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  • 201.
    Bjärntoft, Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    Uppfattningar kring hälsofrämjande ledarskap: En mixad studie om jämförelsen mellan första linjens chefers och medarbetares uppfattning av hälsofrämjande ledarskapsaspekter och dess relation till medarbetarnas välbefinnande2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Aim: Based on the concept of health promotion leadership, the purpose is to examine how the first-line managers perceive their own leadership in comparison to employees' perceptions of the leadership, and whether this relates to employee well-being at work.

    Methods: This study is a recess of the project GodA and it’s based on a cross-sectional design with both quantitative and qualitative methods. To make a comparison between managers and employees perception of leadership, a selection of survey questions from GodA was used. The manager’s valuation of the health promotive leadership aspects were examined through semi-structured interviews.

    Main results: The results shows that there was a wide perception of health promotive leadership among managers. Although it can be interpreted that the managers work from the health promoting leadership aspects, there was a gap between the manager and employee perception of leadership. In half of the groups there was a significant difference. There was also a positive significant correlation between gap and employee well-being, then a larger gap resulted in a lower estimated well-being.

    Summary: Previous research shows that managers often overrate their leadership and a gap can affect employee well-being. It is therefore important to further investigate what the differences between the manager and the employees can depend on and how the gap can be reduced. It is also important to create a clear definition of a health promotive leadership in order to develop health promotion strategies at work.

  • 202.
    Bjärntoft, Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Flexible work: Occupational determinants of work-life balance2018Conference paper (Refereed)
  • 203.
    Björk Brämberg, Elisabeth
    et al.
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm; Institutionen för medicin, Enheten för allmänmedicin, Göteborgs universitet .
    Axén, Iben
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm .
    Strömberg, Carl
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm .
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm; Centrum för Arbets - och Miljömedicin, Stockholms läns landsting, Stockholm.
    Insatser via företagshälsan för att minska eller förebygga psykisk ohälsa: En kartläggning av forskningen - uppdatering 20182018In: FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? Gävle 10-12 juni 2018: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 71-72Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    Psykisk ohälsa är en vanlig orsak till lidande och försämrad arbetsförmåga både i Sverige och internationellt. Effektiva insatser för att förebygga eller minska psykisk ohälsa är därför av stor betydelse för både folkhälsa och arbetshälsa. Företagshälsovården (FHV) är en viktig aktör på svenska arbetsplatser då majoriteten av alla anställda har tillgång till denna tjänst. Kunskapen är dock begränsad vad gäller effekter av de förebyggande eller rehabiliterande insatser som ges av FHV kring psykisk ohälsa. Denna litteratur-genomgång publicerades först 2015 och har nu uppdaterats med studier publicerade fram t.o.m. maj 2017.

    Syfte

    Att genomföra en systematisk kartläggning av nationell och internationell forskning där insatserna getts av företagshälsovården för att förebygga eller minska psykisk ohälsa i arbetslivet.

    Metod

    Litteratursökningar gjordes i fyra databaser och det vetenskapliga underlaget kom att utgöras av 33 studier varav 12 är nytillkomna i denna uppdatering. Prospektiva studier med eller utan jämförelsegrupp inkluderades. Urval av studier och kvalitetsgranskning gjordes av två oberoende forskare.

    Resultat

    I 18 av studierna utvärderades rehabiliterande insatser som riktade sig till an-ställda sjuk-skrivna p.g.a. psykisk ohälsa, i elva studier insatser till anställda i risk för psykisk ohälsa och i 4 studier utvärderades förebyggande insatser. Drygt hälften av de inkluderade stud-ierna (17 studier) var från Nederländerna. Tjugoen av 33 studier bedömdes ha medelhög eller hög kvalitet. För rehabiliterande insatser som ges till anställda sjukskrivna för psykisk ohälsa indikerar det vetenskapliga underlaget att problemlösningsbaserad metod och KBT med arbetsplatsinriktning minskar sjukskrivning och/eller påskyndar arbetsåtergång jämfört med sedvanlig insats. Effekten är oklar för övriga rehabiliterande insatser. Kunskapsläget är oklart gällande effekter av förebyggande insatser och effekter av insatser som ges till anställda i risk för psykisk ohälsa. Några av studierna tyder på positiva effekter men insatserna som utvärderats är olika och det är viktigt att försök till replikering görs av dessa utvärderingar. Det finns ett behov av att förebyggande insatser utvärderas med ett forskningsupplägg som ökar möjligheterna att dra slutsatser om effekter. Flera studier indikerar också att det inte finns en tydlig relation mellan omfattning av symtom och arbetsåtergång. Detta understryker vikten av att vid insatser aktualisera arbetsåtergång tidigt i processen och att erbjuda metoder för samtidig symtomhantering och arbetsåtergång.Sammantaget indikerar resultaten att arbetsplatsinriktade insatser med KBT eller problemlösningsbaserad metod som ges via FHV kan förkorta tid till arbetsåtergång bland anställda sjukskrivna för psykisk ohälsa och att särskilt förebyggande insatser behöver utvecklas och utvärderas ytterligare.

  • 204.
    Björk Brämberg, Elisabeth
    et al.
    Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Närhälsan, Region of Västra Götaland, Hisings-Backa, Sweden .
    Holmgren, Kristina
    Närhälsan, Region of Västra Götaland, Hisings-Backa, Sweden; Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden .
    Bültmann, Ute
    Department of Health Sciences, University Medical Center Groningen, Community and Occupational Medicine, Groningen, Netherlands.
    Gyllensten, Hanna
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Hagberg, Jan
    Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sandman, Lars
    National Centre for Priorities in Health, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Increasing return-to-work among people on sick leave due to common mental disorders: Design of a cluster-randomized controlled trial of a problem-solving intervention versus care-as-usual conducted in the Swedish primary health care system (PROSA)2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 889Article in journal (Refereed)
    Abstract [en]

    Background: Common mental disorders affect about one-third of the European working-age population and are one of the leading causes of sick leave in Sweden and other OECD countries. Besides the individual suffering, the costs for society are high. This paper describes the design of a study to evaluate a work-related, problem-solving intervention provided at primary health care centers for employees on sick leave due to common mental disorders. Methods: The study has a two-armed cluster randomized design in which the participating rehabilitation coordinators are randomized into delivering the intervention or providing care-as-usual. Employees on sick leave due to common mental disorders will be recruited by an independent research assistant. The intervention aims to improve the employee's return-to-work process by identifying problems perceived as hindering return-to-work and finding solutions. The rehabilitation coordinator facilitates a participatory approach, in which the employee and the employer together identify obstacles and solutions in relation to the work situation. The primary outcome is total number of sick leave days during the 18-month follow-up after inclusion. A long-term follow-up at 36 months is planned. Secondary outcomes are short-term sick leave (min. 2 weeks and max. 12 weeks), psychological symptoms, work ability, presenteeism and health related quality of life assessed at baseline, 6 and 12-month follow-up. Intervention fidelity, reach, dose delivered and dose received will be examined in a process evaluation. An economic evaluation will put health-related quality of life and sick leave in relation to costs from the perspectives of society and health care services. A parallel ethical evaluation will focus on the interventions consequences for patient autonomy, privacy, equality, fairness and professional ethos and integrity. Discussion: The study is a pragmatic trial which will include analyses of the intervention's effectiveness, and a process evaluation in primary health care settings. Methodological strengths and challenges are discussed, such as the risk of selection bias, contamination and detection bias. If the intervention shows promising results for return-to-work, the prospects are good for implementing the intervention in routine primary health care. Trial registration: ClinicalTrials.gov Identifier: NCT03346395 Registered January, 12 2018. © 2018 The Author(s).

  • 205.
    Björk, David
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Larsson, Henrik
    University of Gävle, Department of Caring Sciences and Sociology.
    Upplevelser av sjuksköterskerollen och konflikthantering i anhörigkontakten på äldreboenden - en intervjustudie.2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The purpose of this study was to describe how nurses apprehend their role, causes for and managing of conflicts that are possible, encountering relatives of patients living in nursing homes. The design of the study is descriptive and is based on individual interviews.

    The sample was a convenience sample and nine nurses were participating, out of which two were excluded after collecting data due to being interviewed at the same time. Seven nurses remained (six women, one man), working in separate nursing homes in a municipality in southern Norrland.

    The most important part of the nurses’ role in preventing and handling conflicts with relatives consists of keeping in close touch with great understanding, good information and having a dialogue. Creating comfort, by making a good primary contact and letting the relatives contribute with their knowledge and thus make them feel essential, will get the relatives on the nurses’ side. Conflicts often appear when the health care resources run short and cause dissatisfaction and when the relatives’ bad conscience makes them wrongfully project their anger towards the nurse. To solve the problem, bringing a third part into the conflict can sometimes be a solution. Even though it may contest the will of the relatives and cause a conflict the nurse should always do what’s best for the patient, since her medical ability is greater.

  • 206.
    Björk, Madelen
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Wiker, Jennifer
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Den fysiska belastningen och skador hos kvinnliga fotbollsspelare: Finns det ett samband?2018Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Fotboll är en lagsport som innehåller fysiska -och tekniska krav. Till författarnas kännedom finns det begränsat med vetenskaplig forskning om kvinnliga fotbollsspelare, dess belastning och sambandet till skador under träning och match. Syfte: Syftet med denna studie var att mäta den fysiska belastningen och skador under en fyra veckors träning -och matchperiod hos kvinnliga fotbollsspelare i ålder 18–22 år. Metod: Datainsamlingen genomfördes med 10 hertz Global Positioning System (GPS)- enheter på sex kvinnliga fotbollsspelare från mellersta Sverige under säsong 2018. Variablerna som mättes var distans i meter, player load, meter i olika hastigheter, en egenskattad belastning för styrketräningspass och egenskattad veckobelastning. Fotbollsspelarna studerades under 17 träningstillfällen och tre matcher. Data analyserades deskriptivt för att se som det fanns samband mellan player load och egenskattad belastning. Ett t-test användes för att se om det fanns några skillnader i lagets planerade belastning och den uppmätta belastningen. Vidare analyserades även om det fanns ett samband mellan de skador som uppstod och den fysiska belastningen. Resultat: Mätningarna visar att de kvinnliga fotbollsspelarnas planerade belastning stämmer relativt bra med den uppmätta belastningen för distans (m) och player load, dock inte hastighetszonerna. Vid ett högre player load värde skattar sig fotbollsspelarna som en mer ansträngd belastning och muskeltrötthet. Under denna studie uppstår fyra skador hos de deltagande. Slutsats: Resultatet tyder på att hög fysisk belastning kan ha ett samband med skador hos kvinnliga fotbollsspelare.

  • 207.
    Björk, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Liendeborg, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Vårdpersonalens och ledningsgruppens beskrivning av verksamheten med vårdhund samt deras erfarenheter om vårdhundens betydelse för personer med demenssjukdom och äldre somatiskt sjuka samt deras vård2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Human and dog have a close relationship which led to the dog developed an ability to sense the state of mind and body language of the humans. Dogs have been used in health care for many years and studies have shown that the dog gives a human better consciousness and increase the social and physical activity. Aim: To study how healthcare personnel the management team describe the service with animal assisted therapy and their experiences of and reflections about animal assisted therapy with old people with dementia and somatic disease and their care. Method: The study had a descriptive design with qualitative approach. In the study, 21 interviews were performed with staff at a facility for old people; health care personnel working with elderly with somatic diseases, those working with elderly suffering from dementia and staff in the management team. The interviews were transcribed and analyzed using qualitative content analysis. Results: The results showed that staff from the three groups was positive to the service with animal assisted therapy and that they experienced that the animal assisted therapy as positive for the old people physically, mentally and socially. The personnel working with old people suffering from dementia and staff in the management team described a wish to expand and develop the service with animal assisted therapy. One way to develop the service was that health care personnel to a larger extent should be involved in the animal assisted therapy and that animal assisted therapy to a larger extent could be a help in different care situations. Conclusion: The staff was positive to the service with animal assisted therapy and they experienced that the animal assisted therapy were positive for the old people. Possibilities to expand and develop the service with animal assisted therapy were described.

    Keywords: animal assisted therapy, dementia, interviews, personnel, somatic illness

  • 208.
    Björklund, AnnCharlott
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Krigh Brodin, Pernilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Sjuksköterskans omvårdnad och barns upplevelser vid stickprocedurer : – En litteraturstudie2010Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    The aim of this literature review was to describe children's experiences of worry and fear in connection with needle procedures. Further the aim was to describe what kind of nursing the nurse can provide children and parents during needle procedures. Method: Searches for articles were carried out in the databases Cinahl and Medline via PubMed. Fourteen scientific articles were chosen and analyzed. Through this literature study, Joyce Travelbee's nursing theory has been used. Result: Feelings as worry, fear, stress, pain and distress were common occurrence during children's needle procedures and a traumatic needle procedure increased the risk to develop fear of needles. Fear of needles was most often initiated in childhood and can cause avoidance for necessary healthcare in the future. Important for the nurse was to provide with good nursing to prevent the development of needle fear by using  pain relief, interventions, distractions and coping strategies. It was important to communicate with the child and make the child participating and to adapt each situation to the child's development and individual conditions. The nurse should also prepare and involve the guardian because the guardian can have both positive and negative effect on the child's experience of the needle procedure. Conclusion: Children's experiences and the nursing in connection with needle procedures will affect their continued contact with the healthcare, therefore it is of outermost weight that the nurse has knowledge and skills to handle these situations in a correctly and evidence-based way. 

     

     

     

     

     

     

     

    Keywords: Needle procedure, children, nurse, fear, distress 

  • 209.
    Björklund, Erika
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för pedagogik.
    Constituting the Healthy Employee?: Governing gendered subjects in workplace health promotion2008Doctoral thesis, monograph (Other academic)
    Abstract [en]

    With a post-structural approach and an analytical focus on processes of governmentality and biopower, this study is concerned with how discourses of health are contextualized in educational practice and interaction between educators and participants in workplace health promotion (WHP) interventions. Of concern are issues of the discursive production, regulation and representation of power, knowledge and subjects as gendered beings in workplace health promotion interventions. The methods for generating data are participant observation, interviews and gathering of documentation pertaining to four different workplace health promotion interventions. Based on these data, the thesis offers an analysis of the health discourses drawn on in the interventions and the technologies of power and of the self by which the participants are governed and invited to govern themselves in the name of health. It also asks what practices and positions that thus come to be made available or not to the participants. Two health discourses are identified: the biomedical discourse and the wellness discourse. Both discourses are drawn on in all four studied interventions, the biomedical discourse being the dominating discourse drawn on. The biomedical discourse is informed by scientific ‘facts’ and statistics and is underpinned by a notion of risk. The wellness discourse is informed by an understanding of health as a subjective embodied experience and is underpinned by a notion of pleasure. Drawing on these discourses, the responsibility for health is placed with the participants and the healthy participant/employee is constituted as a rationally motivated risk-avoider and disciplined pleasure seeker who is both willing and able to actively make ‘good’ choices regarding their lifestyle. Furthermore, and informed by essentialist and heteronormative ideas about gender, the ideal healthy person is modelled on a male norm, representing women as the deviant Other.

  • 210.
    Björklund, Erika
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Education.
    Nordlöf, Hasse
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Discourses about electricians in vocational education2018Conference paper (Refereed)
    Abstract [en]

    Students in vocational education to become electricians have an increased risk of developing musculoskeletal disorders (MSDs) once in the workforce compared to most other blue collar professions (Toomingas et al., 2014). This increased risk comes from having to work in awkward body positions, with heavy and sometimes poorly adapted tools and with time constraints. Many end up with chronic disabilities, forcing them to change careers or to go on sickness pension. Besides the significant and damaging consequences for the individual concerned, losing electricians from the workforce is a significant loss for the building industry in which electricians these days are scarce, and for society that not only loses tax-incomes but also possibly need to pay sickness pension for these people during quite a few years. It is therefore important to find ways to prevent MSDs and to promote good ergonomics in the building industry in general and among electricians specifically. Electricians’ knowledge and habits regarding MSDs are first formed and shaped in school, during vocational education to become an electrician. Drawing on the ideas of bio-power and governmentality, as introduced and developed by Foucault (1988, 1990, 2003) and developed by Rose (1999; Rabinow and Rose, 2006), discourses govern how it is possible to think and act. From this standpoint, then, talk and discourses are not perceived as innocent or ‘mere’ talk (Hall, 2001) but as governing the production, regulation and representation of both bodies and subjects through the acquisition of specific dispositions, tastes and abilities (Foucault, 1988; Rose, 1999). Thus, discourses drawn on in school about electricians and the profession govern how it is possible to think and act about oneself and others in relation to both ergonomics and MSD and, by extension, have material effects on electricians’ health. This means that, to foster healthy ergonomics one needs to consider how electricians and the profession are conceived and thought about in school, i.e. how electricians and the profession are discursively conceived. The purpose of this paper is thus to explore discursive constructions of electricians and the profession as these are expressed in discussions about MSDs in the vocational education and school context. Methods used are four focus group interviews: two with students, one with teachers and one with school management at one senior high school program for electricians. In the focus group interviews the participants were asked to discuss ideas about causes and reasons to why electricians develop MSDs, consequences and effects of MSDs and ideas about what could be done to prevent MSDs. The interviews were then transcribed and discursively analyzed with questions in mind about how each group conceived of electricians and the profession.

  • 211. Björklund, Martin
    The ProFitMap-neck questionnaire.2014In: Neck pain : new perspectives : 14th Physiatric Summer School : 15.-16.08.2013, Helsinki / [ed] Lindgren Karl August, Helsinki: Rehabilitation Orton, Invalid Foundation , 2014, 1, p. 61-68Chapter in book (Other academic)
  • 212.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Institutionen för samhällsmedicin och rehabilitering, fysioterapi, Umeå universitet.
    What works for whom:challenges in personalising physical therapy: Discussion panel2015Conference paper (Other academic)
  • 213.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert G
    University of Gävle, Centre for Musculoskeletal Research.
    Acute muscle stretching and shoulder position sense2006In: Journal of athletic training, ISSN 1062-6050, E-ISSN 1938-162X, Vol. 41, no 3, p. 270-274Article in journal (Refereed)
    Abstract [en]

    Context: Stretching is common within sports as a potential maneuver for injury prevention. Stretching induced changes in muscle spindIe properties is a suggested mechanism. This may imply a reduction in proprioception following stretching, however, little is known of this association. Our finding showing no effect of acute stretching on shoulder position sense provides insight into this issue.

    Objectives: To evaluate if acute stretching of the shoulder muscles affects position sense.

    Design: A crossover design with subjects randomized to 3 groups, as regarded by the I sequence of 3 interventions.

    Setting: A university human research laboratory.

    Patients or Other participants: Nine female (age, 21 +2) and 9 male (24 + 3) healthy volunteers.

    lntervention(s): The interventions consisted of stretching of shoulder 1) agonists, 2) antagonists, and 3) non-stretching control.

    Main Outcome Measure(s): Position sense acuity of the right shoulder was determined before and arter the interventions by subjects at tempting to reproduce arm positions of 15° and 30° (shoulder adduction) while starting at 45° to the sagittal plane. The outcome variables were the response variability (variable error, VE) and overall accuracy (absolute error, AE).

    Results: A multivariate repeated measures analysis ofvariance revealed that the relative change in VE (i.e., VE after/VE before) was not significantly different between the interventions (p = 0.38). Similarly no change in AE was found (p = 0.76). Furthermore, there were no differences regarding test sequence or in the interaction 'intervention x sequence' for either VE (p = 0.73 and 0.53, respectively) or for AE (p = 0.71 and 0.67, respectively)

    Conclusions: The present study showed no effect on shoulder position sense after an acute bout of stretching either agonist or antagonist shoulder muscles.

  • 214.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Åsa
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Häger, Charlotte
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with nonspecific neck pain: a randomized controlled trial2014Conference paper (Refereed)
    Abstract [en]

    Aim of the investigation: The evidence for physiotherapy treatments of nonspecific neck pain is modest despite a large increase of intervention studies the last decade. One reason could be different underlying causes for pain in individuals with nonspecific neck pain, and that identification of sub-groups or individual needs is seldom accounted for in studies. In the absence of causal treatment options, a tailored treatment approach based on an explicit clinical decision model guided by assessment of function, clinical signs and symptoms, should be considered. Our aim was to evaluate tailored treatment based on such a decision model, targeting women with nonspecific neck pain. Our main hypothesis was that the tailored treatment (T) would have better short, intermediate and long-term effects on pain intensity and pressure pain threshold for the trapezius muscles than either non-tailored treatment (NT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that T or NT has better effect than TAU. For details, cf. Current Controlled Trials registration ISRCTN49348025 and published study protocol.

    Methods: 120 working women with minimum six weeks duration of neck pain were randomized to the T, NT or TAU groups. All participants had more than “no disability” but less than “complete disability” according to the Neck Disability Index, and reported impaired capacity on the quality or quantity to work the preceding month. Main exclusion criteria were trauma-related neck pain, specific diagnoses and generalized pain or concomitant low back pain. The decision model for tailored treatment was based on tests and symptoms with defined cut-off levels comprising the following main categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, trapezius myalgia, cervicogenic headache and impaired eye-head-neck control (cf. published study protocol). Assessment was performed one week before and after the 11-weeks intervention, with follow-ups 6-months (intermediate-term) and 12-months (long-term) after the intervention. Outcome variables were pain intensity (Numeric Rating Scale, NRS, 0 – 10) and pressure pain threshold (PPT) of the upper trapezius muscles (kPa). PPT was not measured at long-term follow-up.  Preliminary statistical analyses for the predefined hypotheses were performed with analysis of covariance (ANCOVA) with baseline outcome values as covariates. This was supplemented with pairwise Bonferroni-compensated comparisons in case of significance of factor group.

    Results: 86% of the participants completed the intervention, and the attrition was similar across groups. Preliminary results for the short term evaluation showed a reduction in NRS from an average of 4.4 and 4.5 to 2.5 in the T and NT groups, respectively, which was significantly greater compared to the TAU group (p=0.024 and p=0.014 for T and NT). For the PPT, there was no difference between T and NT groups at the short term evaluation, but close to a significantly increased threshold for the T compared to the TAU group (p=0,058). No differences were found between treatment groups on the intermediate and long-term evaluations for neither of the two outcome variables.

    Conclusions: The results indicate that tailored treatment for women with nonspecific neck pain may not be more effective, with respect to pain reduction, compared to non-tailored treatment. The hypothesis of superiority of tailored or non-tailored treatment over treatment-as-usual was partly supported for the short-term evaluation. However, the short-term results should be interpreted with caution since the impact of higher attention given to the participants in T and NT groups is not known. Reference:1. Björklund M, Djupsjöbacka M, Svedmark Å, Häger C. (2012) Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial. BMC Musculoskeletal Disorders. May 20;13(1):75

  • 215.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Alfta Research Foundation, Alfta, Sweden.
    Hamberg, Jern
    Alfta Research Foundation, Alfta, Sweden.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Barnekow-Bergkvist, Margareta
    University of Gävle, Centre for Musculoskeletal Research.
    The assessment of symptoms and functional limitations in low back pain patients: validity and reliability of a new questionnaire2007In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 16, no 11, p. 1799-1811Article in journal (Refereed)
    Abstract [en]

    Many of the existing low back pain (LBP) questionnaires of function and symptoms have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. The present study describes the development of a clinically derived back-specific questionnaire incorporating both a functional limitation and a symptom scale, with a further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aims of the study were to assess the overall reliability and validity of the new questionnaire, named the Profile Fitness Mapping questionnaire (PFM). A total of 193 chronic LBP patients answered the PFM together with five validated criterion questionnaires. For the internal consistency of the questionnaires, the three indices of the PFM had the highest Cronbach's alpha (0.90-0.95) and all items had item-total correlations above 0.2. The correlation coefficients between the PFM and the back-specific criterion questionnaires ranged between 0.61 and 0.83, indicating good concurrent criterion validity. The best discriminative ability between patients with different pain severities was demonstrated by the functional limitation scale of the PFM. Well centered score distribution with no patient's score at the floor or the ceiling level indicates that the PFM has the potential to detect the improvement or worsening of symptoms and functional limitations in chronic LBP patients. Classification according to the International Classification of Functioning, Disability and health (ICF) of WHO revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. The present study suggests that the PFM has a high internal consistency and is a valid indicator of symptoms and functional limitations of LBP patients. It offers the combination of a composite total score and the possibility of evaluations within specific domains of disability. Complementary evaluation of test-retest reliability and responsiveness to change is warranted.

  • 216.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Hamberg, Jern
    Alfta Research Foundation, Alfta, Sweden.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Barnekow-Bergkvist, Margareta
    University of Gävle, Centre for Musculoskeletal Research.
    The profile fitness mapping scales, validity of a new back-specific questionnaire2009Conference paper (Refereed)
    Abstract [en]

    Background: Disability questionnaires for LBP-patients mostlyemanate from health professionals and have a content of differentdomains of disability presented as a single sum score, makingit difficult to derive changes within a specific domain. Thisstudy introduces a new back-specific questionnaire, the ProfileFitness Mapping questionnaire (PFM), which was based on patient’sself-reported characteristics of the LBP. The PFM incorporatesboth a functional limitation and a symptom scale, with furthersubdivision of the symptom scale in separate indices for severityand temporal aspects. The aim of the study was to assess theoverall validity of the PFM.

    Methods and Results: Chronic LBP-patients (n=193) answered thePFM and four validated back-specific criterion questionnaires.The correlation coefficients between the PFM and the criterionquestionnaires showed good concurrent criterion validity (0.61– 0.83). The best discriminative ability between patientswith different pain severity was demonstrated by the functionallimitation scale of the PFM. Classification according to theICF revealed a high degree of homogeneous item content of thesymptom scale to the domain of impairments, and of the functionallimitation scale to the domain of activity limitations. Wellcentered score distribution indicates that the PFM has the potentialto detect improvement or worsening of symptoms and functionallimitations in chronic LBP-patients.

    Conclusion: The results of the study signify that the PFM isa valid indicator of symptoms and functional limitations ofLBP-patients. It provides the combination of a composite totalscore and the possibility of evaluations within specific domainsof disability.

  • 217.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden,.
    Tronarp, Rebecca
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Granås, Marie
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Dahlgren, Gunilla
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    McDonough, Suzanne
    University of Ulster, UK.
    Nyberg, André
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Häger, Charlotte
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Office-cycling while working: An innovative concept to prevent and reduce musculoskeletal pain in office workers - a controlled feasibility study2015Conference paper (Refereed)
    Abstract [en]

    Background: According to the World Health Organization, WHO, a sedentary lifestyle is the single largest health risk for a number of diseases including musculoskeletal disorders and metabolic diseases. The negative health effects of excessive sitting are not compensated for by shorter bouts of increased physical activity. However, evidence shows that increased physical activity reduces musculoskeletal pain, which is very prevalent in those who are inactive. About 50-70 % of those who work at a computer report musculoskeletal pain and spend on average about 5 hours/day with very low energy metabolism. Work places are therefore an important arena for prevention and intervention by means of reducing sedentary time and increasing physical activity both for general health benefits and effects on the musculoskeletal pain.

    Purpose: To test the feasibility of office-cycling in an office work place and explore its potential effects on musculoskeletal pain in office workers.

    Methods: Twenty office workers (ages 27-61, 5 males) with musculoskeletal pain participated in this three-week controlled pilot field study. The intervention group (n=10), had access to an innovative customized cycle ergometer (OfficeBiking®) at their regular office workstation whilst performing their usual work tasks. Offie-cycling was an alternative to sitting/standing by their height adjustable office desk; they were instructed to bike as often as comfortable. The control group (n=10) was instructed to continue to work as usual. The experiences of office-cycling and how it influenced work performance was studied with a questionnaire. Musculoskeletal pain was evaluated using pain drawings and pain ratings and participants' total pain was calculated by adding each individuals' self-reported pain from their three most painful areas (NRS 0-10).

    Results: Importantly, office-cycling did not reduce self-reported work performance; the majority (9/10) would like daily access; and made suggestions to improve the user-friendliness of the bike. Office-cycling was used regularly (median, 11/15 workdays; median active time 59 min/day IQR 39;91). There was no observed difference regarding either number of self-reported areas of pain (NSAP) or general musculoskeletal pain (GMP) between the intervention group and the control group at baseline. Self-reported GMP decreased in 8 persons in the intervention group which was one more than in the control group (n=7). NSAP decreased in the intervention group (n=7; md -1,0 IQR -2,3;0,0); and the control group (n=5; md -0,5 IQR -1,3;0,3). The difference in total pain (intervention end-baseline) revealed a clinically important change in the intervention group (NRS -2,5, IQR -8,8;4,0) but not in the control group (NRS 0,0 IQR -6,2;2,5).

    Conclusions: The results suggest that office-cycling is a feasible method for use in work place interventions with some promising results. Future research suggestions are: underlying mechanisms regarding effects of physical activity on pain in parallel with controlled studies in laboratory environments to investigate dose-effects for metabolic expenditure and optimal pain reduction whilst office-cycling.

    Implications: The results in this feasibility study indicate a promising potential of the innovative office-cycling concept to prevent and reduce musculoskeletal pain in sedentary office workers.

  • 218.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umeå Sweden.
    Wiitavaara, Birgitta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain2017In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, no 1, p. 161-170Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in people with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

    Methods

    Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and non-improved participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operator curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

    Results

    The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74 – 0.83; NDI, 0.75 – 0.86). The MIC in the two samples ranged between 6.6 – 13.6% for ProFitMap-neck indices and 5.2 and 6.3% for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47 – 0.72).

    Conclusions

    Validity of change scores was demonstrated for the ProFitMap-neck indices with adequate ability to discriminate between improved and non-improved participants. Values of minimal important change were presented.

  • 219.
    Björklund, Matilda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Är användningen av Instagram ett nytt självskadebeteende?: En tvärsnittsstudie om Instagram-användares reflektioner.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Björklund, M. (2017). Is the use of Instagram a new self-harm behaviour? A cross-sectional study of Instagram users’ reflections. Bachelor thesis in Public Health Science. Department of Occupational and Public Health Science. Faculty of Health and Occupational Studies. University of Gävle, Sweden.

     

    The aim of the study was to investigate the use of Instagram among Swedish internet users. A further aim was to investigate whether there was an association between the increased use of Instagram and mental health.

    The method used was a cross-sectional study with questionnaires. Both quantitative and qualitative questions were included in the survey, which were presented as descriptive statistics as well as thematic analysis with quotes. The selection was a convenience selection and snowball selection, where the surveys were disseminated via the author Facebook.

    The result showed that the majority used Instagram several times a day and many of them were found to be in the risk group of mental illness. Many users found that the images exposed in Instagram contributed to comparisons between themselves and the photos resulting in body dissatisfaction.

    The conclusion was that the use of Instagram several times a day was associated with a decreased level of well-being. The majority of the Instagram users compared themselves with other people and more thought of their appearance, when they were exposed to the images in Instagram.

  • 220.
    Björklund, Ove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi University, Vaasa, Finland.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi University, Vaasa, Finland.
    Nyström, Lisbet
    Åbo Akademi University, Vaasa, Finland.
    Young Finnish Unemployed Men's Experiences of Having Participated in a Specific Active Labor Market Program2017In: American Journal of Men's Health, ISSN 1557-9883, E-ISSN 1557-9891, Vol. 11, no 5, p. 1426-1435Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to describe young Finnish unemployed men's experiences of having participated in a specific active labor market program, intended to fight unemployment and offered at a resource center. Fifteen young unemployed Finnish men in the age range 18 to 27 years were interviewed face-to-face. Purposive sampling was used to increase the variation among informants. The interview texts were analyzed using both manifest and latent qualitative content analysis. The present results reported that the young men felt that they, thanks to the program at the resource center, had acquired daily routines and could ultimately believe in the future. The young men described how they now had a structure, economic support, and that they could return to their daily life. The informants also described how they could see new possibilities and believe in oneself. There is a lack of empirical studies assessing the possible impact of active labor market programs on the unemployed based on participants' own experiences. Further research is needed to describe and elucidate in more detail the effects of targeted support measures and the needs of unemployed men of different ages and living in different contexts.

  • 221.
    Björklund, Ove
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi.
    Söderlund, Maud
    Åbo Akademi.
    Nyström, Lisbet
    Åbo Akademi.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Åbo Akademi.
    Unemployment and Health: Experiences Narrated by Young Finnish Men2015In: American Journal of Men's Health, ISSN 1557-9883, E-ISSN 1557-9891, Vol. 9, no 1, p. 76-85Article in journal (Refereed)
    Abstract [en]

    Studies have shown that the experiences and consequences of unemployment can affect people differently depending on, for example, age and gender. The purpose of the present study was to describe young Finnish men's experiences of being unemployed as well as how their experiences of health emerged. Fifteen young unemployed Finnish men in the age range 18 to 27 years were interviewed face to face. Purposive sampling was used to increase the variation among informants. The interview texts were analyzed using both manifest and latent qualitative content analysis. The present results showed that the young men were strongly negatively affected by being unemployed. They described how they had slowly lost their foothold. They also described feelings of shame and guilt as well as a flight from reality. The present results show that even young men who have only experienced shorter periods of unemployment, in this study periods between 2 and 6 months, are negatively affected, for example, with regard to their identity and emotional life. Further research is needed to describe and elucidate in more detail the effects of unemployment on men of different ages and living in different contexts.

  • 222.
    Björkman, Annica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China .
    Olsson, Annakarin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Wahlberg, Anna Carin
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Identified obstacles and prerequisites in telenurses’ work environment: a modified Delphi study2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 357Article in journal (Refereed)
    Abstract [en]

    Background: Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses’ work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses’ work environment.

    Methods: A modified Delphi design, using qualitative as well as quantitative data sequentially through three phases, was taken. Data were initially collected via semi-structured interviews (Phase I) and later using a web survey (Phase II-III) between March 2015 and March 2016.

    Results: The findings present a consensus view of telenurses’ experiences of important obstacles and prerequisites in their work environment. Central to the findings are the aspects of telenurses having a demanding work, cognitive fatigue and having no opportunity for recovery during the work shift was ranked as important obstacles. Highly ranked prerequisites for managing were being able to focus on one caller at a time, working in a calm and pleasant environment and having technical support 24/7.

    Conclusions: Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work. 

  • 223.
    Björkman, Annica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    The bidirectional mistrust - callers’ online discussions about their experiences of using the national telephone advice service2018In: Internet Research, ISSN 1066-2243, Vol. 28, no 5, p. 1336-1350Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper is to explore and describe online communication about the experiencesand attitudes toward Swedish Healthcare Direct, a national telephone advice nursing (TAN) service.

    Design/methodology/approach – A descriptive research design was adopted using a six-step netnographicmethod. Three Swedish forums were purposefully selected and data from the virtual discussions were collected.

    Findings – Three themes emerged: expectancy and performativity of the nurses, absurdity in accessibilityand the scrutinizing game. The most prominent finding was the scrutinizing game, which included aspects ofbidirectional mistrust from both nurses and callers. Another salient finding was the attitudes that callers heldtoward nurses who used a technique interpreted as “passing the buck.”

    Research limitations/implications – The use of a nethnographic method is novel in this area of research.Consequently, the body of knowledge has regarding telephone advise nursing service has significantly beenbroadened. A limitation in this study is that demographic data for the posters are not available.

    Practical implications – Bidirectional distrust is an important issue that must be acknowledged by TANservices, since it might damage the service on a fundamental level. Healthcare providers, politicians, andresearchers should account for the power and availability of virtual discussions when seeking consumers’opinions and evaluating the quality of the care provided.

    Originality/value – This analysis of the ongoing discussions that take place on the internet provides insightinto callers’ perceptions of a national TAN service. The bidirectional mistrust found from both the nurses andthe callers might be a threat to callers’ compliance with the advice given and their care-seeking behavior.

  • 224.
    Björkman, Josefin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sandberg, Elin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Föräldrars copingstrategier för att hantera tiden efter att deras barn fått en cancerdiagnos: en litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Almost on a daily basis a child gets affected by cancer in Sweden. Childhood cancer can be a long process involving the whole family. The parents are the child’s safety and are usually involved in the care of the child. The cancer diagnosis causes demanding emotions among the parents, and that is when they can institute different ways to manage and adapt to change of living.

    Aim: The aim of the present study was to describe how parents to children diagnosed with cancer handle the life situation during the period of illness. Also to describe the included articles study sample.

    Method: A descriptive literature study based on twelve scientific articles with a qualitative approach, obtained through searches of the databases Cinahl and Pubmed.

    Main results: Throughout the result, coping strategies were seen to be effective. The result showed coping strategies as (1) support which parents obtain from religion, others in similar situation and people in the surrounding. (2) Experience of control, which parents achieved through information, routine and planning. (3) Changing the emotions and way of thinking, by maintaining hope, positive thinking, being optimistic, having an avoidance behavior and performing distracting activities. A majority of the participants in the included articles were women. Ranged in age from 20 to 60 years. Two of the articles were from Sweden and the remaining from other countries.

    Conclusion: Coping strategies were seen to be effective ways for the parents to cope with the difficult time they appeared in. Three general observed coping strategies were accommodating for the parents; support, changed emotions and way of thinking and experiences of control. By gaining an understanding of the management method of the parents and contribute and strengthen coping strategies, the health professionals can work to promote health and well-being among the parents.

  • 225.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Josephson, Malin
    Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rissén, Dag
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Prominent attractive qualities of nurses’ work in operating room departments: a questionnaire study2015In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 52, no 4, p. 877-889Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The shortage of nurses in operating room departments (ORs) in Sweden and other countries can lead to reduced capacity and quality in healthcare, as well as more intense work for those on the job. Little is known about what nurses in ORs perceive as crucial for their workplace to be attractive.

    OBJECTIVE: To capture attractive qualities of nurses work in ORs and to adapt the Attractive Work Questionnaire (AWQ).

    METHODS: The AWQ, rating attractive qualities of work, were completed by 147 (68%) nurses in four Swedish ORs. Principal Component Analyses were performed to determine the underlying structure of the data.

    RESULTS: The factors in the area Work conditions were: relations, leadership, equipment, salary, organisation, physical work environment, location, and working hours; in the area Work content: mental work, autonomy and work rate; and in the area Job satisfaction: status and acknowledgement. The Principal Component Analysis showed consistency with the original AWQ. Cronbach’s alpha varied between 0.57-0.90.

    CONCLUSIONS: The AWQ captured attractive qualities for nurses in ORs, some less discussed regarding nurse retention, i.e. equipment, physical work environment and location. The results suggest that the questionnaire is reliable and valid and can be a useful tool in identifying attractive work.

  • 226.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden .
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rissén, Dag
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Significant factors for work attractiveness and how these differ from the current work situation among operating department nurses2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 1-2, p. 109-116Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

  • 227.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University.
    Rissén, Dag
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University.
    Josephson, Malin
    Department of Occupational and Environmental Medicine, Uppsala University.
    Goal-setting documents did not facilitate nurses’ work at an operating department – a descriptive qualitative study2014In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800Article in journal (Refereed)
    Abstract [en]

    Both effectiveness and good care is demanded of nurses in a complex environment. The aim of the study was to describe how nurse managers and nurses interpret and are guided by stated goals in their health-care organisation, their own influence over work and obstacles to carry out work in an operating department. A qualitative study, consisting of interviews with nurse managers and nurses, and a description of goal documents and the workplace, were conducted in an operating department in Sweden. The interviews were analysed with manifest content analysis. Work was guided by daily goals for the nurses: to meet the operating schedule and to ensure good-quality patient care. The organisational goals were little known and used. The nurse managers and nurses had limited influence over their work, changes in assignments and in the operating schedule, and unsuitable environmental premises created obstacles in their work. If organisational goals are to guide work there is a need for nurse managers to transform them into understandable, applicable goals and incorporate them into nurses’ daily work. Letting the nurses influence the operating schedule could be one way to overcome obstacles in work. The study also highlights the importance of a functional physical work environment.

  • 228.
    Björn, Catrine
    et al.
    Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden; Karlstad University, Sweden.
    Rissén, Dag
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Wadensten, Barbro
    Josephson, Malin
    The opportunities and obstacles nurses have in carrying out their work: a case study in an operating department in Sweden2017In: Perioperative Care and Operating Room Management, ISSN 2405-6030, Vol. 6, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Background To improve working conditions and counteract nursing shortages, more knowledge is needed about the opportunities nurses have to carry out their work and what guide nurses’ work. The aim of this study was to use the ARIA guide to identify the opportunities and obstacles in nurse managers, registered specialist nurses and non-registered assistant nurses work in an operating department. Methods A descriptive case study design was performed in an operating department, comprising structured individual and group interviews according to work content analyses with nurse managers, registered specialist nurses and assistant nurses. Interviews were analysed in terms of predetermined aspects regarding working conditions and criteria for performance obstacles. Extracts from documents stating goals and registered data supplemented the interviews. Results The findings show that the daily surgery schedule, not the goal documents, guided daily work. An over-optimistic surgery schedule with unplanned changes and cancellations, over which the nurses had very little influence, as well as the time required to locate necessary equipment that was spread throughout the ward, resulted in nurses rushing through medical records and other preparations rather than preparing calmly for surgery. Although the registered specialist nurses and assistant nurses considered quality of care to be highly important, no standardised evaluations on quality of care were performed. Conclusion The study reveals the importance of a functioning physical work environment including storage, technical equipment supplies, and the positioning of technical equipment in operating rooms, in order for registered specialist and assistant nurses to perform their tasks well. Due to goal incongruence and performance obstacles, the nurses were often unable to reach their daily goals. Involving registered specialist nurses in the process of planning of the surgery schedule could facilitate their work to better match the prerequisites in the physical work environment and among available staff. In order for the Operating Department Goal Document to guide work, goals must be transformed into understandable, realistic, applicable and evaluable aims, and incorporated into daily work. 

  • 229.
    Björn, Daniella
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Holm, Rebecca
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Personer med schizofreni och deras upplevelser av mötet med sjuksköterskan: en beskrivande litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Psykisk ohälsa existerar i hela världen och år 2016 uppgav 16 % av den svenska befolkningen att de led av nedsatt psykiskt välbefinnande. Enligt WHO (World Health Organisation) lider 21 miljoner personer världen över av schizofreni. Cirka 30 000-40 000 personer i Sverige har i dagsläget diagnosen schizofreni och årligen beräknas 1200-1500 personer insjukna i psykos.

    Syfte: Syftet med denna studie var att beskriva hur personer (från 18+ år) med schizofreni inom öppen- och slutenvården upplever mötet med sjuksköterskan samt att beskriva den metodologiska aspekten av de inkluderade artiklarnas undersökningsgrupp.

    Metod: En litteraturstudie med en deskriptiv design. Sökningarna av artiklarna genomfördes i Cinahl, PubMed och PsycINFO. Båda författarna granskade artiklarna objektivt.

    Huvudresultat: Resultatet presenterades med hjälp av tre rubriker, tillgänglighet, relation och förväntningar. Tillgänglighet, där visades att mer tid önskas med sjuksköterskan för att uppnå ett gott möte. Under relation framkom varierande resultat där både en god samt en dålig relation beskrivs i mötet med sjuksköterskor. Förväntningar där patienterna uttryckte sina förväntningar på sjuksköterskan innan och vid mötet.

    Slutsats: Patienter som i mötet med sjuksköterskan upplevde en god relation, gavs tid samt fick sina förväntningar uppfyllda var mer tillfredsställd med vården. Mer forskning kring patientens upplevelser i mötet med sjuksköterskan behövs.

  • 230.
    Björn, Sara
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Föräldrars kunskap om och attityder till vaccin mot humant papillomvirus: En beskrivande litteraturstudie2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since of January 2010 vaccine against human papillomavirus (HPV) is a part of the Swedish child vaccination program. The decision to vaccinate can be difficult for the parents to make. Purpose: The purpose of the study was to describe parental knowledge and attitude towards vaccine against human papillomavirus and how that influenced their decision to vaccinate their children. Design: Mixed methods research with integrated design. Method: A descriptive literature review. A systematic search was performed in the databases PubMed and CINAHL and 12 studies were identified. The studies had quantitative and qualitative design. Results: Parents were positive towards the HPV-vaccine. Many parents lacked knowledge and felt they didn´t have enough information about the vaccine. There was concern about the safety and side effect. Many got their information from media but the preferred source of information was caregivers. Parents who had gotten information from caregivers were more positive towards the vaccine. The recommended age for vaccination was considered too low and there was concern that a vaccination would have an effect on their daughter’s sexual behavior. Among the parents who had made the choice to vaccinate that concern was lower. Social norms and religion affected the parents in their decision to vaccinate. Lower education was a predictor in the decision to vaccinate. Experience of abnormal pap-smears or cervicularcancer also affected the intention to vaccinate.

     

    Search words: MeSH-therms accept*, attitudes, behavior, beliefs, decision, HPV-vaccine, intent*, knowledge, parents.

  • 231.
    Björnholm, Malin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Yasin, Sara
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Erfarenheter av kvinnlig könsstympning och mötet med västerländsk sjukvård: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: FGM (female genital mutilation [FGM]) affects approximately 100 million to 140 million women worldwide. Each year there are about 3 million girls between the ages of 0-15 years who risk being genitally mutilated. Genital mutilation is present in 26 countries located in Africa, the Middle East & Asia. To circumcise women is a practice that is deeply rooted in the spiritual and cultural vision. According to Swedish law, all forms of genital mutilation are illegal and may not be performed.

    Aim: The purpose of the study was to describe women’s experience and the experience of living with genital mutilation and their encounter with western health care. The purpose was also to describe the studies finding mission in the included articles. Method: In order to answer to the present studies aim, the authors conducted a descriptive literature study. The literature have 11 articles that are of qualitative approach, 1 has the quantitative approach and 3 have both qualitative and quantitative approach, and they were analysed objectively. PubMed and CINAHL were used in this study.

    Results: The women in the study, explains that it's tradition, culture and an honour to the family being mutilated. Emotions such as fear, anxiety and shame are the experiences the women explained when meeting with western health care, and these feelings are related to the lack of communication and treatment. The women believe that there is too little knowledge about genital mutilation in the western health care and that needs to be better. Positive experience was also where the women are talking about that they were treated with respect and a good nursing care.

    Conclusion: The women who have undergone genital mutilation has both positive and negative experiences of being circumcised. Studies show that women who undergone female genital mutilation experience fear and anxiety while coming in contact with western health care. The positive experiences women had in the meeting with the western health care was that they felt treated with respect by medical staff who had good knowledge about female genital mutilation. Through increased knowledge among medical staff will the womens worry and fear gradually decrease in the countries where female genital mutilation not occur.

  • 232.
    Blanck, Susanne
    et al.
    Baldersnäs Din Hälsocentral, Bollnäs, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    District nurses' prescribing practice and its link to structural conditions2015In: Journal of the American Association of Nurse Practitioners, ISSN 2327-6886, E-ISSN 2327-6924, Vol. 27, no 10, p. 568-575Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe district nurses' (DNs') prescribing practice and examine associations between DNs' self-reported prescribing frequency, opinions about prescribing, and structural conditions/empowerment.

    Data sources: A cross-sectional and correlational design was employed. Data were collected during 2012 using questionnaires and a prescribing register. A random sample of 150 DNs from 32 primary care centers in Sweden was invited.

    Conclusions: DNs' ability to prescribe is used to a relatively small extent and access to "opportunities" and "informal power" seems to be the most important structural empowerment conditions for increased prescribing frequency and positive opinions about prescribing. The results support Kanter's theory of structural empowerment.

    Implications for practice: This article regarding restricted prescribing shows how important structural conditions/empowerment is to DNs' prescribing and employers have to enhance nurses' access to especially the structures "opportunities" and "informal power" to increase nurse prescribing. More targeted support and training are needed in different prescribing areas to make use of DNs' prescription qualification to a greater extent.

  • 233.
    Blix, Ellen
    et al.
    Department of Obstetrics and Gynaecology, Hammerfest Hospital, N-9600 Hammerfest, Norway; Nordic School of Public Health, Nya Varvet, Gothenburg, Sweden.
    Öhlund, Lennart S.
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för folkhälsovetenskap.
    Norwegian midwives' perception of the labour admission test2007In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 23, no 1, p. 48-58Article in journal (Refereed)
    Abstract [en]

    Objective: to explore what information and knowledge the labour admission test is perceived to provide and what meaning the test carries in the daily work of practising midwives. Design: in-depth interviews transcribed verbatim and analysed using the grounded theory technique. Setting: four different labour wards in Norway. Participants: a theoretical sample of 12 practising midwives. Findings: the core category "experiencing contradictions" was identified during the analyses, indicating that the midwives found conflicting interests within themselves, or between themselves and others when using the labour admission test. They experienced contradictions between professional identity and the increasing use of technology, between feeling safe and feeling unsafe and between having power and being powerless. Key conclusions: the labour admission traces could be difficult to interpret, especially for newly qualified midwives. Some midwives thought that a labour admission trace could protect them in case of litigation. The hierarchy of power in the labour ward influences the use and interpretation of the labour admission test. Some midwives felt their professional identity threatened and that midwives in general are losing their traditional skills because of the increasing use of obstetric technology. Implications for practice: the findings of the present study should be taken into consideration when changing practice to not routinely perform the labour admission test. There is also a need for further research on what effect the increasing use of obstetric technology has on traditional midwifery skills.

  • 234.
    Blom Johansson, Monica
    et al.
    Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Östberg, Per
    Uppsala University, Uppsala, Sweden.
    Sonnander, Karin
    Uppsala University, Uppsala, Sweden.
    A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia2013In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 27, no 2, p. 201-226Article in journal (Refereed)
    Abstract [en]

    Background: Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).

    Aims: To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.

    Methods & Procedures: An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.

    Outcomes & Results: The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.

    Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.

    Conclusions: The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.

  • 235.
    Blom Johansson, Monica
    et al.
    Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Östberg, Per
    Uppsala University, Uppsala, Sweden.
    Sonnander, Karin
    Uppsala University, Uppsala, Sweden.
    Communication changes and SLP services according to significant others of persons with aphasia2012In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 26, no 8, p. 1005-1028Article in journal (Refereed)
    Abstract [en]

    Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.

    Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others' experiences of SLP services and their motivation to participate in these services. Finally, the significant others' experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.

    Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.

    Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.

    Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.

  • 236.
    Blom, Malin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Hur miljön i hemmet kan påverka elevernas frukostintag: En enkätundersökning bland niondeklassare2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to investigate if the environment at home could affect the pupils breakfast intake; what they choose to eat, if the eat and why they eat breakfast. A quantitative method was used and the data was collected by a questionnaire. In total 64 pupils from ninth grade in public school participated in the study. The result showed that most of the pupils ate breakfast regularly and often ate alone at the kitchen table. Though some of them ate very little and a meager breakfast. Most of the pupils were positive to being served breakfast at school because they often were too tired to eat at home and can eat in the company of friends. The conclusion was that most pupils ate breakfast often and a few ate rarely. The kitchen table was the preferred place to eat breakfast and they often ate alone. Popular choices for breakfast were oatmeal, sandwiches or soured milk/yoghurt with cereals.

  • 237.
    Blomberg, Caroline
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Lindberg, Johanna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Föräldrars upplevelser av att få ett prematurt fött barn som vårdas på neonatalavdelning: En litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 238.
    Blomberg, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindberg, Cathrine
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Upplevelser av djurterapi hos patienter med psykisk ohälsa: En deskriptiv litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In today’s caring of human beings we find animals to assist in a lot of different ways. Therapy with animals has been studied in younger persons and people with dementia but in persons with psychiatric disorders few studies have been made.

    Purpose: The aim of this article was to describe experiences of animal assisted therapy (AAT) in patients with psychiatric disorders and survey the methodological aspect investigational groups in the articles.

    Method: Search of articles was made at Högskolan in Gävle during autumn 2016 using database MedLine and WebCrawler PubMed, CINAHL and PsycINFO using MeSH search word “Animal assisted therapy”. Words used in free text search were “Mental disorders”, “Psychiatric disorders” and ”experience”. Manual search was also made according to relevance, aim and question formulation. Selected articles were read individually and together results and tables were then compiled.

    Result: This review includes 11 articles. Predominant results were shown regarding experiences as a source of joy, feeling of belonging and to be needed, quality of life, self-esteem and social interaction and lower anxiety. Both positive and negative results were found when it comes to depression.

    Conclusion: AAT seems to have positive influence in patients with psychiatric disorders regarding better self-esteem, encourage managing daily life and facilitate social interaction. In nursing this knowledge might be a tool to use in clinical care-giving. This could help nurses to support patients to conquer interaction and promote health progress. Howsoever few studies have been made in this topic and better basis of knowledge is desirable to be able to use AAT in nursing based on evidence.

  • 239.
    Blomberg, Priyanka
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Lindgren, Carina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Trycksårsprevention genom utbildning2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med föreliggande studie var att beskriva hur sjuksköterskor genom utbildning kan förebygga uppkomsten av trycksår samt att beskriva de utvalda artiklarnas urvalsmetod.

    Metod: Studien har en deskriptiv design. Artiklar publicerade mellan årtalen 2007–2017 söktes i databasen Cinahl. Resultatet baseras på 10 artiklar, varav nio hade kvantitativ ansats och en hade kvalitativ ansats.

    Resultat: De inkluderade studierna visade att utbildning inom omvårdnadsåtgärder, riskbedömningsskalor, tryckavlastande hjälpmedel och dokumentation för sjuksköterskor, reducerar uppkomsten av trycksår. Denna litteraturstudie baseras på tio artiklar där urvalet har granskats. Tre av de tio inkluderade artiklarna hade ett ändamålsenligt urval och tre hade ett randomiserat urval. De andra urvalsmetoderna som användes var systematiskt urval, kluster urval och bekvämlighetsurval. I en av de inkluderade artiklarna framgick inte vilken urvalsmetod som använts.

    Slutsats: För att minska uppkomsten av trycksår krävs att sjuksköterskan får mer kunskap gällande sambandet mellan trycksår och preventionsarbete.

  • 240.
    Blomqvist, Elisabeth
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Eriksson, Johanna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Sjuksköterskors upplevelser av att vårda barn och ungdomar med cancer: En kvalitativ intervjustudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att utifrån intervjuerna analysera sjuksköterskornas upplevelser av att arbeta med barn och ungdomar med cancer samt hur de bemöter dessa barn och ungdomar. Genom en deskriptiv empirisk intervjustudie med kvalitativ ansats utfördes sju semistrukturerade intervjuer med hjälp av en intervjuguide. Det insamlade materialet analyserades med kvalitativ manifest innehållsanalys. Tre kategorier identifierades: Interaktioner i vården, Sjuksköterskans bemötande samt Glädje och vanmakt. Studien visade att deltagarna upplevde en stor glädje och tillfredställelse i sitt arbete. Trots det kan arbetet ibland vara påfrestande, till exempel om barnen känner smärta som inte går att lindra. Då fann deltagarna stort stöd i att få ventilera med kollegor. Två betydelsefulla aspekter i mötet med barn och ungdomar med cancer var enligt deltagarna att bemötandet sker på deras individuella utvecklingsnivå och att alltid vara ärlig trots att det kan innebära att ställas inför svåra situationer och frågor. Det var också enligt deltagarna viktigt att se det friska i barnet trots svår sjukdom och behandla dem som alla andra barn.Sjuksköterskor bör anpassa sitt bemötande och den information som ges till barn och ungdomar utifrån individens utvecklingsnivå. Arbetet med barn och ungdomar med cancer var utvecklande och givande men kunde samtidigt vara påfrestande, då var det viktigt att ventilera och få stöd från kollegor.

  • 241.
    Blomqvist, Sven
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Ervasti, Per-Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Evaluating physical workload by position during match in elite bandy2018In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 32, no 9, p. 2616-2622Article in journal (Refereed)
    Abstract [en]

    To improve current understandings of physical Workload (WL) in elite Bandy, ten bandy players were monitored for heart rate (HR) during thirteen matches over one championship season. Participants were divided into five subgroups according to playing position - libero, defender, halves, midfielder and forward. HR measurements were analyzed with two different methods to compute physical WL - (i) percentage of total time spent in different HR zones (HRres) and (ii) WL based on the Edwards method. Also determined was the time spent at HR levels above the lactate threshold (LT). A one-way ANOVA was used for analysis. For WL according to the Edwards method, significant differences (p=0.05) were shown between groups with defenders presenting the highest scores and forwards and liberos the lowest. A significant difference (p=0.05) was found between liberos and halves and the other positions as to how much time they spent in zone 70-80% of HRres. In 91-100% of HRres there was a distinct difference between defenders and the other positions and also forwards differed significantly from liberos, defenders and halves (p=0.05). The libero spent only one percent of the time over the LT, whereas the midfielder spent about 27% of the time over the LT. Overall, defenders showed the greatest WL during a match and liberos the lowest. The practical implications of these findings can help coaches and trainers design training methods specific to each position as well as individualized training sessions for each player in elite bandy.

  • 242.
    Blomqvist, Sven
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Rehn, Börje
    Institutionen för Samhällsmedicin och Rehabilitering, Fysioterapi, Umeå universitet.
    Fysisk aktivitet och hälsa för personer med utvecklingsstörning2015In: Fysioterapi, ISSN 1653-5804, no 1, p. 26-31Article in journal (Other academic)
    Abstract [sv]

    Hälsa är en förutsättning för att kunna förverkliga sina mål i livet. Personer med utvecklingsstörning, cirka 90 000 i Sverige, har nedsatt hälsa jämfört med personer utan utvecklingsstörning och det leder till att denna grupp har svårare att uppfylla sina mål. Personer med utvecklingsstörning drabbas i större utsträckning av övervikt, typ 2-diabetes, hjärt- och kärlsjukdomar, högt blodtryck, benskörhet och depression. Undersökningar visar också på nedsatt fysisk aktivitet, motorik, syreupptagningsförmåga, muskelstyrka och postural balans hos denna grupp. Dessa sjukdomar och nedsatta förmågor går att påverkai positiv riktning med fysisk aktivitet. Fysioterapeuter som har bred kunskap om hälsa och anpassning av fysisk aktivitet kan vara till stor hjälp vid prevention, bedömning och träning.

  • 243.
    Blomqvist, Sven
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Van Biesen, Debbie
    Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, KU Leuven, Belgium.
    Vanlandewijck, Yves
    Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, KU Leuven, Belgium.
    Gear selection between techniques in freestyle cross-country skiing in athletes with intellectual impairment: A pilot study2018In: International journal of sports science & coaching, ISSN 1747-9541, E-ISSN 2048-397X, Vol. 13, no 6, p. 1150-1155Article in journal (Refereed)
    Abstract [en]

    Cross-country skiing is a fast-paced, a cognitively demanding, and a popular sport within international organizationsincluding athletes with intellectual impairment (II); however, research on how the level of II affects skiing performanceis limited. The aim of this exploratory study was to compare differences in the overall performance (segment time and racetime) and gear selection between a sample of cross-country skiers with II (n¼22) and a control group of skiers without II(n¼12), during a competitive 10 km freestyle race. The groups were matched on training background and skiing level basedon interviews with coaches and trainers. The independent samples t-test revealed a higher velocity in the first segment forthe control group (6.100.62 m/s) compared to the skiers with II (5.500.56 m/s; p<0.05), but no significant differencesin total race time between the groups. With respect to their ability to effectively select gears during the races, there was asignificant difference between the groups, where the pattern was that skiers with II used a lower gear compared to theskiers without II and that pattern became even more apparent towards the second half of the race. These findings supportthe assumption that impaired cognitive function may constrain the ability to optimally select the appropriate gear infunction of the characteristics of the skiing track, which is a key determinant of skiing performance.

  • 244.
    Blomqvist, Sven
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Wester, Anita
    Department of Research and Evaluation, Swedish National Agency for Education.
    Lönnberg, Lisa
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Sundelin, Gunnevi
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Rehn, Börje
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Physical exercise frequency seem not to influence postural balance but trunk muscle endurance in young persons with intellectual disability2017In: Journal of Physical Education and Sports Management, ISSN 2373-2156, E-ISSN 2373-2164, Vol. 4, no 2, p. 38-47Article in journal (Refereed)
    Abstract [en]

    Background The influence of various physical exercise frequencies on postural balance and muscle performance among young persons with intellectual disability (ID) is not well understood.

    Method Cross-sectional data from 26 elite athletes were compared with 37 students at a sports school and to 57 students at a special school, all diagnosed with mild to moderate ID and with different exercise frequencies. Data were also compared with a group of 149 age-matched participants without ID.

    Results There were no significant differences in postural balance between young ID groups regardless of physical exercise frequency, all of them had however impaired postural balance compared to the non-ID group. The group with high exercise performed better than the other ID groups in the trunk muscle endurance test.

    Conclusions It appears as if physical exercise frequency don’t improve postural balance but endurance in the trunk muscles for young persons with ID.

  • 245.
    Blomstedt, Josephine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Hakulinen, Emma
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Föräldrars upplevelser av att ha barn med diabetes mellitus typ 1 och stödet från sjukvården: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes mellitus type 1 is an autoimmune disease. Each year 700children aged 0-14 years get diabetes mellitus type 1. To be diagnosed involves majorchanges in daily life that require interactions between physical activity, food intake,daily insulin injections and daily checks of their blood sugar.

    Aim: The purpose of this study was to describe parents' experiences of having a childwith type 1 diabetes mellitus and how parents experience the support from healthcare.The aim was also to describe the study groups and qualitative sampling.

    Methods: This is a descriptive literaturestudy. The authors of the present study used thedatabase Pubmed. The result consists of 13 scientific articles with qualitative approach.

    Main results: The results shows that many parents experience grief, a big shock andfear about their children's health when their child has been diagnosed with diabetesmellitus type 1. Emotional support from health care and individualized care weremissing according to the parents. Study groups show a majority of mothers whoparticipated in the studies. Children's ages varied but in most of the studies were thechildren between 9-16 years. Purposive samples were used in all 13 articles.

    Conclusion: The conclusion of this study is that parents affected large when their childis diagnosed with diabetes mellitus type 1. There was an overwhelming situation with alot of emotions and changes in everyday life. More knowledge is needed in the area fornurses to be able to respond and support these families, which can lead to improvedcare.

  • 246.
    Blomstrand, Veronica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Uppman, Kristina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Följsamhet av handhygien hos hälso- och sjukvårdspersonal och hur sjuksköterskors följsamhet av handhygien kan ökas: En litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva följsamheten av handhygien hos hälso- och sjukvårdspersonal och hur följsamheten av handhygien hos sjuksköterskor kan ökas. Metod: Litteraturstudie med beskrivande design. Data samlades in från databaserna PubMed och Cinahl. Resultatet baserades på 12 artiklar. Resultat: Den generella följsamheten av handhygien hos hälso- och sjukvårdspersonal var låg men sjuksköterskor tenderade att ha en något högre följsamhet än övrig personal. Hälso- och sjukvårdspersonal hade generellt en något högre följsamhet av handhygien efter patientkontakt än före och detta var främst i syfte att skydda sig själva från patientens bakterier. Interventioner hade en positiv påverkan på sjuksköterskors följsamhet av handhygien. Bäst resultat gav interventioner för sjuksköterskor som innehöll praktiskt träning av handdesinfektion kombinerat med information och feedback. Slutsats: Det finns brister i den praktiska tillämpningen av handhygien i den dagliga arbetsrutinen trots att hälso- och sjukvårdspersonal har kunskap om handhygien och varför det är viktigt. Interventioner är gynnsamma för följsamheten av handhygien och kontinuerlig uppdatering av kunskap med information kombinerat med praktisk träning av handhygien kan användas för att minska förekomst av vårdrelaterade infektioner och därmed höja kvaliteten på omvårdnaden.

     

  • 247.
    Blusi, Madeleine
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Jong, Mats
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 211-220Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

  • 248.
    Boberg, Kajsa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Halling, Elin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Manliga och kvinnliga patienters upplevelser av omvårdnadssituationer ur ett genusperspektiv – en litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Genus är den sociala uppfattningen av att vara man, kvinna, flicka eller pojke. Tidigare artiklar har visat att män länge varit en minoritet inom sjuksköterskeyrket, de får inte samma förtroende hos patienterna som kvinnliga sjuksköterskor.

    Syfte: Att beskriva manliga och kvinnliga patienters upplevelser av omvårdnadssituationer ur ett genusperspektiv samt beskriva de i studien ingående artiklarnas datainsamlingsmetoder.

    Metod: En deskriptiv litteraturstudie där 11 vetenskapliga artiklar från Pubmed och Scopus har inkluderats för att besvara syfte och frågeställningar. Artiklarnas resultat och metod har analyserats och sammanställts under rubriker och kategorier.

    Resultat: Män och kvinnor har känt sig ignorerade och underlägsna i omvårdnadssituationer då de inte haft något att säga till om gällande sin egen vård och vårdpersonalen inte lyssnat på deras sjukdomsproblem. Många av artiklarna visar att manliga och kvinnliga patienter känt sig kränkta av vårdpersonalen och män har förlorat en del av sin maskulinitet samt känt sig bortglömda. I de ingående artiklarna hade både män och kvinnor en större tillit till kvinnliga sjuksköterskor. Några artiklar har även berättat om positiva upplevelser, främst hos kvinnor, av omvårdnadssituationer. Vid granskning av artiklarnas datainsamlingsmetod använde sig författarna av enkäter till de studier med en kvantitativ ansats, medans de studier med en kvalitativ ansats använde sig av intervjuer.

    Slutsats: Likheter mellan hur män och kvinnor uppfattar bemötandet från vårdpersonal har uppkommit. Framförallt kvinnor men även män har beskrivit positiva upplevelser av bemötandet från vårdpersonalen men antalet beskrivningar av negativa upplevelser är märkbart större hos båda könen.

  • 249.
    Bodin, Andrea
    University of Gävle, Faculty of Health and Occupational Studies.
    Äldre anhörigvårdares uppfattningar kring stöd och övriga underlättande faktorer: en intervjustudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bodin, A. (2013) Elderly informal caregivers perception about support and other relieving factors. Bachelor’s thesis in public health. The faculty of health and occupational studies, University of Gävle, Sweden.

     

    Abstract

    The purpose of this study was to describe widow’s/widower’s perception of the support they had been offered or missing from society and relatives/friends during their time as informal caregiver to their spouse. The purpose was also to describe other possible relieving factors.

     

    The method used was qualitative semi structured interviews that were held with 4 women and 2 men. Data was analyzed according to Graneheim & Lundman (2004). Two themes were identified; “Experiences of support from society, relatives and family” and “Other relieving factors”.

     

    The main results showed that the way information is given is important both when it comes to approach and procedure. A contact person is desirable. Support that benefits the informal caregiver’s social life is highly appreciated by the informants.

     

    The conclusion is that the feeling of support is crucial and is connected to the way personnel is treating the informal caregiver. The ideal solution could proposedly be for the society to introduce a long-term course, giving adequate information and discussing the majority of aspects of being an informal caregiver, such as care, the spouse’s state of ill-health and how to preserve your own quality of life.

     

  • 250.
    Bodling, Sara
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    Larsson, Sarah
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    A descriptive study of self-perceived attitudes regarding HIV/AIDS in Cambodia2010Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Bodling, S. & Larsson, S. (2010). A descriptive study of how people with HIV/AIDS in Cambodia experience attitudes regarding the disease from people around them. Essay for bachelor degree in Public Health 15 hp, Department of Occupational and Public Health, University of Gävle.

    Cambodia is the most HIV-afflicted country in Southeast Asia. The level of knowledge about the virus among the people is low and because of the poor conditions few people have access to testing and treatment. The HIV/AIDS epidemic has been followed by a stigmatization against people living with the disease and negative attitudes are common. The aim of this study was to identify self-perceived attitudes experienced by people living with HIV/AIDS in Lvea Em, Cambodia.

    In this study, a qualitative interview method was used. Ten interviews were conducted with ten Cambodian men and women, aged 25-48 years. They lived in different villages in the district of Lvea Em, outside Phnom Penh. The contact-organization Asian Outreach Cambodia (AOC) provided us with the informants. Most interviews were conducted in the informant’s own homes. One of the staff from the AOC also worked as an interpreter during the interviews. Since HIV/AIDS can be a sensitive topic, particular consideration was given to ethical considerations. To evaluate the results from the study a content analysis was used.

    The results showed that there are several negative attitudes connected to people living with HIV/AIDS. The main reason for negative attitudes seems to be fear of contagion. The result also showed some positive attitudes that derive from having HIV, like the discovery of love and care from family members and strengthening of the relationship to them. The results indicate that it is important to target the main underlying causes for stigmatization against people living with HIV/AIDS, but also that it is necessary to focus on the positive attitudes that do exist towards them. We wish that this study may contribute a little in the future work to eliminate the stigma and negative attitudes and also in the work to bring forward and increase the positive attitudes.

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