on how these occupational groups experience their working situation with older residents in municipal care.

    AIMS AND OBJECTIVES: The aim of the study was to investigate the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for older residents. The study focused on the narratives supplied by the caregivers at the nursing home. The participants included: one Registered Nurse, sixteen Enrolled Nurses, and three Nurses' Aides. All were directly involved in patient care.

    DESIGN: The present study is part of a larger longitudinal study within the municipal geriatric care system in Sweden, with a quasi-experimental design.

    METHOD: The interviews were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur.

    RESULT: The caregivers experiences of work satisfaction and work dissatisfaction was expressed in four themes: (i) 'Experience of betrayal' describes how the staff felt let down in several ways; (ii) 'Experience of failing others' describes how the staff felt that they did not pay enough attention to older people, in several different ways; (iii) 'Experience of insufficiency' describes how the staff encountered overwhelming demands from several directions; (iv) 'Experience of work satisfaction' describes how the staff felt that they were given support in various ways. Each theme emerged from several subthemes that originated from the caregivers' narratives.

    CONCLUSIONS: The study shows that the caregivers' experience of work dissatisfaction overshadows their experience of work satisfaction. It also suggests that their feelings of failing the older residents are connected to their own experiences of feeling betrayed.

    RELEVANCE TO CLINICAL PRACTICE: The findings can be used when other nursing homes in municipal care are opened, as a means of preventing work dissatisfaction and increasing work satisfaction among future employees.

  • 64.
    Häggström, Elisabeth
    et al.
    University of Gävle, Gävle, Sweden; Centre of Excellence in Elderly Care Research, Neurotec Institute, Karolinska Institutet, Stockholm, Sweden.
    Skovdahl, Kirsti
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Centre of Excellence in Elderly Care Research, Neurotec Institute, Karolinska Institutet, Stockholm.
    Fläckman, Birgitta
    University of Gävle, Gävle, Sweden; Centre of Excellence in Elderly Care Research, Neurotec Institute, Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Annika L
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre of Excellence in Elderly Care Research, Neurotec Institute, Karolinska Institutet, Stockholm.
    Kihlgren, Mona
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre of Excellence in Elderly Care Research, Neurotec Institute, Karolinska Institutet, Stockholm.
    Work satisfaction and dissatisfaction: caregivers' experiences after a two-year intervention in a newly opened nursing home2005Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, nr 1, s. 9-19Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the study was to investigate, from the narratives of nine enrolled nurses and one nurses' aide directly involved in patient care, the deeper meaning of work satisfaction and dissatisfaction when working with the older people.

    BACKGROUND: Both nationally and internationally, there is little research documented regarding the working situation of the enrolled nurses and nurses' aides who make up the majority of care for older people today. With this in mind, it is important to focus on how these occupational groups experience their work with the older residents in municipal care, following a two-year intervention.

    DESIGN: The study is part of a larger longitudinal study, with a quasi-experimental design within the municipal system of care for older people in Sweden. The investigation was carried out following a two-year intervention, which included: education, support and clinical supervision.

    METHOD: The interviews were performed 12 and 24 months after start of the intervention and were analysed with a phenomenological-hermeneutic method inspired by Ricoeur's philosophy.

    RESULTS: The findings from these narratives illustrated a change compared with the findings from the first interviews, when the nursing home had just opened. There was a shift from a dominance of dissatisfaction with work, to a dominance of work satisfaction and this was expressed in the following themes: experience of a changed perspective, experience of open doors, and experience of closed doors. Each theme emerged from several different subthemes and each subtheme that had been expressed in the caregivers' narratives was interpreted.

    CONCLUSIONS: The study shows that the caregivers' experience of work satisfaction in the workplace exceeded their experience of dissatisfaction and that the intervention, consisting of: education, support, and supervision might have facilitated this positive development where the older residents were prioritized. It also shows that communication and understanding between management and staff had increased as the nursing home had opened.

    RELEVANCE TO CLINICAL PRACTICE: The findings can be used to help to prevent work dissatisfaction, and thereby increase work satisfaction for caregivers working in nursing homes.

  • 65.
    Ivarsson, Ann-Britt
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Söderback, Ingrid
    Uppsala universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndals högskola.
    The meaning and form of occupational therapy as experienced by women with psychoses: A phenomenological study2002Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, nr 1, s. 103-110Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 66.
    Jackson, Karin
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Schollin, Jens
    Department of Paediatrics, Örebro Medical Centre Hospital, Örebro, Sweden.
    Bodin, Lennart
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Statistics, Örebro University and Örebro Medical Centre Hospital, Örebro, Sweden,.
    Ternestedt, Britt-Marie
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Utilization of healthcare by very-low-birthweight infants during their first year of life2001Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 90, nr 2, s. 213-217Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    New knowledge in perinatal medicine has resulted in increased survival of very-low-birthweight (VLBW) infants. After leaving hospital, the child is seen at regular medical check-ups, but there is often a persistent worry about the child which affects the family as a whole. This can lead to an increased utilization of healthcare. Our objective was therefore to describe the utilization of healthcare by VLBW infants during their first year of life and its relation to high-risk diagnoses in the neonatal period. The study group comprised 36 infants born at gestational ages of < or = 31 wk and with a birthweight of < or = 1500 g, and was compared with a control group of 36 full-term infants. Utilization of healthcare by the VLBW infants was higher than that by the control group in paediatric and ophthalmic outpatient clinics. The total number of contacts with healthcare was on average 38.7 versus 17.4. High-risk diagnoses in the neonatal period did not correlate with utilization of care, except for visits to the paediatric outpatient clinic, especially planned visits. Further studies focusing on how to support these families after leaving hospital are therefore needed.

  • 67.
    Jackson, Karin
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ternestedt, Britt-Marie
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    Magnuson, Anders
    Clinical Research Centre, Örebro University Hospital, Örebro, Sweden.
    Schollin, Jens
    Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    Quality of care of the preterm infant: the parent and nurse perspective2006Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 95, nr 1, s. 29-37Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To study the subjective opinions about what is important in care at neonatal units and child health centres (CHCs) for premature newborns, and to compare these opinions with the care actually given. SUBJECTS: 21 mothers, 20 fathers and 15 nurses at the neonatal unit, and 21 mothers, 14 fathers and 18 nurses at CHCs.

    METHODS: A questionnaire on quality of Care from the Patient's Perspective was used. It contained three dimensions: identity-oriented approach, medical-technical competence and socio-cultural atmosphere. Each dimension was evaluated in terms of subjective importance and perceived reality of given care.

    RESULTS: In general, subjective importance was rated higher than perceived reality both for neonatal care and care at CHCs for the dimensions identity-oriented approach and medical-technical competence. However, higher ratings were given to neonatal care compared to CHCs for medical-technical competence. High-risk diagnoses and very low gestational age in the newborn did not affect the answers. Mothers rated medical-technical competence higher than nurses for neonatal care. Mothers and nurses rated identity-oriented approach higher than fathers for CHCs.

    CONCLUSION: Although both neonatal care and care at CHCs were highly rated, improvements can be made to fulfil the expectations of parents and nurses. Neonatal units seem to be more efficient in taking care of the special needs of these newborns compared to CHCs. The need for an optimal identity-oriented approach, medical-technical competence and socio-cultural atmosphere could strengthen the possibilities of parents to be confident in their parental role.

  • 68.
    Jackson, Karin
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ternestedt, Britt-Marie
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    Schollin, Jens
    Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
    From alienation to familiarity: experiences of mothers and fathers of preterm infants2003Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 43, nr 2, s. 120-129Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The birth of a preterm infant has a long-term impact on both parents. Mothers report more stress and poor adjustment compared with fathers. Influencing factors, such as family situation and health status of the child, can support or weaken the coping ability of the parents. Studies on experiences of fathers are sparse.

    AIM: The aim of this research was to study how mothers and fathers of preterm infants describe their experiences of parenthood during the infant's first 18 months of life.

    METHODS: Seven consecutively selected sets of parents of preterm infants born at </=34 weeks of gestation with no serious congenital defects were interviewed 1-2 weeks after the infant's birth and at 2, 6 and 18 months of age, and the findings were analysed using a phenomenological method.

    FINDINGS: Internalization of parenthood was described as a time-dependent process, with four syntheses of experiences - alienation, responsibility, confidence and familiarity. Within the syntheses, similarities in how mothers and fathers described their parental roles involved concern for the child, insecurity, adjustment and relationship with the child. Regarding differences, mothers experienced having more responsibility and control of the care and a need to be confirmed as a mother, while fathers described confidence in leaving the care to the staff and wanted to find a balance between work and family life. Important turning points in parenthood experiences often occurred when the infant could be removed from the incubator, discharged from the ward, and when the infant looked normal compared to full-term infants.

    CONCLUSIONS: The structure of the phenomenon of parenthood was formed by the integration of the syntheses of alienation, responsibility, confidence and familiarity. The structure seems to be based on the parents' expectations of the parental role, the infant's health condition and the health care environment. These interacting factors are influenced by cultural beliefs.

  • 69.
    Jerlinder, Kajsa
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Rättvis idrottsundervisning för elever med rörelsehinder: dilemma kring omfördelning och erkännande2005Licentiatavhandling, monografi (Annet vitenskapelig)
    Abstract [en]

    Licentiate dissertation, written in Swedish with an English abstract.

    The educational goal of “a school for all” creates many challenges. Issues of socialjustice and equity are central tenets of the concept of inclusive education. Despitethe goal of comprehensive education for all children, for many pupils with physicaldisabilities in an inclusive school system PE (Physical Education) teaching canresult in experiences of injustice. In the struggle to achieve social equity and createeducational experiences where disability does not matter, it seams to matter verymuch.The aim of this study is to illustrate a dilemma and its potential outcomeswhere demands for justice for pupils with physical disabilities are raised in inclusivephysical education. In the study, based on theories of redistribution andrecognition, two empirical examples are presented.The first example, in the context of the decentralisation of Swedish compulsoryschools, illustrates degrees of awareness about numbers of pupils with physicaldisabilities attending compulsory schools located in a case municipality. Foursources, with varying responsibilities for disabled children, all reported differentnumbers of pupils. Thus, with no congruent data at municipality level, distribu-tion and redistribution of necessary resources becomes difficult.In the second example of a ten year old boy with a physical disability,experiences of participation in inclusive physical education are described, fromthe perspective of five different actors (the boy himself, his PE teachers (2), hisparents, classmates, and his personal assistant).Data for this case study was gathered through interviews and systematic ob-servation. In this particular case, the outcome of inclusive PE was judged to besuccessful. The example illustrates the importance of recognition needing to befulfilled at several distributive levels. The positive outcome is discussed in terms ofthe combination of identification of particular special needs, sensitive adaptation,and general respect for the child with physical disability.Dilemmas of justice for disabled pupils in physical education are best studiedwithin a multi-level context. Recognition and redistribution demands need to besimultaneously addressed in order to fulfil the goal of equitable education forpupils with physical disabilities attending PE within the compulsory school sys-tem. An attempt to combine these different ideological approaches is discussedfrom the perspective of social status.The outcome of the two empirical examples presented in this study illustrategeneral dilemmas reaching beyond the educational challenges facing pupils withphysical disabilities and the responses of the compulsory school system to them.

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  • 70. Johansson, Ingrid
    et al.
    Hildingh, Cathrine
    Wenneberg, Stig
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Fridlund, Bengt
    Ahlström, Gerd
    Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis2006Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, nr 5, s. 463-471Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area. BACKGROUND: When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery. METHOD: Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home. FINDINGS: The theoretical model was developed in 2004-2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated. CONCLUSION: This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used.

  • 71.
    Katrin, Ulrika
    Örebro universitet, Hälsoakademin. Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Existentiella upplevelser och utlösande faktorer hos patienter inom palliativ vård2008Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: När en människa är drabbad av en livshotande sjukdom, t.ex. cancer, amyotrof lateral skleros (ALS) eller hjärtsjukdom, som är i ett palliativt skede innebär det för de flesta människor en existentiell erfarenhet. Både den sjuka människan och dennes närstående tvingas att fundera på bl.a. sin relation till döden och vad som är meningen med livet.

    Syfte: Syftet med litteraturstudien var att beskriva patienters existentiella upplevelser inom palliativ vård och vad som kan utlösa dessa.

    Metod: Forskningsmetoden som användes var en allmän litteraturstudie. En systematisk elektronisk sökning genomfördes i databaserna Cinahl, Medline och Pubmed. Sökorden som användes var palliative care, existential, spiritual och nursing i olika kombinationer. Artiklarna har granskats och värderats enligt Forsbergs och Wengströms checklistor för kvalitativa och kvantitativa artiklar.

    Resultat: Alla studier som ingår i litteraturstudiens resultat visade att existentiella upplevelser utlösta av olika faktorer var vanligt förekommande hos patienter inom palliativ vård. Existentiell ensamhet orsakades av bl.a. bristande kommunikation med närstående, ökat beroende, förlust av kontroll och bristande bemötande från vårdpersonal. Upplevelsen av skuld utlöstes av tidigare levnadssätt som kunde vara orsaken till sjukdomen och för att religiösa normer inte hade följts. Hjälplöshet upplevdes vid förlusten av förmågan att klara av vardagliga situationer. Brister i kommunikation och bemötande från vårdpersonal medförde upplevelsen av bristande autonomi och självbild liksom maktlöshet. Konflikter i familjen, rollförändringar och tankar på familjens framtid utlöste upplevelsen av oro och otrygghet. När sjukdomen försämrades var det svårt att bevara hoppet liksom att finna meningen med livet.

    Konklusion: Det existentiella välbefinnande hos patienter inom palliativ vård kan förbättras om sjuksköterskor har en ökad kunskap om de existentiella upplevelserna och utlösande faktorer som redovisas i litteraturstudiens resultat.

     

     

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  • 72.
    Kihlgren, Annica
    et al.
    Centre for Nursing Science, Örebro University Hospital, Örebro; Nuerotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm.
    Forslund, Kerstin
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre for Nursing Science, Örebro University Hospital, Örebro.
    Managements' perception of community nurses' decision making processes when refering older patients to an emergency department2006Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, nr 6, s. 428-436, artikkel-id PMID16919120Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    In Sweden, older adults are living and being cared for under the responsibility of their respective community. Extensive reorganizations in the community led to management having different backgrounds, which may have caused uncertainty among community nurses, especially in decision-making processes. The aim was to understand how 10 nurses, 10 doctors and 10 home care assistants as leaders for the nurses conceptualized the decision-making processes of community nurses, when referring older persons to Emergency Departments, and whether perceptual differences and/or similarities exist. Narrative interviews and content analysis were performed. The managers had differing views, but all felt there was a need to feel secure in order to trust professional decisions as being correct, thus avoiding inappropriate referrals. Management could see nursesexposed position, but had varying solutions. This might lead to different messages being given regarding what is important and might explain why the nurses reported that the managers did not understand them.

  • 73.
    Kihlgren, Annica Larsson
    et al.
    Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden.
    Nilsson, Margareta
    Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Ersta Sköndal University College, Stockholm,Sweden.
    Skovdahl, Kirsti
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm, Sweden.
    Palmblad, Bert
    Centre for Nursing Science, Örebro University Hospital, Örebro,Sweden; Department of Primary Health Care, Psychiatry and Rehabilitation, Örebro County Council, Örebro, Sweden.
    Wimo, Anders
    Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Karolinska Institutet, Stockholm,Sweden; Department of Family Medicine, Bergsjö, Sweden.
    Older patients awaiting emergency department treatment2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 2, s. 169-176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 74.
    Krumlinde-Sundholm, Lena
    et al.
    Karolinska Institutet.
    Holmefur, Marie
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Kottorp, Anders
    Karolinska Institutet.
    Eliasson, Ann-Christin
    Karolinska Institutet.
    The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change2007Inngår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 49, nr 4, s. 259-264Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Assisting Hand Assessment (AHA) provides a new perspective of hand function evaluation relevant for children with unilateral upper limb disabilities. It measures how effectively the involved hand is actually used for bimanual activity, which, for these children, might be the most important aspect of their hand function. The aim of this paper is to report the conceptual framework and the evidence for validity, reliability, and responsiveness to change for the measures. Previously, the AHA has been evaluated for children aged 18 months to 5 years and excellent inter- and intrarater reliability was demonstrated. This paper reports further evidence of construct validity and reliability for the AHA measures involving an extended age range of children with hemiplegic cerebral palsy or obstetric brachial plexus palsy from 18 months to 12 years of age (mean age 4y 11mo [SD 2y 9mo] range 18mo-12y 8mo). A Rasch measurement model was used to analyze 409 assessments from 303 children (170 males, 133 females). The analysis generated a scale demonstrating large capacity to reliably separate and spread personal ability measures, indicating sensitivity to change and a hierarchy of the items ranging them from easy to hard. Aspects of item fit, relationship between age and ability measures, and development of assisting hand function are discussed.

  • 75.
    Lindberg, Odd
    et al.
    Örebro universitet, Institutionen för samhällsvetenskap.
    Stål, Rolf
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Missbrukande ungdom och deras mammor: den svåra upptäckten1990Inngår i: Social forskning : inblick i SFR:s verksamhetsområde, ISSN 0283-202X, Vol. 5, nr 3, s. 6-7Artikkel i tidsskrift (Annet vitenskapelig)
  • 76.
    Lindberg, Odd
    et al.
    Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
    Stål, Rolf
    Örebro universitet, Hälsoakademin. Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Om mammors livssituation1990Inngår i: Anhörig, ISSN 0280-512X, nr 4, s. 20-25Artikkel i tidsskrift (Annet vitenskapelig)
  • 77.
    Lindberg, Odd
    et al.
    Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
    Stål, Rolf
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Tonårsmissbrukare: kontrollerade eller autonoma?1991Inngår i: Så tuktas ungdomen: forskning om ungdom och offentliga sektorn / [ed] Britta Jonsson, Stockholm: HLS (Högsk. för lärarutbildning) , 1991, s. 117-125Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 78.
    Mamhidir, Anna-Greta
    et al.
    Högskolan i Gävle, Gävle, Sweden.
    Ljunggren, G
    Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Mona
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wimo, A
    Karolinska Institutet, Stockholm, Sweden.
    Underweight, weight loss and related risk factors among older adults in sheltered housing: a Swedish follow-up study2006Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 10, nr 4, s. 255-262Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Underweight and weight loss are important factors in detecting malnutrition.

    OBJECTIVE: To describe underweight, weight loss and related nutritional factors after 12 months among individuals 75 years or older and living in sheltered housing. A further aim was to identify possible risk factors associated with underweight and weight loss.

    DESIGN: This is a part of a cross-sectional follow-up study from a county in Sweden, examining the disabilities, resources and needs of 719 older adults in sheltered housing units. Data were collected twice, with a 12-month interval using the Resident Assessment Instrument.

    RESULTS: Among the 503 remaining chronically ill individuals with cognitive and functional disabilities, 35% were classified as underweight at the initial assessment and 38% at the second, a non-significant difference. A further analysis showed 39% had decreased weight, 27% remained stable and 28% gained weight. A weight loss of 5% occurred in 27% of the older adults and a loss of 10% occurred in 14%. Risk factors associated with being underweight and weight loss, using scales derived from the instrument were cognitive and functional decline. Dementia and Parkinson's disease, eating dependencies and constipation were the strongest risk factors when analyzed as single items.

    CONCLUSION: A high percentage was underweight or exhibited weight loss and several risk factors were identified. Ensuring adequate nutritional status in individuals with a variety of diseases and declining health status is challenging. Increased combined efforts using a wide range of measures, nutritional programs and routines need to be regularly implemented.

  • 79.
    Möllgård, Lars
    et al.
    Karolinska Institutet.
    Prenkert, Malin
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Smolowicz, Adam
    Paul, Christer
    Karolinska Institutet.
    Tidefelt, Ulf
    Örebro universitet, Institutionen för klinisk medicin.
    In vitro chemosensitivity testing of selected myeloid cells in acute myeloid leukemia 2003Inngår i: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 44, nr 5, s. 783-789Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In several studies different chemosensitivity assays have been examined in acute myeloid leukemia (AML). Some have shown that in vitro chemosensitivity testing is an independent prognostic factor but so far no one has been able to show that the use of these methods can improve treatment outcome. In an attempt to improve in vitro chemosensitivity testing in AML we wanted to establish and evaluate a new flow cytometry chemosensitivity assay. After 4 days of incubation viable mononuclear myeloid cells were identified by the exclusion of propidium iodide in CD13 or CD33 positive cells. Sixty-eight samples from 64 AML patients were included. In this study, we showed that the flow cytometry method is feasible in AML and we also found some correlations to clinical data. The secondary AML at diagnosis showed an in vitro resistance to etoposide and amsacrine that was significantly higher compared to de novo AML at diagnosis (p = 0.04 and p = 0.02). When AML patients at diagnosis were compared to resistant disease/relapse patients there was a significantly higher effect of ara-C in the diagnosis group (p = 0.03). Responders and non-responders were compared in vitro but we found no significant differences. In vitro mitoxantrone was more effective in multidrug resistance (MDR) negative cells compared to MDR positive cells (p < 0.01). This new method is feasible and makes it possible to selectively evaluate the effect of cytotoxic drugs in myeloid cells. Further studies with a larger group of patients are needed to evaluate the predictive value of the assay.

  • 80. Olofsson, Peder S.
    et al.
    Wågsäter, Dick
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Sheikine, Yuri
    Jatta, Ken
    Hansson, Göran K.
    Sirsjö, Allan
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    CD137 is expressed on endothelial cells in human atherosclerotic lesions and induced by proinflammatory cytokines and bacterial lipopolysaccharidesManuskript (Annet vitenskapelig)
  • 81. Persson, Jan
    et al.
    Bernfort, Lars
    Hellbom, Gunn
    Danermark, Berth
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Borg, Erik
    Gullbrandsson, Ann
    Husberg, Magnus
    Cost-effectiveness in rehabilitation of hearing impaired people2005Inngår i: Assistive technology: from virtuality to reality / [ed] Alain Pruski, Harry Knops, Amsterdam: IOS Press, 2005, s. 750-754Konferansepaper (Annet vitenskapelig)
  • 82.
    Pettersson, Ingvor
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    The meaning of assistive technology devices in daily life2002Konferansepaper (Fagfellevurdert)
  • 83.
    Pettersson, Ingvor
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Vad betyder det för den enskilde individen att använda hjälpmedel i vardagen?2007Konferansepaper (Fagfellevurdert)
  • 84.
    Pettersson, Ingvor
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ahlström, G.
    Värdet av hjälpmedel i vardagslivet2002Konferansepaper (Fagfellevurdert)
  • 85.
    Pettersson, Ingvor
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Appelros, P.
    Ahlström, G.
    Lifeworld perspectives on using assistive devices - lived experiences of persons with stroke2003Konferansepaper (Fagfellevurdert)
  • 86.
    Pettersson, Ingvor
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Berndtsson, I.
    Appelros, P.
    Ahlström, G.
    Perspectives on assistive devices: lived experiences of spouses of persons with stroke2004Konferansepaper (Fagfellevurdert)
  • 87.
    Pettersson, Ingvor
    et al.
    Örebro universitet, Hälsovetenskapliga institutionen.
    Berndtsson, Inger
    Appelros, Peter
    Ahlström, Gerd
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Lifeworld perspectives on assistive devices: lived experiences of spouses of persons with stroke2005Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 12, nr 4, s. 159-169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to explore how spouses of persons with a disability following stroke describe their lived experiences regarding assistive devices in everyday life. A phenomenological lifeworld approach was used and conversational interviews were conducted with 12 spouses. Their lived experiences of assistive devices were explored in relation to four lifeworld existentials intertwined in everyday life. The results showed that lived body concerns aspects of feelings, habits, and incorporation of the devices with one's own body. The devices are, from the spouses' perspective, a prerequisite for their partner with stroke living at home. Successively the devices are incorporated into the couples' homes, and they provide a new view of the environment, aspects related to lived space. The devices bring about a changed relation to lived time, related to past, present, and future. Further, lived human relation concerns changed relationships to husbands/wives with stroke, including a great responsibility due to the devices and their usage. The results also included stigmatizing aspects and a twofold relationship to health professionals regarding participation in decisions about prescribing assistive devices. Understanding the unique meaning of assistive devices from the spouses' perspective is vital for occupational therapists prescribing such devices.

  • 88.
    Pettersson, Ingvor
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Törnquist, K.
    Ahlström, G.
    The impact of a powered wheelchair for outdoor use on activity, participation and quality of life2006Konferansepaper (Fagfellevurdert)
  • 89.
    Pettersson, Ingvor
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Törnquist, K.
    Ahlström, G.
    The value of an outdoor powered wheelchair with regard to the quality of life of persons with stroke: a follow-up study2007Konferansepaper (Fagfellevurdert)
  • 90. Prenkert, Frans
    et al.
    Ehnfors, Margareta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    A measure of organizational effectiveness in nursing management in relation to transactional and transformational leadership: a study in a Swedish county hospital.1997Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 5, nr 5, s. 279-87Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This paper presents an empirical study of the influences of transactional (TA) and transformational (TF) leadership on organizational effectiveness (OE), measured as the degree of goal attainment and the quality of nursing care (NQ). The study subjects were all head-nurses and assistant head-nurses at a medium-sized hospital in Sweden (n = 23). The methods used were questionnaires and interviews. The multi-leadership questionnaire earlier developed by Bass was modified and named the Leadership Nursing-Effectiveness Questionnaire (LNEQ), comprising 84 items using Likert-type scales. The study showed low mean scores on OE (2.19) and TA (1.05) but high mean scores on NQ (3.17) and TF (3.84). The results suggest that the degree of TA and TF leadership had a low and insignificant connection with OE in this hospital organization. The study did not support the statement that organizational units exposed to a higher degree of TA and TF leadership at the same time show a high degree of OE, as has been shown in studies in other cultural contexts and organizations.

  • 91.
    Sahlberg-Blom, Eva
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ternestedt, Britt-Marie
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Johansson, Jan-Erik
    "Am I going to die now?": Prognostication of survival time by members of the care team2001Inngår i: Omega, ISSN 0030-2228, E-ISSN 1541-3764, Vol. 42, nr 3, s. 219-235Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To get a real chance to make autonomous decisions in the final phase of their life, people who are soon going to die have a right to be informed concerning available knowledge about their prognosis and condition. The aim of this study is to describe how different members of the care team make prognostications about patients survival time, and what motivates their prognostications. Doctors and registered nurses made prognostications to a greater extent, and were also somewhat more successful, than practical nurses and social workers. Different professions seem to differ in some respects concerning the criteria included in their motivations and the knowledge upon which they base their motivations.

  • 92.
    Sahlberg-Blom, Eva
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ternestedt, Britt-Marie
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Johansson, Jan-Erik
    Is good 'quality of life' possible at the end of life?: An explorative study of the experiences of a group of cancer patients in two different care cultures2001Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, nr 4, s. 550-562Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this paper was to explore how a group of gravely ill patients, cared for in different care cultures, assessed their quality of life during their last month of life.* The study material comprised quality of life assessments from 47 cancer patients, completed during their last month of life. Two quality of life questionnaires, the EORTC QLQ-C30 and a psychosocial well-being questionnaire, were used. The data were treated in accordance with instructions for the respective questionnaires, and the results are presented primarily as means, mostly at the group level. Assessments from patients in two different care cultures, care-orientated and cure-orientated, were compared.* The results show that despite having an assessed lower quality of life in many dimensions than people in general, several patients experienced happiness and satisfaction during their last month of life.* 'Cognitive functioning' and 'emotional functioning' were the dimensions that differed least from those of the general population, and 'physical functioning', 'role functioning' and 'global health status/quality of life' differed the most. 'Fatigue' showed the highest mean for the symptom scales/items.* There was a tendency for those cared for in the cure-orientated care culture to report more symptoms than those in the care-orientated care culture. An exception to this was 'pain', which was reported more often by those in the care-orientated care culture.* The implications of the results are discussed from different angles. The significance of knowledge concerning how patients experience their quality of life is also discussed with respect to the care and the planning of care for dying patients.

  • 93.
    Sahlberg-Blom, Eva
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ternestedt, Britt-Marie
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Johansson, Jan-Erik
    The last month of life: continuity, care site and place of death1998Inngår i: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 12, nr 4, s. 287-296Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A hospice ward was opened in 1991 at the Örebro MedicalCentre Hospital (ÖMCH) in Sweden. Shortly afterwards, aresearch project was started, which aimed to describe differentaspects of the final period of life of a group of cancer patients.This exploratory study is part of this project and aims to assesscontinuity in the site of care for a group of severely ill cancerpatients during the final stages of their lives, and their placeof death within different cultures of care.

    This prospective study involved 56 adults with cancer who hadbeen admitted to six specialized departments at ÖMCH. Demographicand diagnostic data, documentation of when the patients changedfrom one care form to another, as well as place of death wereobtained. The analysis of continuity in terms of care site involvedcare-oriented cultures (hospice ward, hospital-based home care,primary care-based home care and nursing home) and cure-orientedcultures (acute hospital wards).

    Considered as a group, the patients spent one-third of theirtime at home during their final month of life, with or withoutformal caregivers. For individual patients, however, there weregreat variations with regard to continuity of care site andcare form. A pattern was found for the type of cancer the patientshad and where they were during their final month. Ten patientsdied in their own homes, and of the 46 who died in an institution,approximately the same number died in a care-oriented cultureas in a cure-oriented culture.

  • 94.
    Shields, Linda
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Using semantic differentials in fieldwork2007Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 13, nr 1, s. 116-119Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rationale A large project was undertaken to examine attitudes and opinions of health staff and parents about the care of hospitalized children in four countries. A simple scoring system, which allowed comparisons between results from each country, was needed to examine concepts under investigation. Aims and objectives This paper describes how, after trialling a range of methods, semantic differentials (SD) were found to be easy for the subjects to use. They translated well into other languages and provided scores which were easy to analyse and compare. Results Semantic differentials are based on a series of line scores using adjectives and their antonyms for a set of characteristics. They are a particularly useful method for fieldwork analysis, as they can be done by hand with no computer support. Conclusions Semantic differentials were found to be useful for cross-cultural, quantitative studies of this kind. I discuss SDs, how they work, their trialling, reliability and validity and their usefulness in cross-cultural research.

  • 95.
    Stål, Rolf
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Lindberg, Odd
    Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
    Alla är kontrollerade, somliga mer än andra: ingen är autonom, somliga mindre än andra1991Inngår i: Så tuktas ungdomen: forskning om ungdom och offentliga sektorn / [ed] Britta Jonsson, Stockholm: HLS (Högsk. för lärarutbildning) , 1991, s. 127-138Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 96.
    Stål, Rolf
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Lindberg, Odd
    Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
    Missbrukande ungdom, deras mammor och socialtjänsten1990Rapport (Annet vitenskapelig)
  • 97.
    Stål, Rolf
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Lindberg, Odd
    Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
    När mammor upptäcker sitt barns narkotikamissbruk1990Inngår i: Locus, ISSN 1100-3197, Vol. 2, nr 4, s. 22-33Artikkel i tidsskrift (Fagfellevurdert)
  • 98.
    Svantesson, Mia
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Sjökvist, Peter
    Thorsén, Håkan
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    End-of-life decisions in Swedish ICUs: how do physicians from the admitting department reason?2003Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 19, nr 4, s. 241-251Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    To study how physicians from the admitting department reason during the decision-making process to forego life-sustaining treatment of patients in intensive care units (ICUs).

    DESIGN:

    Qualitative interview that applies a phenomenological approach.

    SETTING:

    Two ICUs at one secondary and one tertiary referral hospital in Sweden.

    PARTICIPANTS:

    Seventeen admitting-department physicians who have participated in decisions to forego life-sustaining treatment.

    RESULTS:

    The decision-making process as it appeared from the physicians' experiences was complex, and different approaches to the process were observed. A pattern of five phases in the process emerged in the interviews. The physicians described the process principally as a medical one, with few ethical reflections. Decision-making was mostly done in collaboration with other physicians. Patients, family and nurses did not seem to play a significant role in the process.

    CONCLUSION:

    This study describes how physicians reasoned when confronted with real patient situations in which decisions to forego life-sustaining treatment were mainly based on medical--not ethical--considerations.

  • 99. Söderback, Ingrid
    et al.
    Pettersson, Ingvor
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    von Essen, Louise
    Stein, Franklin
    Cancer patients´ and their physicians´ perceptions of the formers' need for occupational therapy2000Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 7, nr 2, s. 77-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims of the study were to identify cancer patients" need for occupational therapy by (a) describing their and their physicians" perceptions of the former"s needs (b) exploring whether patients and physicians agree on the patient"s need for occupational therapy, and (c) identifying the factors related to the physicians" and the patients" perceptions of patient needs. One-hundred-and-two patients with a cancer disease and the 11 physicians responsible for them completed the “Occupational Therapy Needs Assessment” during a visit to a medical consultation unit. Fifty-six percent of the patients felt a need for occupational therapy. In 59% of cases, their physicians judged that there was a need for occupational therapy. Patients and physicians both judged that those patients who were older than 66 years and in the active phase of the disease needed therapy more than those patients under 66 years and not in an active phase of the disease. More patients judged by their physicians to have more than 6 months to live needed occupational therapy more than those judged to have less than 6 months. In conclusion, it seems that occupational therapy is felt by cancer patients and their physicians to be underutilised.

  • 100.
    Sørlie, Venke
    et al.
    University of Oslo, Norway, Institute of Nursing and Health Sciences, PO Box 1153, Blindern, 0318 Oslo, Norway.
    Kihlgren, Annica
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Kihlgren, Mona
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Meeting ethical challenges in acute nursing care as narrated by registered nurses2005Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 12, nr 2, s. 133-42Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Five registered nurses were interviewed as part of a comprehensive investigation by five researchers into the narratives of five enrolled nurses (study 1, published in Nursing Ethics 2004), five registered nurses (study 2) and 10 patients (study 3) describing their experiences in an acute care ward at one university hospital in Sweden. The project was developed at the Centre for Nursing Science at Orebro University Hospital. The ward in question was opened in 1997 and provides care for a period of up to three days, during which time a decision has to be made regarding further care elsewhere or a return home. The registered nurses were interviewed concerning their experience of being in ethically difficult care situations in their work. Interpretation of the theme 'ethical problems' was left to the interviewees to reflect upon. A phenomenological hermeneutic method (inspired by the French philosopher Paul Ricoeur) was used in all three studies. The most prominent feature revealed was the enormous responsibility present. When discussing their responsibility, their working environment and their own reactions such as stress and conscience, the registered nurses focused on the patients and the possible negative consequences for them, and showed what was at stake for the patients themselves. The nurses demonstrated both directly and indirectly what they consider to be good nursing practices. They therefore demand very high standards of themselves in their interactions with their patients. They create demands on themselves that they believe to be identical to those expected by patients.

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