hig.sePublikasjoner
Endre søk
Begrens søket
123456 151 - 200 of 285
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • sv-SE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • de-DE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 151.
    Löfmark, Anna
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Stord/Haugesund University College, Department of Health Sciences, Haugesund, Norway.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Validation of the tool Assessment of Clinical Education (AssCE): a study using Delphi method and clinical experts2017Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 50, s. 82-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the present study was to establish the validity of the tool Assessment of Clinical Education (AssCE). The tool is widely used in Sweden and some Nordic countries for assessing nursing students' performance in clinical education. It is important that the tools in use be subjected to regular audit and critical reviews. The validation process, performed in two stages, was concluded with a high level of congruence. In the first stage, Delphi technique was used to elaborate the AssCE tool using a group of 35 clinical nurse lecturers. After three rounds, we reached consensus. In the second stage, a group of 46 clinical nurse lecturers representing 12 universities in Sweden and Norway audited the revised version of the AssCE in relation to learning outcomes from the last clinical course at their respective institutions. Validation of the revised AssCE was established with high congruence between the factors in the AssCE and examined learning outcomes. The revised AssCE tool seems to meet its objective to be a validated assessment tool for use in clinical nursing education.

  • 152.
    Löfmark, Anna
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Stord/Haugesund University College.
    Slettebo, Åshild
    University of Agder and Akershus University College of Applied Sciences.
    Råholm, Maj-Britt
    Sogn og Fjordane University College, Faculty of Health Studies, Førde, Norway.
    H Larssen, Birte
    Centre of Nursing Research, Viborg, Denmark and School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Science, Deakin University, Australia.
    Similar and different: adjustment of clinical nursing education to educational reforms in the Scandinavian countries2015Inngår i: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 5, nr 2, s. 93-105Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Nursing education in Europe has undergone two reforms, the EU Directives and the Bologna Declaration, during the last decades aimed to create a unified European platform and integration of nursing education into the higher education system. The aim of this study was to describe the adjustment of the nursing education in the Scandinavian countries and especially the clinical parts of the education to these reforms. A review was done of the EU Directives and the Bologna Declaration and overall nationally regulating documents for nursing education in each of the Scandinavian countries with focus on the clinical parts described in for each country. The results show that there were more similarities than differences in the way the Scandinavian countries have adjusted clinical nursing education to the reforms. Denmark, Finland and Norway fulfil according to each qualification ordinance the EU Directives, while the Swedish qualification ordinance contains parts of this information. All Scandinavian countries meet the requirements in the Bologna Declaration e.g. offer a Bachelor´s degree and all have a national accreditation system for quality assurance of the education.

  • 153.
    Mamhidir, Anna-Greta
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Sjölund, Britt-Marie
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Neurobiology, Care Sciences and Society (NVS), Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Fläckman, Birgitta
    Department of Health Care Sciences of Ersta, Sköndal University College, Stockholm, Sweden.
    Wimo, Anders
    Department of Neurobiology, Care Sciences and Society (NVS), Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Sköldunger, Anders
    Department of Neurobiology, Care Sciences and Society (NVS), Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China.
    Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach2017Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, artikkel-id 61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Chronic pain affects nursing home residents’ daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs’ experiences of the intervention.

    Methods

    A cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. No measures were taken in the comparison group; pain management continued as before, but after the study corresponding training was provided. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. Nurse group interviews were carried out twice. Primary outcome measures were wellbeing and proxy-measured pain. Secondary outcome measures were ADL-dependency and pain documentation.

    Results

    Using both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Comparison group (n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time (n = 98). In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain; 8 identified at the first assessment and 9 were new, i.e. developed pain over time. No significant changes in the use of drugs was found in any of the groups. Nursing pain related documentation was sparse. In general, nurses from the outset were positive regarding pain assessments. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management.

    Conclusion

    The implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. However, pain (proxy-measured) and wellbeing level did not reveal any interaction effects between the groups over time.

    Trial registration

    The study was registered in ISRCTN71142240 in September 2012, retrospectively registered.

  • 154.
    Markus, Katarina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Överrapportering av patient från intensivvårdsavdelning till vårdavdelning: Kvalitativ studie2017Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Tidigare forskning har visat att patienter som överrapporteras från intensivvårdsavdelning till vårdavdelning är i en särskilt sårbar situation och att bristfälliga överrapporteringar är ett internationellt patientsäkerhetsproblem.

    Syfte: Syftet var att beskriva intensivvårdssjuksköterskors och avdelningssjuksköterskors upplevelser av överrapportering av patienter från intensivvårdsavdelning till vårdavdelning. Syftet var också att beskriva vad intensivvårdssjuksköterskor och avdelningssjuksköteskor ansåg vara viktigt vid överrapporteringen.

    Metod: Studien hade en kvalitativ ansats med beskrivande design. Åtta semistrukturerade intervjuer gjordes med intensivvårdssjuksköterskor (n=4) och legitimerade sjuksköterskor på vårdavdelning (n=4). Intervjuerna analyserades därefter med kvalitativ innehållsanalys.

    Huvudresultat: Vid analys av intervjuerna framträdde sex kategorier 1) Att se vikten av samverkan, 2) Att ta emot och ge relevant information för den fortsatta vården på vårdavdelningen, 3) Att ge och ta emot information från ett kunskapsområde till ett annat, 4) Miljöns betydelse vid överrapportering, 5) Att ha behov av strukturerad rapport och 6) Att känna ansvar. Intensivvårdssjuksköterskor och sjuksköterskor från vårdavdelning upplevde att brist på förberedelser inför överrapportering försvårade samarbetet. De upplevde att olika information var viktig vid överrapportering på grund av deras olika kunskapsområden. Båda yrkesgrupperna önskade att informationen skulle vara tydlig med relevant information för den fortsatta vården. De upplevde att miljön med frekventa störningar gjorde att information missades och att en strukturerad rapport gjorde överrapporteringen tydligare. De uttryckte också att de har ett ansvar vid informationsöverföringen.

    Slutsatser: Samverkan, strukturerad information för den fortsatta vården, kunskap, miljö och ansvar kan ha betydelse vid överrapportering och att utrymme för förbättring finns för att öka patientsäker överrapportering av patient mellan vårdinrättningar.

  • 155.
    Mejer, Sara
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Nilsson, Agnes
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Vardagen för personer med bensår2017Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Bensår är ett tillstånd som blir allt vanligare i Sverige, ökar i takt med hög ålder och definieras som sår som inte läkt inom sex veckor. Att leva med en kronisk hudsjukdom innebär att anpassningar i det dagliga livet måste ske. Syfte: Syftet med föreliggande studie var att beskriva hur personer med bensår upplever sin vardag samt att beskriva vilka undersökningsgrupper som ingick i de inkluderade artiklarna. Metod: En beskrivande litteraturstudie som inkluderade tio stycken vetenskapliga artiklar som söktes fram i databaserna Cinahl och PubMed. Huvudresultat: Bensår påverkade personernas liv fysiskt, psykiskt och socialt. Stora faktorer som bidrog till begränsningar i det dagliga livet var förekomsten av smärta, depression samt rädsla för att utöva fysisk aktivitet. Kontakten med vården var en stor del av vardagen, där personerna upplevde att vården tog upp mycket tid och personerna upplevde även att sjuksköterskorna hade för lite kunskap avseende deras sjukdom och lidande. I artiklarna som utgör resultatet var det mellan 5-1824 deltagare, de flesta deltagarna var kvinnor, åldersspannet var mellan 18 - 104 år, det var främst venösa bensår som förekom och deltagarna hade haft sina bensår mellan 6 veckor - 43 år. Slutsatser: Att leva med ett bensår skapade begränsningar i det dagliga livet och smärta, depression samt rädsla för att utöva fysiskt aktivitet förekom. Det är viktigt som sjuksköterska att uppmärksamma denna patientgrupp för att ge ett professionellt bemötande och en god omvårdnad.

  • 156.
    Melin, Jan
    et al.
    Uppsala University Hospital, Uppsala, Sweden.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Stenberg, Jenny
    University Hospital Uppsala, Uppsala, Sweden.
    Hans, Furuland
    University Hospital Uppsala, Uppsala, Sweden.
    Bedside BNP as a marker of overhydration in hemodialysis patients2017Inngår i: Journal of the American Society of Nephrology, ISSN 1046-6673, E-ISSN 1533-3450, Vol. 28, nr Suppl., s. 878-878, artikkel-id SA-PO772Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusion

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

  • 157.
    Melin, Jenny
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Sundberg, Cecilia
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Att leva med KOL utifrån ett psykiskt perspektiv: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Kroniskt obstruktiv lungsjukdom (KOL) är ett sjukdomstillstånd som kännetecknas av ett begränsat luftflöde, främst vid utandning, till följd av exponering av giftiga ämnen i inandningsluften. Sjuksköterskan möter dessa patienter i primärvården, allmän medicinavdelning och specialiserad lungmedicinsk avdelning.

     

    Syfte: Syftet med denna litteraturstudie var att utifrån vetenskaplig litteratur beskriva upplevelser av att leva med kroniskt obstruktiv lungsjukdom (KOL) utifrån ett psykiskt perspektiv. Syftet var även att beskriva artiklarnas datainsamlingsmetoder.

     

    Metod: Deskriptiv design. Tio stycken vetenskapliga artiklar söktes i databaserna CINAHL och Medline via Pubmed. Dessa användes som underlag till resultatet.

     

    Huvudresultat: Många patienter med KOL upplevde oro, rädsla, depression, en känsla av förlorad identitet, förändrad familjesituation och en känsla av otillräcklighet. Resultatet visade även att flertalet patienter med KOL påvisade symtom liknande PTSD-symtom. Generellt tyckte alla KOL-patienter att andnöden var den främsta orsaken till deras oro. Patienterna upplevde att deras familjer blev drabbade då diagnos ställdes. Familjeaktiviteter och individens potential att bidra till hushållet ändrades vilket bidrog till en förändrad familjesituation, en känsla av förlorad identitet och otillräcklighet.

     

    Slutsats: Upplevelsen hos KOL-patienter definieras av oro, rädsla, depression, en känsla av förlorad identitet, förändrad familjesituation och en känsla av otillräcklighet. Symtom liknande PTSD-symtom påvisades dessutom hos denna patientgrupp. Andnöden generaliserades som den främsta orsaken till deras upplevda psykiska ohälsa.

  • 158.
    Molavi, Sara
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Sjöström, Emma
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Kvinnors upplevelser före och efter mastektomi relaterat till bröstcancer2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Sammanfattning

    Bakgrund: Bröstcancer är den mest förekommande cancerdiagnosen hos kvinnor. Förstahandsbehandlingen av bröstcancer är kirurgi, antingen som enskild behandling eller i kombination med strålning, cytostatika eller hormonbehandling. Operationen som utförs vid bröstcancer benämns mastektomi och innebär att tumören och den omkringliggande vävnaden avlägsnas, en så kallad partiell mastektomi. Om hela bröstet avlägsnas benämns det istället för radikal mastektomi.

     

     

    Syfte: Syftet med litteraturstudien var att beskriva kvinnors upplevelser före och efter mastektomi relaterat till bröstcancer samt att granska vilka datainsamlingsmetoder som används i de inkluderade vetenskapliga artiklarna.

     

     

    Metod: En litteraturstudie av deskriptiv design som grundar sig i elva vetenskapliga artiklar. En artikel utgjordes av kvantitativ ansats och resterande tio av kvalitativ ansats.

     

    Huvudresultat: Litteraturstudien visade att majoriteten av kvinnorna upplevde tiden före och efter mastektomin som påfrestande då det var känslosamt att förlora ena eller båda brösten. De upplevde att kroppsbilden, kvinnligheten och sexualiteten påverkades negativt. Många kvinnor beskrev att de upplevde att de förlorat en del av sig själva och deras identitet i samband med mastektomin. För att hantera sin levnadssituation fann kvinnorna stöd i bland annat tron på Gud, sina partners och även vårdpersonalen.

     

    Slutsatser: Majoriteten av kvinnorna upplevde tiden före och efter mastektomin påfrestande och upplevde att stora delar i deras liv påverkats negativt. Det är därför viktigt att sjuksköterskor är lyhörda och ser till de behov kvinnorna har samt att få en förståelse för vad dessa kvinnor genomgått och för den situationen de befinner sig i.

  • 159.
    Molén, Olivia
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Forslund, Karolina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Att lida är inte att leva: Anledningar till att personer vill påskynda döden med eutanasi: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Eutanasi är lagligt i ett fåtal platser i världen. I länder där det är otillåtet är detta ett outforskat ämne, särskilt ur ett patientperspektiv. Palliativ vård anses vara ett alternativ till eutanasi, trots detta önskar en del personer att avsluta livet med eutanasi.

    Syfte: Att beskriva anledningar till varför vuxna personer vill påskynda döden med hjälp av eutanasi och att beskriva undersökningsgruppen i utvalda artiklar.

    Metod: En deskriptiv litteraturstudie byggd på elva kvalitativa vetenskapliga artiklar hämtade ur databaserna Cinahl, PubMed och PsycINFO.

    Huvudresultat: Resultatet visade att bristande symtomkontroll, i synnerhet smärta, var en vanlig anledning till att önska eutanasi. Funktionsförluster gjorde att deltagare förlorat sig själva och inte längre kunde delta i aktiviteter som tidigare. Rädslor för framtida lidande och förlust av självständighet uttrycktes. De önskade en värdig död genom att återta kontroll över sin kropp och sitt liv. De ville inte vara en börda ochkände sig inte längre behövda. Undersökningsgrupperna innehöll deltagare från länderdär eutanasi är lagligt såväl som olagligt. Deltagare varierade i antal, ålder ochmedicinskt tillstånd.

    Slutsats: Eutanasi är relativt outforskat ur perspektivet från de som önskar sjukvårdens hjälp med att avsluta livet. Det förekommer att svårt sjuka och äldre utan livshotande sjukdom, vill dö i förtid. En vanlig anledning bland deltagarna, var att återta kontroll över kroppen samt bestämma hur och när livet tar slut. Eftersom individens syn på en värdig död ibland skiljer sig från vad sjukvården tillåter och anser värdigt, förekom rädslor för en smärtsam och utdragen död.

  • 160.
    Muntlin Athlin, Åsa
    et al.
    Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; University of Adelaide, Adelaide, Australia.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, School of Medicine and Health, Lishui University, Lishui, China.
    Gunningberg, Lena
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Quality Department, Uppsala University Hospital, Uppsala, Sweden.
    Bååth, Carina
    Department of Health Sciences, Faculty of Health, Sciences and Technology, Karlstad University, Karlstad, Sweden; County Council of Värmland, Karlstad, Sweden.
    Heel pressure ulcer, prevention and predictors during the care delivery chain - when and where to take action?: a descriptive and explorative study2016Inngår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 24, artikkel-id 134Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes. However, few studies have investigated optimal pressure ulcer prevention in the initial stage of the care process, e.g. in the ambulance care or at the emergency department. The aim of the study was to describe heel pressure ulcer prevalence and nursing actions in relation to pressure ulcer prevention during the care delivery chain, for older patients with neurological symptoms or reduced general condition. Another aim was to investigate early predictors for the development of heel pressure ulcer during the care delivery chain.

    Methods

    Existing data collected from a multi-centre randomized controlled trial investigating the effect of using a heel prevention boot to reduce the incidence of heel pressure ulcer across the care delivery chain was used. Totally 183 patients participated. The settings for the study were five ambulance stations, two emergency departments and 16 wards at two hospitals in Sweden.

    Results

    A total of 39 individual patients (21 %) developed heel pressure ulcer at different stages across the care delivery chain. Findings revealed that 47–64 % of the patients were assessed as being at risk for developing heel pressure ulcer. Preventive action was taken. However, all patients who developed pressure ulcer during the care delivery chain did not receive adequate pressure ulcer prevention actions during their hospital stay.

    Discussion and Conclusions

    In the ambulance and at the emergency department, skin inspection seems to be appropriate for preventing pressure ulcer. However, carrying out risk assessment with a validated instrument is of significant importance at the ward level. This would also be an appropriate level of resource use. Context-specific actions for pressure ulcer prevention should be incorporated into the care of the patient from the very beginning of the care delivery chain.

  • 161.
    Myren, Gunn-Eva
    et al.
    Centre for Care Research, Mid-Norway, Steinkjer, Norway; Department of Nursing Science, Mid-Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Centre for Care Research, Mid-Norway, Steinkjer, Norway.
    Hellzen, Ove
    Department of Nursing Science, Mid-Sweden University, Sundsvall, Sweden.
    Saur, Ellen
    Department of Education, Norwegian University of Science and Technology, Trondheim, Norway.
    The Influence of Place on Everyday Life: Observations of Persons with Dementia in Regular Day Care and at the Green Care Farm2017Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 9, nr 2, s. 261-278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Day care services for persons with dementia are becoming an important aspect of community services. Place, therefore, becomes vital concerning how such establishments are organized regarding both the physical and social environment and the programs that are offered. The aim of this study was to describe the influence of place on everyday life in two different organized daycare services for persons with dementia. Based on observations and informal conversations with persons with dementia and staff members at a green care farm and a regular day care, we used an inductive manifest content analysis. The analysis reveals a main category: enabling and collaboration in daily life. The results are discussed in light of Goffman’s analysis of the structures of social encounters from the perspective of the dramatic performance. The main findings in this study involve how place contributes to enabling activities and collaboration between participants and staff, as it influences participants’ ability to achieve an active or passive role in everyday life at the day care services.

  • 162.
    Mårtensson, Gunilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Löfmark, Anna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Stord/Haugesund University College, Norway.
    Kliniska slutexaminationer – en kombination av OSCE och BOE2015Inngår i: Kliniska examinationer: Handbok för sjuksköterskestudenter på grund- och avancerad nivå / [ed] Almerud Österberg, C. Elmqvist, C. (red), Lund: Studentlitteratur AB, 2015, s. 139-160Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 163.
    Mårtensson, Gunilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Löfmark, Anna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Stord/Haugesund University College, Department of Health Sciences, Haugesund, Norway.
    Mamhidir, Anna-Greta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Preceptors' reflections on their educational role before and after a preceptor preparation course: a prospective qualitative study2016Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 19, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During clinical practice, preceptors play an important educational role in helping nursing students become secure and effective practitioners. For this educational role they need adequate preparation. The aim of the present prospective study was to describe preceptors' experiences of their educational role before and after attending a university preceptor preparation course. This 7.5-credit, Master's level course is offered on a part-time basis and covers one semester. The theoretical approach was self-directed and reflective learning. Twentyseven preceptors participated in group interviews before and after the course, and data were analyzed using qualitative content analysis. The findings revealed a shift in preceptors' perceptions. Their view of the educational role changed from being characterized by individual experiences and notions to being guided by personal and formal demands. Before the course, the lack of sufficient preconditions for preceptorship predominated, whereas after the course participants described ways of creating such preconditions. Before the course, the supervisory process was described as teaching, whereas after the course it was described as a learning process for students. Using reflective learning in a preceptor preparation course can develop and strengthen preceptors' view of their educational role and help them manage and create the preconditions for preceptorship.

  • 164.
    Naseri, Fatemeh
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Omar, Yalda
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Sjuksköterskans arbete i förebyggandet av fotsår hos personer med diabetes mellitus: En beskrivande litteraturstudie2017Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Diabetes mellitus är en kronisk folksjukdom som drabbar miljoner människor över hela världen. Denna långvariga sjukdom kan leda till komplikationer som svårläkta fotsår som medför lidande för patienten, begränsar vardagen och sänker livskvaliten, vilket i svåra fall kan leda till amputation. Dessa svårläkta fotsår kostar samhället massor vilket är ett bekymmer.

    Syfte: Syftet med denna litteraturstudie var att beskriva sjuksköterskans arbete i förebyggandet av fotsår hos personer med diabetes mellitus samt att beskriva de ingående artiklarnas undersökningsgrupp.

    Metod: En beskrivande litteraturstudie som baserats på tio vetenskapliga artiklar, åtta med kvantitativ ansats, en med kvalitativ ansats samt en med mixad ansats. Artiklarna söktes i sökmotorn PubMed samt databasen Cinahl.

    Resultat: Det finns några punkter som spelar stor roll i förebyggandet av diabetes fotsår. Detta är att sjuksköterskor ska identifiera risker hos personer med diabetes. Detta görs med hjälp av olika instrument för att upptäcka neutrovaskulärpati. Det andra sättet i förebyggandet är att öka kunskap hos personer med diabetes och vägleda dem till egenvård. Detta möjliggörs genom att ge fotvårdsutbildning till patienter för att sköta sina fötter och på så sätt förhindra uppkomsten av fotsår och fotkomplikationer. Det sista resultatet som kom fram i den här litteraturstudien är att ett samarbete mellan olika vårdprofessioner krävs i det förebyggande arbetet. Framför allt är ett bra samarbete mellan sjuksköterskor och undersköterskor som är angeläget.  

    Slutsats: Olika faktorer kan påverka positivt på förebyggandet av fotsår hos personer med diabetes. Dessa faktorer är att identifiera risker, upptäcka neurovaskulärpati i tid, öka kunskap hos dessa personer och vägleda dem till egenvård samt skapa en bra kommunikation mellan olika vårdprofessioner. 

  • 165.
    Ngaosuvan, Leonard
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    The Equality Principle: Splitting the Difference in Custody Disputes2018Inngår i: Family Court Review, ISSN 1531-2445, E-ISSN 1744-1617, Vol. 56, nr 4, s. 583-596Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In some custody disputes parents are equally fit, other factors are not decisive, shared custody is ruled out, and the parental conflict is the only threat to children's well-being. There are no systematic principles to resolve these disputes. To fill this gap, I introduce the equality principle. Following splitting the difference and goal-setting theory, parents renegotiate under threat of randomization. If renegotiation fails, their chances of winning are equal. This principle may improve children's well-being, parental behavior, court efficiency, and custody investigations. The principle is discussed in terms of child perspective, appellate rights, applicability, irrationality, and attorney effects on negotiations. Key Points for the Family Court Community: _ The equality principle is a strategy to motivate litigating parents to agree about custody, living, or visitation disputes. _ Compared to the present system, the equality principle is beneficial because. Children spend less time in harmful uncertainty,. Parents are incentivized to behave more rationally and generously,. Courts and parents save resources,. Custody evaluations are improved as irrelevant differences between parents are ignored, and. Judges are less emotionally strained to make important decisions based on insufficient information.

  • 166.
    Nilsson, Annika
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindqvist, Ragny
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    A comparative correlational study of coping strategies and quality of life in patients with chronic heart failure and the general Swedish population2017Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 4, nr 3, s. 157-167Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to compare coping strategies and quality of life (QoL) in patients with chronic heart failure (CHF) with such strategies and QOL in persons from two general Swedish populations as well as to investigate relationships between personal characteristics and coping strategies. Methods:A cross-sectional, comparative and correlational design was used to examine data from three sources. The patient group (n=124), defined using ICD-10, was selected consecutively from two hospitals in central Sweden. The population group (n=515) consisted of persons drawn randomly from the Swedish population. Data were collected with questionnaires in 2011; regarding QoL, Swedish population reference data from 1994 were used. Results: Overall, women used more coping strategies than men did. Compared to the general population data from SF-36, patients with CHF rated lower QoL. In the regression models, perceived low ‘efficiency in managing psychological aspects of daily life’ increased use of coping. Other personal characteristics related to increased use of coping strategies were higher education, lower age and unsatisfactory economic situation. Conclusion: Differences between the patients and the general Swedish population showed an unclear pattern for coping and a clear pattern for QoL. To deal with the psychological consequences of daily life, men with CHF and persons in the general Swedish population seemed to use both problem- and emotion-focused coping. 

  • 167.
    Nilsson, Annika
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    E-assessment and an e-training program among elderly care staff lacking formal competence: results of a mixed-methods intervention study2015Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, nr 1, artikkel-id 189Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Among staff working in elderly care, a considerable proportion lack formal competence for their work. Lack of formal competence, in turn, has been linked to higher staff ratings of stress symptoms, sleep disturbances and workload. Objectives: 1) To describe the strengths and weaknesses of an e-assessment and subsequent e-training program used among elderly care staff who lack formal competence and 2) to study the effects of an e-training program on staff members’ working life (quality of care and psychological and structural empowerment) and well-being (job satisfaction and psychosomatic health). The hypothesis was that staff who had completed the e-assessment and the e-training program would rate greater improvements in working life and well-being than would staff who had only participated in the e-assessments.

    Methods

    An intervention study with a mixed-methods approach using quantitative (2010–2011) and qualitative data (2011) was conducted in Swedish elderly care. Participants included a total of 41 staff members. To describe the strengths and weaknesses of the e-assessment and the e-training program, qualitative data were gathered using semi-structured interviews together with a study-specific questionnaire. To study the effects of the intervention, quantitative data were collected using questionnaires on: job satisfaction, psychosomatic health, psychological empowerment, structural empowerment and quality of care in an intervention and a comparison group.

    Results

    Staff who completed the e-assessments and the e-training program primarily experienced strengths associated with this approach. The results were also in line with our hypotheses: Staff who completed the e-assessment and the e-training program rated improvements in their working life and well-being.

    Conclusion

    Use of the e-assessments and e-training program employed in the present study could be one way to support elderly care staff who lack formal education by increasing their competence; increased competence, in turn, could improve their self-confidence, working life, and well-being.

  • 168.
    Nilsson, Jan
    et al.
    Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden; Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden; Japanese Red Cross Institute for Humanitarian Studies, Tokyo, Japan.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Florin, Jan
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Gardulf, Ann
    Japanese Red Cross Institute for Humanitarian Studies, Tokyo, Japan; Unit of Clinical Nursing Research, Immunotherapy and Immunology, Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.
    Carlsson, Marianne
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    A short version of the nurse professional competence scale for measuring nurses' self-reported competence2018Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 71, s. 233-239, artikkel-id S0260-6917(18)30695-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The Nurse Professional Competence (NPC) Scale with 88-items has been used to measure self-reported competence among nursing students and registered nurses in many national and international nursing research projects. However, a shorter version of the scale with maintained quality has been requested to further enhance its usability.

    Objectives: To develop and evaluate the construct validity and internal consistency of a shorter version of the NPC Scale. Design: A developmental and methodological design. Participants and Settings: The study was based on a sample of 1810 nursing students at the point of graduation from 12 universities in Sweden.

    Methods: The number of items in the original NPC Scale was reduced using several established research steps and then evaluated for data quality and construct validity using principal component analysis and confirmatory factor analysis. Reliability was measured as internal consistency using Cronbach's alpha.

    Results: The extensive process of reducing the number of items resulted in a version with 35 items. Principal component analysis resulted in six factors explaining 53.6% of the variance: “Nursing Care” “Value-based Nursing Care” “Medical and Technical Care” “Care Pedagogics” “Documentation and Administration of Nursing Care” and “Development, Leadership, and Organization of Nursing Care”. All factors showed Cronbach's alpha values of >0.70. The confirmative factor analysis goodness-of-fit indexes were for root mean square error of approximation 0.05 and for comparative fit index 0.89.

    Conclusions: The NPC Scale Short Form (NPC Scale-SF) 35-items revealed promising results with a six-factor structure explaining 53.6% of the total variance. This 35-item scale can be an asset when used alone and together with other instruments it can provide the possibility of more complex analyses of self-reported competence among nursing students and registered nurses. 

  • 169.
    Nilsson, Jan
    et al.
    Karlstad University, Karlstad, Sweden; The Japanese Red Cross Institute for Humanitarian Studies, Tokyo, Japan.
    Johansson, Eva
    Karolinska Institutet, Huddinge, Sweden.
    Carlsson, Marianne
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala University, Uppsala, Sweden.
    Florin, Jan
    Dalarna University, Falun, Sweden.
    Leksell, Janeth
    Dalarna University, Falun, Sweden.
    Lepp, Margret
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Østfold University College, Halden, Norway.
    Lindholm, Christina
    Sophiahemmet University, Stockholm, Sweden.
    Nordström, Gun
    Karlstad University, Karlstad, Sweden; Hedmark University College, Elverum, Norway.
    Theander, Kersti
    Karlstad University, Karlstad, Sweden.
    Wilde-Larsson, Bodil
    Karlstad University, Karlstad, Sweden; Hedmark University College, Elverum, Norway.
    Gardulf, Ann
    Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden; The Japanese Red Cross Institute for Humanitarian Studies, Tokyo, Japan .
    Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters2016Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 17, s. 102-108Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self-reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events. 

  • 170.
    Nilsson, Ylva
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Wallberg, Camilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Fysisk aktivitet och depressiva symtom/depression: En deskriptiv litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund:Var fjärde svensk drabbas någon gång i livet av sjukdomen depression, 25% kvinnor och 15% män. Uppskattningsvis lider 300 miljoner människor i hela världen av depression och antalet växer. Diagnosen depression är den mest återkommande och kostsamma diagnosen av psykiatriska sjukdomar som behandlas inom primärvården. Depression kan utvecklas till ett allvarligt hälsotillstånd vilket kan leda till att personen som drabbats av depression tar sitt liv.

    Syfte: Syftet med litteraturstudien var att beskriva vilken betydelse fysisk aktivitet har som omvårdnadsåtgärd vid depression och depressiva symptom. Vidare var syftet att granska den metodologiska aspekten för litteraturstudiens ingående artiklar och beskriva deras urvalsmetod.

    Metod: Deskriptiv litteraturstudie med systematisk litteraturöversikt, vetenskapliga artiklarna söktes via CINAHL och Medline via PubMed, även en manuell sökning genomfördes. Totalt ingick 16 antal artiklar i litteraturstudien.

    Huvudresultat: Fysisk aktivitet har en god förebyggande effekt samt symtomreducerande effekt vid depressiva symtom/depression. Fysisk aktivitet kan även bidra till förbättring i kognitiva funktioner.

    Slutsatser: Fysisk aktivitet har en förebyggande och reducerande effekt på depressiva symtom och depression patienterna bör definieras i tid och information, motivation och uppmuntran är viktiga åtgärder för sjuksköterskan att känna till i sitt hälsofrämjande arbete.

  • 171.
    Niva-Wonevik, Rebecka
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Patientens upplevelse av stigmatisering i vården vid alkohol och, - eller substansmissbruk: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Socialstyrelsen har dokumenterat 450 000 individer mellan 18 år och äldre med alkoholmissbruk och 55 000 individer med narkotikamissbruk. Siffrorna representerade enbart dokumenterade fall av missbruk, men utesluter de antal missbruk vilka inte dokumenterats. Alla individer har rätten att tillgodoses med likvärdig vård och ett icke stigmatiserande från vårdpersonal oavsett livssituationer, bakgrund, fysiska och psykiska aspekter.

    Syfte: Syftet med litteraturstudien var att beskriva patientens upplevelse av stigmatisering i vården vid alkohol och,- eller substansmissbruk samt beskriva genomförandet av datainsamlingsmetoden till samtliga artiklar.

    Metod: Studien var en deskriptiv litteraturstudie. Resultatet har framtagits och sammanställts genom upprepad granskning av 12 vetenskapliga artiklar från tre databaser.

    Huvudresultat: Patienterna beskrev att upplevelsen av stigmatisering generellt uppfattades negativt och påverkade deras självkänsla, egenvärde, värdighet och hälsa. Patienterna berättade att stigmatiseringen skapade rädsla och vissa undvek kontakt med vården till följd av detta. Stigmatiseringen upplevdes nedvärderande och patienterna kände att de beskylldes för sitt tillstånd och därför inte förtjänade ett gott bemötande och god vård, medans några upplevde stigmatisering positivt och motiverande.

    Slutsats:  Varje individ skall bemötas med likvärdig vård anpassat efter dennes behov oavsett individens bakgrund eller livssituation. Därför borde sjukvårdspersonal utöka sin kunskap och förståelse i mötet med dessa individer genom att tillgodoses med relevant utbildning i ämnet, anskaffa förståelse i stigmatiseringens innebörd och påverkan i syfte att tillhandahålla likvärdig och icke stigmatiserande vård till alla individer. 

  • 172.
    Nordbøe, Christianne
    et al.
    Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway.
    Enmarker, Ingela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Centre for Care Research, Mid-Norway, Nord University, Steinkjer, Norway.
    The Benefits of Person-Centred Clinical Supervision in Municipal Healthcare - Employees’ Experience2017Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, nr 5, s. 548-560Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Satisfied employees in healthcare services who have opportunities to develop their professional competence by reflecting on professional challenges play an important role in the quality of care. The aim of the present study was to describe the employees’ experience of the benefits of participating in a person-centred clinical supervision setting. The supervision, guided by a professional supervisor, was carried out with a group of six day- and night-shift municipal healthcare professionals for a period of four months during their mandatory work hours. Data were obtained from written individual evaluations and group interviews shortly after the last session and again twelve months later. The results showed that the participants experienced that their internal resources and coping skills had been strengthened by the supervision. They developed abilities to meet the challenges more constructively than before. New understandings gave them the opportunity to alternative actions in practice. Further intervention studies of person-centred clinical supervision must focus on such clinical outcomes as patient safety and professional development.

  • 173.
    Nordström, Sara
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Berglund, Anna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Patienters erfarenhet av kostvanor efter Gastric Bypass-operation: Litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Fetma och övervikt är ett globalt växande problem och kan medföra välfärdssjukdomar, till exempel diabetes typ II. Gastric Bypass (GBP) är den mest utförda överviktsoperationen för behandling av fetma och övervikt. Det saknas forskning om patienters kostvanor efter GBP och det är kunskap som behövs för att sjuksköterskan ska kunna bidra med råd och motivation till dessa patienter efter deras GBP-operation.

    Syfte: Att beskriva GBP-patienters erfarenheter av sina kostvanor efter operation, samt beskriva vilka urvalsmetoder som använts i de valda studierna.

    Metod: En deskriptiv litteraturstudie med elva vetenskapliga studier.

    Huvudresultat: Många av patienterna beskrev att deras kostvanor hade förändrats efter GBP-operationen. Framförallt kolhydratrik mat hade exkluderats ur deras kost. Det enda som inte hade exkluderats ur kosten var vegetabilier. De beskrev även att de hade utvecklat låg tolerans mot främst kött- och mejeriprodukter. Antalet måltider under dagen hade ökat och storleken på portionerna hade blivit mindre, vilket beror på den minskade volymen i magsäcken.

    Slutsats: De allra flesta GBP-patienternas kostvanor hade förändrats. Energiintaget var som lägst under den första tiden efter operationen, men med tiden lärde patienterna sig hur och vad de kunde äta, vilket ledde till ett successivt ökat energiintag. Få patienter uppgav att de fått professionell hjälp angående kost och kostvanor. Sjuksköterskan ska kunna undervisa och bidra med svar på frågor om förändringar i kostvanor för att patienten ska kunna uppnå god hälsa efter GBP-operationen.

  • 174.
    Nyberg, Somwang
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Uwitonze, Christella
    Sjuksköterskans arbetsrelaterande stress på akutmottagning: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Arbetsrelaterad stress har varit ett hälsoproblem bland sjuksköterskor i flera årtionden. Sjuksköterskor på en akutavdelning utsätts ofta för stress på sin arbetsplats, i synnerhet i stressiga situationer och vid oförutsägbara händelser. Sådana möten kan få dem att känna sig mer stressade än sjuksköterskor på andra avdelningar.

    Syftet: Syftet med litteraturstudien var att beskriva sjuksköterskors erfarenheter av arbetsrelaterad stress inom akutmottagningen och vilka datainsamlingsmetoder som har använts i de utvalda artiklarna.

    Metod: En litteraturstudie med beskrivande design som byggts på 11 artiklar med både kvalitativ och kvantitativ ansats.

    Huvudresultat: Redovisas med kategorierna bristande organisation, arbetsmiljö och coping och betydelsen av stress vid omvårdnad. Brister i organisationen orsakades av otillräcklig kompetensutveckling och bristfälligt samarbete mellan kollegor. Även dåligt stöd från organisationen var av stor betydelse för arbetsrelaterade stress. Otillräcklig coping är relaterat till den stress som uppstod på grund av överbeläggning, brist på personal, dålig lön och oro för att göra misstag på arbetsplatsen, särskild för ensamarbetande. Betydelsen av stress vid omvårdnad belyses av att sjuksköterskorna påverkades negativt på en mängd olika sätt och medföra att patientsäkerheten kunde bli lidande.

    Slutsats: Effekten av arbetsrelaterad stress leder till försämrat omvårdnadsarbete och försämrad hälsa hos sjuksköterskan. Arbetsmiljön på akutavdelningen behöver förbättras så att sjuksköterskan kan utföra sina arbetsuppgifter utan att känna stress eller otrygghet. 

  • 175.
    Nyström, Anita
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Pålsson, Ylva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Hofsten, Anna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
    Häggström, Elisabeth
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
    Nursing students' experiences of being video-recorded during examination in a fictive emergency care situation2014Inngår i: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 20, nr 5, s. 540-548Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Promoting bachelor nursing students’ learning in simulated care can be achieved through dynamic scenario-based training sessions that are documented using simple video equipment. One valuable aspect of this kind of training is the subsequent reflective dialogue that takes place between the teacher and the students during the examination.

    Aim: The aim of the present paper is to describe bachelor nursing students’ experiences of being video-recorded during an examination with a simulated patient in emergency care.

    Method: The study was descriptive in design and used a qualitative approach with written answers to open-ended questions; 44 bachelor nursing students participated.

    Results: A latent content analysis resulted in three themes: (1) Visualization may cause nervousness at first, (2) Visualization promotes dialogue and acknowledgement, and (3) Visualization promotes increased self-knowledge and professional growth.

    Conclusion: The conclusion is that video-recording is a good way for bachelor nursing students to develop skills in emergency care situations and to understand their own actions; it may also help them increase their self-knowledge.  

  • 176.
    Olsson, Annakarin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Åsenlöf, Pernilla
    Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden .
    Skovdahl, Kirsti
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden ; Faculty of Health Sciences, Buskerud University College, Drammen, Norway.
    Lampic, Claudia
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
    Effects of Tracking Technology on Daily Life of Persons With Dementia: Three Experimental Single-Case Studies2015Inngår i: American Journal of Alzheimer’s Disease and Other Dementia, ISSN 1533-3175, E-ISSN 1938-2731, Vol. 30, nr 1, s. 29-40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To investigate the effects of using tracking technology on independent outdoor activities and psychological well-being in 3 persons with dementia (PwDs) and their spouses.

    Methods: Three experimental single-case studies with an A1B1A2B2 design. The intervention entailed access to a passive positioning alarm and technical support. Continual daily measures of independent outdoor activities among PwDs’ and spouses’ worries about these activities were made during all phases.

    Results: Access to a tracking technology consistently increased the independent outdoor activities of 2 PwDs. One of the spouses consistently reported decreased worry during B phases, another’s worry decreased only in B2, and the third showed little variability in worrying across all phases.

    Conclusion: Tracking technology may support PwDs to engage in independent outdoor activities and decrease spouses’ worries; however, randomized controlled group studies are needed to investigate whether these results can be replicated on a group level.

  • 177.
    Olsson, Annakarin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Skovdahl, Kirsti
    Buskerud and Vestfold University College, Kongsberg, Norway.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala University, Uppsala, Sweden.
    Using diffusion of innovation theory to describe perceptions of a passive positioning alarm among persons with mild dementia: a repeated interview study2016Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, artikkel-id 3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Problems with memory and decline in cognitive abilities are common during development of dementia. Different kinds of technologies may be useful in supporting persons with dementia and their relatives in daily life. Tracking technologies have the potential to improve independence among persons with dementia. Consequently, the aim of the present study was to describe perceptions of a passive positioning alarm (PPA) among persons with mild dementia.

    Methods

    A repeated interview study was conducted in Sweden with a strategic sample of 11 persons with mild dementia. Roger’s Diffusion of Innovation Theory was used to deductively analyse the data.

    Results

    Regarding the advantages of the PPA, participants described perceived safety and security for, both themselves, and their relatives, as well as freedom and independence. However, they also expressed concern about the cost of the PPA, reflected on who might be the receiver of the alarm from the PPA, emphasized the importance of opportunities to test the device before becoming a user and early introduction before their problems start, thus allowing them to decide for themselves.

    Conclusions

    Supporting persons with dementia in their own homes using, e.g., a PPA may enable them and their relatives to remain longer in their own homes and be safer in their own neighbourhoods.

  • 178.
    Olsson, Helen
    et al.
    School of Education, Health and Social Studies, Dalarna University, Sweden .
    Kristiansen, Lisbeth Porskrog
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. 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 study2017Inngår i: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 9, nr 12, s. 56-63Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 179.
    Olsson, Sofie
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Wasberg, Frida
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Livskvaliteten hos patienter som genomgått en tarmstomioperation: En beskrivande litteraturstudie2016Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Tarmstomi är en kirurgisk förbindelse mellan tarmen och huden där avföringen ska komma ut i en stomipåse. Det finns olika typer av tarmstomi beroende på vilken tarmdel som är påverkad. Att få en tarmstomi innebär en stor händelse för patienten och kan ge både fysiska och psykiska komplikationer. Genom att öka förståelsen och kunskapen hos sjuksköterskan för denna händelse och hur den inverkar på patientens liv skapas förutsättningar att på bästa sätt ge god omvårdnad och stärka patientens livskvalitet.

    Syfte: Syftet med litteraturstudien var att undersöka hur patienter beskriver sin livskvalitet efter en tarmstomioperation, samt beskriva hur undersökningsgruppen sett ut i de inkluderade artiklarna.

    Metod: En beskrivande design har använts i denna litteraturstudie. De inkluderade artiklarna i studien söktes fram genom databaserna Cinahl och Pubmed. Artiklarna har kvalitativ och kvantitativ ansats.

    Huvudresultat: Patienter upplevde svårigheter med att leva med en tarmstomi, dessa innefattar det fysiska-, psykiska- och sociala livet samt svårigheter med kroppsuppfattningen. Dessa svårigheter påverkade livskvaliteten negativt. För att kunna handskas med det nya livet utvecklade patienterna inre- och yttre copingstrategier.

    Slutsats: Livskvaliteten hos patienter med tarmstomi påverkas negativt på grund av fysiska, psykiska och sociala begränsningar. Patienterna använder inre och yttre strategier för att förbättra sin livskvalitet. Stöd från omgivningen är den viktigaste bidragande faktorn till förbättrad livskvalitet.

  • 180.
    Pahus, Jytte
    et al.
    VIA university College Silkeborg.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Finderup, Jeanette
    Department of Clinical Medicine Aarhus University.
    Spliid Ludvigsen, Mette
    Department of Clinical Medicine Aarhus University.
    Validation of the Fluid Intake Appraisal Inventory for patients on haemodialysis in Denmark2016Konferansepaper (Fagfellevurdert)
  • 181.
    Pålsson, Ylva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    En intervention om peer learning som riktar sig mot nyutexaminerade sjuksköterskor2018Inngår i: FALF KONFERENS 2018: Arbetet – problem eller potential för en hållbar livsmiljö? / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, s. 131-132Konferansepaper (Annet vitenskapelig)
    Abstract [sv]

    En intervention om peer learning som riktar sig mot nyutexaminerade sjuksköterskor

    Pålsson Y, Engström M, Leo Swenne C, Mårtensson G. A peer learning intervention targeting newly graduated nurses: A feasibility study with a descriptive design based on the Medical Research Council framework. J Adv Nurs. 2017;00:1–12. https://doi.org/10.1111/jan.13513

    Bakgrund : Studier har visat att nyutexaminerade sjuksköterskor som träffas, socialiseras och delar erfarenheter med varandra stödjer varandra i att hantera stress. Peer learning är en läran-destrategi där personer i liknande situation lär av och med varandra genom inter-aktion. Studier där nyutexaminerade sjuksköterskor använder peer learning i sin introduk-tion har inte hittats. När en ny intervention ska implementeras rekommenderar Medical Research Council att genomförbarhetsstudier genomförs för att minimera problem inför framtida större utvärderingsstudier.

    Syfte: Att beskriva genomförbarheten av en intervention rörande peer learning som riktar sig mot nyutexaminerade sjuksköterskor. Genomförbarheten testades beträffande samstäm-mighet mellan den teoretiska beskrivningen av peer learning och empiriska fynd i den nya kontexten samt följsamhet och acceptans till interventionen.

    Metod: Data samlades in från tio nyutexaminerade sjuksköterskor (fem par) från januari till mars 2015 genom upprepade semi-strukturerade intervjuer samt checklista för att se följsam-heten till interventionen. Interventionens huvuddelar innefattade att ett par nyutexami-nerade sjuksköterskor arbetade samma skift och hade ett gemensamt ansvar för en grupp patienter under tre veckor. Vidare innefattade interventionen att paret under tre månaders tid hade reflektion tillsammans.

    Resultat: Den deduktiva dataanalysen visade att den teoretiska beskrivningen gällande peer learning och de empiriska fynden i de nyutexaminerade sjuksköterskornas intervjuer var samstämmiga. Guidad av teoretisk beskrivning av peer learning kodades de transkri-berade intervjuerna in i fyra kategorier: (1) arbeta med andra – definierad som att paret delade upplevelser och känslor med varandra; (2) diskutera och kritiskt reflektera över uppfattningar – definierad som att paret lärde av och med varandra genom att dela och diskutera sina uppfattningar; (3) hantera sitt lärande – definierad som att lära genom att dela kunskap och kompetens med varandra; (4) bedöma sig själv och kamraten – defin-ierad som att paret gav och fick återkoppling samt bekräftelse på varandras arbete.

    I resultatet om följsamhet och acceptans till interventionen användes data från checklistor samt beskrivningar av följsamhet och acceptans från intervjuerna. Under interventionens tre första veckor beskrev alla fem paren att de hade delat ansvar för en grupp patienter, vissa nyutexaminerade sjuksköterskor delade upp så de hade ett större ansvar för några patienter var medans andra delade sysslor. På grund av sjukdom arbetade de inte alla arbetsskift tillsammans. De tre första veckorna hade paren daglig reflektion, därefter tog paren sällan sig tid att reflektera tillsammans. Sammanfattningsvis kan sägas att interven-tionen gällande peer learning verkar genomförbar i den nya kontexten. Lärdomar som drogs angående studiens följsamhet och acceptans kommer att användas i framtida större studier.

  • 182.
    Pålsson, Ylva
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala,Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala,Sweden; Nursing Department, Medicine and Health College, Lishui University, China.
    Leo Svenne, Christine
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Surgical Sciences, Thoracic Surgery Uppsala University, Uppsala, Sweden.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala,Sweden.
    A peer learning intervention targeting newly graduated nurses: a feasibility study with a descriptive design based on Medical Research Council framework2018Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, nr 5, s. 1127-1138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS:

    To describe the feasibility of a peer learning intervention targeting newly graduated nurses. Feasibility was tested concerning consistency of the theoretical description of peer learning with empirical findings in a new context, compliance and acceptability, as well as usability of a questionnaire measuring the intended future outcome variables.

    BACKGROUND:

    Newly graduated nurses who meet, socialize and share experiences have described supporting each other's ability to cope with stress. Peer learning involves individuals in a similar situation learning from and with each other through interaction. When implementing new interventions, feasibility studies are used to minimize problems in future evaluation studies.

    DESIGN:

    Quasi-experimental design with an intervention group, followed over time using descriptive methods. The study was based on the Medical Research Council framework.

    METHODS:

    Repeated semi-structured interviews, a checklist for fidelity and a questionnaire were conducted with 10 newly graduated nurses from January - March 2015. The intervention's main component included pairs of newly graduated nurses working the same shift and having joint responsibility for a group of patients for a period of three weeks. The intervention also included three months of regular reflection by the pair.

    FINDINGS:

    Using deductive analysis, the peer learning intervention was found to be consistent with the theoretical description. Due to the compliance and acceptability, there were lessons learned. The tested questionnaire was found to be useful.

    CONCLUSIONS: This peer learning intervention seems to be feasible in this context. The present study will serve as the basis for a future full-scale evaluation study.

  • 183.
    Pålsson, Ylva
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Leo Svenne, Christine
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Ädel, Eva
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, China .
    A peer learning intervention for nursing students in clinical practice education: a quasi-experimental study2017Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 51, s. 81-87Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Studies of peer learning indicate that the model enables students to practice skills useful in their future profession, such as communication, cooperation, reflection and independence. However, so far most studies have used a qualitative approach and none have used a quasi-experimental design to study effects of nursing students' peer learning in clinical practice.

    OBJECTIVES: To investigate the effects of peer learning in clinical practice education on nursing students' self-rated performance.

    DESIGN: Quasi-experimental.

    SETTING: The study was conducted during nursing students' clinical practice.

    PARTICIPANTS: All undergraduate nursing students (n=87) attending their first clinical practice were approached. Seventy students out of 87 answered the questionnaires at both baseline and follow-up (42 of 46 in the intervention group and 28 of 39 in the comparison group).

    METHODS: During the first two weeks of the clinical practice period, all students were supervised traditionally. Thereafter, the intervention group received peer learning the last two weeks, and the comparison group received traditional supervision. Questionnaire data were collected on nursing students' self-rated performance during the second (baseline) and last (follow-up) week of their clinical practice.

    RESULTS: Self-efficacy was improved in the intervention group and a significant interaction effect was found for changes over time between the two groups. For the other self-rated variables/tests, there were no differences in changes over time between the groups. Studying each group separately, the intervention group significantly improved on thirteen of the twenty variables/tests over time and the comparison group improved on four.

    CONCLUSIONS: The results indicate that peer learning is a useful method which improves nursing students' self-efficacy to a greater degree than traditional supervision does. Regarding the other self-rated performance variables, no interaction effects were found.

  • 184.
    Pöllä, Mona
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Distriktssköterskans upplevelser och reflektioner av att vårda palliativa patienter och möta deras närstående i hemmet2017Independent thesis Advanced level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Många väljer att dö hemma vid obotlig sjukdom och det innebär ökat behov av palliativ vård i hemmet. Palliativ vård syftar till att förbättra livskvaliten för patienter och deras närstående när de drabbas av problem vid livshotande sjukdom. Syftet: Syftet med studien var att beskriva distriktssköterskans upplevelser och reflektioner av att vårda palliativa patienter och möta närstående i hemmet. Metod: Studien hade en kvalitativ ansats, beskrivande design. En intervjustudie genomfördes där åtta distriktssköterskor medverkade med erfarenhet av palliativ vård i hemsjukvården. Vid analysen har kvalitativ innehållsanalys använts. Resultat: I resultatet framkom fyra kategorier: Patientens sjukdomsinsikt är betydelsefull för palliativ vård, där beskrevs att det är av betydelse för distriktssköterskan hur insiktsfull patienten är gällande sitt tillstånd. Närståendes betydelse i palliativ vård visade att närstående var i behov av stöd, stödet kunde ibland upplevas som ifrågasättande vilket beskrevs försvårande för distriktssköterskan. Distriktssköterskan i samarbete med andra yrkeskategorier där framkom att samarbete var betydelsefullt eftersom palliativ vård utförs av flera yrkeskategorier. Distriktssköterskans roll och behov av stöd i arbetet visade att arbetet upplevdes givande men kunde också kännas utmanande vid tidsbrist för distriktsköterskan. Slutsats: Slutsatsen av studien är att distriktssköterskorna känner sig positiva till palliativ vård, de upplever det givande trots att det känns tungt ibland. Distriktsköterskan kunde känna sig frustrerad vid tidsbrist och upplever att arbetssituation behöver ses över av chefer eftersom distriktsköterskan förväntas tillgodose behov hos både patient, närstående och samarbeta väl med andra yrkeskategorier för att den palliaitva vården ska bli av bra kvalitet.

     

  • 185.
    Randmaa, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Communication and Patient Safety: Transfer of information between healthcare personnel in anaesthetic clinics2016Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Communication errors are frequent during the perioperative period and cause clinical incidents and adverse events. The overall aim of the thesis was to study communication – the transfer of information, especially the postoperative handover – between healthcare personnel in an anaesthetic clinic and the effects of using the communication tool SBAR (Situation-Background-Assessment-Recommendation) from a patient safety perspective.

    The thesis is based on studies using a correlational (Paper I), quasi-experimental (Paper II and III) and descriptive (Paper IV) design. Data were collected using digitally recorded and structured observations of handovers, anaesthetic records, questionnaires, incident reports and focus group interviews.

    The results from baseline data showed that lack of structure and long duration of the verbal postoperative handover decreased how much the receiver of postoperative handover remembered; the item most likely not to be remembered by the receiver was anaesthetic drugs. The variation in remembered information showed that there were room for improvement (Paper I). Implementing the communication tool SBAR increased memorized information among receivers following postoperative handover. Interruptions were frequent during postoperative handover, which negatively affected memorized information (Paper III). Furthermore, after implementation of SBAR, the personnel’s perception of communication between professionals and the safety climate improved, and the proportion of incident reports related to communication errors decreased in the intervention group (Paper II). The results of the focus group interviews revealed that the nurse anaesthetists, anaesthesiologists and post-anaesthesia care unit nurses had somewhat different focuses and views of the postoperative handover, but all professional groups were uncertain about having all information needed to secure the quality of postoperative care (Paper IV).

    The findings indicate that using a predictable structure during postoperative handover may improve the information memorized by the receiver, perception of communication between professionals and perception of safety climate. Incidents related to communication errors may also decrease. Long duration of the handover and interruptions may negatively affect the information memorized by receiver. To ensure high quality and safe care, there is a need to achieve a shared understanding across professionals of their work in its entirety.  

  • 186.
    Randmaa, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, China .
    Leo Swenne, Christine
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    The postoperative handover: a focus group interview study with nurse anaesthetists, anaesthesiologists, and PACU nurses2017Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 8, artikkel-id e015038Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES To investigate different professionals’ (nurse anaesthetists’, anaesthesiologists’, and postanaesthesia care unit nurses’) descriptions of and reflections on the postoperative handover.

    DESIGN A focus group interview study with a descriptive design using qualitative content analysis of transcripts.

    SETTING One anaesthetic clinic at two hospitals in Sweden.

    PARTICIPANTS Six focus groups with 23 healthcare professionals involved in postoperative handovers. Each group was homogeneous regarding participant profession, resulting in two groups per profession: nurse anaesthetists (n=8), anaesthesiologists (n=7) and postanaesthesia care unit nurses (n=8).

    RESULTS Patterns and five categories emerged: 1) Having different temporal foci during handover, 2) Insecurity when information is transferred from one team to another, 3) Striving to ensure quality of the handover, 4) Weighing the advantages and disadvantages of the bedside handover, and 5) Having different perspectives on the transfer of responsibility. The professionals’ perceptions of the postoperative handover differed with regard to temporal foci and transfer of responsibility. All professional groups were insecure about having all information needed to ensure the quality of care. They strived to ensure quality of the handover by: focusing on matters that deviated from the normal course of events, aiding memory through structure and written information, and cooperating within and between teams. They reported that the bedside handover enhances their control of the patient, but also that it could threaten the patient’s privacy and that frequent interruptions could be disturbing.

    CONCLUSIONS The present findings revealed variations in different professionals’ views on the postoperative handover. Healthcare interventions are needed to minimize the gap between professionals’ perceptions and practices and to achieve a shared understanding of postoperative handover. Furthermore, to ensure high-quality and safe care, stakeholders/decision-makers need to pay attention to the environment and infrastructure in postanaesthesia care.

  • 187.
    Randmaa, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
    Leo Swenne, Christine
    Uppsala universitet.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
    Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information retention among receivers: a prospective interventional study of postoperative handovers2016Inngår i: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 33, nr 3, s. 172-178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Communication errors cause clinical incidents and adverse events in relation to surgery. To ensure proper postoperative patient care, it is essential that personnel remember and recall information given during the handover from the operating theatre to the postanaesthesia care unit. Formalizing the handover may improve communication and aid memory, but research in this area is lacking.

    OBJECTIVE: The objective of this study was to evaluate whether implementing the communication tool Situation-Background-Assessment-Recommendation (SBAR) affects receivers' information retention after postoperative handover.

    DESIGN: A prospective intervention study with an intervention group and comparison nonintervention group, with assessments before and after the intervention.

    SETTING: The postanaesthesia care units of two hospitals in Sweden during 2011 and 2012.

    PARTICIPANTS: Staff involved in the handover between the operating theatre and the postanaesthesia care units within each hospital.

    INTERVENTION: Implementation of the communication tool SBAR in one hospital.

    MAIN OUTCOME MEASURES: The main outcome was the percentage of recalled information sequences among receivers after the handover. Data were collected using both audio-recordings and observations recorded on a study-specific protocol form.

    RESULTS: Preintervention, 73 handovers were observed (intervention group, n = 40; comparison group, n = 33) involving 72 personnel (intervention group, n = 40; comparison group, n = 32). Postintervention, 91 handovers were observed (intervention group, n = 44; comparison group, n = 47) involving 57 personnel (intervention group, n = 31; comparison group, n = 26). In the intervention group, the percentage of recalled information sequences by the receivers increased from 43.4% preintervention to 52.6% postintervention (P = 0.004) and the SBAR structure improved significantly (P = 0.028). In the comparison group, the corresponding figures were 51.3 and 52.6% (P = 0.725) with no difference in SBAR structure. When a linear regression generalised estimating equation model was used to account for confounding influences, we were unable to show a significant difference in the information recalled between the intervention group and the nonintervention group over time.

    CONCLUSION: Compared with the comparison group with no intervention, when SBAR was implemented in an anaesthetic clinic, we were unable to show any improvement in recalled information among receivers following postoperative handover.

    TRIAL REGISTRATION: Current controlled trials http://www.controlled-trials.com Identifier: ISRCTN37251313.

  • 188.
    Randmaa, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. County Council Gävleborg; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Leo Swenne, Christine
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    An Observational Study of Postoperative Handover in Anesthetic Clinics: The Content of Verbal Information and Factors Influencing Receiver Memory2015Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 30, nr 2, s. 105-115Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim was to examine the handover process in the postanesthesia care unit, how much the receiver remembered, and what factors influenced memory. Design: An observational study with a descriptive and correlational design. Methods: A total of 73 handovers were investigated, and data were collected using observation, audiotape recordings of the handovers, and the patient's anesthetic record. Finding: Interruptions occurred at 56 (77%) handovers and the sender expressed unclear information at 51 (70%) handovers. The mean of the verbally given information remembered by the receivers was 47%; the items mostly likely not to be remembered were the drugs used during anesthesia. A linear generalized estimating equation was used and identified variables that were significantly associated with receivers' retention of information were structure and handover duration. Conclusion: Lack of structure and long duration of the verbal handover decrease how much the receiver will remember.

  • 189.
    Randmaa, Maria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Leo Swenne, Christine
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    An Observational Study of Postoperative Handover in Anesthetic Clinics: The Content of Verbal Information and Factors Influencing Receiver Memory2015Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Purpose The aim was to examine the handover process at the post-anaesthesia care unit, how much the receiver remembers and what factors influence memory.

    Design An observational study with a descriptive and correlational design.

    Methods Seventy-three handovers were investigated, and data were collected using observation, audio-tape recordings of the handovers and the patient´s anaesthetic record.

    Finding Interruptions occurred at 56 (77%) handovers and the sender expressed unclear information at 51 (70%) handovers. The mean of the verbally given information remembered by the receivers was 47%; the items mostly likely not to be remembered were the drugs used during anaesthesia. A linear generalized estimating equation was used and identified variables that were significantly associated with in receivers´ retention of information were structure and handover duration.

    Conclusion Lack of structure and long duration of the verbal handover decrease how much the receiver will remember.

  • 190.
    Rashid, Mamunur
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
    Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study2018Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, nr 1, artikkel-id 672Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back.

    METHODS:

    A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively.

    RESULTS:

    Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively.

    CONCLUSIONS:

    The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

  • 191.
    Rashid, Mamunur
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Predictors of work ability among women on long-term sick leave due to musculoskeletal pain2017Inngår i: NES2017 conference proceedings / [ed] Anna-Lisa Osvalder, Mikael Blomé and Hajnalka Bodnar, 2017, s. 140-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Musculoskeletal pain is one of the leading causes of sick leave (SL), especially among women in Sweden and in other western countries. It is, therefore, important to know which health- and work-related factors are associated with work ability (WA) among women with long-term musculoskeletal pain.

         Purpose: The aim of this study was to determine whether there is any association between self-efficacy, anxiety, depression, sense of coherence, job strain, support at work, pain intensity, physical activity, beliefs to be back at the same work, coping strategies, and WA.

         Methods: A cross-sectional study was conducted on women with long-term pain who were on SL. Inclusion criteria: (i) age 18-65 years, (ii) SL: ≥ 1 months, (iii) SL: ≥ 50%, (iv) pain in neck, shoulder or back (≥ 3 months), and (v) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. In spring 2016, self-administered questionnaires were sent out to 600 women who were receiving time-loss benefits according to the Swedish Social Insurance registers. Out of these, a total of 208 participants responded and were included in the analysis. For assessing the predictors and the outcome, seven instruments were used: General Self-Efficacy, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Sense of Coherence, Multidimensional Pain Inventory, Coping Strategy Questionnaire and Work Ability Index. Two of the predictors, physical activity and beliefs to be back at the same work, were measured by single questions. Multiple linear regression analyses were performed to detect which of the factors were associated with WA.

         Results: Women who more strongly believed that they would return to the same work within 6 months had higher WA (β= 0.39, p < .001), whereas women with higher pain intensity (β= -0.28, p < .001) and higher job strain (β= -0.12, p < .05) had lower WA. The results did not change when age, cohabitant, economic situation and social support were controlled for in the analysis. The regression model was significant (p < .0001), and its adjusted R- square was 48%.

         Discussion and practical implications: Women’s positive beliefs are associated with higher WA in accordance with previous studies. Our study also found that pain intensity and high job strain are associated with reduced WA. The results suggest that health care providers and employers should take women’s beliefs to be back at the same work into account for supporting them to return to work. Furthermore, the focus of rehabilitation program should be on women suffering from high pain intensity to increase WA.

         Conclusion: This study showed that beliefs to be back at the same work, pain intensity and job strain might be predictors of WA. Further studies are needed to identify if these predictors are also important for WA among women with long-term pain who are at work.

     

    Key words: Factors, ability to work, sickness absence, women and pain

  • 192.
    Rashid, Mamunur
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Work ability, well-being and return-to-work among women in Gävleborg on sick leave due to long-term pain in the neck/shoulders and/or back2018Inngår i: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, s. 68-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background

    Sickness absence due to long-term musculoskeletal pain (MSP) is a common phenom-enon in Sweden as well as in other European countries. Sick leave due to MSP (i.e. pain in the neck/shoulders and/or back) is higher among women than among men; therefore, women can be considered as a vulnerable group.

    Aim

    The overall aim is to identify factors of importance for work ability, well-being and return to work among women of working age who are on sick leave due to long-term pain in the neck/shoulders and/or back. The project includes three empirical studies.

    Methods

    The project was a result of a joint collaboration between the University of Gävle and the Swedish Social Insurance Agency in Gävleborg. Initially, a postal survey was sent to 600 women in Gävleborg who were receiving time-loss benefits during spring 2016. The inclusion criteria were: women aged 18-65 years, ≥ 50% sick leave from service, sick leave ≥ 1 month due to pain in the neck/shoulders and/or back (≥ 3 months) and understanding the Swedish language. The exclusion criteria were: rheumatoid arthritis, multiple sclerosis, stroke, cancer, Parkinson, bipolar disease, schizophrenia and preg-nancy. After 12 months, a follow-up survey was sent to the 208 women who answered the survey at baseline, and 141 responded.

    Results

    Study-I aimed to identify factors associated with work ability and well-being among women on sick leave. The results showed that beliefs to be back at the same work, pain intensity and job strain correlated with work ability. Self-efficacy and depression correlated with well-being. Study-II aimed to compare work ability and well-being over time, among women who returned to work (RTW) versus women who remained on sick leave in one year. The findings indicated that out of 141 women, 94 did RTW and 47 remained on sick leave. The group that RTW improved in work ability as well as well-being over time, whereas the group that remained on sick leave tended to decline over time in well-being. Study-III aims to identify predictors of RTW among women on sick leave. The analysis is under way. This project highlights factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave in this vulnerable group.

  • 193.
    Rashid, Mamunur
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Kristofferzon, Marja-Leena
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala University, Uppsala, Sweden.
    Nilsson, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala University, Uppsala, Sweden.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Factors associated with return-to-work among people on work absence due to long-term neck or back pain: a narrative systematic review2017Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 6, artikkel-id e014939Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    The purpose of this narrative systematic review was to summarise prognostic factors for return to work (RTW) among people with long-term neck/shoulder or back pain.

    METHODS:

    A systematic literature search was performed through three databases (Medline, CINAHL and PsycINFO) for studies published until February 2016. Only observational studies of people on work absence (≥2 weeks) due to neck/shoulder or back pain were included. The methodological quality of the included studies was assessed using guidelines for assessing quality in prognostic studies on the basis of Framework of Potential Biases. Factors found in the included studies were grouped into categories based on similarities and then labelled according to the aspects covered by the factors in the category.

    RESULTS:

    Nine longitudinal prospective cohort studies and one retrospective study fulfilled the inclusion criteria. From these, five categories of factors were extracted. Our findings indicate that recovery beliefs, health-related factors and work capacity are important for RTW among people with long-term neck or back pain. We did not find support for workplace factors and behaviour being predictive of RTW.

    CONCLUSIONS:

    Our findings suggest that recovery beliefs, perceived health and work capacity may be important targets of intervention for people with long-term neck or back pain. However, more high-quality prospective studies are needed to confirm the results and improve our understanding of what is needed to facilitate RTW in this population.

  • 194.
    Richter, Hans
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Domkin, Dmitry
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Elcadi, Guilherme H.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Idrottsvetenskap.
    Anderson, H. W.
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Englund, Martin
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    A comparison of mental and visual loads resulting from semi-automated and conventional forest harvesting: An experimental machine simulation study2018Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    This study is concerned with a new method for partly automating forestry harvesting work. Work-related injuries and constant demands for a higher productivity are two of the many arguments for why forestry work must be improved. Forestry work places great mental demands on the driver because they must continuously evaluate and act on relevant parts in a heavy visual information flow. Against this background the purpose of the present study was to extend the knowledge of functional linkages between visual and mental fatigue, performance, and prefrontal cortex activity, during semi-automated and conventional forestry harvesting work. Eleven healthy participants, range 21–51 years old, with a minimum of 1-year work experience, carried out the task of loading logs along a standardized path in a machine simulator during two counterbalanced 45-min periods: (i) conventional forest harvesting, and; (ii) semi-automated forest harvesting. Equal emphasizes was put on accuracy and speed. During manual forest harvesting the driver controlled the crane arm, used to load logs into the load space of the forest vehicle (“forwarder”), by manually operating the joysticks and so guide the crane to the location of the log and then back to the load space. During semi-automatic forest harvesting the driver moved the crane with the press of a button to a pre-programmed location near the log and then, after another button press, to a pre-programmed location within the load space. The following joystick usage parameters were considered for the statistical analysis: Sequential work cycle number, work phase (1-loading in basket, 2-movement to log, 3-picking up log, 4-movement to load space), number of simultaneously used controls across samples of one phase, number of direction changes of joystick movements per phase. Mental load was assessed by quantification of oxygenated hemoglobin (HbO2) concentration changes over the right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional near infrared spectrometry (fFNIRS: PortaLite mini, Artinis Medical Systems, Zetten, the Netherlands). The frequency and duration of horizontal amplitudes of eye/head/neck angles was assessed continuously with 8 SmartEye cameras and used as a measure of visual load. NASA-TLX and Borg CRS was used to assess perceived mental and physical fatigue. Linear Mixed Model will be used to test and to analyze the effect of the duration of work, joystick usage, work type (manual or semi-automated) and perceived mental and physical effort on the outcome of oxygenated hemoglobin concentration. This study contributes with new knowledge of the consequences of the current increase in automation. The 4th industrial revolution can have tremendous implications on how we perceive and organize work in the future, but little is still known about the impact on human body and brain.

  • 195.
    Richter, Hans
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Domkin, Dmitry
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Elcadi, Guilherme H.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Andersson, Helena
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Forsman, Mikael
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Englund, Martin
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    A comparsion of mental and visual loads resulting from semi-automated and conventional forest harvesting: An experimental machine simulation study2018Inngår i: FALF Konferens 2018: Arbetet - problem eller potential för en hållbar livsmiljö?: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle Universtiy Press , 2018, s. 96-Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    This study is concerned with a new method for partly automating forestry harvesting work. Work-related injuries and constant demands for a higher productivity are two of the many arguments for why forestry work must be improved. Forestry work places great mental demands on the driver because they must continuously evaluate and act on relevant parts in a heavy visual information flow. Against this background the purpose of the present study was to extend the knowledge of functional linkages between visual and mental fatigue, performance, and prefrontal cortex activity, during semi-automated and conventional forestry harvesting work. Eleven healthy participants, range 21–51 years old, with a minimum of 1-year work experience, carried out the task of loading logs along a standardized path in a machine simulator during two counterbalanced 45-min periods: (i) conventional forest harvesting, and; (ii) semi-automated forest harvesting. Equal emphasizes was put on accuracy and speed. During manual forest harvesting the driver controlled the crane arm, used to load logs into the load space of the forest vehicle (“forwarder”), by manually operating the joysticks and so guide the crane to the location of the log and then back to the load space. During semi-automatic forest harvesting the driver moved the crane with the press of a button to a pre-programmed location near the log and then, after another button press, to a pre-programmed location within the load space. The following joystick usage parameters were considered for the statistical analysis: Sequential work cycle number, work phase (1-loading in basket, 2-movement to log, 3-picking up log, 4-movement to load space), number of simultaneously used controls across samples of one phase, number of direction changes of joystick movements per phase. Mental load was assessed by quantification of oxygenated hemoglobin (HbO2) concentration changes over the right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional near infrared spectrometry (fFNIRS: PortaLite mini, Artinis Medical Systems, Zetten, the Netherlands). The frequency and duration of horizontal amplitudes of eye/head/neck angles was assessed continuously with 8 SmartEye cameras and used as a measure of visual load. NASA-TLX and Borg CRS was used to assess perceived mental and physical fatigue. Linear Mixed Model will be used to test and to analyze the effect of the duration of work, joystick usage, work type (manual or semi-automated) and perceived mental and physical effort on the outcome of oxygenated hemoglobin concentration. This study contributes with new knowledge of the consequences of the current increase in automation. The 4th industrial revolution can have tremendous implications on how we perceive and organize work in the future, but little is still known about the impact on human body and brain.

  • 196.
    Roos, Charlotte
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
    Promoting living in dignity and with a sense of well-being among older people living in residential facilities – older people’s perspective2017Licentiatavhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The Swedish national fundamental values state that care of older people who are living in residential facilities should ensure that they live in dignity and with a sense of well-being. The overall aim of this licentiate thesis was to study, from older residents’ perspective, the effects of a caregiver intervention intended to put the Swedish national fundamental values into practice and to describe residents’ perceptions of what promotes the values: living in dignity and having a sense of well-being. The licentiate thesis is based on two studies, one using a descriptive design (Study I) and the other a cluster-randomized controlled trial with a pre- and one post-test design (Study II). Data were collected using interviews and questionnaires. The results showed that to promote dignity and well-being, it was important for residents to maintain their independence despite reduced abilities; to feel secure about care/services and certain about receiving assistance when it was needed; to maintain and create social relationships and to have a feeling of being at home (Study I). The intervention, aimed at putting the Swedish national fundamental values into practice, increased the self-reported empowerment, person-centered climate and life satisfaction regarding everyday activities of residents in the intervention group. There were significant interaction effects (differences in change over time between the intervention and control group) for empowerment, person-centered climate and life satisfaction regarding the factor everyday activities (Study II). Several conclusions can be drawn from the studies: In order to experience dignity and a sense of well-being, it was important for residents to maintain their independence, social relationships and their feeling of being at home. A caregiver intervention aimed at putting the Swedish national fundamental values into practice can improve everyday life among older residents. It is important that staff work alongside residents and that staff be given appropriate structural conditions, in the form of time, when putting the Swedish national fundamental values into practice.

  • 197.
    Roos, Charlotte
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Silén, Marit
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    An intervention targeting fundamental values among caregivers at residential facilities: Effects of a cluster-randomized controlled trial on residents' self-reported empowerment, person-centered climate and life satisfaction.2016Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, nr 1, artikkel-id 130Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: In Sweden the national fundamental values for care of older people state that care should ensure that they can live in dignity and with a sense of well-being. Our hypothesis was that a caregiver intervention targeting the national fundamental values would improve perceived empowerment, person-centered climate and life satisfaction among older people living in residential facilities.

    METHODS: The study was a cluster-randomized controlled trial with a pre- and one post-test design, conducted in 27 units (17 study units) at 12 residential facilities for older people in five municipalities in central Sweden. The units in each municipality were randomly assigned to intervention or control group. The caregiver intervention was carried out using an interpretative approach with eight guided face-to-face seminars, where self-reflection and dialogue were used. Data were collected using questionnaires. The number of residents was 43 (78 %) in the intervention group and 37 (71 %) in the control group. The Chi-square test and Mann-Whitney U-tests were performed to detect differences between groups and Wilcoxon signed rank tests to explore differences in change over time within groups. Furthermore, generalized estimating equation (GEE) models were used to study effects of the intervention controlling for clustering effects.

    RESULTS: Primary outcome measures were empowerment, person-centered climate and life satisfaction. In the intervention group, improvements at follow-up were found in residents' self-reported empowerment (n = 42; p = 0.001, Median difference 4.0, 95 % CI 1.5;6.0), person-centered climate (n = 42; p ≤0.001, Median difference 8.0, 95 % CI 4.5;11.4) and life satisfaction regarding the factor quality of everyday activities (n = 40; p = 0.033, Median difference 9.7, 95 % CI 1.0;21.9) while disempowerment decreased (n = 43; p = 0.018, Median difference -1.3, 95 % CI -2.0;0.0). In the control group person-centered climate decreased (n = 37; p = 0.002, Median difference -8.5, 95 % CI -13.6;-3.0) and quality of everyday activities (n = 36; p = 0.012, Median difference -11.6, 95 % CI-21.7;-3.4). Change over time between groups was significant for empowerment (p = 0.001, Median difference 6.0, 95 % CI 3.0;9.0), disempowerment (p = 0.006, Median difference -2.0, 95 % CI -4.0;-1.0) and person-centered climate (p ≤ 0.001, Median difference 16.0, 95 % CI 9.7;23.0) and for life satisfaction regarding the factor quality of everyday activities (p = 0.002, Median difference 22.1, 95 % CI 8.2;37.4). Results of GEE confirmed earlier results; revealed interaction effects for empowerment (parameter estimate -5.0, 95 % CI -8.3;-1.8), person-centered climate (parameter estimate -16.7, 95 % CI -22.4;-10.9) and life satisfaction regarding the factor quality of everyday activities (parameter estimate -25.9, 95 % CI -40.3;-11.5).

    CONCLUSION: When the Swedish national fundamental values were put into practice increases in empowerment, person-centered climate and quality of everyday activities were found among older people with intact cognitive ability living in residential facilities. Limitations to consider are the differences between the two groups at baseline, drop-outs and that neither the data collector nor the outcome assessors were blinded to group assignment of participants.

    TRIAL REGISTRATION: The study was registered in ISRCTN92658034 in January 2013.

  • 198.
    Råholm, Maj-Britt
    et al.
    Sogn og Fjordane University College, Førde, Norway.
    Löfmark, Anna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Stord/Haugesund University College, Haugesund, Norge.
    Henriksen, Jette
    VIAUniversityCollege, Horsens, Denmark.
    Slettebo, Åshild
    University of Agder, Kristiansand S, Norway.
    Nurse Education — Role Complexity and Challenges2016Inngår i: International journal for human caring, ISSN 1091-5710, Vol. 20, nr 2, s. 76-82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Numerous factors in today’s health care environment make nursing education a critical priority and challenge. Changes are needed in order to provide quality education, and nursing education must drive this change instead of trying to keep pace. This study aims to evaluate nurse educators’ experience of their current role and future challenges within nursing education in Denmark, Finland, Norway, and Sweden. A qualitative, explorative study was used by means of four focus-group interviews with 18 participants in Scandinavia. The data were processed using content analysis to identify several relevant themes. This study revealed four themes that feature the role complexity and challenges faced by nurse educators: role complexity, the tension between academia and practice, the ideal role as a nurse educator, and future challenges within nursing education. 

  • 199.
    Rönngren, Ylva
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Björk, Annette
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Audulv, Åsa
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden; Center for Care Research, Mid-Norway, Steinkjer, Norway .
    Kristiansen, Lisbeth
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Haage, David
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Educational nurse-led lifestyle intervention for persons with mental illness.2018Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 3, s. 1022-1031Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.

  • 200.
    Rönngren, Ylva
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Björk, Annette
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Kristiansen, Lisbeth
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Haage, David
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden; Center for Care Research, Mid-Norway,Steinkjer, Norway.
    Audulv, Åsa
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting2018Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 1, s. 390-399Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.

123456 151 - 200 of 285
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • harvard-cite-them-right
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • sv-SE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • de-DE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf