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  • 1.
    Blusi, Madeleine
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Jong, Mats
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 211-220Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence.

    AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas.

    DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service.

    METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis.

    FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends.

    CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence.

    IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

  • 2.
    Hallin, Karin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Bäckström, Britt
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Häggström, Marie
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    High-fidelity simulation: Assessment of student nurses' team achievements of clinical judgment2016In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 19, p. 12-18Article in journal (Refereed)
    Abstract [en]

    Nursing educators have the challenge of preparing nursing students to handle complex patient care situations in real life, but much remains unknown about the ability to make clinical judgments. In this study, high-fidelity simulation (HFS) was used at a Swedish university to find answers about pre-licensure nursing students' success in clinical judgment in terms of team ability and relationships with theoretical achievements, and personal and scenario circumstances. The matrix Lasater Clinical Judgment Rubric (LCJR) was used to analyze and score the students' ability in teams to notice, interpret and respond to complex care situations. Overall, the results showed the student teams in their first meeting with HFS in a complex care situation achieved low clinical judgment points; most teams were in the stages of Beginning and Developing. For attaining high team achievements the majority of the students in the team should theoretically be "high performance". Being observers and having HFS experience before nursing education was significant too. However, age, health care experience, and assistant nurse degrees were of secondary importance. Further research at universities regionally, nationally, and internationally is needed.

  • 3.
    Hallin, Karin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Häggström, Marie
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Bäckström, Britt
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Correlations between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room2016In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 8, no 6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students’ team achievements in clinical judgement and emotional, sociological and physiological learning style preferences.

    METHODS: A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed.

    RESULTS: Three significant correlations were found between the team achievements and the students’ learning style preferences: significant negative correlation with ‘Structure’ and ‘Kinesthetic’ at the individual level, and positive correlation with the ‘Tactile’ variable. No significant correlations with students’ ‘Motivation’, ‘Persistence’, ‘Wish to learn alone’ and ‘Wish for an authoritative person present’ were seen.

    DISCUSSION & CONCLUSION: There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences, cognitive learning outcomes and group processes.

  • 4.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    En studie i kvantitetssäkring av omvårdnad – En möjlig metod att fokusera kvaliteten?2003In: Incitament : för en hälso- & sjukvård i förvandling, ISSN 1103-503X, Vol. 12, no 7, p. 638-640Article in journal (Other academic)
  • 5.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Norbergh, Karl Gustaf
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Nurses' attitudes towards older residents with long-term schizophrenia.2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 43, no 6, p. 616-622Article in journal (Refereed)
    Abstract [en]

    Aim: to investigate whether the carers’ approach could be explained as referring to the clinical picture or the fact that the patient had a diagnosis of schizophrenia. Background: In institutional care, a symptom-oriented approach is a frequently used but seldom-discussed method for treating people with severe mental illness. Design/method: An exploratory study of the staff’s view of a caring approach for a fictitious elderly long-term schizophrenic resident was conducted. All the carers working in the field of psychiatry at seven different units in one municipality in northern Sweden were an integral part of the study. The units were divided into two groups and classified as ‘dwelling’ and ‘support’. The ‘dwelling group’ was characterised by carers working at traditional group dwellings, the ‘support group’ by carers working in small teams and visiting people with long-term mental illness in their homes. Answers were received from 62 women and 23 men, of whom 14 were RNs and 69 were ENs. Measurements: A questionnaire was used; it was developed from a case description of a 68-year-old woman with typical symptoms of severe cognitive decline with problematic behaviour and a diagnosis of long-term schizophrenia. Findings: The main finding in this study is that carers with long experience become less sensitive in their relationship with the resident than less experienced carers. There appears to be a tendency for long work experience to have a negative effect on the carers’ attitude towards the resident. Conclusions: The carers could be interpreted as being caught in a moral dilemma between ends and means. On the one hand, the ‘conformist mode’, with the acceptance of ends and means, and, on the other hand, the ‘innovation mode’, with acceptance of ends but with few legitimate means to achieve them.

  • 6.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Being an outsider: nurses' statements about a vignette of an elderly resident with a schizophrenia diagnosis and dementia behaviour.2004In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 11, no 2, p. 213-220Article in journal (Refereed)
    Abstract [en]

    In an exploratory study of nurses' approach to elderly people with a diagnosis of long-term schizophrenia, the aim was to investigate nurses' views of the care of an elderly fictitious person with long-term schizophrenia. All the nurses in one municipality in northern Sweden working at seven different units were investigated. A vignette, which was based on a case description in a previous study of an 84-year-old woman with severe dementia and problematic behaviour, was used after a minor alteration. In this study, the woman's age in the case description was changed from 84 to 68 years and the diagnosis was changed from severe dementia to long-term schizophrenia; otherwise, the description was the same as in the original case. The main finding was the nurses' inability to see the resident as anything other than what the 'label', the diagnosis, said. The nurses are interpreted as being caught in a dilemma of loyalty - on the one hand, the loyalty to the organization with its traditional goals and means and, on the other hand, the loyalty to the resident with her wishes in the forefront of their minds.

  • 7.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Living in a group dwelling: how do residents spend their time in a psychiatric group dwelling?2004In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 41, no 6, p. 651-659Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate how residents at psychiatric group dwellings spend their time. The study consisted of two parts: questionnaires and an observation survey. It included all the staff at two municipal psychiatric group dwellings where the residents were primarily diagnosed as having long-term schizophrenia. This study indicated that, even if the dwellings had a creative climate, there was a negative process in terms of nurses' well-being with a high level of depersonalisation. The residents who displayed a predominant picture of negative symptoms were left alone for 84% of the day, and 29.5% of this could be explained by their illness. The remainder of the residents' time alone remains unexplained. Copyright 2004 Elsevier Ltd

  • 8.
    Holmström, Malin
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Folkhälsocentrum, Landstinget Västernorrland, Härnösand, Sweden.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Exploring the development of school children´s health2012In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 7, no 4, p. 189-197Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the association between positive self-reported health (SRH) in pre-school and 4th grade SRH in a long–term prospective population-based study in Sweden.

    Methods: Data originated from the Health Dialogue (HD) a structured instrument used by school nurses. 1084 children participated. Odds ratios were analyzed.

    Results: In 10-year-old children’s SRH, comfort in school, normal BMI and absence of headaches were shown to be significantly important health indicators. Normal BMI showed to have a potentially causal effect on 10-year-old girls and absence of headaches showed a potentially causal effect among 10-year-old boys.

    Conclusion: Schools should be designed to meet the children’s needs so that they are perceived as comfortable, safe and secure places. Schools should advocate physical activity and play, serve healthy nutritious food in order to motivate, support and promote a healthy lifestyle. Schools are a unique arena for health promotion as they reach practically all school-age children.

  • 9.
    Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Folkhälsocentrum, Härnösand, Sweden.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Assessing the validity and reliability of the "Health Dialogue" in 10-year-olds2013In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 8, no 8, p. 384-391Article in journal (Refereed)
    Abstract [en]

    Aim:

    The aim was to assess the concurrent, construct and convergent validity of the Health Dialogue questionnaire (HD) in 4th grade in compulsory school, through comparison of the HD questionnaire with Pediatric Quality Of Life Inventory (PedsQL), and Health Behavior in School-aged Children (HBSC).

    Methods:

    A sample was created from the HD n=1956, HBSC, n=1500 and PedsQL n=425. An exploratory factor analysis was performed in order to evaluate the construct validity of HD.

    Results:

    A majority of the questions show acceptable concurrent validity and the results support the HD as a valid 16-item three factorial model for school children aged 10 years old (grade 4). The HD's three factorial model's degree of explanation was 39% of the school children's health in school settings.

    Conclusion:

    The HD questionnaire is a valid instrument for measuring 10-year-old school children's self-reported-health and to identify positive health factors.

  • 10.
    Häggström, Marie
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    How can nurses facilitate patient’s transitions from intensive care?: A grounded theory of nursing2012In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 28, no 4, p. 224-233Article in journal (Refereed)
    Abstract [en]

    Objectives: Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process.

    Methods: Group interviews, individual interviews and participant observations were conducted with nurses in two hospitals in Sweden and were analysed using grounded theory.

    Result: The substantive theory shows the process of nursing care activities — from the contexts of the ICU and the general ward. The main concern was to achieve a coordinated, strengthening, person-centered standard of care to facilitate patient transitions. The core category ‘‘being perceptive and adjustable’’ was a strategy to individualise, that was related to the other categories; ‘‘preparing for a change’’ and ‘‘promoting the recovery’’. However, the nurses were forced to ‘‘balance between patient needs and the caregivers’ resources’’ and consequently were compromising their care.

    Conclusions: To facilitate an ICU-patient’s transition, individual care planning is needed. It is also essential that the patients are adequately prepared for the change to facilitate the transitional care. Knowledge about transitional needs, empowerment and patient-education seems to be important issues for facilitating transitions.

  • 11.
    Häggström, Marie
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Important quality aspects in transfer process2014In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 27, no 2, p. 123-139Article in journal (Refereed)
    Abstract [en]

    Purpose: Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward. Design/methodology/approach: The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden. Findings: A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU. Research limitations/implications: The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality. Practical implications: The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality. Originality/value: The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.

  • 12.
    Häggström, Marie
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Struggle with a gap between intensive care units and general wards2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 3, p. 181-192Article in journal (Refereed)
    Abstract [en]

    Nursing critically ill patients includes planning and performing safe discharges from Intensive Care Units (ICU) to the general wards. The aim of this study was to obtain a deeper understanding of the main concern in the ICU transitional process-the care before, during, and after the transfer of ICU patients. Interviews were conducted with 35 Swedish nurses and analysed according to grounded theory. The main concern was the nurses' "struggling with a gap." The "gap" was caused by differences in the altered level of care and contributed to difficulties for nurses encountering an overlap during the transitional care. The categories: Sheltering, seeking organizational intertwining and striving for control are related to the core category and were used to generate a theory. The nurses sought improved collaboration, and employed patient-centred routines. They wanted access to necessary tools; they relayed or questioned their own competence and sought assurance of the patients' ability to be transferred. If the nurses felt a loss of control, lack of intertwining and lack of collaboration, they sheltered their patients and themselves. Intertwining was more difficult to perform, but actually even more important to do. With knowledge about ICU transitional care, collaboration, routines, and with an organization that provides an educational environment, the process could be improved.

  • 13.
    Häggström, Marie
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    To reduce technology prior discharge from intensive care –important but difficult?: A grounded theory2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 506-515Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to provide a deeper understanding of the experience of intensive care staff regarding the reduction in the use of medical technology prior to patients’ transfer from the ICU.

    Background: The goal of ICU transitional care, provided for intensive care patients before, during and after the transfer from the ICU to another care unit, is to ensure minimal disruption and optimal continuity of care for the patient. To smooth this transition, there is a need to prepare for a less technological environment and therefore also a need for a gradual reduction in the use of monitoring equipment.

    Method: Group interviews and individual interviews, together with participant observations, were conducted with ICU staff in two hospitals in Sweden. The data were analysed using classic grounded theory.

    Results: The main concern was the ICU staff’s ambiguity regarding whether and how to reduce the use of medical technology devices. Insecurity about weaning patients from medical equipment combined with a lack of standardized routines made it difficult for staff to reduce the technical support. The core category describes how the ambiguity was solved primarily by ’prioritizing control’. However, this often caused the ICU staff to use advanced technology while the patients were in the ICU until the ward staff arrived, even if this should have been handled otherwise. Why and how the ICU staff used the strategy of ’prioritizing control’ is further explained in the categories ’being affected by cultural/contextual aspects’, ’searching for guidance and a shared understanding’ and ’weighing advantages with more v s less technology’.

    Conclusion: It is important to consider ICU staff ambiguity concerning the reduction in technology and to establish strategies for a safe and structured transitional phase with step-down procedures in which technology and monitoring is gradually reduced prior to transfer from ICU.

  • 14.
    Häggström, Marie
    et al.
    Department of Nursing science, Mid Sweden University, Sweden.
    Bäckström, Britt
    Department of Nursing science, Mid Sweden University, Sweden.
    Vestling, Irene
    Department of Nursing science, Mid Sweden University, Sweden.
    Hallin, Karin
    Department of Nursing science, Mid Sweden University, Sweden.
    Segevall, Cecilia
    Department of Nursing science, Mid Sweden University, Sweden.
    Kristiansen, Lisbeth Porskrog
    Department of Nursing science, Mid Sweden University, Sweden.
    Overcoming Reluctance towards High Fidelity Simulation - A Mutual Challenge for Nursing Students’ and Faculty Teachers2017In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 9, no 7, p. 127-137Article in journal (Refereed)
    Abstract [en]

    Background: One strategy to develop nursing students’ clinical judgment are the use of high-fidelity patient simulation (HFS). The aim of the study was twofold. Firstly, the aim of this study was to describe the nursing students’ experiences while participating in HFS, and secondly to describe faculty teachers’ reflections about nursing students’ need in HFS and the related teaching challenges.

    Method: Data was collected in focus group discussions and individual interviews, analyzed using thematic qualitative content analysis.

    Findings: The nursing students’ experienced HFS as being thrown into an uncertain, exposure situation. This were for some, reason for reluctance. The teachers challenge was motivating and coaching the students throughout a demanding teaching situation.

    Discussion: Students’ ability to perform in HFS is influenced by self-perceived efficacy, own attitudes and responsibility for one’s learning, which are a challenge for the teachers.

    Conclusion: HFS methodology can be useful to identify gaps and strengths in students’ professional transition towards becoming registered nurses. Overcoming reluctance towards HFS is a mutual challenge for faculty teachers and nursing students. By entering the scenario with a positive mindset, nursing students can improve their ability to perform clinical judgments.

  • 15.
    Kjällman Alm, Annika
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Danielsson, Sandra
    Region Jämtland/Härjedalen.
    Porskrog-Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of  Dementia — An Integrated Literature Review2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 8, p. 434-447Article in journal (Refereed)
    Abstract [en]

    The objective of this integrated literature review was to identify and examine effectiveness of non-pharmacological interventions towards BPSD. Database searches were documented following the PRISMA flow diagram and included papers were judged by the researchers using the SAHTAASS protocol. Coding of the papers was carried out using Polit and Beck matrix for literature review. It was concluded that several non-pharmacological interventions showed a positive influence on BPSD such as stimulating interventions, social and personalized activities and physical exercise. Also, education/training of healthcare professionals and equipment in form of a structured BPSD protocol resulted in decreased BPSD.

  • 16.
    Kleebthong, Duangkaew
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Chareonsuk, Sukjai
    Boromarajonani College of Nursing, Chakriraj, Thailand.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Thai psychiatric nurses' experiences and perceptions of the professional role when caring for older people displaying depressive symptoms2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 1, p. 45-59Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to describe Thai psychiatric nurses’ experiences and perceptions of their professional role when caring for older people whom displayed symptoms of clinical depression. Methods: A qualitative descriptive research design was used. Thirteen psychiatric nurses working in the field of mental health and psychiatric nursing at a rural district hospital were purposively included. The data were collected through in-depth, face to face interviews and analyzed using qualitative latent content analysis. Results: All participants were female, and the mean age was 43 years, and the mean experience of caring for mentally ill patients was 8.3 years. The psychiatric nurses’ experiences and perceptions of their professional role were mirrored in the following themes: 1) managing a central role in the care of the patients; 2) conflicting interests between the professional needs of caregiving and other requests; and 3) being compassionate beyond the profession. Conclusion: The psychiatric nurses were challenged by the complexity of the caregiving situations and the partners involved in the process of caring for older people with depression. Professionally, the psychiatric nurses played an important role in preventive care and managerial work. They underwent stress under the influence of stakeholders, but they also contributed to the holistic patient care. Health service authorities may use these results to develop plans for psychiatric nurses in managing a central role and in advocating for holistic care to mitigate the influence of stakeholders to enhance quality of caring for older individuals with depression.

  • 17.
    Kleebthong, Duangkaew
    et al.
    Deparment of Nursing Sciences, Faculty of Human Sciences, Mid Sweden University, Sundsvall, Sweden; Boromarajonani College of Nursing, Chakriraj, Thailand.
    Chareonsuk, Sukjai
    Boromarajonani College of Nursing, Chakriraj, Thailand.
    Kristiansen, Lisbeth Porskrog
    Deparment of Nursing Sciences, Faculty of Human Sciences, Mid Sweden University, Sundsvall, Sweden .
    Older Thai peoples’ experiences of major depression2017In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 9, no 9, p. 26-35Article in journal (Refereed)
    Abstract [en]

    Background: Depressive disorders are common mental health problems and may be disabling among the general older population. Although older people have significant symptoms of depression, the symptoms are likely to be underreported. The condition often co-exist along with somatic ill and has often been unrecognized. The aim of the study was to explore and understand the perceptions and experiences of older Thai people diagnosed with major depressive disorder.

    Methods: A qualitative inductive research design was used and latent content analysis was utilized. The data were collected through face-to-face, in-depth interviews.Fourteen older people diagnosed with major depressive disorder were selected for participant using purposive sampling.

    Findings: Older Thai peoples’ perceptions and experiences of depression were abstracted into two themes. First theme was leading a lifein detachment, which included three subthemes: living with meaninglessness, holding distress with one’s self, and feeling judged by surrounded people. The second theme was inconvenience of approaching mental health treatment, which included two subthemes: sensing an unapproachable health care service, and lacking knowledge about clinical depression.

    Conclusion: Older Thai peoples’ perceptions and experiences of major depression were affected with high level suspected existential loneliness that might even be worse in a collect oriented society as in the Thai context. Further, it seem hard to approach the mental health care. The central reason for this is interpreted as lack of mental health literacy, and in this case, specifically, knowledge on depression. Future studies should focus on relatives’ experiences of living with an older family member that suffered from major depression, and on the state of mental health literacy in the rural Thai population.

  • 18.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Die Auswirkung der Meinung von Pflegekräften uber das Verhalten und die sozialen Fähigkeiten von patienten auf die mit den Patienten verbrachte Zeit2007In: Psychiatrische Pflege Heute, ISSN 0949-1619, E-ISSN 1439-0213, Vol. 13, no 6, p. 329-336Article in journal (Other academic)
  • 19.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Hot och våld i en del av vardagen2007In: Tidningen Äldreomsorg, ISSN 1403-7025, Vol. 4, no 23, p. 5-10Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Inom vård- och omsorgsyrket finns särskilt hög risk att drabbas av våldshandlingar. Ett viktigt sätt att komma tillrätta med problemet är att arbeta förebyggande, bland annat genom regelbundna diskussioner för att öka medvetenheten om risken för våld.

  • 20.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kvalitativ manifest og latent indholdsanalyse2018In: Kvalitative analysemetoder i sundhedsforskning / [ed] Hounsgaard, L., & Gildberg, F., Aarhus, Danmark: Klim , 2018, 1, p. 301-319Chapter in book (Other academic)
  • 21.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Låt den ilskna maktlösheten komma till tals2012In: Att leva med psykisk ohälsa: - ett närstående perspektiv / [ed] Kim Lützén och Suanne Syrén, Lund: Studentlitteratur , 2012, 1, p. 113-124Chapter in book (Other academic)
  • 22.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Wanting a Life in Decency!: A Qualitative Study from Experienced Electric Wheelchairs Users’ perspective2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 7, p. 419-433Article in journal (Refereed)
    Abstract [en]

    Background: The functionality and the safety of the electric wheelchairs were essential for users’ everyday life. Some evidence indicated that the wheelchair Per Se highly influenced users’ occupational life, their personal identity and social life; further, the wheelchair became an extension of the body and more than a technical device. Besides, there was still both environmental and self-efficacy or/and mental health factors obstacles for full social participation. Even so, there was to some extent stigma related to being a wheelchair user. There was a need to reflect users’ perspective on being depended on electric wheelchair. The aim, accordingly, was to describe and to get a deeper insight into electric wheelchairs users’ perspective and experiences of utilizing this device; a qualitative design with an inductive approach was used. Method: Qualitative latent and interpretative content analysis [1] [2] was used after repeated face-to-face semi-structured interviews with three experienced Swedish electric wheelchair users during the autumn 2017. Findings: The findings showed a high degree of dependability of the assistants that supported the users, and of the quality of that working relationship. The findings were formulated, abstracted and interpreted in several steps. It showed one theme of meaning: “Living in a space shifting between potential violation of or respect for human dignity”. Conclusion: The study showed that electric wheelchair users were relatively content with their lives as well as with their devices in turns of mobility and accessibility, but the meaning of their narrations showed a life at constant risk of having the respect of human rights and human respect violated. Besides, the importance of having access to good and high quality devices, good staffing, and environmental support, all in concordance with human rights, the clinical and practical implications of this study narrows down to a question of encountering the other person as a whole and worthy individual.

  • 23.
    Kristiansen, Lisbeth
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Björk, Annette
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Kock, Viveka Broman
    County and Public Hospital, Sundsvall, Sweden .
    Nilsson, Annika
    Public Nursing Home and Primary Health Care, Sweden.
    Rönngren, Ylva
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Smedberg, Agneta
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Trillo, Åsa
    County and Public Hospital, Sundsvall and Härnösand, Sweden.
    Urinary incontinence and newly invented pad technique: patients', close relatives' and nursing staff's experiences and beliefs2011In: International Journal of Urological Nursing, ISSN 1749-7701, E-ISSN 1749-771X, Vol. 5, no 1, p. 21-30Article in journal (Refereed)
    Abstract [en]

    Urinary incontinence (UI) is a major public health issue and considered to be undertreated, costly and often lead to suffering for patients. Close relatives involved in caring for sufferers describe UI as a complicated problem. For older patients, close relatives and staff, it is important with high absorption UI pads in order to have an undisturbed nightly rest and to prevent bedsores. The aim was twofold: to understand older persons', close relatives' and nursing staff's views and experiences of UI, and their experience of using a particular UI pad system with an alarm. A qualitative design with individual and focus-group interviews was used to describe 6 patients', 14 close relatives' and 22 staff's experience of UI. These were analysed by using qualitative manifest analysis. The findings were divided into four categories. The patients expressed that they, due to UI, regarded themselves as burdens to others. The patients, the relatives and some staff experienced UI as a natural consequence of ageing. The UI pad system appeared to be a functional incontinence aid during the night, but more research is needed to develop the product and to find new fields of applications. From all perspectives, it appears that nursing cannot be replaced by technology, though the UI pad system can be a very useful complement in UI nursing care. Complementary use of the UI pad system might lead to a more economically effective and safe use of the existing nursing resources.

  • 24.
    Kristiansen, Lisbeth
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Dahl, Annika
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Institutionen för hälsovetenskap.
    The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients2005In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 12, no 6, p. 719-727Article in journal (Refereed)
    Abstract [en]

    The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients For people afflicted with different kinds of psychiatric disorder, suffering is a common denominator. The time the nurses spend with psychiatric clients may mirror their attitudes towards and feelings for these clients. The aim of this study was to investigate the connections between the time spent together and the nurses' opinion of client behaviour and social functioning in community-based psychiatry. In this quantitative study, 29 clients were assessed by 30 nurses, who answered the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). At the same time, 11,200 non-participant observations of clients were registered using the Patient Activity Classification (PAC) to investigate how they spent their time at two psychiatric group dwellings. The PAC instrument revealed that clients spent an average of 60.8% of time alone, while only 20% of their daily time was spent with the nurses. Based on a factor analysis, indices were made by setting cut-off points for the PANSS and the GAF scores, and four small groups of clients were generated: a relatively high level of social functioning and a low degree of psychiatric symptoms (A); a relatively high level of social functioning and a high degree of psychiatric symptoms (B); a low level of social functioning and a low degree of psychiatric symptoms (C); and, finally, a low level of social functioning and a high degree of psychiatric symptoms (D). The clients judged as having a low level of social functioning in combination with high degrees of psychiatric symptoms, that is, the most vulnerable and dependent individuals, receive less staff attention (18%) and are the clients who spend the most time alone (71.4%). It might be possible to interpret the results of this study in the light of a process of dehumanization.

  • 25.
    Kristiansen, Lisbeth
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Hellzén, Ove
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Left alone - Swedish nurses' and mental health workers' experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era: A focus-group interview study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 3, p. 427-435Article in journal (Refereed)
    Abstract [en]

    The professional role of nurses and mental health workers in social psychiatry is being re-defined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses' and mental health workers' views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly 'strangled' situation', and 'Feeling overwhelming frustration'. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general.

  • 26.
    Kristiansen, Lisbeth
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall; Karolinska institutet, Stockholm.
    Hellzén, Ove
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Swedish assistant nurses´experiences of job satisfaction when caring for persons suffering from dementia and behavioural disturbances: An interview study2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 4, p. 245-256Article in journal (Refereed)
    Abstract [en]

    Job satisfaction is complex and is an important component in facilitating high quality nursing care. Behavioural and psychological symptoms of dementia (BPSD) can be clustered into one of five syndromes: psychosis, aggression, psychomotor agitation, depression and apathy, and comprise signs and symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia. BPSD can cause tremendous distress both for the patients and for their caregivers and they have been seen as the most stressful aspect of care giving. Two registered nurses, 16 assistant nurses and two nursing assistants in Sweden talked about their job satisfaction when caring for residents suffering from dementia and BPSD. Thematic content analysis was conducted. The nurses' narrations indicate exposure, insufficiency, not being valued and doubt, as well as respect and importance and devotion towards the residents. One core theme was formulated: "Job satisfaction as a process moving between breaking down and occasionally building up the working person". A positive relationship with colleagues was the primary reason for nurses continuing to work at the group dwellings. The organization and resident behaviours were seen as very negative. Some nurses described insecurity in terms of how long they could continue to take rudeness, being spat at, being scratched or physically hit by residents, without "hitting back". In order to increase the well-being of the nurses, the pressure on them needs to be relieved. The development of leadership, education, supervision and reflection might be one possible way of reducing the prevalence of BPSD-related violence, enhancing job satisfaction and handling moral stress.

  • 27.
    Kristiansen, Lisbeth
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Häggström, Marie
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Hallin, Karin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Andersson, Ingela
    Bäckström, Britt
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Svensk översättning, kvalitativ relevansvärdering och kvantitativ reliabilitetstestning av Lasater Clinical Judgment Rubric: Swedish translation, qualitative relevance evaluation and quantitative reliability test of Lasater Clinical Judgment Rubric 2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 2, p. 113-122Article in journal (Refereed)
    Abstract [en]

    Newly graduated nurses show lacking skills and competences regarding the ability to make appropriate clinical assessment of acute, complex care situations. There is also a lack of translated, qualitative relevance evaluated and reliability tested rubrics in the Swedish language. The purpose of this method article was to translate, conduct a relevance evaluation and reliability test of the identified Lasater Clinical Judgment Rubric (LCJR). In this article the Swedish translation LCJR (S) is presented. The results showed that the LCJR (S) was both  qualitatively relevant and quantitatively reliable. We claim that there are several advantages to systematic use LCJR (S) for assessment of nursing students' clinical judgment in laboratory simulation environments with acute patient situations

  • 28.
    Kristiansen, Lisbeth
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Karlström, Annika
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Rising Holmström, Malin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Boman, Niklas
    Jonsson, Cathrin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Avdelningen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    A health promotion intervention strengthening Swedish high school students' wellbeing: A feasibility study2018In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 13, no 6Article in journal (Refereed)
    Abstract [en]

    The majority of Swedish school children enjoy a general good health. Still, mental health problems are increasing among young people in Sweden. According to Swedish law all school staff members (teachers and student health professionals) have mutual responsibility to provide a safe school environment and health. Since 2010, there is an emphasis on health promotion in schools. The aim of this study is to describe the feasibility and pilot outcomes of a health promoting intervention targeting healthy high school students (the Strengthening Adolescent Wellbeing [SAW] project).

    A descriptive design was used with an intervention group that was assessed before and after the implementation of the programme using quantitative methods. The study was based on the Medical Research Council Framework. The study and the data collection were performed during the autumnof 2016 and the early spring of 2017.

    Public high school students' health professionals, that is school nurses, student counselors and specialist educators, facilitated a research-based intervention consisting of eight sessions with education and mind-body practices. Pre- and post-testing were carried out.

    The main findings showed enhanced levels of wellbeing among the participating students and the student-related measures all showed improvements.

    The intervention seems to have been feasible in this context. Findings from this study indicate that the SAW methodology contributed to an improvement in high school students' wellbeing. The study will provide a base for a full-scale evaluation study intended to evaluate the effect of this health-promoting programme.

  • 29.
    Kristiansen, Lisbeth Porskrog
    et al.
    Mid Sweden University, Sundsvall, Sweden.
    Lif, Ulrika
    Mid Sweden University, Sundsvall, Sweden.
    Asklund, Helene
    Mid Sweden University, Sundsvall, Sweden.
    Experiences on Participation in Literary Activities : Intellectual Stimuli Empower People with Mental Health Problems2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 11, p. 1307-1323, article id 80506Article in journal (Refereed)
    Abstract [en]

    Some research acknowledges engagement in creative and literary activities as constructively impacting rehabilitation and recovery. Nevertheless, there is a deficit of literature describing experiences of participation in literary activities. This study examined how members of a non-profit association for mental health, with experiences of mental problems or illnesses, experienced group-based literary activities facilitated of a bi-disciplinary research team during one semester. This study held a constructive/naturalistic design and used a qualitative methodology with a latent analysis to describe how participants experienced literary activities (creative writing, reading and conversations about published and own written poetry and prose texts). Both individual and focus-group interviews were performed early 2014. Despite previous negative experiences, the findings showed that the participants perceived the literary activities empowering. Four categories were created: Presumptions of personal literacy, leadership role, participants’ role, and literacy development. These were abstracted and interpreted into three themes: Identifying a reading and writing self-image, challenging and redefining one’s reading and writing identity, and strengthening one’s intellectual and humanistic capacity. Literary activities seemed to positively change the participants’ attitudes towards writing and reading, and also enhanced their literacy skills. We argue that literacy skills are interconnected with health literacy. Involvement of literary activities into rehabilitation in mental health practice may be beneficial for some groups, and merits further studies.

  • 30.
    Kristiansen, Lisbeth
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Rising Holmström, Malin
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Olofsson, Niclas
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Assessing the Construct Validity and Reliability of School Health Records Using the 'Health Dialogue Questionnaire' in the Eleventh Grade2016In: AIMS Public Health, ISSN 2327-8994, Vol. 3, no 3, p. 470-486Article in journal (Refereed)
    Abstract [en]

    Background and aims: The aim for this study was to assess the construct validity and reliability of the Health Dialogue Questionnaire (HDQ (c)) for eleventh grade in school through comparison of the HDQ (c) with Paediatric Quality Of Life Inventory (PedsQL (TM)), Local monitoring of youth policy questionnaire (LUPP (R)), Health behaviour in Swedish school-aged children (HBSC (c)), Equal health (EH (c)) and The Swedish Survey Youth on Alcohol Consumption (SSYAC (c)). Methods: Cross-sectional samples of eleventh graders from the academic year 2009/2010 was used from the HDQ (c) (n = 2752), the HBSC (c) (n = 2090), the PedsQL (TM) (n = 666), the "LUPP (R)" questionnaires (n = 2400), EH (c) (n = 258), and SSYAC (c) (n = 1748) in the academic year 2009/2010. A comparison between HDQ (c) and the different proxies was done. Exploratory and confirmatory factor analyses were performed as well as a Multitrait-Multimethod Matrix (MTMM), in order to evaluate the construct validity and reliability of HDQ (c). Results: An average disagreement between HDQ (c) and proxies with 10 percentages was found. Exploratory factor analysis of HDQ (c) on the 2009/2010 sample suggested a four factor solution (girls factor solution 65% of total variance explained, and in the boys' solution 59% of total variance explained). A second sample 2010/2011 of eleventh graders were used for the confirmatory solution. Almost perfectly similar four factor solutions with were found (girls 58% of total variance explained and boys 56% of the total variance explained). Using MTMM the reliability was generally high and HDQ (c) and showed agreeable validity. Discussion and conclusions: The HDQ (c) questionnaire is a reliable and valid instrument for measuring eleventh graders self-reported-health in school.

  • 31.
    Kristiansen, Lisbeth
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Rättspsykiatri2010In: Omvårdnad vid psykisk ohälsa - på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur , 2010, 1, p. 279-303Chapter in book (Other academic)
  • 32.
    Lif, Ulrika
    et al.
    Avdelningen för humaniora, Mittuniversitetet, Sundsvall.
    Asklund, Helen
    Avdelningen för humaniora, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    LIFEHOPE Litteratur – en studie om ”makten att” berätta och berättelsens kraft2016In: Makten att berätta: om tal och tystnad i tid och rum / [ed] Karin Jarnkvist & Anna Molin, Sundsvall: Mid Sweden University , 2016, p. 32-43Chapter in book (Other (popular science, discussion, etc.))
  • 33.
    Lundberg, Kristina
    et al.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Husum Health Center, Västernorrland County Council, Husum, Sweden.
    Jong, Miek C.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Louis Bolk Institute, Driebergen, The Netherlands; National Information and Knowledge Center for Integrative Medicine, Amsterdam, The Netherlands.
    Kristiansen, Lisbeth Porskrog
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Jong, Mats
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Health Promotion in Practice - District Nurses Experiences of Working with Health Promotion and Lifestyle Interventions among Patients at Risk of Developing Cardiovascular Disease2017In: Explore: The Journal of Science and Healing, ISSN 1550-8307, E-ISSN 1878-7541, Vol. 13, no 2, p. 108-115Article in journal (Refereed)
    Abstract [en]

    Objective

    Health Promotion Practice (HPP) has the objective to promote a healthier lifestyle and reduce the risk of disease. The aim of this study was to examine district nurses׳ experiences of working with health preventive actions among patients with risk factors for cardiovascular disease (CVD), and to identify facilitators and obstacles in HPP.

    Design/Setting

    The study was carried out with a qualitative approach where individual semistructured interviews were performed with a total of 12 district nurses in primary care. Data transcripts were analyzed with a manifest content analysis.

    Findings

    Five categories were identified. Firstly, informants regarded HPP as the core essence of their work. Secondly, counseling and coaching were reported as crucial elements in working with HPP. Thirdly, informants identified tools such as motivational interviewing (MI) to facilitate HPP. In the fourth category facilitators and barriers of HPP appeared, consisting of both positive and negative attitudes and presence as well as lack of organizational culture and structure. Finally, some informants were dissatisfied with HPP and viewed it as compulsory or as a burden, while others were satisfied and experienced it as a stimulating challenge.

    Conclusion

    This study identified that HPP is the core of the district nurses׳ work to promote a healthier lifestyle in individuals with CVD. Organizational structures and culture need to be improved in order to support district nurses to successfully work with HPP. To optimize health promotion and strengthen patients׳ self-care, it is recommended that HPP include holistic elements of care.

  • 34.
    Lundberg, Kristina
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Jong, Miek C.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Jong, Mats
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    District Nurses Experiences of Working with Health Promotion and Lifestyle Interventions Among Patients at Risk of Developing Cardiovascular Disease2014In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, no 5, p. A118-, article id P04.32Article in journal (Refereed)
    Abstract [en]

    Purpose: In preventive health work it is possible to map risk factors at healthy individuals which include information and advice aiming to decrease the risk of developing cardiovascular disease. This preventive health care is in Sweden carried out primarily by the district nurses and they have a key role in promoting health and prevent cardiovascular disease. The aim of the study was to examine district nurses' experiences of working with health promotion among patients with risk factors of cardiovascular disease, and to identify possibilities and obstacles for prevention work in the practical reality.

    Methods: The study has been carried out with a qualitative approach where narrative interviews were performed with a total of 12 district nurses working at health centers in north Sweden. Data transcripts were analyzed with qualitative content analysis.

    Results: The participants express that their work in health promotion is an essence of the job as district nurse. It gives an opportunity to promote healthier lifestyle on an individual level with direct effects on patients' health. Participants are clear about what should be included in the preventive work and mention the topics of diet, exercise, tobacco, alcohol habits and obesity. The district nurses state that education in Motivational Interviewing, (MI), in Physical Activity on Prescription, (PAP) and the colleagues attitudes are important facilitators for making the health promotive work to function in the practical reality. Lack of knowledge (own and among colleagues) and inadequate organizational structures constitute obstacles.

    Conclusion: District nurses are unanimous about what should be included preventive health care. It is experienced as an important part of their duties but has sometimes difficulties to prioritize it. Furthermore, the district nurses consider that knowledge within MI, PAP and the employees' attitudes constitute possibilities while one sees lack of time, negative attitudes and inadequate structures that obstacles for the preventive work.

  • 35.
    Nystedt, Astrid
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Ehrenstråle, Kerstin
    Hildingsson, Ingegerd
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Exploring Some Swedish Women’s Experiences of Support During Childbirth2014In: International Journal of Childbirth, ISSN 2156-5287, E-ISSN 2156-5295, Vol. 4, no 3, p. 183-190Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Caregivers need to better understand women's experiences of support during childbirth because research suggests that social support positively influences childbirth. AIM: This study describes women's experiences of support given by caregivers during pregnancy and childbirth. METHOD: The study design was inspired by grounded theory. Seven interviews of women were analyzed with an open coding, and different time-related categories related to the childbirth process emerged. The categories were marked by fear and a negative birth experience, being guided on own terms, feel supported, and transformation into courage to give birth. The analysis continued with a selective coding, reflecting the process of mistrust to trust in caregivers. FINDINGS: The mistrust in caregivers began with feelings of fear of birth and a negative birth experience. Through being guided on own terms and feeling supported by the caregivers, a trusting relationship could be established. If the trusting relationship continued during labor, then a woman could transform the fear of birth into the courage to give birth. CONCLUSIONS: Women's experience of support can be seen as a product of earlier experiences from interactions with caregivers. Therefore, caregivers must be sensitive to the potential power and far-reaching consequences their actions can have.

  • 36.
    Nystedt, Astrid
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Hildingsson, Ingegerd
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Exploring some Swedish womens´ experiences of support during childbirth2010Conference paper (Refereed)
  • 37.
    Olofsson, Niclas
    et al.
    Department of Research and Development, Västernorrland County Council, Sundsvall Hospital, Sweden.
    Rising Holmström, Malin
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Assessing the Construct Validity and Reliability of School Health Records of the ‘Health Dialogue Questionnaire,’ in 7th Grade in Compulsory School2015In: MOJ Public Health, ISSN 2379-6383, Vol. 2, no 1, article id 00010Article in journal (Refereed)
    Abstract [en]

    Background: The aim for this study was to assess the construct validity and reliability of the Health Dialogue Questionnaire (HDQ), 7th grade in compulsory school through comparison of the HDQ, with Paediatric Quality Of Life Inventory (PedsQLTM), Local monitoring of youth policy questionnaire (LUPP®) and Health behaviour in Swedish school-aged children (HBSC).Design and methods: A sample was created from HDQ (n= 2008), PedsQLTM (n=477), LUPP (n=2648), HBSC, (n=1500) andan exploratory factor analysis was performed in order to evaluate the construct validity of HDQ of the school children´s health in school settings.Results: The results supported the HDQ as a valid 24 items factorial model, for girls a five factorial model and for boys a four factorial model for school children aged 13 years old (grade 7). The girls' model explained 63 % of the variance, while the boys' model explained 58 % of the variance. A majority of the questions showed an agreeable concurrent and discriminant validity.Conclusions: The HDQ questionnaire is a valid instrument for measuring 13-year-old school children's self-reported-health.

  • 38.
    Olsson, Helen
    et al.
    Dalarna University.
    Audulv, Åsa
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall; Sundsvall Forensic Psychiatric Hospital.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Reducing or Increasing Violence in Forensic Care: A Qualitative Study of Inpatient Experiences2015In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 29, no 6, p. 393-400Article in journal (Refereed)
    Abstract [en]

    Semi-structured interviews with 13 forensic psychiatric inpatients that had decreased their assessed risk of violence were analyzed using interpretive description. The main contribution from this study is a detailed description of patients' own strategies to avoid violence. Participants described having an ongoing inner dialog in which they encouraged themselves, thereby increasing their self-esteem and trying to accept their current situation. An unsafe and overcrowded ward with uninterested and nonchalant staff increased the risk of aggressive behavior. In the process of decreasing violence, the patients and the forensic psychiatric nursing staff interacted to create and maintain a safe environment.

  • 39.
    Olsson, Helen
    et al.
    School of Education, Health and Social Studies, Dalarna University, Sweden .
    Kristiansen, Lisbeth Porskrog
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Nursing Sciences, Mid Sweden University, Sweden.
    Violence risk assessment in clinical practice: How forensic nurses experience violence risk assessment in daily work -A qualitative interview study2017In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 9, no 12, p. 56-63Article in journal (Refereed)
    Abstract [en]

    Background: The legislation of Swedish forensic psychiatric care states that the risk of further violence must be assessed before a patient is granted release from a forensic psychiatric hospital. The aim of the study was to describe the experiences of forensic nurses with in-patient risk assessment processes, and their implication for daily clinical forensic praxis.

    Method: Semi-structured interviews with staff who were involved in the patients risk assessment process. The interview texts were analyzed using qualitative latent content analysis.

    Discussion: The forensic nursing staff has to deal with many contradictory realities. The description was about being able to balance between supporting their work with an EBP approach of risk assessment while trying to establish interpersonal relationships and to allow for positive meetings with the patient. The study indicated that staff used a multiple sources of knowledge in order to make credible and accurate risk assessments.

    Conclusions: If the risk assessment process are to be used in a legally secure manner, the staff must receive regular support from team leadership that can provide both guidance and training. Based on a holistic approach, the link between the instinct of staff and their work with structured risk assessment must be founded on routines and solid platforms.

  • 40.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Turning points and treatment readiness in forensic patients: A study based on staff experiences.2014In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 4, no 3, p. 175-188Article in journal (Refereed)
    Abstract [en]

    Many individuals sentenced to forensic psychiatric care fail in the rehabilitation process, resulting in long-term inpatient hospital care. The concepts of turning points and treatment readiness in forensic settings should therefore be afforded more attention. Much can be learned from the features that characterize trajectories of recovery and processes related to turning points. The aim of this study was to explore forensic nursing staff’s experiences of forensic psychiatric patients’ turning towards recovery. A qualitative content analysis was used to analyse interviews with 13 forensic psychiatric nursing staff. Analysis of the data revealed two main themes with implications for clinical practice: promoting a turning point and recognizing a turning point. In the first of these, the emphasis was on actions and conditions that must exist to promote a turning. In the second, the main experiences related to recognizing a turning point were stories about visible and perceptible changes in the patient. The experiences that stood out most distinctly were those of being able to wait out the patient, and having patience when there was a lack of progression. The composition of staff and patients contributed to whether or not the environment was perceived as salutary.

  • 41.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Reaching a turning point – how patients in forensic care describe trajectories of recovery2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 505-514Article in journal (Refereed)
    Abstract [en]

    In Sweden, the duration of treatment is increasing for patients admitted to forensic psychiatric care. To reduce the length of stay it is important for the forensic rehabilitation and recovery process to be effective and safe. Not much is known about how the process of recovery and transition begins and how it is described by the forensic patients. The purpose of this study was to explore how forensic patients with a history of high risk for violence experienced the turn towards recovery. A qualitative content analysis was used to analyze interviews with 10 patients who had decreased their assessed risk for violence on the risk assessment instrument HCR-20, and who were successfully managed a lower level of security. Three themes were identified: (1) the high risk phase; facing intense negative emotions and feelings (2) the turning point phase; reflecting on and approaching oneself and life in a new way (3) the recovery phase; recognizing, accepting and maturing. In the high risk phase chaotic and overwhelming feelings were experienced. The turning point phase was experienced as a sensitive stage and it was marked by being forced to find a new, constructive way of being. The recovery phase was characterized by recognizing personal circumstances in life, including accepting the need for structure, a feeling of maturity and a sense of responsibility for their own life. In order to ensure a successful recovery, the forensic nursing staff needs to recognize and support processes related to treatment motivation and turning points. Recommendations for best nursing practice are given accordingly.

  • 42.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall; Sundsvall Forensic Psychiatric Hospital, Sweden.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Sjöling, Mats
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Decreased risk for violence in patients admitted to forensic care, measured with the HCR-202013In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 4, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Aim: To explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the Clinical (C) and Risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.

    Methods: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.

    Results: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.

    Conclusion: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.

  • 43.
    Porskrog Kristiansen, Lisbeth
    Karolinska institutet, avdelningen för omvårdnad, institution för neurobiologi, omvårdnadsvetenskap och samhälle. .
    Features of Swedish municipal elderly and psychiatric group dwelling care after the health-care reforms of the 1990s2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The over all aim of this thesis, consisting of six studies, was to explore features of the Swedish municipal elderly and psychiatric group dwelling care after the 1990s health care reformation era. Focus is primarily on the municipal psychiatry. The mixed design, used here, employs both quantitative and qualitative methods. In paper I all psychiatric municipal care providers' caring approaches towards a fictitious elderly long-term client with schizophrenia was explored through a questionnaire. Approximately 70 per cent of the nurses had a symptom-orientated approach which focuses on correction of disease-related symptoms towards the clients. If the nurses had been working for less than 10 years they tend to have a more person-centred approach, which indicate that long- term job experience might affect the care providers' attitudes towards the clients negatively. In paper II the existence of a visible pattern in care providers' attitudes and their arguments for the preferred approaches towards a fictitious elderly person (Mrs NN) with a diagnosis of long term schizophrenia was investigated. Fourty-eight (73%) of the respondents (n = 66) emphasized the importance of meeting Mrs NN within the framework of reality and the need as a care provider to focus on the present or the 'here and now' when they communicate with her. Twenty-seven per cent stressed the importance of meeting Mrs NN within the framework of a person-focused approach to the same question. The majority was unable to see the client a as anything else than what the diagnosis said. The purpose of paper III was to investigate twenty care providers' experiences of job satisfaction, whose work involves taking care of clients suffering from dementia and elements of ' aggressiveness' and 'psychomotor agitation'. The individual narrative interviews indicated exposure, insufficiency, a feeling of not being valued and doubt, as well as respect and importance and devotion towards the residents. The interpretation of the narrations showed that an ambiguous and complex core-theme: 'job satisfaction as a process moving between breaking down and occasionally building up the working person'. The care providers experienced that they only got support from each other and the positive relationship with colleagues was mentioned as the primary reason for care providers' continuing to work at the group dwellings. The organisation and resident behaviours were seen as very negative. Just a small degree of support was experienced from the side of the organisation. In paper IV the aim was to investigate how clients at two psychiatric group dwellings spend their time using the Patient Activity Classification (PAC). The clients who displayed a predominant picture of negative symptoms were left alone for 84% of the day. Of this 29.5% could be explained by their illness. The results indicated that, even if the dwellings had a creative climate, there was a negative process in terms of care providers' well-being with a moderate degree of emotional exhaustion, depersonalisation, and personal accomplishment. In paper V the aim was to investigate the connections between the time spent together and the care providers' opinion of client behaviour and social functioning in community-based psychiatry. Twenty nine clients' were assessed by 30 care providers, who answered the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). The PAC instrument revealed that clients spent, an average of 60.8 per cent of time alone, while only 20 per cent of their daily time was spent with the care providers. Four groups of clients were created based on the GAF scores, high and low, and a PANSS scores, high and low, related factor analysis. The clients in the group judged as having a low level of social functioning in combination with high degrees of psychiatric symptoms, receive less staff attention (18%) and are the clients who spend the most time alone (73.4%). Finally, in paper VI, the professional role of care providers in social psychiatry is in the midst of a period of role re-definition towards a recovery, client-focused perspective. In three focus group interviews 13 care providers discussed their views and experiences of their professional role at a social PGD (Psychiatric Group Dwelling) context when caring for clients suffering from severe mental illness. Thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly "strangled" situation', and 'Feeling overwhelming frustration'.

    The findings showed that when aspects of the care were related to Kari Martinsen's ontological theory of care, including a practical, relational- and moral dimension, the moral dimension seemed to cause the care providers suffering. Furthermore, a figure is presented to illuminate how the findings contributing to different levels of the features of municipal EGD (Elderly Group Dwelling) and PGD care can be understood and related to each other. There is a hope that the results of this research could be used as a foundation to develop educational- and "contact" programs for care providers and others with the interpretation and the power to decide. This might, in a longer perspective, lead to a positive development for all identified levels, with special focus on a higher degree of experienced quality of life for both elderly and psychiatric clients.

  • 44.
    Rising Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Promoting a relationship-based health practice: A challenge for school nurses2013In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 8, no 1, p. 30-38Article in journal (Refereed)
    Abstract [en]

    Background:

    School nurses have a unique opportunity to promote health when they meet school children during the Health Dialogue. The Health Dialogue concept is used by all the school nurses in a county in Mid Sweden.

    Aim:

    To describe school nurses' experiences of the Health Dialogue concept.

    Methods:

    A qualitative descriptive study with latent content analysis of interviews performed during February–April 2012, where 16 school nurses participated.

    Findings:

    The school nurses experienced the Health Dialogue concept as a useful tool to work with school children's health in a relationship-based, child focused, structured, and systematic way, which was reflected in one overarching theme: 'To be in a relationship-based, health-promoting practice.' However, school nurses also experienced loneliness and frustration from the many difficult situations with school children, and they indicated needs for further collaboration.

    Conclusions:

    The Health Dialogue concept is child-focused, systematic and structured, but it requires further development and continuing work on statistical feedback. School nurses indicated a need for collaboration with teachers, parents, and other health professionals, as well as professional-reflective supervision.

  • 45.
    Rising Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Marie, Häggström
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Skolsköterskans rolltransformering till den nya hälsofrämjande positionen [The transformation of the school nurse’s role towards the new health-promoting position]2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 4, p. 210-217Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this study was to describe the role transformation of school nurses towards primary health promotion, and secondary preventive and health treatment work.Background According to the Swedish educational act, the school nurse profession has changed towards being mainly health promotion and secondary preventive and health treatment work.Method The study consisted of a qualitative study design with content analysis inspired by Elo and Kyngäs. Sixteen individual interviews were conducted with school nurses from across one county.Findings The role transformation towards a more health promotion was described by school nurses' statements. The process of the transformation differed among the school nurses. Three categories illuminated their work; professional approach, student-centred and collaboration.Conclusion The role transformation process required enhanced relation and communicational skills. Structured collegial supervision might support the process.

  • 46.
    Rising Holmström, Malin
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Olofsson, N.
    Public Healthcare Center Härnösand, County Council Västernorrland, Härnösand, Sweden.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Health among 6-year-old children in a Swedish county: Based on the Health dialogue2011In: Acta Paediatrica. Supplement, ISSN 0803-5326, Vol. 100, no 463, p. 105-106Article in journal (Refereed)
  • 47.
    Rising Holmström, Malin
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Folkhälsocentrum, Landstinget Västernorrland, Härnösand, Sweden.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Transitions in the Swedish school system and the impact on student's positive self-reported-health2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 1045Article in journal (Refereed)
    Abstract [en]

    Background: To explore three school based transitions and their impact on positive self-reported-health (SRH), pre-school to elementary school (6-10 y), elementary school to junior high school (10-13y), and junior high school to upper secondary school/high school (13-16y), in a long-term longitudinal population based study. Methods: The study followed three cohorts through one school transition each. A longitudinal study with data from 6693 Health Dialogue questionnaires were used. Data were collected in the middle of Sweden during 2007-2012 with school children age 6-16 years old. Results: Several significant factors were identified with an impact for a positive self-reported-health among children age 6-16y; not feeling sad or depressed, afraid or worried, positive school environment (schoolyard and restrooms), not bullied, good sleep, daily physical activity and ability to concentrate. There was no single factor identified, the factors differed according to gender and age. Conclusion: The study have identified several gender and age specific factors for successful school transitions relevant for a positive SRH. This is valuable information for school staff, parents and school children and provides a possibility to provide support and assistance when needed.

  • 48.
    Rising Holmström, Malin
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Olofsson, Niclas
    Landstinget Västernorrland.
    Kristiansen, Lisbeth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Health among 6-year-old children in a Swedish county: based on the health Dialogue2012In: Vulnerable Groups & Inclusion, ISSN 2000-8023, E-ISSN 2000-8023, Vol. 3, no 1, article id 8416Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the experiences of self-reported health (SRH) of 6-year-old boys and girls.

    Background: The goals for the Swedish School Health Services (SHS) are to identify health problems, take measures to prevent illness, and promote health. One approach used to achieve this is the use of the Health Dialogue (HD) questionnaire. The HD is offered at three occasions during compulsory school and once in high school; it follows the child’s development and growth from 6 to 16 years old.

    Methods: The HD is a structured questionnaire consisting of 15 questions related to health, each phrased in a positive manner. The HD represents a cross-sectional image of the child’s SRH according to the child and parents. The SRH in this study is based on the results from the 5259 HD questionnaires conducted during 20062009 with 6-year-old children and parents. OR were analyzed for the HD.

    Results: Experiencing comfortableness in preschool, good sleep, absence of severe headaches, being physical active/play every day, and not being a victim for bullying shows to be important preschool indicators for boys and girls. Discussion: The most important health variable tagging in the preschool children’s positive SRH was comfortableness in preschool. Both boys and girls need to feel comfortable in preschool to report a positive SRH in school. The girls seem to be more dependent on comfortableness, being physical active, and not being bullied while the boys need to have lunch in school every day and not to show symptoms like severe headaches.

    Conclusion: The most important health variable tagging the preschool children’s SRH is comfortableness in school. The HD can increase the knowledge of 6-year-old children’s SRH and also be a tool to gain further insight into children’s health by highlighting patterns in children’s SRH

  • 49.
    Rönngren, Ylva
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Björk, Annette
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Haage, David
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Audulv, Åsa
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Kristiansen, Lisbeth Porskrog
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support2017In: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, Vol. 54, no 2, p. 309-316Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the present study was to describe the acceptability of the lifestyle program PHYS/CAT and to get information about the tools used for assessment of functional exercise capacity, cognitive performance, and self-health-related quality of life.

    Design and Methods: The findings are based on focus groups and the researchers’ experiences of conducting the program as well as using the assessment tools.

    Findings: The acceptability of the program and the assessment tools was mainly satisfactory.

    Practice Implications: The program with relational, educational, and supportive dimensions may be a promising tool to be integrated into daily nursing care.

  • 50.
    Rönngren, Ylva
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Björk, Annette
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Haage, David
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    LIFEHOPE.EU: Lifestyle & Healthy Outcome in Physical Education: Development of a lifestyle intervention program for people with severe mental illness: Physical activity, dietary changes, and cognitive adaptation training2014In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 21, no 10, p. 924-930Article in journal (Refereed)
    Abstract [en]

    People with severe mental illness (SMIs) are more prone to physicalillnesses, increased mortality and cognitive impairments, all of whichnegatively influence their daily lives. Physical activity (PHYS)programmes have helped alleviate SMI. LIFEHOPE is an ongoing researchproject with the purpose of developing a sustainable lifestyleintervention for physical and mental health. PHYS/cognitive adaptationtraining (CAT) is a newly created lifestyle intervention that providesgroup education and is based on CAT. It provides individualized supportfor PHYS and dietary change in a natural nursing environment. The aim ofthis study was to obtain further knowledge for developing a sustainablelifestyle programme by exploring psychiatric clients' experiences withPHYS and lifestyle habits, which we did by interviewing a localreference group, community mental healthcare users and community mentalhealthcare workers. Then, we developed a lifestyle programme for peoplewith SMI using information obtained from these focus group interviews.Our results suggest that there is a need for support and education, aswell as active interventions, in carrying out PHYS and dietary changesamong people with SMIs, and the PHYS/CAT may be a useful strategy.

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