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  • 151.
    Fläckman, Birgitta
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Fagerberg, Ingegerd
    Department of Caring and Public Health Sciences, Mälardalen University, Västerås; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Häggström, Elisabeth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Kihlgren, Annica
    Department of Health Sciences, Örebro University, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Kihlgren, Mona
    Centre of Nursing Science, Örebro University Hospital, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Despite shattered expectations a willingness to care for elders remains with education and clinical supervision2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, p. 379-389Article in journal (Refereed)
    Abstract [en]

    Despite shattered expectations a willingness to care for elders remains with  education and clinical supervision The aim was to describe nursing home (NH) caregivers’ work experiences while receiving education and clinical supervision for 2 years. Working in elder care seems to be losing its attraction especially with organizational changes, cutbacks and changes in work place conditions. Clinical supervision has been reported to increase job satisfaction and creativity. Semi-structured interviews from caregivers working at an NH in Sweden were conducted, at the start and again at 12 and 24 months. At about 12 months the caregivers were informed of planned cutbacks. Content analysis was the method used to analyse the interviews from seven caregivers who participated throughout the entire period. Findings show that the value of a caring milieu was one category generated by the subcategories: experiences related to work activities and changes, and experiences related to relationships. The value of knowledge was the other category that was influenced by the experiences related to the different backgrounds and the experiences related to increased knowledge gained from the support through education and clinical supervision. The categories contained positive as well as negative influences on care. The initial focus on practical duties associated with the opening of the NH shifted towards caregiver activities with the elders they spoke warmly about. After 2 years the caregivers’ willingness to care continued despite their disappointment in the worsened working conditions. The main theme that resulted was: Despite shattered expectations a willingness to care for elders remained. Continued education and clinical supervision seems to be one factor behind the retained willingness. These findings demonstrate that support and caregiver involvement in educational programmes are important during times of change and when disappointments arise in the workplace.

  • 152.
    Fläckman, Birgitta
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Karolinska Institute, Stockholm, Sweden.
    Hansebo, Görel
    Karolinska Institute, Stockholm, Sweden; Ersta Sköndal University College, Stockholm, Sweden.
    Kihlgren, Annica
    Karolinska Institute, Stockholm, Sweden; Örebro University, Örebro, Sweden.
    Struggling to adapt: Caring for older persons while under threat of organizational change and termination notice : Feature2009In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 16, no 1, p. 82-91Article in journal (Refereed)
    Abstract [en]

    Organizational changes are common in elder care today. Such changes affect caregivers, who are essential to providing good quality care. The aim of the present study was to illuminate caregivers' experiences of working in elder care while under threat of organizational change and termination notice. Qualitative content analysis was used to examine interview data from 11 caregivers. Interviews were conducted at three occasions during a two-year period. The findings show a transition in their experiences from 'having a professional identity and self-confidence', to 'being a professional in a threatening situation caused by someone else' and to 'struggling to adapt to a changed working environment as a person and a professional'. The caregivers experienced a loss of pride and satisfaction. Previous literature indicates that this may have consequences for the quality of care and that employees may be at risk of negative health effects. However, the caregivers continued to struggle, doing their best to complete their duties. The study has implications for high-level decision-makers, managers and caregivers in similar work-life situations in that it deals with factors that facilitate or impede similar transitions.

  • 153.
    Fläckman, Birgitta
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Sørlie, Venke
    Kihlgren, Mona
    Unmet expectations: why nursing home staff leave care work2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 1, p. 55-62Article in journal (Refereed)
    Abstract [en]

    Background. The shortages of healthcare professionals have been a common topic in care of older people.

    Aim and objectives. The aim of the present study was to illuminate what caused the nursing home caregivers to decide to leave their employment.

    Design. A two-year intervention study was performed in three nursing homes in Sweden.

    Method. This qualitative interview study was conducted with 18 caregivers who decided to leave their employment during the first year. Content analysis was the method used to analyse the interviews.

    Result. The caregivers’ decisions to leave their work in care of older people could be encompassed in one main category: ‘Unmet Expectations’. Their experiences were of lack of encouragement and trust and professional development. Feelings of insecurity, different opinions on the care delivered, being disregarded and betrayed followed as did thoughts of leaving work and pursuing other opportunities.

    Conclusions. The main findings indicated that organizational work pressure with information about pending financial cutbacks caused the caregivers to leave the nursing homes.

    Relevance to clinical practice. The study’s results show the value of meeting the needs of caregivers, as caregivers consider that they meet the needs of the older people. Optimal use of caregivers’ skills, experiences, competence and respect for their aspirations is also likely to result in cost-efficient care.

  • 154.
    Fogelin, Jane
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Ström, Marina
    University of Gävle, Department of Caring Sciences and Sociology.
    Vårdarnas upplevelser av sin arbetssituation i äldrevården - en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to describe how carers in the elderly care experience their work situation. The method used was a study of literature with descriptive design. Data was collected via the databases Medline and Cinahl. The search words were nursing homes, elderly care and geriatric care in combination with experience and personnel, because the authors wanted a wide database search. The search word Scandinavia was used because the authors wanted to focus on the Scandinavian elderly care. The result shows that the carers thought it was the lack of time that affected the good care of the elderly. The elder's relatives were considers as a resource for the elder's wellbeing but sometimes as demanding and as trying the carers patience. The carers thought that a poor organisation and management were some of the reasons to why the elders' need of good care was not implemented. Good fellowship and team spirit in the working group were important for giving good care to the elderly. Education and supervision helped the carers to reflect and prioritise their work.  The carers felt work satisfaction through the mutual togetherness between them and the elderly. When the carers work efforts were confirmed positive feelings aroused.

  • 155.
    Forsberg, Laila
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Kron, Kristina
    University of Gävle, Department of Caring Sciences and Sociology.
    Vårdpersonalens följsamhet till basala hygienrutiner och klädregler på särskilda boenden: En observationsstudie2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Syftet med studien var att beskriva i vilken grad vårdpersonalen närmast vårdtagaren på kommunens särskilda boenden visade följsamhet till basala hygienrutiner och klädregler.

    Studien genomfördes genom icke deltagande observationer efter ett fastställt observationsschema. Observationerna genomfördes på 73 vårdpersonal vid sex särskilda boenden i två skilda kommuner i Mellansverige. Datainsamlingen utfördes under perioden juni 2007 – februari 2008.

    Huvudresultatet visade att följsamheten gällande basala hygienrutiner och klädregler var bristfällig. Endast 10 av 73 observationer gällande basala hygienrutiner visade korrekt följsamhet. Lägst följsamhet sågs vid spritning av händer och användning av plastförkläde/skyddsrock.

    Gällande klädregler var följsamheten korrekt i 47 av 73 observationer. Följsamhet till kortärmad arbetsdräkt var korrekt hos 72 av 73 vårdpersonal. Det som påverkade resultatet i negativ riktning när det gällde klädregler var användandet av ringar vilket registrerades hos 17 vårdpersonal.

    Resultatet av föreliggande studie har visat på behov av insatser i form av utbildning och ökad tillgänglighet av plastförkläde/skyddsrock och desinfektionsmedel. Detta för att få en ökad följsamhet av basala hygienrutiner och klädregler hos personal vid kommunens särskilda boenden.

  • 156.
    Forsmark, Cecilia
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Vårdgivares uppfattning om fallrisker och fallprevention inom tre vårdnivåer2008Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The progress of the health among the elderly has a major meaning for the needs of care, nursing and social services. The health of the elderly has improved but fall and fall accidents are a major problem. Acute diseases, activities and environment risks are often related to fall accidents. The aim of the study was to describe health care staffs’ opinions about fall risk and fall prevention. The study had a qualitative approach with a descriptive design. Twelve persons from a primary healthcare centre, a hospital and a community elder care unit in the middle of Sweden were interviewed. The material was analyzed through qualitative content analysis and data from the interviews resulted in two categories; The category “Factors contributing to falls” was formulated from the subcategories; The older persons health status and their care needs, Physical environment, Lack of competence among staff, Lack of time, stress and insufficient staffing, Staffs’ responsibilities and not followed routines and Insufficient cooperation between professional groups. The category “Factors preventing falls” was formulated from the subcategories; Physical environment and physical aid, Competence and fall risk assessment instruments, Different professionals’ responsibilities and Cooperation between different professionals. The results showed that the health care staff viewed several factors, which according to them contributed to falls as well as prevented falls. Cooperation between different professionals, increased competence and use of systematic fall risk assessment instruments were mentioned resulting in advantages for the patient.

  • 157.
    Fröjd, Camilla
    et al.
    Department of Public Health and Caring Sciences, Psychosocial Oncology, Uppsala University, Uppsala, Sweden.
    Lampic, Claudia
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Larsson, Gunnel
    Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University, Uppsala, Sweden.
    Birgegård, Gunnar
    Department of Medical Sciences, Section of Haematology, Uppsala University, Uppsala, Sweden.
    von Essen, Louise
    Department of Public Health and Caring Sciences, Psychosocial Oncology, Uppsala University, Uppsala, Sweden.
    Patient attitudes, behaviours, and other factors considered by doctors when estimating cancer patients' anxiety and desire for information2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 4, p. 523-529Article in journal (Refereed)
    Abstract [en]

    The aim was to describe the patient attitudes, behaviours, and other factors, considered by doctors when estimating cancer patients' worry about how the disease may develop and the desire for information about the disease and its treatment. Data was gathered through semi-structured interviews with 19 doctors regarding 29 patients within endocrine oncology and haematology care, and the data were analysed by content analysis. The doctors considered the patients' verbal expressions, verbal behaviours, questions, body language, and facial expressions together with their own professional knowledge and experience, when estimating the patients' worry and desire for information. The doctors also considered contextual factors, patients' demographical factors, and medical situation when estimating the patients' worry, and also when estimating the patients' desire for information. The findings illustrate that estimating patients' worry and desire for information is a multifaceted and complex task, and that doctors consider not only the patients' verbal and nonverbal cues, but also factors, such as their own professional knowledge and experience, contextual factors, and patients' demographical variables. The findings should be communicated to doctors who meet cancer patients in medical consultations in order to illuminate the complexity of the medical consultation. The awareness of potentially important patient cues and other factors may aid doctors in their efforts to gain insight about their patients' emotions and informational needs.

  • 158.
    Fröjd, Camilla
    et al.
    Department of Public Health and Caring Sciences, Psychosocial Oncology, Uppsala University, Uppsala Science Park, Uppsala, Sweden.
    Lampic, Claudia
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Larsson, Gunnel
    Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden.
    von Essen, Louise
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Is satisfaction with doctors' care related to health-related quality of life, anxiety and depression among patients with carcinoid tumours?: A longitudinal report2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 1, p. 107-116Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate (i) whether specific aspects of the initial consultation (IC) and/or patients' satisfaction with doctors' care are related to health-related quality of life (HRQoL), anxiety and depression among patients with carcinoid tumours and (ii) whether patients' satisfaction with doctors' care changes over time. The study has a longitudinal design. The HRQoL and psychosocial function among patients who met the doctors showing good ability to identify patients' worry and wish for information were compared with those patients who met doctors showing less good ability. Patients' HRQoL, anxiety, depression and satisfaction with doctors' care were assessed longitudinally, shortly after each of the first four admissions to specialist care. Patients who met doctors showing good ability to identify their wish for information at the IC reported higher levels of cognitive function. Higher satisfaction with doctors' care was related to higher emotional and cognitive function, to higher global QoL, and to lower levels of problems with diarrhoea, financial difficulties, constipation, anxiety and depression shortly after each of the first three admissions, although not after the fourth admission to the specialist care. Although most patients with carcinoid tumours report high satisfaction with care, it is important to be aware of the fact that some patients may be less satisfied. Doctors should provide patients with information which matches the individual patients' needs and preferences as patients' satisfaction with doctors' provision of information is related to patients' HRQoL, anxiety and depression.

  • 159.
    Fröjd, Camilla
    et al.
    Department of Public Health and Caring Sciences, Psyc hosocial oncology, Uppsala Un iversity, Uppsala, Sweden.
    Larsson, Gunnel
    Department of Medical Sciences, Uppsala Un iversity, Uppsala, Sweden.
    Lampic, Claudia
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sc iences, Caring Sciences, Uppsala University, Uppsala, Sweden.
    von Essen, Louise
    Department of Public Health and Caring Sciences, Psyc hosocial oncology, Uppsala Un iversity, Uppsala, Sweden.
    Health related quality of life and psychosocial function among patients with carcinoid tumours: a longitudinal, prospective, and comparative study2007In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 5, article id 18Article in journal (Refereed)
    Abstract [en]

    Background: The aim was to investigate HRQoL and psychosocial function among patients with carcinoid tumours, longitudinally and prospectively, and to compare HRQoL among patients with carcinoid tumours to that of the Swedish general population. The aim was also to investigate the prevalence of distress during the first year after diagnosis. Methods: At four assessments during the first year after diagnosis, HRQoL was measured by the EORTC QLQ-C30 3.0, anxiety and depression by the HADS, and prevalence, and worst aspects of distress by an interview guide. ANOVA was performed in order to study changes over time with regard to HRQoL, anxiety and depression. Comparisons regarding HRQoL between patients and the Swedish population were made by the use of one-sample t-tests and changes over time regarding the prevalence of distress was investigated by means of Cochran's Q. Results: High levelsof physical-, emotional-, cognitive-, and social function and somewhat lower levels of role function and global quality of life were reported at all assessments. Role- and emotional function increased over time. Patients reported lower role function and global quality of life and more problems with fatigue and diarrhoea than the Swedish general population, at all assessments. Fatigue, limitations to work and pursue daily activities, and worry that the illness will get worse were among the most prevalent aspects at all assessments. At all assessments the majority reported worrying about the family's situation, the ability to care for the family, and worrying before the check-up. Conclusion: It is concluded that HRQoL and psychosocial function among patients with carcinoid tumours remains stable during the first year, that the patients report a lower HRQoL than the Swedish general population, and that a majority of the patients report a number of aspects of emotional distress. In the clinical care, it should be considered that the majority of patients report not only fatigue and diarrhoea but also worries about their prognosis, their families, tests, and examinations. Efforts to reduce these worries should be made.

  • 160.
    Färlin, Charlotte
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Norman, Maria
    University of Gävle, Department of Caring Sciences and Sociology.
    Hur kvinnor med bröstcancer skattar sitt optimistiska och pessimistiska personlighetsdrag före och efter strålbehandling - en studie om stabilitet2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The aim of the study was to evaluate if the optimistic/pessimistic trait among women with breast cancer are changed by undergoing radiation treatment. The study had a comparative design and the sample was selected through convenience sampling. The sample consisted of 67 women in the age 30 to 86 years with treatable breast cancer. The optimistic trait was estimated before and after the radiation treatment by means of a validated scale, LOT-R. The questionnaire is a ten-item self report measure, responded to on a scale of five (0="Strongly disagree", …, 4="Strongly agree"). The points were summarized to get a total, an “optimistic score” (0-24 points). Four categories were created to interpret the result: major pessimist (0-6 points), small pessimist (7-12 points), small optimist (13-18 points) and major optimist (19-24 points). A majority of the women was in the category “small optimist” both before and after the treatment. The median score was 17 points before the radiation treatment, and 18 points after the treatment. The estimation before as well as after the radiation treatment was compared by means of Wilcoxon’s signed ranked test. The result showed no significant difference between the estimations before and after the radiation treatment (p=0.141; Z=-1.471). The main result of the study was that the optimistic trait is stable among women with treatable breast cancer, and does not change by undergoing radiation treatment.

  • 161.
    Gabrielsson, Göran
    University of Gävle, Department of Caring Sciences and Sociology.
    "Lasta och åk": Akutbilens anestesisjuksköterskors uppfattningar om intubation vid traumatiska skallskador2009Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 162.
    Gavanlooi, Sima
    University of Gävle, Department of Caring Sciences and Sociology.
    Transkulturell omvårdnad2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Sammanfattning

    Syftet med studien var att beskriva och belysa vilka faktorer som är av betydelse i sjuksköterskans omvårdnad och möte med patient med en annan kulturell bakgrund än sjuksköterskans egen kultur. Utifrån detta syfte var det främst följande frågor som lyftes fram: Vilka faktorer kunde ha betydelse i mötet mellan vårdpersonal och patient med annan kulturell bakgrund än vårdpersonalen egen kultur? Hur kan vårdpersonalen bemöta en patient med en annan kulturell bakgrund än vårdpersonalen egen kultur, för att denne skall känna sig respekterad och trygg?

    Metoden bestod i att aktivt söka efter vetenskapliga artiklar i databasen Academic Search Elite. 25 artiklar valdes ut.

    Resultatet visade att det är svårt att utforma en modell eller en riktlinje som kan beskriva hur mötet med patienter med annan kulturell bakgrund bör ske. Det finns olika faktorer som är beroende av varandras samverkan och utgör varandras förutsättningar. Varje individ är unik med egna värderingar, uppfattningar och sin kulturella bakgrund. Individen är inte en slav under sina normer och traditioner. Kultur är en process som utvecklas och förändras kontinuerligt. En sjuksköterska bör ha en holistisk människosyn och se patienten utifrån ett helhetsperspektiv.

  • 163.
    Gillström, Sara
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Ekbo, Sofie
    University of Gävle, Department of Caring Sciences and Sociology.
    Livskvalitet hos stomiopererade patienter: En litteraturstudie2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Abstract

    The aim of this literature review was to describe the quality of life in stoma patients after stomasurgery. Different combinations of the keywords “stoma”, “Quality of Life”, “stomasurgery” were used when searching in the databases Medline, Cinahl, Academic Search Elite and PubMed. A total of nineteen articles were used in the result. Fifteen studies had comparing design and four studies had describing design. Eighteen studies used questionnaires and one study used interviews for data collecting. Five studies did not concern the instruments' validity or reliability, fourteen studies referred to previously performed reliability's/validity tests. The sample sizes varied from 7 to 704 patients. Long-term quality of life in stoma patients shows contradictory results. Four studies showed that a brook uniting reservoir/pouch more or less did not change the quality of life. But that the body perception became better. One study showed that men´s Quality of Life was not effected by having a stoma, while women were effected to a greater extent, which led to a changed lifestyle and self-image among the women. Three studies showed that patients that are fecal incontinent has better social quality of life if they undergo stomasurgery. Four studies showed that patients with colon or rectal cancer and stoma had poorer quality of life than non-stoma cancer patients. Four studies showed that more therapy such as colostomy irrigation and relaxation gives better quality of life.

    Keywords; “Quality of Life”, “stoma” and “stomasurgery”

  • 164.
    Gizachew, Sirgut
    University of Gävle, Department of Caring Sciences and Sociology.
    Människors upplevelser av att leva med typ 2 diabetes2008Independent thesis Basic level (degree of Bachelor), 15 points / 22,5 hpStudent thesis
  • 165.
    Glad, Mathias
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Asplund, Helene
    University of Gävle, Department of Caring Sciences and Sociology.
    Oro och nedstämdhet hos heterosexuella par som genomgår behandling med ägg- eller spermiedonation2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Every year children all over the world are born as a result of gamete donation. In Sweden oocyte donation has been legally used since 2003 and sperm donation has been regulated in law since 1984. The aim of this study was to investigate the extent of anxiety and depression in couples going through treatments with oocyte- or sperm donation. Participants of the study were men and women who received treatment with oocyte- and sperm donation at one of the seven fertility centers in Sweden. A total of 348 men and women answered two questioners, the first one at the beginning of the treatment and the second one around 10 weeks after the end of the treatment. The drop-out rate was 16 percent. Data collection was made with the HADS – Hospital Anxiety and Depression scale. When the data had been statistically processed the results showed following significant differences: 1.The women reported a higher degree of anxiety than the men before as well as after the treatment and a higher degree of depression after the treatment. 2. The extent of depression was higher among those women and men who didn´t become pregnant compared to those who did. 3. The women who didn´t become pregnant were more anxious after failed treatment than the women who became pregnant. The conclusion is that women who receive treatment with oocyte- or sperm donation are more anxious and depressed than their partners. The feelings are temporary and seem to decrease when the treatment results in pregnancy.

  • 166.
    Goldberg, Ted
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Becoming a problematic consumer of narcotics2009In: The Praeger International Collection on Addictions, Vol. 2: Psychobiological Profiles / [ed] Angela Brown-Miller, Westport, Conn: Praeger , 2009, p. 19-45Chapter in book (Other academic)
  • 167.
    Goldberg, Ted
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Den svenska narkotikapolitiken: en kritisk betraktelse2007In: Glänta, ISSN 1104-5205, no 2-3, p. 106-117Article in journal (Other academic)
  • 168.
    Goldberg, Ted
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för sociologi.
    Därför misslyckas narkotikapolitiken2008In: Expressen, ISSN 1103-923X, no 20 februari, p. 1Article in journal (Other (popular science, discussion, etc.))
  • 169.
    Goldberg, Ted
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Invandrades levnadsvillkor2006In: Vad vet vi om narkotikaanvändarna i Sverige?, Stockholm: Mobilisering mot narkotika , 2006, p. 42-47Chapter in book (Other academic)
  • 170.
    Goldberg, Ted
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Invandrare och problematisk konsumtion av narkotika2009In: Alkohol & Narkotika, ISSN 0345-0732, Vol. 103, no 4, p. 10-12Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Under åren mellan de två senaste undersökningarna av det tunga missbruket steg antalet invandrare som är problematiska konsumenter av narkotika mycket kraftigt. Ökningstakten var betydligt snabbare än bland svenskar och procentuellt sett långt överskrider ökningen av antalet invandrare i landet under samma period.

    I delstudie 1 gjordes en kunskapsöversikt där ca 100 vetenskapliga artiklar ingick. Syftet var att jämföra invandrares livsvillkor med svenskars vad gäller 1) arbetsmarknad, 2) ekonomi, 3) hälsa, 4) boende, 5) utbildning, 6) socialtjänstens verksamhet, 7) övrigt deltagande i samhället. I studien framkom ett återkommande trappstegsmönster med inrikes födda med svensk bakgrund på högsta steget och flyktingar från tredje världen (Asien, Afrika och Latinamerika) med kort vistelsetid i Sverige på det lägsta. Övriga invandrargrupper intar mellanpositioner.

    I delstudie 2 jämfördes uppväxt- och levnadsförhållanden hos individer med utländsk bakgrund som var aktuella på socialtjänsten i Stockholms stad p.g.a. tungt narkotikamissbruk med en matchad kontrollgrupp som inte var aktuell hos socialtjänsten. Fokus var på de sju områden som studerades i delstudie 1. Jämfört med kontrollgruppen har undersökningspopulationen haft betydligt sämre uppväxtvillkor, och som vuxna lever de under avsevärt svårare förhållanden.

    En del implikationer som de två studiernas resultat har för primärprevention diskuteras.

  • 171.
    Grandell, Ann-Kristin
    University of Gävle, Department of Caring Sciences and Sociology.
    Hemtjänsten-Arbetet som går hem: -En studie om hemtjänstpersonalens arbetssituation2008Independent thesis Basic level (professional degree), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Det har skett stora förändringar inom den svenska äldreomsorgen, där bl.a. arbetsuppgifterna inom hemtjänsten har gått från social service till mer omvårdande arbetsuppgifter. Det är idag också allt vanligare att verksamheter drivs genom självstyrande arbetsgrupper där mer ansvar har lagts på arbetsgruppen. Syftet med denna studie är att förstå hur hemtjänstpersonal på en utvald arbetsplats upplever sin arbetssituation. Genom intervjuer av hemtjänstpersonal framkom att de anser att arbetet har förbättrats när det gäller den fysiska arbetssituationen men den psykiska arbetssituationen kan upplevas som stressig genom förändrade arbetsuppgifter i form av administrativa arbetsuppgifter som har lagts på arbetsgrupperna. Detta kan i viss mån påverka deras hälsa. Respondenterna upplever en viss delaktighet och inflytande i sitt arbete där framförallt arbetstider och planering av arbetet görs av arbetsgruppen själv.

  • 172.
    Green, Ulrika
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nyutexaminerade specialistsjuksköterskors upplevelse av introduktionen på intensivvårdsavdelning2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to investigate how newly graduated intensive care nurses experienced their introduction at the intensive care unit. The data were collected by semi-structured interviews with ten new graduates further analysed using a qualitative content analysis method. The main result is presented in two themes. The first theme “External factors influencing the experience of introduction both negatively and positively”, included the categories: response, checklist/introduction program, supervision, mentorship, psychosocial environment and organisational factors. These external factors had an impact on the experience of the introduction, and the nurse herself/himself had difficult to influence those factors. The second theme “Individual factors influencing the experience of introduction both negatively and positively”, included the categories: social bonding among the graduates, to cope by herself/himself as a new graduate and sense of opportunity to influence. To be able to satisfy the needs of good quality introduction for newly graduate intensive care nurses, both external and individual factors must be considered.

     

  • 173.
    Groth, Eva
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Knies, Ulrica
    University of Gävle, Department of Caring Sciences and Sociology.
    Vårdrelaterade postoperativa sårinfektioner vid femoralis poplitea by pass: en journalgranskning2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

     

    Introduction: Infections related to hospital treatment is a large and expensive problem in healthcare today. The presence of multi-resistant bacteria increases and makes infections more difficult to treat. The nurse should, among other things, act to prevent contamination and participate in developing the care.

    The purpose of this study was to compare the frequency of post-operative wound infections amongst all patients operated with femoral popliteal bypass at the clinic in 2004 and 2007. The purpose was also to describe any factor, in common for the patients, which could be a cause of post-operative wound infection.

    Method: a descriptive study with comparative contribution by research in medical journals.

    Result: the survey of the patient files has not shown any increasing frequency of wound infections between 2004 and 2007 at the clinic. The numbers of operations are constant and the numbers of infections are slightly lower. The frequency of the post-operative wound infections rate was 50 % and the prevalence between the sexes were equal. The women that attracted an infection had a higher mean age than men. More women than men had diabetes.

    Conclusion: The frequency of post-operative wound infection was high (> 50 %), although the registration of this were very insufficient. The survey was an assignment by the clinic in order to increase the security for the patients and reduce the incidence of care-induced post-operative wound infections.

  • 174.
    Gustafsson, Magnus
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Yousef, Dahlia
    University of Gävle, Department of Caring Sciences and Sociology.
    Att dokumentera rätt är inte lätt: en intervjustudie om omsorgspersonalens uppfattning om och syn på social dokumentation2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Uppsatsen handlar om den sociala dokumentationen inom vård- och omsorgsverksamheter som bedriver vård utifrån socialtjänstlagen. Syftet med uppsatsen är att synliggöra omsorgspersonalens uppfattning om och syn på social dokumentation. Utifrån syftet utgår uppsatsen från följande frågeställningar:

    - Vad, varför och hur ska man, enligt omsorgspersonalen, dokumentera?

    - Vem har, enligt omsorgspersonalen, ansvar för att social dokumentation ska utföras?

    - Hur uppfattar omsorgspersonalen att dokumentationen påverkar kommunikationen på arbetsplatsen, den muntliga respektive den skrivna kommunikationen?

    För att uppnå vårt syfte och besvara frågeställningarna valdes ett kvalitativt tillvägagångssätt, där vi genomförde tre gruppintervjuer med omsorgspersonal och tre enskilda intervjuer med enhetschefer. Informanterna som deltog i vår studie var omsorgspersonal och enhetschefer som arbetar inom äldreomsorgen. Intervjuerna genomfördes på informanternas arbetsplats, dels för att det var en ekonomisk och praktisk fråga, dels för att informanterna skulle befinna sig på hemmaplan. Valet av plats gjordes av enhetscheferna och godkändes av omsorgspersonalen.

    Analysen av vårt empiriska material och diskussion utgår från informanternas syn på och uppfattning om den sociala dokumentationen. Meningskoncentrering är den analysmetod som har använts i uppsatsen, där intervjuinnehållet har koncentrerats och kodats in i olika kategorier. Kategorier som framkommit utifrån meningskoncentreringen är social dokumentation som arbetsverktyg, utbildning och kunskap, språk - det skriftliga och det muntliga, tillsyn och ansvar, tid för dokumentation och informationsöverföring samt former för dokumentation.

    Resultatet av vår studie visar att såväl omsorgspersonal som enhetschefer anser att omsorgspersonalen har ett huvudansvar för att social dokumentation utförs. Detta för att omsorgspersonalen arbetar för och med omsorgstagare och att man även är kontaktman till en eller fler omsorgstagare. Vidare anses att sjuksköterskorna har ansvaret att se till att det dokumenteras, eftersom de, enligt denna studie, arbetar i närkontakt med omsorgstagarna och omsorgspersonalen. Både muntlig och skriftlig rapport tycks vara nödvändig. Den muntliga för att ha en möjlighet att reflektera, samtala och utbyta tankar. Den skriftliga för att säkerställa att omsorgstagaren får den hjälp som han/hon är beviljad och i behov av.  Resultatet av vår studie visar att omsorgspersonal uppfattar den sociala dokumentationen som något komplext, att den är svår men nödvändig.

  • 175.
    Göterfors Lichota, Therese
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Hedlund, Anette
    University of Gävle, Department of Caring Sciences and Sociology.
    Kundval i hemtjänsten: möjligheter och begränsningar2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Stora förändringar har ägt rum inom äldreomsorgen de senaste decennierna med kommuner som infört kundvalsmodellen och fler kommuner som är på gång att införa den. Kundvalsmodellen innebär att äldre personer med beviljad hemtjänst får möjlighet att själva välja utförare av insatserna och därmed har möjligheten att välja mellan privata eller kommunala utförare. Kundvalet innebär således att det finns minst två olika typer av utförare som kan utföra tjänsten. År 1992 infördes i Nacka kommun, Stockholms län, den första kundvalsmodellen i Sverige. Enligt politiker och anhängare av kundvalsmodellen fick kunderna större valmöjlighet och inflytande över sin situation. Denna studie har som syfte att undersöka vilka för- och nackdelar kundmodellen har, vilken betydelse och inverkan modellen har på hemtjänstens omsorgskvalitet och möjligheterna att tillgodose de äldres behov.

     

    Kvalitativa telefonintervjuer har genomförts i syfte att besvara frågeställningarna och syftet med denna studie. Intervjuerna har utförts med åtta verksamhetschefer inom hemtjänsten med blandade erfarenheter av kundvalsmodellen där fem av de åtta cheferna arbetar i en verksamhet där man infört kundval och tre av cheferna arbetar i en verksamhet där man ännu inte har infört kundvalsmodellen. Fyra av dessa chefer arbetar i en kommunal verksamhet och fyra i privat regi. Detta urval användes för att få olika aspekter angående kundvalsmodellen och dess betydelse. Detta innebär att skillnader kunde urskiljas beroende på om informanten arbetade i privat eller kommunal verksamhet och även beroende på dennes erfarenhet till kundvalsmodellen. Till analysen av intervjuerna har vi använt Habermas teori om kommunikativt handlande, Maslows behovshierarki, Waerness begrepp omsorgsrationalitet och tjänstegarantier som teoretisk behovsmodell.

     

    Vårt resultat visar att omsorgskvaliteten ökar med konkurrens eftersom verksamheterna blir tvingade att arbeta med kvalitetsutveckling. Vi har inte funnit några stora skillnader i uppfattning om kundvalsmodellen mellan privata och kommunala utförare, förutom att de privata utförarna har större möjligheter till konkurrens. Det som avgör om kundvalsmodellen införs i en kommun eller ej, är den ideologiska tillhörigheten i kommunen. En nackdel med kundvalsmodellen är att själva valet är svårt och att det inte finns tillräcklig information om utförarna som underlättar kundens valmöjligheter.

  • 176.
    Hallberg, Catharina
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Edwall, Gustav
    University of Gävle, Department of Caring Sciences and Sociology.
    Sjuksköterskestudenters uppfattningar av betydelsefulla omvårdnadsbeteenden för att ge patienter en god omvårdnad.2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Abstract

    The aim with the study was to describe and to compare nurse students' views about important

    caring behaviors in order to give good caring. An empirical comparative study was

    implemented on a college in the middle of Sweden. Nurse students in the beginning and at the

    end of their education sorted and prioritized 50 caring behaviors (CARE-Q). The result showed

    that the students' description of important caring behaviors has many similarities. However, the

    result also showed that there were significant differences between the student-groups where the

    students at the beginning of their education rated several caring behavior as significant more

    important than the students in the end of their education. The findings showed that there were

    significant differences in 7 caring behaviors. “Gets to know the patient as an individual

    person”, “Volunteers to do “little” things for the patient, e.g., brings a cup of coffee, a paper

    etc.”, “Offers reasonable alternatives to the patient, such as choice of appointment times, bath

    times etc.”, “Is cheerful”, “Introduces herself/himself and tells the patient what he/she does”,

    “Touches the patient when he/she needs comfort”, “Knows when to call the doctor”. The result

    showed on that there was not any significant difference between the study-groups in CARE-Q

    different dimensions. Conclusion; In those cases where differences were found between the

    student groups these most often concerned caring behavior of human nature, i e. the more

    fundamental in the nurse trade's area of responsibility and that students at beginning of their

    education assessed these as more important in order to provide good care.

    Keywords: Nursing student, Caring behavior, Perceptions, CARE-Q.

  • 177.
    Hallqvist, Carola
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Gustavsson, Nina
    University of Gävle, Department of Caring Sciences and Sociology.
    Hur föräldrar till barn med läpp- käk- och gomspalt upplever beskedet samt bemötande från vårdpersonal: -en litteraturstudie2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The aim of this study was to, from scientific articles, illustrate how parents with children born suffering from cleft lip and palate (CLP) reacted when informed of their childs diagnosis, how they experienced the first time period after the birth and the attitude and support from the caregivers. The 15 scientific articles used were found in Medline. Parents with children with CLP are at first in a vulnerable situation beacuse of their many questions and need of support. The result of this study showed that an important factor for the well-being of the parents was profound information and support from well-educated personnel which not only focused on the malformation of the child but also their health. During the hospitalization the caregivers should observe the possible needs the parents could have and how they could be involved in the care of their own child. Further, the result found that prenatal diagnosis had a positiv affect on the parents experience when having a child with cleft lip and palate. The result also proved that the caregivers attitude and their selection of words towards the parents was very important of how the parents experienced the situation. Another important aspect for the parents experience was the possibilty of contact with psychologist and other parents with children with CLP.

  • 178.
    Hallqvist, Susanne
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Wilhelmsson, Therese
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Sjuksköterskors attityder gentemot kvinnliga patienter som har blivit utsatta för misshandel av sin partner– en litteraturstudie.2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this literature study was to describe nurses' attitudes toward female patients who have been victims of spouse abuse. In this descriptive literature study, fifteen scientific articles were used in the result. The articles were of both qualitative and quantitative nature. The nurses felt that domestic violence was a social problem and that they had an important role in the detection of such violence. Several had themselves experienced violence but couldn‟t believe that so many in their vicinity or in the care were affected. Nurses thought that abused women had low self esteem and factors such as economics and children played into why the woman stayed in the violent relationship. The nurses often had a lack of education about the subject and felt uncomfortable in the situation that routinely screening all female patients for domestic violence. Education increased awareness and nurses felt more confident to talk about domestic violence with their female patients. The study found barriers to routine screening, as time constraints and lack of opportunity to talk separately with the patient. More education and knowledge of the subject is desirable so these women can be discovered and be helped by the health services.

  • 179.
    Hansson, Eva
    University of Gävle, Department of Caring Sciences and Sociology.
    Livskvalitet efter hjärtstopp2008Independent thesis Advanced level (degree of Magister), 10 points / 15 hpStudent thesis
  • 180.
    Hansson, Hilda
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Simonsson, Madeleine
    University of Gävle, Department of Caring Sciences and Sociology.
    Behandlingsmetoder mot övervikt och fetma hos barn2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Overweight and obesity among children and adolescents is increasing. Diseases which earlier occurred exclusively among adults are now also observed among children. There is an urgent need for new treatments that can change this negative trend. The aim of this study was to describe existing treatments for obesity among children in the age of 6-12 and the effect of those treatments. This descriptive literature study is based on 17 research articles published between 2000 and 2007 from different parts in the world. The treatments found in the studies could be categorised as follows: treatment with only physical activity, multidisciplinary treatment, multidisciplinary treatment with family participation, behavioural program with support from parents and alternative medicine treatments. No significant pattern could be observed for the effects of the different treatments. Similar treatments showed different effects, which makes the data difficult to interpret. Good results among the studied treatments were however, often obtained using multidisciplinary programs. Moreover it was shown that support from parents had a positive effect. It is of major importance to adjust the treatment to each individual and to construct the program in such a way that the effect reside also after completion of the treatment.

  • 181.
    Hansson, Lars
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Granqvist-Westling, Christina
    University of Gävle, Department of Caring Sciences and Sociology.
    Hjärt- och lungräddning eller inte - en etisk konflikt inom prehospital sjulvård2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Abstract

    The aim of this study was to describe exsisting research about the ethical conflicts, faced by paramedics surrounding the decision makeing in CPR and to determine the influence that prehospital CPR guidelines have on ethical issues regarding CPR. A litterature rewiew was conducted by analyzing thirteen scientific articles.The result showed that ethical conflicts appeared whithin paramedics decision, wheter to start or whithheld CPR in situations described by the litterature as patients that have a terminal illness or in elderly terminally ill patients. Sometimes paramedics violated the patients autonomi, when performing CPR despite the precense of a DNR wish from the patient and the patients family. The main reason that such situations occured was indistinct legalisation in prehospital CPR guidelines in USA and Canada.

    The opposite situation also occured,were the paramedics initiated CPR in order to honour the wishes from the patients relatives. Overall paramedics showed a will to respect the patients autonomi in the CPR question. Paramedics in the Northen America supported prehospital guidlines statues allowing them to withheld CPR,under cirumstances initiating CPR in terminally ill and elder terminally ill patients.

    Keywords : Ethics, Emergency medical services, CPR, CPR guidelines and Emergency medical technicians.

  • 182.
    Haraldsson, Elin
    University of Gävle, Department of Caring Sciences and Sociology.
    Distriktssköterskors upplevelser av att arbeta med palliativa patienter i hemmet2008Independent thesis Advanced level (degree of Magister), 10 points / 15 hpStudent thesis
    Abstract [en]

    Abstract

    The aim of the study was to describe district nurses’ work with palliative patients in home care and their experience of the work. The study had a descriptive design and ten district nurses from five different health care centres in the Middle of Sweden participated in the study. Data were collected with semi-structured interviews and analysed with qualitative content analysis. The results are presented from the categories, which formed two themes. The theme “To balance between the prevailing situation and to plan the end – to lie ahead. emerged from the categories To see the patient’s life situation and to perform nursing interventions, To structure the work, To support and have contact with relatives, To experience developmental and educational needs and To be professional in one’s approach and describes the district nurses’ experience of caring for palliative patients. The district nurses’ efforts at the patients home were intensified as the disease progressed, the contact with the relatives and other caregivers were described as good. The theme “To experience stimulation and strain” emerged from the categories To be professional in one’s approach and To experience and handle one’s own feelings and describes the district nurses’ feelings about caring for palliative patients. The district nurses experienced their work as important and valuable; however it was also experienced as trying with several palliative patients at the same time and extra tough when the patients where younger.

  • 183.
    Hardy, Jennifer
    et al.
    Faculty of Health Sciences, School of Nursing and Human Movement, Australian Catholic University.
    Lindqvist, Ragny
    Kristofferzon, Marja-Leena
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Dahlberg, Ola
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för medicinsk vetenskap.
    The current status of nursing informatics in undergraduate nursing programs: Comparative case studies between Sweden and Australia1997In: Nursing informatics: The impact of nursing knowledge on health care informatics / [ed] Gerdin U, Tallberg M & Wainwright P, Amsterdam: IOS Press , 1997, p. 132-136Conference paper (Refereed)
  • 184.
    Hardy, Jenny
    et al.
    Faculty of Health Sciences, School of Nursing and Human Movement, Australian Catholic University, Australia.
    Lindqvist, Ragny
    Kristofferzon, Marja-Leena
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Dahlberg, Ola
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för medicinsk vetenskap.
    The current status of nursing informatics in undergraduate nursing programs: comparative case studies between Sweden and Australia1997In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 46, p. 132-136Article in journal (Refereed)
    Abstract [en]

    During the last ten years, the inclusion of education in health information systems has assumed an important role in graduate programs for health professionals. More recently, attention has focused on undergraduate programs. Throughout the world schools of nursing, organisations and associations are addressing the issue of educational offerings in nursing informatics. This paper reports on the status of nursing informatics at undergraduate level. Nurse academics from Gavle and Lund in Sweden, and from Melbourne and Sydney in Australia, took part in a survey of the respective nursing courses. The purpose of the study was to identify and describe examples of types of nursing informatics courses in Australia and Sweden A convenient sample of academics were approached and interviewed The results of the survey illustrate, in the schools surveyed, the slow emergence of nursing informatics into nursing curricula.

  • 185.
    Harnevall, Anna
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Åhman, Katarina
    University of Gävle, Department of Caring Sciences and Sociology.
    Professionell makt och Empowerment: En studie av dilemmat professionell makt och omsorgstagarens självbestämmande på ett boende för yngre demenssjuka personer2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Syftet med denna uppsats är att studera dilemmat mellan å ena sidan yngre demenssjuka personers självbestämmande och å andra sidan omsorgspersonalens professionella makt. Våra frågeställningar i uppsatsen utgörs av: den professionella makten, omsorgstagaren självbestämmande samt omsorgstagaren självbestämmande i relation till omsorgspersonalens makt. Den struktur som utgör analysen bygger på teman, dessa är: yrkesrollen, självbestämmande samt hantering av svåra situationer. Det empiriska materialet i uppsatsen utgörs av en kvalitativ metod bestående av en gruppintervju med en personalgrupp på ett boende för yngre demenssjuka personer samt av litteraturstudier, detta för att illustrera teori med empiriska exempel i vår analys. I analysen av det empiriska materialet används en heremenuetisk tolkningsansats. Litteraturen utgörs i huvudsak av Greta Marie Skaus (2006) bok Mellan makt och hjälp och Ole Petter Askheims och Bengt Starrins (2007) bok Empowerment i teori och praktik. Vi har också använt oss av Jürgen Habermas kommunikationsteori samt av tidigare forskning bestående av två utredningar från Socialstyrelsen och en arbetsrapport från Dalarnas forskningsråd.

    Det som uppmärksammats i undersökningen och som tydligt framkommer är att kunskap och en medvetenhet om makt hos omsorgspersonalen är av stor vikt. Detta för att skapa en förståelse för omsorgstagaren självbestämmande och makten som yrkesrollen medför samt är det en förutsättning för att motverka maktmissbruk. Det framkommer även att informanternas synsätt på självbestämmande har tydliggjorts ytterligare sedan de börjat arbeta med målgruppen yngre demenssjuka personer. I informanternas uttalande observerades att med en yngre målgrupp uppstår en ny problematik att hantera och att målgruppen har gett informanterna en ny förståelse för vikten av självbestämmande.

  • 186.
    Hayat Roshanai, Afsaneh
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rosenquist, Richard
    Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden.
    Lampic, Claudia
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nordin, Karin
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
    Cancer genetic counselees' self-reported psychological distress, changes in life, and adherence to recommended surveillance programs 3-7 years post counseling.2009In: Journal of Genetic Counseling, ISSN 1059-7700, E-ISSN 1573-3599, Vol. 18, no 2, p. 185-94Article in journal (Refereed)
    Abstract [en]

    The aim of the present cross-sectional study was to investigate psychological distress, changes in life, adherence to surveillance programs and satisfaction with cancer genetic counseling based on Swedish participants' self-reported data. A total of 218 probands (72% response rate) affected by breast, breast/ovarian or colorectal cancer and/or a family history of cancer were surveyed 3-7 years after receiving cancer genetic counseling. Participants reported a relatively high level of anxiety and a low level of depression. Probands affected by colorectal cancer reported a higher level of depression than did non-affected individuals with a family history of colorectal cancer. Overall, the participants reported moderate changes in family relations, priorities and appreciation of daily life activities. The majority of at-risk probands reportedly adhered to recommended surveillance programs. The mean level of satisfaction with cancer genetic counseling was high. About half of the participants would have accepted additional counseling sessions, contact with a psychologist or further help concerning informing family members. The present results indicate no adverse effects of genetic counseling, but they do suggest that typical counseling procedures could be improved by provision of additional psychosocial support.

  • 187.
    Hedlund, Åke
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Krång Persson, Maria
    University of Gävle, Department of Caring Sciences and Sociology.
    Patienternas upplevelse av prehospital vård vid Kronisk obstruktiv lungsjukdom (KOL): Kvalitativ intervjustudie2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    ABSTRACT

    The aim was to investigate how Chronic Obstructive Pulmonary Disease (COPD) patients experience the approach and medical care provided by ambulance workers during transportations and domestic emergencies. The investigation was carried out as a qualitative interview study. The heart and lung-disease association in Dalarna was contacted in order to supply respondents to the study. Overall five women and three men were interviewed, based on the criteria that they would all be diagnosed with COPD and that they had, during the past three years, been in contact with a nurse within the ambulance health care in the county council of Dalarna. The interviews were semi structured with open questions. All participants got to tell about their experiences and how they were received, approached and treated by ambulance workers when having domestic emergencies or during ambulance transportations. Data were parsed on the basis of a qualitative analysis. The result is presented in five main categories and thirteen subcategories which describes the participant’s experiences with approaches and treatments. The people investigated felt very secure during treatments given to them in their urgent state of illness caused by COPD. It came to light that participants experienced a composed and pleasant approach from the nurse within the ambulance healthcare in Dalarna.

    Keywords: Attitude, take care of, experience, COPD

  • 188.
    Hedov, Gerth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Annerén, Göran
    Uppsala universitet.
    Children with Down syndrome. How are new parents supported?1993In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 90, no 39, p. 3319-3320Article in journal (Refereed)
  • 189.
    Hedov, Gerth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Annerén, Göran
    Wikblad, Karin
    Self-perceived health in Swedish parents of children with Down's syndrome.2000In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 9, no 4, p. 415-422Article in journal (Refereed)
    Abstract [en]

    In this comparative study, self-perceived health was investigated in 165 parents of 86 children with Down's syndrome (DS), using the Swedish version of the SF-36 questionnaire. Questionnaires were mailed to parents of children with DS in a defined Swedish population. The results were compared with those in a randomised control group of parents from the Swedish SF-36 norm population. Mothers and fathers replied separately. Student's t-test with the Bonferroni correction was used for multiple statistical comparisons. The mothers of children with DS ('DS mothers') had significantly lower, less favourable scores than did the fathers of DS children ('DS fathers') in the Vitality (p < 0.0005) domain. Further, DS mothers spent significantly more time in caring for their child with DS than did the DS fathers (p < 0.0001). DS mothers also had lower scores than the mothers of the control group in the Vitality (p < 0.001) and Mental Health (p < 0.001) domains. DS fathers and control fathers differed significantly in the Mental Health domain (p < 0.002), but not otherwise. In conclusion, DS mothers showed poorer health than their spouses and the control mothers. No differences similar to those found between the DS mothers and DS fathers were observed between control mothers and control fathers.

  • 190.
    Hedov, Gerth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Annerén, Göran
    Wikblad, Karin
    Swedish parents of children with Down's syndrome.2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 4, p. 424-430Article in journal (Refereed)
    Abstract [en]

    Becoming parents of a child with Down's syndrome (DS) challenges the adjustment ability in parenthood. Individuals with higher sense of coherence (SOC) are supposed to manage stressors better than those with lower SOC. The aims of this study were to investigate parental self-perceived stress, SOC, frequency of gainful employment and amount of time spent on child care in Swedish DS parents (165 parents; 86 mothers, 79 fathers) and to compare those with control parents of healthy children (169 parents; 87 mothers, 82 fathers). The mean age of the children was 4.7 years. Parents responded to questionnaires separately including Hymovich's Parent Perception Inventory as stress measurement and Antonovsky's short version of the Orientation to Life. No differences concerning total employment rate were observed, but the DS mothers were more often employed part-time than control mothers. The DS parents did not spend more time on child care than the control parents and they did not differ in mean SOC score, but the DS parents perceived greater stress. The differences in stress, particularly between the DS and control mothers, were related to time-demanding areas. Parents with high SOC scores experienced significantly less self-perceived stress.

  • 191.
    Hedov, Gerth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Wikblad, Karin
    Annerén, Göran
    First information and support provided to parents of children with Down syndrome in Sweden: clinical goals and parental experiences.2002In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 91, no 12, p. 1344-1349Article in journal (Refereed)
    Abstract [en]

    When parents are informed that their newborn child has Down syndrome (DS), they often respond with a traumatic crisis reaction. The aims of this study were to assess the clinical goals regarding the first information and support provided to parents of newborn children with DS at the Swedish paediatric departments, and to analyse the parents' experiences of how they were first informed and treated. Data were collected during 1992-1993 from all of the 51 departments of paediatrics in Sweden. Information on the parents' experiences, collected retrospectively in 1996, was based on recollection by 165 parents of 86 children with DS born between 1989 and 1993 at 10 of the paediatric departments considered representative for Sweden. Seventy-five percent of the families were informed about the diagnosis within 24 h post partum. Some parents felt they were informed too late, and a few parents that they were told too soon. Half of the parents were satisfied with the timing. About 70% of the parents considered the information insufficient and 60% felt that they had been unsupported. Seventy percent would have liked more frequent information. Parental criticisms concerning the way in which the information was provided were that they received too much negative information about DS and that both the communication skills and the basic knowledge of DS on the part of the professionals could have been better. CONCLUSION: The Swedish paediatric departments fall short of their reported strong clinical goals regarding the initial information in Sweden, and improvements in this area are desirable.

  • 192.
    Hedov, Gerth
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Unit of Paediatrics, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Wikblad, Karin
    Department of Welfare and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Annerén, Göran
    Unit of Clinical Genetics, Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden.
    Sickness absence in Swedish parents of children with Down's syndrome: relation to self-perceived health, stress and sense of coherence.2006In: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 50, no 7, p. 546-552Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aims of present study were to study sickness absence among Swedish parents of children with Down's syndrome (DS) and to compare their rates of absence with those of control parents. Sickness absence data for 165 DS parents were compared with those for 174 control parents; all data were for the period 1997-2000. Sickness absence rates were also related to parental self-perceived health, stress and sense of coherence. METHODS: The self-administrated measures of parental self-perceived health, stress and sense of coherence were compared with the number of days of sickness absence. RESULTS: In about two-thirds of the parents in both the study and the control group, no days of sickness absence were registered. Six of the DS parents had remarkably large numbers of days of sickness absence (more than 100 per year). None of the control parents had such high sickness absence rates. It is speculated that there is a small group (less than 5%) of parents who are more vulnerable to the birth of a child with DS. Apart from these six DS parents, sickness absence was not more frequent among the DS parents than among the control parents. DS parents stayed at home to care for their sick DS child three times more often than control parents did for their non-disabled child. DS fathers took greater responsibility in the care of their temporarily sick child and stayed at home to care for the child even more often than control mothers did. DS parents with sickness periods experienced small deterioration in self-perceived health, significantly higher stress and decreased sense of coherence in comparison with parents without sickness periods. CONCLUSIONS: There was a great similarity in sick leave rates due to one's own sickness between DS and control parents, but a small group of DS parents (<5%) may be more vulnerable. DS fathers stayed at home to care for their sick DS child remarkably often.

  • 193.
    Hedqvist, Marie
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Fogelberg, Anna
    University of Gävle, Department of Caring Sciences and Sociology.
    Kvinnors upplevelser av att leva med gynekologisk cancer: - en litteraturstudie2008Independent thesis Basic level (degree of Bachelor), 15 points / 22,5 hpStudent thesis
    Abstract [sv]

    Studiens syfte var att utifrån en litteraturstudie beskriva kvinnors upplevelser av att leva med en opererad eller behandlad gynekologisk cancer. Databaserna Academic Search Elite och MedLine via PubMed användes. Tjugo artiklar inkluderades i studien. Resultatet kunde utifrån artiklarna grupperas i huvudkategorierna sexualitet, aspekter på livskvalitet samt information och kommunikation. Kvinnorna fick problem med sin sexualitet efter operation och behandling. De fick fysiska defekter som beskrevs var problem med att bli våt vid sexuell upphetsning, torr vagina, smärta vid samlag, svårare att uppnå orgasm och mindre känsel i underlivet. Många kvinnor upplevde stor trötthet och kände mindre sexuell lust. Sjuksköterskor spelade en stor och viktig roll i patienternas känslomässiga hantering av sjukdomen. Kvinnorna var i behov av att prata med någon om känslor eftersom de kände sig nervösa, ängsliga, oroliga, rädda, sorgsna och hade känslan av att inte ha kontroll. De som var med i stödgrupp upplevde att de fick känslomässigt stöd genom att lyssna, prata, jämföra och utbyta kunskaper med varandra och det fick dem att känna sig mindre oroliga, rädda, osäkra, ensamma. Kvinnorna önskade få mer information om olika effekter och biverkningar efter sjukdom och behandling och vilka effekter cancern kunde ha på sexualiteten samt hjälpande mediciner. De ville även förstå om problemen var normala. Ge och upprepa information var viktigt och tiden för när den skulle ges. Brist på information medförde stora svårigheter i hantering av sjukdom och behandling.

  • 194.
    Hedström, Katarina
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Gunnarsson, Angelica
    University of Gävle, Department of Caring Sciences and Sociology.
    Mäns och kvinnors skattning av oro och nedstämdhet, före och efter ett års hjärtrehabilitering: En empirisk kvasiexperimentell studie2008Independent thesis Basic level (degree of Bachelor), 15 points / 22,5 hpStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka hur patienter som haft en hjärtinfarkt och/eller genomgått en kranskärlsoperation skattar sin oro och nedstämdhet före och efter ett års hjärtrehabilitering samt om det fanns skillnader mellan mäns och kvinnors skattningar.

    Enkäter innehållande patienters självskattning av oro och nedstämdhet före och efter hjärtrehabilitering, Hospital Anxiety and depression scale (HAD), samlades in från Hälsoinvest i Högbo. Författarna till denna studie valde att samla in enkäter från 1996- 2001.

    För att få delta i hjärtrehabiliteringen måste patienterna vara i arbetsför ålder och haft hjärtinfarkt och/eller genomgått kranskärlsoperation samt vara icke rökare. HAD- formuläret innehöll sju frågor rörande oro och sju frågor rörande nedstämdhet. Undersökningsgruppen bestod av 115 personer: 34 kvinnor och 81 män. Medelåldern på deltagarna var 52,4 år (range = 33-61 år). Huvudresultatet visade att deltagarna signifikant hade minskat graden av oro och nedstämdhet över tid. Det fanns inga signifikanta skillnader mellan mäns och kvinnors skattningar av oro och nedstämdhet före eller efter hjärtrehabilitering. Kvinnor respektive män minskade signifikant sin grad av oro och nedstämdhet över tid. Denna studie indikerar att hjärtrehabilitering behövs för att minska patienters oro och nedstämdhet i samband med kranskärlssjukdom.

  • 195.
    Hedén, Eva-Lena
    University of Gävle, Department of Caring Sciences and Sociology.
    Autistiska barns situation i särskolan, utifrån lärares perspektiv2009Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien är att undersöka autistiska barns situation i särskolan, utifrån lärares perspektiv. Som lärare krävs det mycket planering och tålamod, vilket inte alltid är så lätt. Studien börjades med en undersökning av vad autism är, autism finns i olika varianter, allt från svår till mycket högfungerande autism. Det centrala med barn med autism är att de har problem med autismtriaden, därav namnet autism. Barnen har problem med socialt samspel, muntlig och icke muntlig kommunikation och har ett specifikt avvikande beteende.

    Som teori valde jag att utgå från makt och hjälp. Tanken är att klienten är eleven/barnet med autism och hjälparen i det här fallet är läraren. Relationen mellan makt och hjälp är relevant för de flesta yrkesgrupper som arbetar med människor, som exempelvist lärare. Förhållandet mellan hjälpare och klient är en process som genomgår olika stadier och drivs framåt av viktiga konflikter. Konflikter mellan frihet och tvång, makt och vanmakt, hjälp och skada, jämlikhet och ojämlikhet, system och individ, vilka är de begrepp jag kommer att använda i min analys.

    Ett val gjordes av att göra en kvalitativ studie där jag intervjuat lärare. analysen av intervjuerna pekade på att lärarna tycker att en medvetenhet om relationen mellan makt och hjälp är viktig. Förhållandet kännetecknas av konflikter mellan frihet och tvång, makt och vanmakt, hjälp och skada, jämlikhet och ojämlikhet, system och individ.

    De slutsater jag funnit med studien är att alla autistiska barn i särskolan uppfattas som olika individer med olika personligheter och intressen, utifrån lärares perspektiv. det som verkade vara centralt för autistiska barn i särskolan var deras svårigheter med; socialt sampel, muntlig och icke-muntlig kommunikation samt att de hade ett specifikt avvikande beteende. Avslutningsvis har jag kommit fram till att skolformen särskola möjliggör att autistiska barn får/kan lära sig efter deras möjligheter, då skolformen har en enkom pedagogik som hjälp och även assistenter som hjälper barnen.

  • 196.
    Helander, Linnea
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Schröder, Marina
    University of Gävle, Department of Caring Sciences and Sociology.
    Sjuksköterskors erfarenheter av hot och våld samt deras arbetssituation inom psykiatrisk vård.2008Independent thesis Advanced level (professional degree), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    It is common in most areas of psychiatric healthcare that nurses come into contact with threatening and aggressive patients. In order to ensure that healthcare units shall be able to meet the needs of patients and at the same time be certain that the work environment is safe for nurses, it is important to precision what threats and violence actually mean. If threatening and violent situations can be identified before they lead to physically or psychologically damaging encounters, this will save the both patients and nurses unnecessary suffering. The Purpose: was to bring to light nurses’ definitions and experiences of threats and violence and at the same time describe how they perceive daily working enviroment within psychiatry. The Method: the work was built on twenty nurses presently working in various psychiatric clinics. We made use of a data collection method that is built upon semi-structured interviews where we there after, in a sytematic and step by step process, classified the data through qualitative content analysis in order to more easily identify and condense pertinent sentence concepts. We created codes which were then placed into three categories. The Results: are split up into categorys: The precision of threats of violence, the experience of threats, and violence in the workplace. These categories are presented by the codes: threat, violence, sexual harassment, direct threats, the effects of threats, violence in combination with compulsory psychiatric care, the consequences of threats and violence, the acceptance of threats and violence, safety measures, the psychiatric nurses’ work enviroment, and the support of the nurses’ colleagues and the care organisation, were made apparent during the interviews. The Discussion: The majority och nurses enjoy their job and feel safe working at psychiatric clinics and wards, despite that incidents of threats and violence do occur.

  • 197.
    Hellgren, Frida
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    von Schlieben, Annette
    University of Gävle, Department of Caring Sciences and Sociology.
    Viktiga aspekter i sjuksköterskors strategier i omvårdnaden av ungdomar med anorexia nervosa och deras föräldrar: En litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this descriptive study was to describe important aspects in the care of adolescents who suffer from Anorexia Nervosa and their parents, out of adolescents, parents and nurses perspective. The scientific articles (n=16) was searched in the database Medline (PubMed), PsychInfo and Academic Search Elite (ASE) and a quality analysis of all articles was made. In the result it was concluded that it was important that nurses developed good relationship with young people with anorexia, which in turn lead to an effective treatment. Through motivation and encouragement the nurses could strengthen the self esteem of the anorectic person and in this a good foundation for an effective treatment was build. The nurses also needed to set up rules and to be controlling in order to help the young people to stay within the framework of the treatment. It appeared also that it was very important to involve parents to anorectic youths in the care and treatment of their children. Many parents lacked understanding and knowledge of the illness, nurses should therefore inform the parents of the nature of the illness and its treatment. It was not unusual that parents blamed themselves for their children´s illness and felt psychologically bad, which in turn affected the anorectic young people´s health in a negative way. For this reason it was important that the nurses were supportive also to the parents.

  • 198.
    hellström-hyson, eva
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Att ta ansvar eller att vara åskådare: en studie av två handledningsmodeller2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 199.
    Hellzén, Jenny
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Backman, Linda
    University of Gävle, Department of Caring Sciences and Sociology.
    Äldre personer och sömn: En litteraturstudie2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The aim of this literature review was to describe circumstances that affect the sleep in elderly people and to determine which non-pharmacological treatments that can be used to relive sleep disorder. Elderly in the review were people over 60 years, but there where no agelimitations in the selection of the studies. To answer the questions at issue a literature review was done in the following databases, Medline (Pubmed), Academic search elite and Science Direct on the basis of the inclusion criteria’s. There were 12 empirical studies that were included and reviewed. The result showed that circumstances for sleep disorder were to be old and to be depressed. External circumstances that affects the sleep: were noise, light, uncomfortable temperature in the room and an unknown environment. The internal circumstances were incontinence, reduced mobility, impaired cognitive capacity, medication and pain. Preventing circumstances were daytime activity and a satisfying social life. Alleviating circumstance on sleep disturbance was self selected music. Warm and neutral socks did not relive sleep problems in the elderly people with sleep problems, but relived on-set time in the elderly people without sleep problems.

  • 200.
    Henningsson, Lovisa
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Holmström, Lotta
    University of Gävle, Department of Caring Sciences and Sociology.
    Till vilka patientgrupper använder sjuksköterskor motiverande samtal och vad är samtalsmetodens beskrivna resultat?: en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to describe to what patient groups nurses are using the counseling approach motivational interviewing (MI) and to present the described result of the approach.

    The method was a literature review. Scientific articles were searched from the databases CINAHL and PubMed (MedLine) and the key words used were motivational interviewing and nurse*. The result showed that nurses are using MI to many different patient groups like smokers, patients needing life style changes, alcoholics, HIV-patients and other patient groups. The results of MI were generally found to be positive, however a few studies presented no, unclear or a varied result of an MI-intervention. The conclusion of this literature review is that MI can be a valuable method in everyday nursing and not only as a treatment for alcohol abuse, for which the method originally was developed. The MI principles can be related to typical human behavior as the counseling approach is based on an individual choice if and how life changes are wanted. This is decisive if changes are implemented and maintained.

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