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Melin, J., Lindberg, M., Stenberg, J. & Hans, F. (2017). Bedside BNP as a marker of overhydration in hemodialysis patients. Paper presented at American Society of Nephrology, ASN Kidney Week 2017, 31 October-5 November 2017, New Orleans, USA. Journal of the American Society of Nephrology, 28(Suppl.), 878-878, Article ID SA-PO772.
Open this publication in new window or tab >>Bedside BNP as a marker of overhydration in hemodialysis patients
2017 (English)In: Journal of the American Society of Nephrology, ISSN 1046-6673, E-ISSN 1533-3450, Vol. 28, no Suppl., p. 878-878, article id SA-PO772Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background

Management of hydration status in dialysis patients is a great challenge to nephrologists, and new tools to understand the hydration status (HS) are needed. The aim of this study was to investigate the usefulness of brain natriuretic peptide (BNP), analyzed bedside, as a marker of overhydration (OH) in hemodialysis (HD) patients.

Methods

We investigated the distribution of BNP, measured by Alere Triage® BNP Test, and analyzed the correlation between BNP and HS, defined by bioimpedance spectroscopy (BIS) in 64 HD patients. We assumed there would be a difference in HS between patients with high levels of BNP (h-BNP) and low levels of BNP (l-BNP) and choose an arbitrary cut off of 500 ng/ml, and then differences between the groups were tested for significance. HS, blood pressure (BP) and heart rate was measured, and BNP analyzed, before one mid-week dialysis session. Blood samples were also drawn for analysis of NT-proBNP and inflammatory markers. Demographic data, comorbidities, lab values and nutritional status were collected from medical records.

Results

A positive correlation was found between BNP and OH (r = 0.4), although many severely overhydrated patients had normal or just slightly elevated BNP. BNP levels were above 500 in 38 % (n=24) of the participants. The level of OH before dialysis was higher in the h-BNP group than in the l-BNP group. There was no difference in BP before or after dialysis, but patients in the h-BNP group were older, had lower muscle strength and lower Hemoglobin and Albumin levels compared to the l-BNP group.

Conclusion

A normal BNP does not rule out OH as defined by BIS in HD patients, on the other hand euvolemia was rare in patients with elevated BNP. This suggests that BNP might serve as a marker of OH in a subgroup of old and frail patients. In a further study we aim to investigate if the relationship between BNP, when elevated, and OH is reproducible at an individual level.

National Category
Urology and Nephrology
Identifiers
urn:nbn:se:hig:diva-25553 (URN)
Conference
American Society of Nephrology, ASN Kidney Week 2017, 31 October-5 November 2017, New Orleans, USA
Note

Poster with a published abstract

Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2018-03-13Bibliographically approved
Lindberg, M., Lindberg, M. & Skytt, B. (2017). Risk behaviours for organism transmission in health care delivery: A two month unstructured observational study. International Journal of Nursing Studies, 70, 38-45
Open this publication in new window or tab >>Risk behaviours for organism transmission in health care delivery: A two month unstructured observational study
2017 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 70, p. 38-45Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Errors in infection control practices risk patient safety. The probability for errors can increase when care practices become more multifaceted. It is therefore fundamental to track risk behaviours and potential errors in various care situations.

OBJECTIVE: The aim of this study was to describe care situations involving risk behaviours for organism transmission that could lead to subsequent healthcare-associated infections.

DESIGN & SETTING: Unstructured nonparticipant observations were performed at three medical wards.

PARTICIPANTS & METHODS: Healthcare personnel (n=27) were shadowed, in total 39h, on randomly selected weekdays between 7:30 am and 12 noon. Content analysis was used to inductively categorize activities into tasks and based on the character into groups. Risk behaviours for organism transmission were deductively classified into types of errors. Multiple response crosstabs procedure was used to visualize the number and proportion of errors in tasks. One-Way ANOVA with Bonferroni post Hoc test was used to determine differences among the three groups of activities.

RESULTS: The qualitative findings gives an understanding of that risk behaviours for organism transmission goes beyond the five moments of hand hygiene and also includes the handling and placement of materials and equipment. The tasks with the highest percentage of errors were; 'personal hygiene', 'elimination' and 'dressing/wound care'. The most common types of errors in all identified tasks were; 'hand disinfection', 'glove usage', and 'placement of materials'. Significantly more errors (p<0.0001) were observed the more multifaceted (single, combined or interrupted) the activity was.

CONCLUSION: The numbers and types of errors as well as the character of activities performed in care situations described in this study confirm the need to improve current infection control practices. It is fundamental that healthcare personnel practice good hand hygiene however effective preventive hygiene is complex in healthcare activities due to the multifaceted care situations, especially when activities are interrupted. A deeper understanding of infection control practices that goes beyond the sense of security by means of hand disinfection and use of gloves is needed as materials and surfaces in the care environment might be contaminated and thus pose a risk for organism transmission.

Keywords
Hand hygiene, Healthcare-associated infections, Hygiene, Infection control
National Category
Nursing Infectious Medicine
Identifiers
urn:nbn:se:hig:diva-23690 (URN)10.1016/j.ijnurstu.2017.02.016 (DOI)000399853700005 ()28231441 (PubMedID)2-s2.0-85013187208 (Scopus ID)
Available from: 2017-02-27 Created: 2017-02-27 Last updated: 2019-08-28Bibliographically approved
Westerberg Jacobson, J., Lindberg, M., Bjuhr, M. & Willmer, M. (2016). A wish to be thinner increases the odds for disturbed eating 20 years later. In: : . Paper presented at 2016 International Conference on Eating Disorders (ICED 2016, 5-7 May 2016, San Francisco, California, USA.
Open this publication in new window or tab >>A wish to be thinner increases the odds for disturbed eating 20 years later
2016 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Background: Studies from various cultures show that a large number of adolescent girls have a wish to be thinner, and thus more often go on diets. The purpose of this longitudinal study was to examine if a wish to be thinner among Swedish girls contributes to the development of disturbed eating, and to describe motives for wishing to be thinner.

Methods: Following ethical approval (reg. no: 258/94; 2014/401) the Demographic and Dieting Questionnaire and the Eating Disorder Examination Questionnaire were used in a general population cohort of 7-11year-old-girls (n=462), 20 years later in October 2015.Threshold for DE was 1 SD above general population mean. Chi-square tests providing OR were used.

Results: A wish to be thinner during adolescence increases the likelihood 3-5 times to develop disturbed eating during the following 20-year period. Self-described motives for the wish to be thinner was to “correspond to the societal ideal” and to “dealing with difficulties”.

Conclusions: For prevention, it is of importance to detect girls who wish to be thinner as early as possible. By considering the girls’ motives, preventive efforts might be perceived as more meaningful and relevant to the girls at risk of developing eating disorders.

National Category
Social Sciences
Identifiers
urn:nbn:se:hig:diva-21517 (URN)
Conference
2016 International Conference on Eating Disorders (ICED 2016, 5-7 May 2016, San Francisco, California, USA
Projects
IDA-projektet
Available from: 2016-05-23 Created: 2016-05-23 Last updated: 2018-11-26Bibliographically approved
Stenberg, J., Lindberg, M. & Furuland, H. (2016). Clinical praxis for assessment of dry weight in Sweden and Denmark: a mixed-methods study. Hemodialysis International, 20(1), 111-119
Open this publication in new window or tab >>Clinical praxis for assessment of dry weight in Sweden and Denmark: a mixed-methods study
2016 (English)In: Hemodialysis International, ISSN 1492-7535, E-ISSN 1542-4758, Vol. 20, no 1, p. 111-119Article in journal (Refereed) Published
Abstract [en]

Overhydration is an independent predictor of mortality in hemodialysis (HD) patients. More than 30% of HD patients are overhydrated, motivating the development of new methods for assessing hydration status. This study surveyed clinical praxis and local guidelines for dry weight (DW) assessment in Swedish and Danish HD units, and examined if differences in routines and utilization of bioimpedance spectroscopy (BIS) and other assistive technology affected frequency of DW adjustments and blood pressure (BP) levels. Cross-sectional information on praxis, guidelines and routines, plus treatment-related data from 99 stratified patients were collected. Qualitative data were analyzed with content analysis and interpreted in convergence with statistical analysis of quantitative data in a mixed-methods design. Local guidelines concerning DW existed in 54% of the units. A BIS device was present in 52%, but only half of those units used it regularly, and no correlations to frequency of DW adjustments or BP were found. HD nurses were authorized to adjust DW in 60% of the units; in these units, the frequency of DW adjustments was 1.6 times higher and systolic BP pre-HD 8 mmHg lower. There is a wide variation in routines for DW determination, and there are indications that authorization of HD nurses to adjust DW may improve DW assessment. BIS is sparsely used; its implementation may have been delayed by uncertainty over how to manage the device and interpret measurements. Hence, better methods and guidelines for assessing DW and using BIS need to be developed.

Keywords
Hemodialysis, dry weight, bioimpedance spectroscopy, guidelines, blood-pressure, mixed-methods design
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:hig:diva-20103 (URN)10.1111/hdi.12336 (DOI)000369304400022 ()26264888 (PubMedID)2-s2.0-84956572024 (Scopus ID)
Available from: 2015-08-16 Created: 2015-08-16 Last updated: 2018-03-13Bibliographically approved
Friberg, S., Jansson, J., Westergren, E. & Lindberg, M. (2016). Grundutbildade sjuksköterskors upplevelse att börja arbeta på en barnavdelning. Nordisk sygeplejeforskning, 6(1), 20-33
Open this publication in new window or tab >>Grundutbildade sjuksköterskors upplevelse att börja arbeta på en barnavdelning
2016 (Swedish)In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 6, no 1, p. 20-33Article in journal (Refereed) Published
Abstract [en]

Basic trained nurses experience to start working on a children’s ward

The aim of the study was to describe nurses trained to a basic level experience of starting work on a children's ward. A qualitative study has been conducted with a purposively drawn sample of informants. Semi-structured interviews were conducted with eight basic trained nurses. Data were analyzed using qualitative content analysis. The results showed that respondents felt that the pediatrics course is not preparing for the professional work with children. Most felt that it was through real situations in the workplace that they gained necessary knowledge. Furthermore, it was found that only a few were satisfied with the induction. Spending time with many different supervisors was an important factor for experiencing dissatisfaction with the induction. Good support was received from employees; however the support of the organization was poor. Conclusion: Today's undergraduate education in nursing does not include enough pediatrics to prepare students for professional work with children and adolescents. Actions at individual and workplace levels are needed to increase knowledge of the basic trained nurse. Continuity and support during the induction is important for newly employed nurses to feel competent in their work.

Keywords
general nurses, children, knowledge, supervision, safety, allmänsjuksköterskor, barn, kunskap, handledning, trygghet
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-20700 (URN)10.18261/issn.1892-2686-2016-01-03 (DOI)000436681800003 ()
Available from: 2015-11-30 Created: 2015-11-30 Last updated: 2018-12-06Bibliographically approved
Björn, C., Lindberg, M. & Rissén, D. (2016). Significant factors for work attractiveness and how these differ from the current work situation among operating department nurses. Journal of Clinical Nursing, 25(1-2), 109-116
Open this publication in new window or tab >>Significant factors for work attractiveness and how these differ from the current work situation among operating department nurses
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 1-2, p. 109-116Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: The aim was to examine significant factors for work attractiveness and how these differ from the current work situation among operating department nurses. A second objective was to examine the associations between age, gender, length of employment, work engagement, work ability, self-rated health indicators and attractiveness of the current work situation.

BACKGROUND: The attractiveness of work is rarely taken into account in research on nurse retention. To expand this knowledge, it is relevant to examine factors that make work attractive and their associations with related concepts.

DESIGN: Correlational, cross-sectional survey using a convenience sample.

METHODS: Questionnaires were answered by 147 nurses in four operating departments in Sweden. Correlation and regression analyses were conducted.

RESULTS: The nurses rated the significance of all factors of work attractiveness higher than they rated those factors in their current work situation; salary, organisation and physical work environment had the largest differences. The most significant attractive factors were relationships, leadership and status. A statistically significant positive correlation between work engagement and attractive work was found. In the multiple regression model, the independent variables work engagement and older age significantly predicted work attractiveness.

CONCLUSIONS: Several factors should be considered in the effort to increase work attractiveness in operating departments and thereby to encourage nurse retention. Positive aspects of work seem to unite work engagement and attractive work, while work ability and self-rated health indicators are other important dimensions in nurse retention.

RELEVANCE TO CLINICAL PRACTICE: The great discrepancies between the significance of attractive factors and the current work situation in salary, organisation and physical work environment suggest ways in which work attractiveness may be increased. To discover exactly what needs to be improved may require a deeper look into the construct of the examined factors.

Keywords
attractive work, cross-sectional survey, health manpower, perioperative care, personnel turnover, workplace
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-20370 (URN)10.1111/jocn.13003 (DOI)000368278200010 ()26419701 (PubMedID)2-s2.0-84955645341 (Scopus ID)
Available from: 2015-10-02 Created: 2015-10-02 Last updated: 2018-12-03Bibliographically approved
Pahus, J., Lindberg, M., Finderup, J. & Spliid Ludvigsen, M. (2016). Validation of the Fluid Intake Appraisal Inventory for patients on haemodialysis in Denmark. In: : . Paper presented at 45th EDTNA/ERCA International Conference, 17-20 September 2016, Valencia, Spain.
Open this publication in new window or tab >>Validation of the Fluid Intake Appraisal Inventory for patients on haemodialysis in Denmark
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Urology and Nephrology Nursing
Identifiers
urn:nbn:se:hig:diva-25600 (URN)
Conference
45th EDTNA/ERCA International Conference, 17-20 September 2016, Valencia, Spain
Available from: 2017-11-25 Created: 2017-11-25 Last updated: 2018-03-13Bibliographically approved
Bjuhr, M., Westerberg Jacobson, J., Willmer, M. & Lindberg, M. (2016). Women with disturbed eating behavior rate less work engagement. In: : . Paper presented at 2016 International Conference on Eating Disorders(ICED 2016), 5-7 May 2016, San Francisco, California, USA.
Open this publication in new window or tab >>Women with disturbed eating behavior rate less work engagement
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

There is a lack of research exploring emotional commitment to work in relation to eating attitudes. Since eating disorders are associated with adverse psychological and social consequences, work engagement could be affected. The purpose was to compare work engagement among women with and without disturbed eating (DE).

A cross-sectional survey using the Utrecht Work Engagement Scale and the Eating Disorder Examination Questionnaire in a general population cohort of 26-36-year-old women (n=847). Threshold for DE was 1 SD above general population mean. Independent t-test was used to compare work engagement. Ethical approval (reg no:2014/401)

The level of work engagement was lower (p=0.02) among women with DE (mean 3.69 +-1.43) than women without DE (mean 4.06 +-1.18). The score for dedication was also lower (p=0.02) within the DE group (mean 3.74+-1.57 vs 4.22 +-1.26). However, vigour and absorption were not different.

The work engagement in the cohort was within the average range although women with DE had significantly lower emotional commitment to work. As work engagement is linked to business success, workplace growth and sustainability it seems important to explore tailored strategies to improve work engagement among women with DE.

National Category
Health Sciences
Identifiers
urn:nbn:se:hig:diva-21516 (URN)
Conference
2016 International Conference on Eating Disorders(ICED 2016), 5-7 May 2016, San Francisco, California, USA
Projects
IDA-projektet
Available from: 2016-05-23 Created: 2016-05-23 Last updated: 2018-11-26Bibliographically approved
Ludvigsen S, M., Hermansen M, H. & Lindberg, M. (2015). The quality of nursing care during intradialytic fluid removal in haemodialysis: time to change practice?. Journal of Clinical Nursing, 24(11/12), 1733-1736
Open this publication in new window or tab >>The quality of nursing care during intradialytic fluid removal in haemodialysis: time to change practice?
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 11/12, p. 1733-1736Article in journal (Refereed) Published
Keywords
dialysis, haemodialysis, intradialytic fluid removal, nursingsensitive
National Category
Urology and Nephrology Nursing
Identifiers
urn:nbn:se:hig:diva-18182 (URN)10.1111/jocn.12735 (DOI)000355331300030 ()25420553 (PubMedID)2-s2.0-84929662620 (Scopus ID)
Available from: 2014-11-25 Created: 2014-11-25 Last updated: 2018-03-13Bibliographically approved
Lindberg, M. & Ludvigsen, M. S. (2013). Authors' response. International Journal of Nursing Studies, 50(1), 138-9
Open this publication in new window or tab >>Authors' response
2013 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 1, p. 138-9Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Nursing
Identifiers
urn:nbn:se:hig:diva-15148 (URN)23330170 (PubMedID)
Available from: 2013-09-06 Created: 2013-09-06 Last updated: 2018-03-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1289-9896

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