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  • 1.
    Ackelman, Birgitta Helmerson
    et al.
    Karolinska Univ Hosp, Area Occupat Therapy & Phys Therapy, Stockholm, Sweden..
    Sundholm, Anna
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Kierkegaard, Marie
    Karolinska Univ Hosp, Funct Area Occupat Therapy & Phys Therapy, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden..
    Hedborg, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Waldenlind, Elisabet
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Ingela, A.
    Remahl, M. Nilsson
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Migraine patient school (MPS) - A structured multimodal educational programme for patients with high frequency and chronic migraine2019In: Cephalalgia, ISSN 0333-1024, E-ISSN 1468-2982, Vol. 39, p. 332-332Article in journal (Other academic)
  • 2.
    Al- Barghouthi, Luma
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sager, Sarah
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Stigmatisering av individer med schizofreni utanför vården: En deskriptiv litteraturstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Schizophrenia is a psychosis mental illness which the cognitive functions are somehow impaired. This sickness is still surrounded by prejudice, fear and ignorance.Aim: The aim of this descriptive literature study was to describe the experiences of stigma outside the hospital for people with schizophrenia.Method: This literature study was based on 10 scientific articles searched in the databases Medline via PubMed and PsykINFO.Main results: The articles in this literature study showed that stigma was experienced among patients with schizophrenia in their encounter with people outside of care. Patients are faced with discrimination and violence both from family members and others. Stigmatization also exists in the media. The results also showed that stigma had a great impact on the participants' self-esteem and affected their perception of the disease.Conclusion: The results of this literature study show that patients with schizophrenia face stigma and discrimination in society. This has mainly been shown to be due to ignorance about the disease. In the work to reduce stigma, more people should stand up and support those patients. More knowledge about stigma is needed in this subject.

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  • 3.
    Andreassen Devik, Siri
    et al.
    Centre for Care Research Mid-Norway, Norway; Nord University, Norway.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Hellzén, Ove
    Mid Sweden University, Sweden.
    Nurses’ experiences of compassion when giving palliative care at home2020In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 27, no 1, p. 194-205Article in journal (Refereed)
    Abstract [en]

    Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised.

    Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data.

    Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes.

    Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content.

    Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective. 

  • 4.
    Arakelian, Erebouni
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Rudolfsson, Gudrun
    Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway;Division of Nursing, Department of Health Sciences, University West, Trollhättan, Sweden.
    Sharing the Same Reality, Healthy Relations Between Colleagues at Work: A Meta-Synthesis2023In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Introduction

    Good relations are important at work, leading to well-being among coworkers. Since the latest research in nursing is mostly about bullying, and lateral violence, it was important to study what healthy relations mean.

    Objectives

    The aim was to identify and synthesize qualitative studies that describe healthy relations, creating health and well-being between colleagues at work.

    Methods

    A meta-synthesis approach, inspired by Sherwood's steps of analysis, was chosen for this study. Ten articles from three continents, comprising 230 participants, were included.

    Results

    Two themes were identified as follows: (a) creating a mutual bond on a personal level and a permissive atmosphere through the human warmth; and (b) sharing togetherness in a greater whole, offering unconditional help and devoting themselves to taking care of each other. An overarching metaphor implicating the home/homeness was abstracted from the two themes: “Healthy relations between colleagues at work constitute the community as a common world, containing feelings of being at home, implying acting in an expression of the ethos and dignity, a culture created that makes the ideal form of healthy relations visible.”

    Conclusion

    Nurses find their meaning when they work in a permissive environment, and when they are allowed to be themselves. Such meaning can be found through their engagement with one another, by offering each other unconditional help. Good relationships lead to a place they call their home, where there is trust and friendship.

  • 5.
    Arvidsson, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Healthcare personnel assessed self-efficacy levels to medical asepsis and their relationship to structural empowerment, work engagement and work-related stressManuscript (preprint) (Other academic)
    Abstract [en]

    BACKGROUND: Healthcare personnel’s working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees’ behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions. 

    OBJECTIVE: To investigate the relationship between healthcare personnel assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress. 

    METHODS: A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and nursing assistants at surgical and orthopaedic units responded to a questionnaire containing: Infection Prevention Appraisal Scale, Conditions of Work Effectiveness Questionnaire-II, Utrecht Work Engagement Scale and HSE Management Standards Indicator Tool. Correlational analysis and group comparisons were performed. 

    RESULTS: Healthcare personnel rated high levels of self-efficacy to medical asepsis in care situations. Low correlations with a definite, but small relationship were found between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis. The comparative analysis revealed significant differences between some of the groups within the questionnaires. There were also differences between assessments of risk for organism transmission at work and self-efficacy. 

    CONCLUSIONS: This study revealed that HCP rated high levels of self-efficacy to medical asepsis, and to some extent, it seems to have a relationship to structural empowerment, work engagement and work-related stress. It is valuable knowledge that it would be possible to make improvements at the managerial and organisational level that benefit both HCP and patients in the long run. 

  • 6.
    Arvidsson, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Healthcare personnel's working conditions relationship to risk behaviours for organism transmission2021Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Healthcare personnel (HCP) often experience undesirable working conditions. Risk behaviours for organism transmission can lead to healthcare associated infections and risk behaviours has been described to be influenced by working conditions. Research is lacking regarding HCPs working conditions and its relation to risk behaviours for organism transmission which this thesis aims to investigate. 

    Methods: Study I had a mixed-methods convergent design. Observations and interviews were performed with 79 HCP, i.e., registered nurses (RNs) and assistant nurses (ANs). First-line managers were interviewed about the unit´s overall working conditions. The qualitative and quantitative data were analysed separately and then merged. Study II was a cross-sectional study with 417 RNs and ANs. The questionnaire included: self-efficacy to aseptic care, structural empowerment (SE), work engagement (WE) and work-related stress (WRS). Correlational analysis and group comparisons were performed. 

    Results: In Study I risk behaviours frequently occurred regardless of measurable and perceived working conditions. The HCP described e.g. staffing levels and interruptions to influence risk behaviours. In the statistical analyses, risk behaviours were more frequent in interrupted activities and when the HCP worked together. In Study II the HCP rated high levels of self-efficacy to aseptic care. Differences were found between self-efficacy and some of the grouped working condition variables and definite but small relationships were found between self-efficacy to aseptic care and SE/WE/WRS. 

    Conclusion: The HCP rated high levels of self-efficacy to aseptic care, but on the other hand, risk behaviours frequently occurred irrespective of working conditions. Healthcare managers are responsible for HCPs work environment and should continuously work to promote sufficient working conditions and to increase HCPs understanding of risk behaviours, which consequently also promote patient safety.

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  • 7.
    Arvidsson, Lisa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Lindberg, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: A mixed-methods study2022In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, no 7-8, p. 878-894Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To investigate healthcare personnel's working conditions in relation to risk behaviours for organism transmission.

    BACKGROUND: Healthcare personnel's behaviour is often influenced by working conditions that in turn can impact the development of healthcare-associated infections. Observational studies are scarce, and further understanding of working conditions in relation to behaviour is essential for the benefit of the healthcare personnel and the safety of the patients.

    DESIGN: A mixed-methods convergent design.

    METHODS: Data were collected during 104 h of observation at eight hospital units. All 79 observed healthcare personnel were interviewed. Structured interviews covering aspects of working conditions were performed with the respective first-line manager. The qualitative and quantitative data were collected concurrently and given equal priority. Data were analysed separately and then merged. The study follows the GRAMMS guidelines for reporting mixed-methods research.

    RESULTS: Regardless of measurable and perceived working conditions, risk behaviours frequently occurred especially missed hand disinfection. Healthcare personnel described staffing levels, patient-level workload, physical factors and interruptions as important conditions that influence infection prevention behaviours. The statistical analyses confirmed that interruptions increase the frequency of risk behaviours. Significantly higher frequencies of risk behaviours also occurred in activities where healthcare personnel worked together, which in the interviews was described as a consequence of caring for high-need patients.

    CONCLUSIONS: These mixed-methods findings illustrate that healthcare personnel's perceptions do not always correspond to the observed results since risk behaviours frequently occurred regardless of the observed and perceived working conditions. Facilitating the possibility for healthcare personnel to work undisturbed when needed is essential for their benefit and for patient safety.

    RELEVANCE FOR CLINICAL PRACTICE: The results can be used to enlighten healthcare personnel and managers and when designing future infection prevention work.

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  • 8.
    Arvidsson, Lisa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Lindberg, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nurses’ assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 74, no 2, p. 501-513Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses’ working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees’ behaviour at work. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.

    OBJECTIVE: To investigate the relationship between nurses assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.

    METHODS: A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions of Work Effectiveness Questionnaire-II, Utrecht Work Engagement Scale-9 and the Health & Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.

    RESULTS: The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and self-efficacy to medical asepsis were 0.254–0.268. Significant differences in self-efficacy were found in the grouped working conditions.

    CONCLUSIONS: This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.

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  • 9.
    Asylbekova, Gulmira
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science.
    Upplevelser av livskvalité hos patienter med bensår: Litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Omkring 100 000 svenskar beräknas lida av bensår vilka kräver långa behandlingstider och medför ekonomiska kostnader för samhället. Olika sjukdomstillstånd såsom trauma och försämrad blodcirkulation anses som riskfaktorer. Att leva med bensår kan ha negativ inverkan på människors dagliga liv. Det är viktigt för sjuksköterskor att informera patienterna kring behandlingen, ge stöd samt ha förmågan att bemöta dem med respekt och empati. Syfte: Syftet med föreliggande studie var att beskriva hur patienter med bensår upplever sin livskvalitet samt att beskriva undersökningsgrupperna som ingick i de inkluderade artiklarna. Metod: Beskrivande litteratur studie som inkluderade tolv vetenskapliga artiklar som söktes fram i databasen Cinahl. Huvudresultat: Patienterna beskrev smärta som påverkade deras dagliga liv både fysiskt och psykiskt. Sömnproblem påverkade det psykiska måendet negativt. Rädslan för att skada sig begränsade patienterna fysiskt och man beskrev även känslan av skam, missmod, ensamhet, oro, ångest, depression och förlust av hopp. Bensår upplevdes tidssamt energikrävande och brister i kunskap hos sjukvårdpersonalen hade negativ påverkan på patienternas livskvalité. Undersökningsgrupperna varierade i antal från 5 till 247 deltagare, majoriteten var kvinnor, åldern var mellan 18 till 99 år. De flesta deltagarna hade haft venösa bensår, vilka varade mellan 6 veckor till 43 år. Slutsats: Att leva med bensår påverkade livskvaliteten. Relationen mellan sjuksköterska – patient hade stort betydelse för sårläkningen och välbefinnande. Det är viktigt att sjuksköterskor har tillräcklig kunskap om denna patientgrupp samt att ge ett professionellt bemötande, stöd och information om en egenvård. 

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  • 10.
    Barker Strömbom, Charlotta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Wetterskog, Tove
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sjuksköterskors erfarenheter kring omvårdnaden av människor med demenssjukdom2021Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden there are approximately 130 000 to 150 000 people suffering from dementia and according to research this number may double by the year 2050. Dementia is a chronic disorder meaning it is irreversible and those suffering from dementia will deteriorate with time, therefore patients often need specialist care. Knowledge and experience within the field of the various dementia disorders is necessary to provide effective care and ensure quality of life for these patients. According to patients, and relatives of those suffering, the quality of care depends on the relationship between the nurse and patient, and whether nurses have specialist training in dementia care and person centred care (PCC). Aim: The aim of this literature study is to describe nurses' experience of caring for people with dementia. Method: A literature study with descriptive design was conducted based on twelve scientific articles from three different databases: PubMed, Cinahl and PsycINFO. Main results: Through thematic analysing of the twelve chosen scientific articles three main headings emerged along with eight subheadings describing nurses experiences of caring for people with dementia. Theme number one described the importance of individual care in terms of examination, communication, activities and environmental factors. Theme number two focused on relationships that according to the nurses affected the quality of care they provided for the patients. The third theme described nurses' experiences of how resources such as further education as well as better organisation of work and staffing affected their quality of care for patients suffering from dementia. Conclusion: The literature study shows that nurses within dementia care need further education and practical experience to deliver good quality PCC. To make this possible well organised staffing and work structuring from a higher level of management is necessary to create a secure and caring environment where both nurses and patients are satisfied.

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  • 11.
    Bengtsson, Mimmi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Norberg, Adina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Föräldrars upplevelse i samband med sitt barns typ 1-diabetesdiagnos2023Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 1-diabetes is a chronic autoimmune disease that often affects children, where the body's own insulin production is partially or completely impaired. In the year 2021, 979 children were diagnosed with type 1-diabetes in Sweden, and the incidence increases every year. The disease occurs quickly and the path to diagnosis can look different. When a child falls ill, it also affects parents who are often present and involved in their child's care. Aim: To describe parents' experience in relation to their child's type 1-diabetesdiagnosis. Method: A descriptive literature study based on twelve qualitative studies and was assembled with Aveyards thematic analysis. Main results: Based on the aim four themes were identified: Feelings related to diagnosis, Relations with the healthcare staff, Information and training at the hospital, Increased responsibility in parenthood. The majority of parents experienced shock at diagnosis and other emotions that emerged were sadness at the loss of their child's health, feelings of guilt and also a lack of knowledge about the disease. The parents’ healthcare experience varied, some parents described the time in hospital as safe, while others experienced a lack of support and empathy with healthcare staff. Education about diabetes was experienced differently, however, it appears that the majority of parents felt an overload of information. During the period in the hospital, parents describe a changed responsibility in their role as a parent. Conclusion: If healthcare professionals assist the parents with individually tailored information, are present and provide support, it can create conditions that can contribute to the parents being able to understand and manage the disease more easily.

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  • 12.
    Bergh, Amanda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sievers, Alexandra
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Patienters erfarenheter av tvångsvård inom den psykiatriska slutenvården: En beskrivande litteraturstudie2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background:Within the psychiatric inpatient care in Sweden, about one in five patients are cared for against their will, according to the Act on Psychiatric Forcible Care (LPT). Suffering from mental illness and being subjected to obsessive-compulsive care is a life-changing event for patients. It is desirable to improve coercive care and reduce the incidence of coercive measures. To be able to do that, and to be able to provide the best possible care as a nurse, a deeper understanding of patients experience of coercion is required.

    Aim: To describe patients experiences of coercion in psychiatric inpatient care.

    Method: A descriptive literature review based on 13 scientific articles with a qualitative approach.

    Main results: The results were presented in five categories and showed that many patients have similar experiences of compulsive care. Coercion was often described as the right measure to protect the patient or others, but many patients felt that it was performed incorrectly. Negative experiences mentioned were lack of information and communication, not being able to participate in their own care or being treated as a diagnosis by the staff. However, responsive, empathetic and helpful staff, adequate information on illness and treatment, the sense of participation and autonomy as well as a pleasant external environment and flexible rules were described as positive experiences and favorable to the recovery process.

    Conclusion: Patients often described both good and bad experiences of compulsive care. In order to provide the best possible care, and to minimize the risk of coercive measures, it is important for the nurse to know and understand patients' experiences of compulsive care. Then the patients suffering can be reduced and their recovery can be promoted.

     

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  • 13.
    Bergsheden, Jasmine
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sjuksköterskors erfarenheter av att vårda patienter med en annan kulturell bakgrund2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Den ökande strömmen av immigranter på grund av katastrofer, krig ochandra svårigheter skapar en komplicerad situation inom sjukvården i Europa. Mångaflyktingar lider av depressioner och svårartade stressymptom som kräver avanceradevårdinsatser från sjuksköterskor. För patienter från en annan kulturell bakgrund, kan ensjukhusvistelse verka skrämmande och skapa känslor av utanförskap. De kan ha svårtatt förstå vårdgivarens beslut kring behandlingar eftersom de inte är liknande se sompatienten är van vid att få. Kulturella skillnader och svårigheten att bli förstådd kan ledatill missförstånd, vilket i sin tur kan leda till skeptisk hållning kring helavårdsituatuationen.Syfte: Syftet är att beskriva sjuksköterskors erfarenheter i vården av patienter medannan kulturell bakgrund.Metod: Metoden som författaren valt för denna studie är en deskriptiv litteraturstudie.Huvudresultat: Resultatet var framtaget från elva olika artiklar. Kommunikation ärcentralt för förståelsen av vad som händer mellan patient och sjuksköterska så att intekonflikter och missförstånd uppstår, vilket kan skada patientens förtroende för vårdenoch samtidigt vara en risk för att patientsäkerheten äventyras. Könsperspektivet när detgäller vård av patienter med en annan kulturell bakgrund och hur sjuksköterskor kanhantera de problem som kan uppkomma när kvinnliga patienter har svårt att göra sighörda och lyssnade till vittnar många sjuksköterskor om och detta visar på ett viktigtresultat. För att kunna förändra och förbättra vården av patienter med annan kulturellbakgrund, pekar sjuksköterskorna på vikten av relevant utbildning av olika sorter, ochatt detta kan nås, tillsammans med mycket annat, genom ökande åtaganden rentorganisatoriskt.Slutsats: Slutsatsen av denna litteraturstudie är att adekvat träning av vården avpatienter med annan kulturell bakgrund är av stor vikt och att det högst prioriteradedelen är kommunikation och att klara av att inte fastna i de språkliga barriärer somfinns. Erfarenheter från mångkulturella möten inom vården är viktiga att vidarebefordraoch dela med andra sjuksköterskor för att öka kunskapen om vården av patienter medannan kulturell bakgrund. Denna litteraturstudie visade att det fanns många områden därsjuksköterskors kompetens borde höjas, men även att det finns mycket positivt som hargjorts.

  • 14.
    Bergsten, Eva L.
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Kristiansen, Lisbeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Ett hållbart arbetsliv genom riktade och samordnade insatser för individer med psykisk ohälsa i Ockelbo kommun2023Report (Other academic)
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  • 15.
    Birgisdóttir, Dröfn
    et al.
    Lunds universitet.
    Bylund-Grenklo, Tove
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College, Stockholm; Karolinska institutet.
    Steineck, Gunnar
    Karolinska institutet; Lunds universitet.
    Fürst, Carl Johan
    Lunds universitet.
    Kristensson, Jimmie
    Lunds universitet.
    Family cohesion predicts long-term health and well-being after losing a parent to cancer as a teenager: A nationwide population-based study2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 4, article id e0283327Article in journal (Refereed)
    Abstract [en]

    Background

    Parentally bereaved children are at increased risk of negative consequences, and the mediating factors most consistently identified are found to be related to family function after the loss, including cohesion. However, existing evidence is limited, especially with respect to children and youths’ own perception of family cohesion and its long-term effects on health and well-being. Therefore, the aim of this study was to investigate self-reported family cohesion the first year after the loss of a parent to cancer and its association to long-term psychological health and well-being among young adults that were bereaved during their teenage years.

    Method and participants

    In this nationwide population-based study, 622 of 851 (73%) young adults (aged 18–26) responded to a study-specific questionnaire six to nine years after losing a parent to cancer at the age of 13 to 16. Associations were assessed with modified Poisson regression.

    Results

    Bereaved youth that reported poor family cohesion the first year after losing a parent to cancer had a higher risk of reporting symptoms of moderate to severe depression six to nine years after the loss compared to those reporting good family cohesion. They also had a higher risk of reporting low levels of well-being, symptoms of anxiety, problematic sleeping and emotional numbness once a week or more at the time of the survey. These results remained statistically significant after adjusting for a variety of possible confounding factors.

    Conclusion

    Self-reported poor family cohesion the first year after the loss of a parent to cancer was strongly associated with long-term negative psychological health-related outcomes among bereaved youth. To pay attention to family cohesion and, if needed, to provide support to strengthen family cohesion in families facing bereavement might prevent long-term suffering for their teenage children.

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  • 16.
    Birgisdóttir, Dröfn
    et al.
    Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Institute for Palliative Care, Lunds University, Lund, Sweden.
    Bylund-Grenklo, Tove
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
    Nyberg, Tommy
    Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Caring Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Steineck, Gunnar
    The Sahlgrenska Academy, Department of Oncology, Division of Clinical Cancer Epidemiology, University of Gothenburg Institute of Clinical Sciences, Gothenburg, Sweden.
    Fürst, Carl J.
    Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Institute for Palliative Care, Lunds University, Lund, Sweden.
    Losing a parent to cancer as a teenager: Family cohesion in childhood, teenage, and young adulthood as perceived by bereaved and non-bereaved youths2019In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 9, p. 1845-1853Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate levels of perceived family cohesion during childhood, teenage years, and young adulthood in cancer-bereaved youths compared with non-bereaved peers.

    METHODS: In this nationwide, population-based study, 622 (73%) young adults (aged 18-26) who had lost a parent to cancer 6 to 9 years previously, when they were teenagers (aged 13-16), and 330 (78%) non-bereaved peers from a matched random sample answered a study-specific questionnaire. Associations were assessed using multivariable logistic regression.

    RESULTS: Compared with non-bereaved youths, the cancer-bereaved participants were more likely to report poor family cohesion during teenage years (odds ratio [OR] 1.6, 95% CI, 1.0-2.4, and 2.3, 95% CI, 1.5-3.5, for paternally and maternally bereaved youths, respectively). This was also seen in young adulthood among maternally bereaved participants (OR 2.5; 95% CI, 1.6-4.1), while there was no difference between paternally bereaved and non-bereaved youths. After controlling for a number of covariates (eg, year of birth, number of siblings, and depression), the adjusted ORs for poor family cohesion remained statistically significant. In a further analysis stratified for gender, this difference in perceived poor family cohesion was only noted in females.

    CONCLUSION: Teenage loss of a parent to cancer was associated with perceived poor family cohesion during teenage years. This was also noted in young adulthood among the maternally bereaved. Females were more likely to report poor family cohesion. Our results indicate a need for increased awareness of family cohesion in bereaved-to-be families with teenage offspring, with special attention to gender roles.

  • 17.
    Bjuhr, Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Being active in working life at older ages2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the thesis was to examine factors associated with (Study 1), predictors (Study II), and experiences (Study III) involved with being active in working life after the expected retirement age and the experiences of exiting working life before the expected retirement age (Study IV). In Studies I and II, a quantitative approach was used, with data derived from the Swedish National Study on Aging and Care (SNAC). In Studies III and IV, a qualitative approach was used, with data collected through semi-structured interviews. The results from Studies I and II revealed that being active in working life at age 66 was associated with being male, having a university education, working in a highly skilled occupation, having light physical activity at work, or having no more than one diagnosed disease. Being male (Studies I and II), having a university education (only in Study I) or working in a highly skilled occupation (only in Study II) were associated with being active in working life at age 72. The results from Studies III and IV revealed that from an individual perspective, health was a prominent aspect in either remaining in or exiting from working life. Staying active in working life increased feelings of vitality; the innermost dimension of health. Favorable working conditions could be beneficial to cognitive and physical health as well as to social well-being and a sense of meaningfulness. In contrast, strenuous working conditions contributed to the deterioration of health and pushed people at older ages toward an early exit from working life. The present results confirm the complexity regarding the predictors for being active in working life at older ages. The results add knowledge regarding how health in overall life and staying active in or exiting from working life at older ages can be experienced from a subjective perspective. With a successive increase in statutory retirement ages, the focus on the possibilities for healthy aging through being active in working life at older ages needs to be increased.

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  • 18.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Welmer, Anna-Karin
    Karolinska institutet.
    Elmståhl, Sölve
    Lunds universitet.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Being active in working life at age 60, 66 and 72 - a study of two Swedish cross-sectional samples 12 years apart2023In: Article in journal (Refereed)
  • 19.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden.
    Welmer, Anna-Karin
    Aging Research Centre (ARC), Department of Neurobiology, Care Sciences and Society (NVS) Karolinska Institute and Stockholm University, Stockholm, Sweden.
    Elmståhl, Sölve
    Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University, Sweden.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Aging Research Centre (ARC), Department of Neurobiology, Care Sciences and Society (NVS) Karolinska Institute and Stockholm University, Stockholm, Sweden.
    Health and work-related factors as predictors of still being active in working life at age 66 and 72 in a Swedish population: A longitudinal study2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 76, no 4, p. 1481-1492Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health and work environment are known factors in being active in working life beyond legal retirement.

    OBJECTIVE: To investigate sociodemographic, health and work environment factors as possible predictors of being active in working life at ages 66 and 72. Secondly, investigate eventual changes over time, shortly after a major reform in the Swedish pension system, and predictors of still being active in working life at age 66.

    METHODS: We used a longitudinal design with two separate cohorts of people at age 60. One baseline assessment was made in 2001–2003 with two 6 years follow-ups, and one in 200–2009 with one 6 years follow-up. Data were accessed through a Swedish national population-based study and analysed using logistic regression. To examine possible differences between the two cohorts, interaction terms with each independent variable were analysed.

    RESULTS: Being a man and working in a profession that requires at least three years of university education predicted that the person would still be active in working life at age 66 and 72. Additionally, having a light level of physical activity at work and being diagnosed with fewer than two diseases, also predicted still being active in working life at age 66. Only physical activity at work showed significant changes over time.

    CONCLUSION: Shortly after a major reform of the public pension system, there was an increase in participation in working life after age 66 and 72. However, gender, profession, and health factors are still important considerations regarding older people’s participation in working life.

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  • 20.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Welmer, Anna-Karin
    Karolinska institutet.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Incentives behind and experiences of being active in working life after age 65 in Sweden2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 23, article id 15490Article in journal (Refereed)
    Abstract [en]

    Since individual and societal expectations regarding the possibility of an extended working life after the expected retirement age are increasing, research on sustainable working life combined with healthy ageing is needed. This study explores the incentives behind and experiences of an extended working life after the expected retirement age of 65 among Swedish people. The inductive qualitative content analyses are based on 18 individual semi-structured interviews among persons 67–90 years old with varying characteristics and varying experiences of extended working lives. The analyses revealed that working contributed to (1) sustained internal resources, i.e., cognitive function, physical ability and increased vigor; (2) sustained external resources, i.e., social enrichment, better daily routines and economic benefits; (3) added meaningfulness to life, i.e., being needed, capability and satisfaction with working tasks. Meanwhile, having flexible working conditions enabled a satisfying balance between work and leisure. Altogether, these different aspects of overall health and working life were interpreted as contributing to increased feelings of vitality, the innermost dimension of health. Conclusions: regardless of biological age, our results indicate that being able to remain active in working life can be beneficial to vitality and could make these results valuable for both health-care personnel and employers.

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  • 21.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Welmer, Anna-Karin
    Karolinska institutet.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Antecedents of and experiences with voluntary early exit from working life before the expected retirement age in Sweden2023In: Article in journal (Refereed)
  • 22.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Welmer, Karin
    Karolinska institutet.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sustained health in working life among an aging population and an aging working force2023Conference paper (Refereed)
    Abstract [en]

    Background. A crucial factor for social sustainability is equal health and social justice. With an aging population andincreased expectations on senior workers to prolong their working life, research focusing on sustainable working life incombination with healthy aging is needed.

    Purpose. To explore factors related to and experiences of prolonging working life after the expected retirement age of65 among Swedish people.Methods. Cross-sectional and longitudinal data were used to assess associations with participation in working life atages 66 and 72. Additionally, qualitative data, based on 18 individual semi-structured interviews with workers 67–90years were used to gain an extended understanding of incentives for prolonged working life.

    Findings. Male gender and profession were associated with participating in working life at age 72, additionally, fewerdiagnosed diseases and a light level of physical activity at work at 66. Senior workers described that workingcontributed to sustained internal and external resources, added meaningfulness to life and flexible working conditionsenabled a satisfying balance between work and leisure. Altogether, these different aspects of working life wereinterpreted as contributing to increased feelings of vitality, the innermost dimension of health.

    Conclusion. Regardless of biological age, being able to remain active in working life can be beneficial to vitality.Actions to provide flexible working conditions, especially for disadvantaged senior workers, may facilitate working lifeafter the expected retirement age with extended equality.

  • 23.
    Björklund, Ove
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    FRÅN LIVSLEDA TILL LIVSMOD : Unga människors erfarenheter av arbetslöshet och stödåtgärder2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this dissertation is to increase our understanding of what it is like to live as an unemployed young person, by looking at young people’s narratives. An additional aim is to explore and describe how unemployed young people’s experiences of participating in a support project can be understood from a caring science perspective. The overall questions addressed in the dissertation are: What does living in unemployment mean to a young person? How can a resource center for unemployed young people provide care? The dissertation includes a compilation of four scientific articles and an introductory chapter; it has a descriptive design and a hermeneutical approach. The dissertation starts from four meta-concepts used in caring science: human being, health, caring, and the world. These meta-concepts are the mainstays of the dissertation, at the same time as they give the research themes their caring science framework. The informants were 15 unemployed Finnish young men, aged 18-27 years, and 12 unemployed Finnish young women, aged 18-26 years. All had been out of work for between two and six months. The data were gathered by means of semi-structured interviews. The interviews were examined using content analysis and hermeneutic interpretation. To increase understanding of the dissertation’s themes as related to caring science, empirical results from the four studies were connected to elements of caring science theory taken from Katie Eriksson’s caritative caring theory. In summary, the results pertaining to the young men’s and women’s experiences of unemployment can be likened to a kind of suffering or weariness of life. Activities at the resource center for unemployed young people were characterized by Eriksson’s caring science concepts of tend, play and learn. Tending was revealed in how the young people were made to feel appreciated and accepted as the persons they were and are. The concepts play and learn were revealed in how the unemployed young people were given opportunities to express their dreams for the future and to dare to see other perspectives. At the resource center, positive caring powers could be identified – powers that worked together to enable the transition from suffering and weariness of life to a feeling of zest and the courage to face life. It can be established, in summary, that unemployment affects young people’s health. Not only for the unemployed individual, but also for society at large, it should be of great value to characterize the everyday life and reality of the unemployed at an early stage, and to move those who are suffering into a caring context in order to, if all goes well, replace weariness of life with the courage to face life.

  • 24.
    Björklund, Ove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Unemployment may increase feelings of lacking context in Life: Experiences narrated by Young Finnish Women2019Manuscript (preprint) (Other academic)
  • 25.
    Björklund, Ove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nyström, L.
    Hope and Faith in the Future. Young Unemployed Finnish Women´s Experiences of Having Participated in a Specific Active Labor Market ProgramManuscript (preprint) (Other academic)
  • 26.
    Björkman, Annica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Winblad, Ulrika
    Uppsala universitet.
    Holmström, Inger K
    Uppsala universitet; Mälardalens högskola.
    Malpractice claimed calls within the Swedish Healthcare Direct: a descriptive – comparative case study2021In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 20, article id 21Article in journal (Refereed)
    Abstract [en]

    Background

    Medical errors are reported as a malpractice claim, and it is of uttermost importance to learn from the errors to enhance patient safety. The Swedish national telephone helpline SHD is staffed by registered nurses; its aim is to provide qualified healthcare advice for all residents of Sweden; it handles normally about 5 million calls annually. The ongoing Covid-19 pandemic have increased call volume with approximate 30%. The aim of the present study was twofold: to describe all malpractice claims and healthcare providers’ reported measures regarding calls to Swedish Healthcare Direct (SHD) during the period January 2011–December 2018 and to compare these findings with results from a previous study covering the period January 2003–December 2010.

    Methods

    The study used a descriptive, retrospective and comparative design. A total sample of all reported malpractice claims regarding calls to SHD (n = 35) made during the period 2011–2018 was retrieved. Data were analysed and compared with all reported medical errors during the period 2003–2010 (n = 33).

    Results

    Telephone nurses’ failure to follow the computerized decision support system (CDSS) (n = 18) was identified as the main reason for error during the period 2011–2018, while failure to listen to the caller (n = 12) was the main reason during the period 2003–2010. Staff education (n = 21) and listening to one’s own calls (n = 16) were the most common measures taken within the organization during the period 2011–2018, compared to discussion in work groups (n = 13) during the period 2003–2010.

    Conclusion

    The proportion of malpractice claims in relation to all patient contacts to SHD is still very low; it seems that only the most severe patient injuries are reported. The fact that telephone nurses’ failure to follow the CDSS is the most common reason for error is notable, as SHD and healthcare organizations stress the importance of using the CDSS to enhance patient safety. The healthcare organizations seem to have adopted a more systematic approach to handling malpractice claims regarding calls, e.g., allowing telephone nurses to listen to their own calls instead of having discussions in work groups in response to events. This enables nurses to understand the latent factors contributing to error and provides a learning opportunity.

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  • 27.
    Björkman, Annica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Giving advice to callers with mental illness: adaptation among telenurses at Swedish Healthcare Direct2019In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, no 1, article id 1633174Article in journal (Refereed)
    Abstract [en]

    Purpose: Our aim was to describe Swedish Healthcare Direct (SHD) and its features as a complex system.

    Methods: Qualitative interviews were conducted with 20 SHD telenurses, covering their experiences and skills when encountering and advising callers with mental illness. Complexity science was used as an a priori theoretical framework to enhance understanding of the complex nature of telenursing.

    Results: SHD was described as a complex system as nurses were constantly interacting with other agents and agencies. During these interactions, dynamic processes were found between the agents in which the nurses adapted to every new situation. They were constantly aware of their impact on the care-seekers, and perceived their encounters with callers with psychiatric illness as "balancing on a thin line". SHD was also described as both an authority and a dumping ground. The openness of the system did not give the nurses possibility to control the number of incoming calls and the callers' intentions.

    Conclusions: These new insights into SHD have important implications for organization developers and nursing management in terms of overcoming linear thinking.

  • 28.
    Blom, Emma
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Blomqvist, Viktor
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Patienters upplevelser efter fetmakirurgi2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Förekomsten av fetma ökar till följd av dålig kost, stillasittande, ärftlighet och att fler väljer motordrivna transportmedel. Fetma ökar risken för hjärt- och kärlsjukdomar, diabetes och flertalet andra komorbida sjukdomar. Att leva med fetma är utmanande och att ta sig ur det osunda leverne som föranlett fetman är inget som görs enkelt. Oftast finns kunskapen om hur, men strategierna som krävs för att lyckas saknas. För de som gjort upprepade försök men misslyckas kan fetmakirurgi vara en alternativ lösning. Syfte: Beskriva patienters upplevelser efter fetmakirurgi. Metod: En sammanställning av resultatet från 12 artiklar har gjorts med tematisk dataanalys. Huvudresultat: Nya fysiska och psykiska utmaningar uppstod efter operation. Den plötsliga kroppsliga förändringen lockade nyfikenhet från omgivningen i både positiv och negativ bemärkelse. En ny mage krävde ett nytt sätt att äta och felsteg resulterade i flera möjliga oönskade konsekvenser såsom gasbildning, illamående, kräkningar, mm. Att plötsligt rasa i vikt medför även en stor mängd överbliven hud. Trots flertalet svårigheter så anser merparten att operationen varit värd mödan. Positiva aspekter som nyvunnen energi, bättre fysisk och psykisk hälsa, sundare leverne, mindre komorbida sjukdomar samt upplevelsen av att ha fått en ny chans i livet. Slutsats: Fetmakirurgi påverkar patienternas liv på flera sätt. Fördelarna grundar sig i bättre sociala relationer och familj, friskare kroppar och en bättre hälsa. Nackdelarna är komplikationer som patienterna drabbats av och förvirrande tankar och känslor. Genom bättre kunskap om patienters upplevelser efter fetmakirurgi kan sjuksköterskor ge bättre och mer närvarande vård till dessa patienter.

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  • 29.
    Blom Johansson, Monica
    et al.
    Uppsala University, Sweden.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala University, Sweden.
    Östberg, Per
    Karolinska University Hospital, Sweden.
    Sonnander, Karin
    Uppsala University, Sweden.
    Self-reported changes in everyday life and health of significant others of people with aphasia: a quantitative approach2022In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 36, no 1, p. 76-94Article in journal (Refereed)
    Abstract [en]

    Background: Changes in the everyday life and health of the significant others (SOs) of people living with stroke sequalae have been widely investigated. However, information regarding the frequency of the changes in daily life and the variables most associated with these perceived life changes is limited. Aims: To examine the extent to which SOs of persons with aphasia (PWAs) experience changes in everyday life and health after the stroke event and how they evaluate these changes and to identify which variables are associated with these perceived life changes. Methods & Procedures: A study-specific questionnaire about perceived changes in everyday life and health was completed by 173 SOs of PWAs living in Sweden (response rate 67.8%). The items concerned the SO’s working and financial situation, leisure time and social life, relationship with the PWA, household work and responsibility, and health and quality of life. Outcomes & Results: The everyday life and health of the SOs were greatly affected by the stroke event. The changes the SOs experienced were mainly appraised negatively. The relationships with the PWA and immediate family were least affected by the stroke. The perceived existence and severity of physical, cognitive, and language impairments of the PWA were the variables most strongly associated with the everyday life situation of the participants. The sex and age of the participants and the nature of the relationship with the PWA were only marginally associated with the experience of the situation. Conclusions: SOs’ perceptions of the PWA’s stroke-related disabilities and need for assistance may be a key factor in identifying SOs who may require support and guidance to help them cope with their new life situation.

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  • 30.
    Blom, Kerstin
    et al.
    Karolinska Institutet; Haukeland University Hospital, Bergen, Norway.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sleep during pelvic-abdominal radiotherapy for cancer: a longitudinal study with special attention to sleep in relation to nausea and quality of life2021In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 44, no 4, p. 333-344Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Poor sleep, nausea, psychological distress, and a lowered quality of life are common during radiotherapy for cancer. There is a lack of studies on the relationship between radiotherapy-induced nausea and sleep. This longitudinal study analyzes data from 196 patients who underwent pelvic-abdominal radiotherapy for cancer.

    OBJECTIVE: The aim of this study was to investigate sleep parameters weekly before, during, and after radiotherapy in relation to nausea and other patient characteristics, clinical characteristics, psychological distress, and quality of life.

    METHODS: Patients (n = 196, 84% women; mean age, 63 years; 68% had gynecological tumor, 28% had colorectal tumor, and 4% had other tumors) longitudinally answered questionnaires before, during, and after their radiotherapy over the abdominal and pelvic fields.

    RESULTS: Poor sleep was experienced by 30% of the participants, and sleep (quality and difficulty falling asleep) improved during and after treatment compared with baseline. Experiencing nausea during treatment was associated with worse sleep quality during radiotherapy. Baseline anxiety was associated with worse sleep quality before, during, and after treatment. Poor sleep was associated with worse quality of life.

    CONCLUSION: Nausea, more than a number of other variables, is a possible predictor of poor sleep in patients during radiotherapy for cancer.

    IMPLICATIONS FOR PRACTICE: The results indicate that effectively managing nausea may be important for sleep quality, and possibly quality of life, in patients undergoing radiotherapy for cancer. More research is needed before recommendations for practice can be made.

  • 31.
    Blomqvist, Nicklas
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Bergsten, Ellen
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Att bemöta patienter med förvrängd verklighetsuppfattning: En litteraturstudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In 2018, mental illness was the most common reason for inpatient care for men and women aged 15–44. What is central to a mental illness is that people who fall ill lose their normal perception of reality. The formation of a therapeutic relationship is a major part of the care of mentally ill patients and for such a relationship to arise, the treatment can be part of it. The nurse has a responsibility to care for patients and to have a good attitude towards care when mentally ill patients are vulnerable, this to make them more likely to dare to open up and be able to actively participate in the treatment.

    Aim The aim of this study was to describe nurses’ experiences of what affects the interaction with a distorted perception of reality.

    Method: A literature study with descriptive design.

    Main result: The results showed that the response was affected by several aspects. Commitment, relationship building and organization affected the approach of patients with distorted perceptions of reality on different levels. Being there for the patients and being open in communication led to an improved relationship. Furthermore, the importance of having enough time and education is emphasized to communicate with these patients.

    Conclusion: Attendance is a central part of psychiatric care. Training and competence in the workplace empowers nurses and gives them a good basis for meeting patients. An equal, open approach to patients strengthens the relationship between patient and nurse and provides the conditions for good care. Further development of nurses’ experiences can provide better conditions for nurses to treat and care for mentally ill patients.

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  • 32.
    Blomqvist, Sven
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Sports Science.
    Seipel, Stefan
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Computer and Geospatial Sciences, Computer Science. Uppsala universitet.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Using augmented reality technology for balance training in the older adults: a feasibility pilot study2021In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 21, article id 144Article in journal (Refereed)
    Abstract [en]

    Background: Impaired balance leading to falls is common in the older adults, and there is strong evidence that balance training reduces falls and increases independence. Reduced resources in health care will result in fewer people getting help with rehabilitation training. In this regard, the new technology augmented reality (AR) could be helpful. With AR, the older adults can receive help with instructions and get feedback on their progression in balance training. The purpose of this pilot study was to examine the feasibility of using AR-based visual-interactive tools in balance training of the older adults.; Methods: Seven older adults (66-88 years old) with impaired balance trained under supervision of a physiotherapist twice a week for six weeks using AR-based visual-interactive guidance, which was facilitated through a Microsoft HoloLens holographic display. Afterwards, participants and physiotherapists were interviewed about the new technology and their experience of the training. Also, fear of falling and balance ability were measured before and after training.; Results: Five participants experienced the new technology as positive in terms of increased motivation and feedback. Experiences were mixed regarding the physical and technical aspects of the HoloLens and the design of the HoloLens application. Participants also described issues that needed to be further improved, for example, the training program was difficult and monotonous. Further, the HoloLens hardware was felt to be heavy, the application's menu was difficult to control with different hand manoeuvres, and the calibration took a long time. Suggestions for improvements were described. Results of the balance tests and self-assessment instruments indicated no improvements in balance performance after AR training.; Conclusions: The study showed that training with the new technology is, to some extent, feasible for the older adults, but needs further development. Also, the technology seemed to stimulate increased motivation, which is a prerequisite for adherence to training. However, the new technology and training requires further development and testing in a larger context.

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  • 33.
    Boström, Åsa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Tajik, Farnoush
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    En beskrivande litteraturstudie om personers upplevelser av livsstilsförändringar efter en hjärtinfarkt2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 34.
    Brink, Amanda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Olsson, Ida
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Patienters erfarenheter av egenvård vid diabetes mellitus typ 22022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes mellitus type 2 (DMT2) is a common disease that is increasing worldwide and usually affects people over 50 years of age, but is increasingly seen at younger ages. The risk of contracting it depends on both heredity and lifestyle, where physical activity, good diet and avoiding tobacco are some factors that can prevent contracting DMT2. Carrying out good self-care is important for the disease to be under control and not worsen. Purpose: To describe people's experiences of self-care in diabetes mellitus type 2. Method: A descriptive literature study where the database search was done in Pubmed. Thirteen primary studies generated content for the study results. Results: Three main themes emerged in the study, which were, Knowledge when performing self-care in people with DMT2, The importance of lifestyle changes in self-care in people with DMT2 and Obstacles in performing self-care in people with DMT2. In these main themes, seven subthemes emerged, Knowledge an important importance in managing self-care, The nurse's knowledge affects the person's self-care, New routines a challenge for self-care, The importance of support from relatives and people with the same illness for the maintenance of self-care, The economy affects the maintenance of self-care, Other diseases affect self-care and Stigma affects self-care. Conclusion: People's experiences of self-care in DMT2 showed that self-care management was challenging. The literature study can contribute to increased understanding and at the same time be a tool for the nurse, people with DMT2 and their surroundings and contribute to good experiences of self-care in DMT2.

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  • 35.
    Bylund-Grenklo, Tove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Birgisdóttir, Dröfn
    Lund University.
    Beenaert, Kim
    Ghent University, Netherlands.
    Nyberg, Tommy
    University of Cambridge, UK; Karolinska Institute.
    Skokic, Viktor
    Karolinska Institute.
    Kristensson, Jimmie
    Lund University.
    Steineck, Gunnar
    Karolinska Institute; University of Gothenburg.
    Fürst, Carl Johan
    Lund University.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College; Karolinska Institute.
    Acute and long-term grief reactions and experiences in parentally cancer-bereaved teenagers2021In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 20, no 1, article id 75Article in journal (Refereed)
    Abstract [en]

    Background

    Previous research shows that many cancer-bereaved youths report unresolved grief several years after the death of a parent. Grief work hypothesis suggests that, in order to heal, the bereaved needs to process the pain of grief in some way. This study explored acute grief experiences and reactions in the first 6 months post-loss among cancer-bereaved teenagers. We further explored long-term grief resolution and potential predictors of having had “an okay way to grieve” in the first months post-loss.

    Methods

    We used a population-based nationwide, study-specific survey to investigate acute and long-term grief experiences in 622 (73% response rate) bereaved young adults (age > 18) who, 6–9 years earlier, at ages 13–16 years, had lost a parent to cancer. Associations were assessed using bivariable and multivariable logistic regression.

    Results

    Fifty-seven per cent of the participants reported that they did not have a way to grieve that felt okay during the first 6 months after the death of their parent. This was associated with increased risk for long-term unresolved grief (odds ratio (OR): 4.32, 95% confidence interval (CI): 2.99–6.28). An association with long-term unresolved grief was also found for those who reported to have been numbing and postponing (42%, OR: 1.73, 95% CI: 1.22–2.47), overwhelmed by grief (24%, OR: 2.02, 95% CI: 1.35–3.04) and discouraged from grieving (15%, OR: 2.68, 95% CI: 1.62–4.56) or to have concealed their grief to protect the other parent (24%, OR: 1.83, 95% CI: 1.23–2.73). Predictors of having had an okay way to grieve included being male, having had good family cohesion, and having talked about what was important with the dying parent.

    Conclusion

    More than half of the cancer-bereaved teenagers did not find a way to grieve that felt okay during the first 6 months after the death of their parent and the acute grief experiences and reaction were associated with their grief resolution long-term, i.e. 6–9 years post-loss. Facilitating a last conversation with their dying parent, good family cohesion, and providing teenagers with knowledge about common grief experiences may help to prevent long-term unresolved grief.

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  • 36.
    Bylund-Grenklo, Tove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Oncology Pathology, Karolinska Institutet, Stockholm, Sweden.
    Werkander-Harstäde, Carina
    Department of Health and Caring Sciences, Linnaeus University, Växjö; Center for Collaborative Palliative Care, Växjö, Sweden; Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Sandgren, Anna
    Department of Health and Caring Sciences, Linnaeus University, Växjö; Center for Collaborative Palliative Care, Växjö, Sweden; Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Benzein, Eva
    Department of Health and Caring Sciences, Linnaeus University, Kalmar; Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden .
    Östlund, Ulrika
    Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle; Faculty of Medicine and Health, School of Health Sciences, Örebro University; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Dignity in life and care: The perspectives of Swedish patients in a palliative care context2019In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 25, no 4, p. 193-201Article in journal (Refereed)
    Abstract [en]

    Background: How patients preserve their sense of dignity in life is an important area of palliative care that remains to be explored. Aims: To describe patients' perspectives of what constitutes a dignified life within a palliative care context. Methods: Twelve palliative care patients were interviewed about their views on living with dignity. Data were analysed using qualitative content analysis. Results: What constitutes a dignified life during end-of-life care was captured by the theme 'I may be ill but I am still a human being' and presented under the categories 'preserving my everyday life and personhood', 'having my human value maintained by others through 'coherence' and 'being supported by society at large'. Conclusion: Patients' sense of dignity can be preserved by their own attitudes and behaviours, by others and through public support. Health professionals need to adopt a dignity-conserving approach, for which awareness of their own attitudes and behaviours is crucial. 

  • 37.
    Bäck, Stina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Omvårdnadsåtgärder som har effekt på oro, ångest och patienttillfredsställelse i samband med operation: En systematiskt utförd litteraturstudie2023Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Oro och ångest är vanligt förekommande i samband med operation och kan leda till onödigt lidande och negativa följder för patienten. Preoperativ information är viktigt för patientsäkerheten men även för patientens delaktighet och är en av de faktorer som påverkar oro, ångest och patienttillfredsställelsen i samband med operation.Syfte:  Syftet med studien var att beskriva vilka omvårdnadsåtgärder, utöver sedvanlig preoperativ information, som visat sig ha effekt på oro, ångest och patienttillfredsställelse hos vuxna patienter som genomgår en operation med anestesi.

    Metod: En systematiskt utförd litteraturstudie genomfördes för att sammanställa tidigare publicerade forskningsresultat inom området. Sökningar av artiklar gjordes i PubMed samt CINAHL. Totalt 14 randomiserade kontrollstudier inkluderades i studiens resultat.

    Huvudresultat: Resultatet visade att användning av en behovsbaserad utbildning, PowerPoint eller informationsvideos i det preoperativa mötet gav signifikant positiva effekter på oro, ångest och patienttillfredsställelse. Vid användning av multimediautbildning, skräddarsydda broschyrer eller patientutbildning med rundvandring sågs ingen effekt på oro och ångest, däremot sågs en positiv effekt genom ökad patienttillfredsställelse.

    Slutsats: Omvårdnadsåtgärder i form av behovsbaserad utbildning, PowerPoint, multimediautbildning, informationsvideos, skräddarsydda broschyrer eller patientutbildning med rundvandring visade positiv effekt för patienters oro, ångest och/ eller patienttillfredsställelse i samband med operation. Genom att rutinmässigt utvärdera patienters oro och ångest kan individanpassade omvårdnadsåtgärder underlätta informationsöverföringen i det tidiga preoperativa skedet.

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  • 38.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University.
    Self-reported competence in female and male nursing students in the light of theories of hegemonic masculinity and femininity2020In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, no 1, p. 191-198Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In most parts of the world, nursing historically has been considered an occupation for women. Gender stereotypes are associated with the nursing profession.

    AIM: The aim was to describe and compare the self-reported competence in female and male nursing students. The students were also compared according to their different background college educations. The theoretical framework of hegemonic masculinity and femininity was used.

    DESIGN: A cross-sectional design with a questionnaire was used at two points in time, 2012 and 2017.

    METHODS: Nursing students completed a questionnaire on graduation from a three-year university nursing program from 12 universities/university colleges in Sweden. In total, 1,810 students were participating, 1577 female and 227 male students. The Nurse Professional Competence scale was used for data collection.

    RESULTS: There were statistical significant differences in the self-reported competence between female and male students (t-tests and ANOVAs). These differences are in agreement with the patterns of hegemonic masculinity and femininity. Female students estimated their competence in giving value-based nursing care as higher than male did. Male students estimated their competence in development and leadership higher than female did.

    CONCLUSION: The pattern of hegemonic masculinity and femininity could be identified. This indicates a difference in power between female and male students.

    IMPACT: The study addresses the self-reported competence of female and male nursing students. The results indicated that male students possibly looked on themselves as superior to the female students. In order to change the image of nursing as a woman's work, the self-images should be discussed in nursing education as well as in college education. Women interested in development, research and leadership and men interested in nursing care and administration must feel that nursing is a suitable profession for them. The stereotypical image of nursing as a women's work is a barrier to nurses' professional development.

  • 39.
    Cederqvist, Erika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Strand, Andreas
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Personer med psykisk ohälsas upplevelser av stigmatisering2023Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research shows that stigmatizing attitudes towards persons with mental illness are sometimes harbored by the public and by health care personnel, and that this can sometimes lead to persons with mental illness being treated by others in stigmatizing ways. Aim: The aim of this study was to describe the experiences of persons with mental illness of stigmatization. Method: A literature review of descriptive design. The result is based on 12 scientific articles with qualitative approaches. Main Result: Persons with mental illness often experience stigmatizing attitudes in relation to health care personnel. Persons with mental illnesses often experience that mental illnesses are not considered to be as serious as somatic illnesses. Persons with mental illness make use of various strategies in order to handle stigmatization. Conclusion: Because of the stigmatization they experience and the strategies they employ to handle stigmatization, persons with mental illness risk being alienated from society. The relations between persons’ with mental illness and health care organizations risk being damaged through the stigmatizing attitudes they experience in relations with health care organizations. The experiences of persons with mental illnesses of health care personnels’ attitudes towards them could be improved by nurses treating them in a professional and emphatic manner.

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  • 40.
    Chen, Jian Hua
    et al.
    Department of Nursing, Medicine and Health College, Lishui University, Lishui, Zhejiang Province, China.
    Björkman, Annica
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Zou, Ji Hua
    Department of Nursing, Medicine and Health College, Lishui University, Lishui, Zhejiang Province, China.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Self–regulated learning ability, metacognitive ability, and general self-efficacy in a sample of nursing students: A cross-sectional and correlational study2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 15-21Article in journal (Refereed)
    Abstract [en]

    The healthcare sector is fast-growing and knowledge-intensive, and to meet the demands associated with it, nursing students must have high levels of self-regulated learning (SRL), metacognition, and general self-efficacy (GSE). In this cross-sectional, correlational study, data were collected from 216 nursing students through a questionnaire. The aims were: 1) to describe the levels of SRL ability, metacognitive ability and GSE among second- and third-year nursing students; 2) to explore the relationships between the SRL ability, metacognitive ability and GSE of second- and third-year nursing students; 3) and to compare SRL ability, metacognitive ability and GSE between second- and third-year nursing students. Nursing students had moderate levels of SRL ability and metacognitive ability, but lower levels of GSE. Positive relationships between SRL ability, metacognitive ability, and GSE were observed. Third-year nursing students had a higher level of SRL ability but lower levels of GSE, compared to second-year students. In terms of metacognitive ability, no significant differences were observed between the student batches. Interventions are required for the improvement of nursing students’ SRL ability, metacognitive ability, and GSE.

  • 41.
    Crafoord, Marie-Therése
    et al.
    Karolinska Institutet.
    Sundberg, Kay
    Karolinska Institutet.
    Nilsson, Marie I.
    Karolinska Institutet.
    Fjell, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Karolinska Institutet.
    Langius-Eklöf, Ann
    Karolinska Institutet.
    Patients' Individualized Care Perceptions and Health Literacy Using an Interactive App During Breast and Prostate Cancer Treatment2023In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 41, no 9, p. 706-716Article in journal (Refereed)
    Abstract [en]

    The use of symptom management mobile apps can reduce patients' symptom burden during cancer treatment, but the evidence is lacking about their effect on care. Moreover, if patients' health literacy can be improved, it needs to be more rigorously tested. This study aimed to evaluate patients' perceptions of individualized care and health literacy using an interactive app in two randomized trials. Patients undergoing neoadjuvant chemotherapy for breast cancer (N = 149) and radiotherapy for prostate cancer (N = 150) were consecutively included and randomized into one intervention or control group. Outcome measures were Individualized Care Scale, Swedish Functional Health Literacy Scale, and Swedish Communicative and Critical Health Literacy Scale. In the breast cancer trial, no group differences were observed regarding individualized care or health literacy. Most patients had sufficient health literacy levels. In the prostate cancer trial, intervention group patients rated higher perceived individualized care regarding decision control at follow-up than the control group. Less than half had sufficient health literacy levels and intervention group patients significantly improved their ability to seek, understand, and communicate health information. Education level explained significant variance in health literacy in both trials. Using an interactive app can positively affect individualization in care and health literacy skills among patients treated for prostate cancer, although further research is warranted.

  • 42.
    Croné, Jennie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Emanuelsson, Malin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Personers erfarenheter av livet efter ett hjärtstopp2020Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Background: In the report from the CPR-register 8663 cardiac arrests were reported in Sweden in 2018 and 1482 successful resuscitations was performed. In the event of a cardiac arrest the brain is suffering from hypoxia and without adequate treatment the person may suffer permanent brain damage, or in worst case it could cause death. The nurse has responsibilities when it comes to care giving, and through increased understanding for peoples experiences of life after a cardiac arrest there is an opportunity to provide better individual treatment.

    Aim: To describe people´s experiences after surviving a cardiac arrest.

    Method: A literature study with a descriptive design and a thematic analysis method. 15 scientific articles with both qualitative and quantitative approach were retrieved from the databases MEDLINE through PubMed and CINAHL.

    Result: The survivors often experienced loss of memory and cognitive difficulties after a cardiac arrest. Information and support from the care givers seemed to be important factors for the survivors so they could feel safe and secure. It also seemed that the physical abilities had deteriorated and going back to work was not obvious after acardiac arrest. Many of the personal roles were lost, and the survivors had a though experience adapting to a new identity. At the same time the survivors felt grateful that they had survived and many realized that they had a second chance of life.

    Conclusion: To suffer from a cardiac arrest is a life changing event that often leaves thes urvivors with feelings of fear and anxiety but also with gratefulness that they had survived. There is an unintentional change of physical functions, roles and identity and this can be hard to handle for the survivors. Through individual treatment, the nurse may strengthen the survivors´ sense of coherence which leads to increased health of thesurvivors.

    Keywords: Cardiac arrest, Experiences, Health, Sense of coherence

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  • 43.
    Dahlkvist, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Residents’ use and perceptions of residential care facility gardens: a behavior mapping and conversation study2020In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 15, no 1, article id e12283Article in journal (Refereed)
    Abstract [en]

    Aim

    To describe the gardens and their use by individuals living at residential care facilities (RCFs) with high ratings on restorative values.

    Background

    Being outdoors has been described as important to older people's well‐being. Use of outdoor gardens may increase residents’ well‐being through experiences of restorative qualities such as being away and fascination. Thus far, there has been little research on restorative experiences of gardens in the care of older people.

    Design

    A descriptive design using behaviour mapping observations integrated with qualitative field notes and recorded conversations.

    Methods

    A criterion sampling of two gardens (out of a total of 87) was made based on residents’ ratings of restorative values; the two with the highest values were chosen. Eleven residents at the two RCFs took part. Data were collected through behaviour mapping observations, field notes and conversations on five occasions in the respective facilities during residents’ visits to the garden.

    Results

    The observations revealed that the main uses of the gardens were to socialise and relax. The conversations also showed that the garden stimulated residents’ senses and evoked memories from the past. These restorative values were interpreted as a sense of being away and fascination. Not having opportunities for outdoor visits was reported to result in disappointment and reduced well‐being.

    Conclusions

    The findings showed that two basic gardens with different characteristics and views could stimulate residents’ senses and evoke memories from the past; this supports the call for residents to be able to spend time in gardens to promote their well‐being.

    Implications for practice

    First‐line managers, nurses and healthcare staff in the care of older people should consider that regular opportunities to spend time outdoors may promote older people's well‐being through feelings of being away and fascination.

  • 44.
    Dahlkvist, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Wallhagen, Marita
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science.
    Bergsten, Eva L.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Luleå University of Technology.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    First-line managers’ leadership behavior profiles and use of gardens in residential care facilities: An interview study2023In: Journal of Aging and Environment, ISSN 2689-2618, Vol. 37, no 1, p. 65-84Article in journal (Refereed)
    Abstract [en]

    This study explored first-line managers’ leadership behavior profiles regarding their goals for utilizing the garden at residential care facilities for older people. Semi-structured interviews were conducted with a convenience sample of first-line managers (n = 12) in Sweden. Data were analyzed using deductive content analysis theoretically guided by the Three-dimensional Leadership Model. The results showed that the main leadership behavior profiles were related to the dimensions structure, relation and change. The managers emphasized workplace regulations and goals. They allowed staff to make decisions and encouraged them to see problems and opportunities.

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  • 45.
    Dyvik, Joanna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sjuksköterskans upplevelse av att vårda patienter med substansberoende2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: I Sverige lever det ca 330 000 människor med beroendeproblematik. Att leva med substansberoende påverkar individens liv negativt och ofta lever individen med en psykisk och/eller fysisk samsjuklighet. Individer med substansberoende upplever ofta skuld och skam över sin situation och upplever dåligt bemötande såväl av samhället som av vården. Utifrån den etiska koden ska individer med substansberoende bemötas respektfullt och de har rätt till värdig och lika vård trots sitt tillstånd. När en individ söker vård upplever ofta sjuksköterskorna oro för det kopplat till okunskap och tidigare negativa erfarenheter. Det är av vikt att sjuksköterskor har adekvat kunskap inom detta område. Syfte: Syftet med denna litteraturöversikt var att beskriva sjuksköterskans upplevelse av att vårda patienter med substansberoendeMetod: En beskrivande litteraturöversiktHuvudresultat: Resultatet visade att sjuksköterskan upplever att det är utmanande att arbeta med patienter med substansberoende. De upplever en försämrad arbetsmiljö, rädsla för sin säkerhet och en hög arbetsbelastning. Resultatet visar också att adekvat kunskap och utbildning i arbetet med patienter med substansberoende är avgörande för att kunna ge en god och säker vård och omvårdnad. Sjuksköterskorna upplever också att det stöter på komplexa etiska dilemman som de måste tackla dagligen.Slutsats: Studien redogör för de utmaningar som sjuksköterskan stöter på inom sitt yrke. Sjuksköterskan arbetar med vad de beskriver vara en komplex patientgrupp och är i behov av adekvat kunskap och det leder många gånger till en utmanande arbetsmiljö. I omvårdnaden av personer med substansberoende kan sjuksköterskan befinna sig i situationer som kan upplevas vara komplicerade, svåra, stressiga, hotfulla, otydliga och manipulativa. Dessa situationer har som följd att lämna sjuksköterskan med känslor av maktlöshet, hopplöshet, utmattning samt frustration. Bristande kunskap, riktlinjer och förståelse inom substansberoende, smärta och patienter med substansberoende bidrar till en vård som inte anses vara av god kvalité.

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  • 46.
    Edberg, Maja
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Karlsson, Sofia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Sjuksköterskors erfarenheter av att vårda patienter som önskar dödshjälp2022Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Euthanasia has been a controversial debate for many years. Whether or not euthanasia is legal differs from country to country. In Sweden euthanasia is not legalized yet. When a person has an incurable disease or in end-of-life care, some people may express a desire to be helped to end their own life, which may mean that the nurse then needs to deal with euthanasia requests regardless of whether euthanasia is legalized or not and to be there for the patient.

    Aim: The aim of the literature study was to describe nurses' experiences of caring for patients who wish to be euthanized. 

    Method: A descriptive literature study based on 12 scientific qualitative articles. Articles were searched in the CINAHL database. The articles were then processed and analyzed according to Aveyard's thematic analysis method.

    Main Results: The results showed that nurses' experiences were that euthanasia was a complex, emotional and intense process. Suffering and maintaining one's autonomy were the main reasons for patients' desire for euthanasia. Different factors were decisive for whether the nurse chose to participate or not participate in euthanasia. The results were presented in three main themes: euthanasia is a complex process, main reasons why patients wish euthanasia and nurses' experiences of factors that influence attitudes towards euthanasia.

    Conclusion: Several studies show that nurses will encounter patients who wish to be euthanized regardless of where the nurses work. Euthanasia is associated with strong emotions and is a complex process that challenges nurses professionally and personally. Different factors influence how nurses relate to the euthanasia process and patient’s request for euthanasia. The literature study aims to spread knowledge and understanding about euthanasia based on nurses' previous experiences.

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  • 47.
    Edin, Lina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Ericsson Karlström, Linnea
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Vårdupplevelser för patienter med anorexia nervosa inom slutenvården -en litteraturstudie2022Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Anorexia nervosa is a severe eating disorder characterized by low BMI, fear of weight gain and anxiety problems. The disease causes great suffering for both the patient itself and relatives. Currently, there is a lack of sufficient research on experience and treatment. The disease is complicated and the nurse has an important role in the care of these patients and therefore needs a broad knowledge of how to respond to these patients. Aim: The aim of this study was to describe patient´s experiences of being treated for anorexia nervosa in an inpatient ward. Method: The study was based on 12 scientific articles with qualitative approaches that were extracted from the databases PubMed and CINAHL. The articles were reviewed and analyzed by the authors. Through the University of Gävle's qualitative review template, the articles were assessed for relevance. The material was analyzed and resulted in three main themes: Experiences of illness, experiences of care environment and experiences of care relationships. Main results: The patients described the experience of being treated with anorexia nervosa in an inpatient ward and how the experience was affected by their disease. The patients described a need to be seen as a whole and that the nurses had an individual approach. The care relationship was of great importance to the patients' experience and treatment, and through increased knowledge the nurses were able to improve the experience. Conclusions: The study showed that the experience of inpatient treatment varied from case to case and that an individually tailored approach by the nurse is needed when treating these patients. Creating a good relationship is a cornerstone of nursing care for patients with anorexia nervosa. Through increased understanding and knowledge by the nurse, patients' experience of inpatient care can be improved.

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  • 48.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Implementation of acupuncture in routine oncology care: A comparison of physicians’, nurses’, physiotherapists’ and acupuncturists’ practice and beliefs2022In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 21, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Background:

    It is important to investigate beliefs in acupuncture in professionals because professionals’ expectations may affect treatment outcomes.

    Aim:

    To document the type, number, and education of professionals practicing acupuncture. Further, to compare beliefs about the effectiveness of acupuncture for common cancer related symptoms in the different types of professionals.

    Methods:

    This cross-sectional study employed a questionnaire on practice and beliefs regarding acupuncture effects for symptoms that commonly occur in patients treated within oncology care settings. The respondents (n = 555) consisted of oncology professionals that is, physicians (n = 133), nurses (n = 172), and physiotherapists (n = 117). Additional respondents consisted of acupuncturists (n = 133), working outside approved health care.

    Results:

    Of the respondents, acupuncture was practiced by 4% of the physicians, 6% of the nurses, 58% of the physiotherapists, and 90% of the acupuncturists. The professionals believed acupuncture to be effective for pain (of the physicians, nurses, physiotherapists, and acupuncturists, 94%, 98%, 89%, and 99% respectively believed in the effectiveness), chemotherapy-induced nausea (corresponding figures: 74%, 89%, 89%, and 93%), and vasomotor symptoms (corresponding figures: 71%, 81%, 80%, and 97%). The physicians believed acupuncture to be effective in a mean of 5 symptoms, nurses in 6 symptoms, physiotherapists in 6 symptoms, and acupuncturists in 10 symptoms (P < .001).

    Conclusions:

    Since the professionals varied substantially regarding practice, education and beliefs in acupuncture, oncology clinics may consider delivering patient preferred acupuncture according to evidence-informed guidelines rather than on varying preferences among the professionals, since professionals’ treatment expectations may modify treatment outcomes.

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  • 49.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Physical, leisure, and daily living activities in patients before, during, and after radiotherapy for cancer: Which patients need support in activities?2023In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804Article in journal (Refereed)
    Abstract [en]

    Background: Avoiding inactivity and staying active during cancer therapy have great health effects.

    Objective: The aims of this study were to describe level of daily, leisure, and physical activities before, during, and after radiotherapy and to investigate whether patients who had not restored activity level after radiotherapy differed from patients who had restored activity level regarding different characteristics.

    Methods: In this descriptive longitudinal study, 196 patients undergoing pelvic-abdominal radiotherapy reported their activity level at baseline, weekly during radiotherapy, and at 1 month after radiotherapy.

    Results: Patients decreased activity level during radiotherapy (P < .001 for all activities): physical activity (34% of patients decreased level), walking (26%), leisure activities (44%), social activities (15%), housework (34%), shopping (28%), and activities in general (28%). Almost half (47%) had not restored activity level after radiotherapy. Patients with colorectal cancer, older than 65 years, who had less education than university, and high capacity in overall daily activities at baseline were more likely than other patients not to restore activity level after radiotherapy. The patients not restoring their activity level after radiotherapy were more likely than others to experience anxious mood (P = .016), depressed mood (P = .003), and poor quality of life (P = .003) after radiotherapy.

    Conclusion: Patients’ activity level decreased during radiotherapy, and almost half of patients did not restore activity level after radiotherapy.

    Implications for Practice: Given that restored activity level after radiotherapy was less common in certain subgroups and that patients who restored activity level experienced better quality of life and less frequent anxious and depressed mood, cancer nursing professionals should consider supporting these subgroups of patients in performing activities. Guidelines recommend avoiding inactivity and staying active during and after cancer therapy, because of the great health effects of activity.1,2 However, little is known about the characteristics of patients who decrease their activity level during radiotherapy for cancer and do not restore activity level after radiotherapy; this is a subgroup of patients who may need more support from cancer nursing professionals.

  • 50.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Treatment expectations seem to affect bowel health when using acupuncture during radiotherapy for cancer: Secondary outcomes from a clinical randomized sham-controlled trial2020In: Complementary Therapies in Medicine, ISSN 0965-2299, E-ISSN 1873-6963, Vol. 52, article id 102404Article in journal (Refereed)
    Abstract [en]

    Objective

    To investigate if frequent stools (“diarrhoea”), infrequent stools (“constipation”), capacity in daily activities and Quality of Life (QoL) differed between patients treated with verum or sham acupuncture, and if patients with more positive treatment expectations differed regarding frequent stools and infrequent stools from patients with less positive treatment expectations.

    Methods

    In this randomized sham controlled trial, 200 patients received verum traditional penetrating acupuncture or sham acupuncture using a telescopic non-penetrating sham-needle 2–3 times a week during abdominal-pelvic radiotherapy (12 needling sessions during median 5 radiotherapy weeks). The patients registered stool frequency once a week, and registered capacity in daily activities and QoL at the start and end of radiotherapy, and at a one-month follow-up.

    Results

    In the verum acupuncture group, 29 of 96 answering patients (30 %) experienced frequent stools and 7 (7 %) experienced infrequent stools at least one week of radiotherapy. In the sham acupuncture group, 21 of 97 (22 %) experienced frequent stools (p = 0.175) and 10 (10 %) experienced infrequent stools (p = 0.613). Patients with low treatment expectancy were more likely than other patients to experience frequent stools (60 % versus 26 %, p = 0.014) but not to experience infrequent stools (25 % versus 12 %, p = 0.334).

    Conclusion

    Penetrating acupuncture was not effective for frequent stools or for infrequent stools and did not improve capacity in daily activities or QoL in patients undergoing pelvic-abdominal irradiation for cancer more than non-penetrating acupuncture. Since patients with low acupuncture treatment expectations were more likely to experience frequent stools compared to other patients, non-specific treatment effects warrant further studies.

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