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  • 201.
    Bertils, Petra
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Åhlén, Camilla
    University of Gävle, Department of Caring Sciences and Sociology.
    Mödrars upplevelse av amning efter hemgång från sjukhus2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Syftet med denna studie var att beskriva kvinnors upplevelser av amning och metoden som användes i litteraturstudien var deskriptiv. Upplevelserna i 17 studier kategoriserades i fem grupper; förutsättningar, motstridiga råd, svårigheter, positiva erfarenheter och samhällssyn. Att få motstridiga råd från sjukvården var den upplevelse som beskrevs oftast och de olika känslomässiga svårigheter kvinnorna upplevde i samband med amningen var en annan tydlig upplevelse. Kvinnorna upplevde också att de hade bristfällig kunskap om amning och dess fördelar. Amning sågs som något naturligt men förväntningarna stämde inte överens med upplevelsen. Kvinnorna använde sig av olika strategier för att lyckas med amningen och många ansåg att amning är viktigt för barnet och de trivdes med att amma. I Sverige och i Västvärlden vill man främja amning pga. dess hälsomässiga och känslomässiga betydelse för mamma och barn. Amning är dock ett sammansatt fenomen som kräver en helhetssyn och framtida forskning bör sträva efter att öka förståelsen för ammande kvinnors situation för att rätt bemöta dessa kvinnor i vården. Kvinnor behöver få ökad kunskap för att upplevelserna ska överensstämma med förväntningarna. Sjukvården bör ge enhetliga råd och adekvat stöd, och även skapa medvetenhet om hur attityder påverkar amningspraktiken.

  • 202.
    Beyene, Ellelta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Karelius, Matilda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Hanteringsstrategier hos personer med inflammatorisk tarmsjukdom: En beskrivande litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Inflammatory bowel disease involves major changes where psychological and physical stress becomes a part of ones daily life. The ability to adapt and cope well with the situation, increases the chances of feeling satisfied with life. There are various management strategies that people with IBD use to cope with their daily life.

    Aim: The aim of this study is to describe strategies that people with inflammatory bowel disease use to manage their daily lives. A further purpose is to describe the study group in the included articles.

    Method: A descriptive literature review. This study is based on 12 scientific articles, searched in the databases Cinahl and Pubmed. Keywords used were; Inflammatory Bowel Disease, Management strategies and Self-management.

    Main Results: A positive attitude stimulate energy and hope which in turn prevents people with IBD from being controlled by their disease. Help with practical aspects such as, seeing a therapist, charring information with close ones and complementary alternative methods have been shown to have positive effects. Warm baths, speaking to one`s self and use of analgesic drugs or other stimulation is used as pain relief (Audulv 2013). A passive attitude, avoidance behavior and allowing disease to take over ones life is less common. Normalization and understanding that there are less fortunate people in worse conditions, is also a management strategy.

    Conclusion: Management strategies used by people with IBD in everyday life are problem and emotionally oriented coping strategies. According to the authors, the result is of great importance for a better understanding between nurses and patients with IBD. Keywords: Inflammatory bowel disease, coping strategies and management.

  • 203.
    Bhambhani, Yagesh
    et al.
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
    Mactavish, Jennifer
    Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.
    Warren, Sharon
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
    Thompson, Walter R.
    Department of Kinesiology and Health, Georgia State University, Atlanta, GA, United States.
    Webborn, Anthony
    Sussex Centre for Sport and Exercise Medicine, Chelsea School Research Centre, University of Brighton, United Kingdom.
    Bressan, Elizabeth
    Department of Sport Science, Stellenbosch University, South Africa.
    De Mello, Marco Tuilo
    Medicina e Biologia Do Sono, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
    Tweedy, Sean
    School of Human Movement Studies, University of Queensland, Brisbane, Australia.
    Malone, Laurie
    Lakeshore Foundation, Research and Education, Birmingham, AL, United States.
    Fröjd, Kennet
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports and health. Swedish Development Centre for Disability and Sport.
    Van De Vliet, Peter
    International Paralympic Committee, Bonn, Germany.
    Vanlandewijck, Yves
    Faculty of Kinesiology and Rehabilitation Sciences, Catholique University, Leuven, Belgium.
    Boosting in athletes with high-level spinal cord injury: Knowledge, incidence and attitudes of athletes in paralympic sport2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 26, p. 2172-2190Article in journal (Refereed)
    Abstract [en]

    Autonomic dysreflexia (AD) is unique to individuals with spinal injuries (SCI) at T6 or above and can be voluntarily induced. Although AD improves wheelchair racing performance in some athletes, it also elicits exaggerated blood pressure, which could be dangerous. The International Paralympic Committee considers AD doping and banned its use. Purpose. The purpose of this study is to evaluate AD knowledge, incidence and attitudes (KIA) of Paralympians with SCI. Methods. An existing questionnaire was modified to include questions of AD KIA, validated by three experts and piloted with a small sample. It was administered on-line, mailed to members of a scientific network and distributed during the Beijing Paralympic Games. Fisher Exact test was used to evaluate differences across gender, injury and education. Results. Of 99 participants, 54.5% had previously heard of AD while 39.4% were unaware; 16.7%, all males, had used AD to enhance performance. Participants reported that AD was (1) useful for middle (78.6%) and long distance (71.4%), marathon (64.3%) and wheelchair rugby (64.3%); (2) somewhat dangerous (48.9%), dangerous (21.3%) or very dangerous (25.5%) to health. Results were not influenced by age, injury level or injury duration. Conclusions. Findings indicate the need for educational programmes directed towards enhancing the AD knowledge of rehabilitation professionals, coaches and trainers working with SCI individuals.

  • 204.
    Billberg, Linda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Johansson, Anton
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Luftvägshantering utanför operationsavdelningen, teamdynamik, tillit till sin egen förmåga och psykologisk empowerment – en kvantitativ studie ur anestesisjuksköterskans perspektiv2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Anestesisjuksköterskan ansvarar för omvårdnaden av patienter i en högteknologisk miljö och arbetet sker självständigt med ASA I - II patienter. Anestesisjuksköterskan är en del av det team som ställs inför uppgiften att hantera en ofri luftväg och i en sådan situation är ett väl fungerande samarbete viktigt. Simuleringsträning är effektivt för att förbättra teamarbete och kunskaper. Incidensen av en svårhanterad luftväg är dubbelt så hög hos patienter utanför operationsavdelningen och då blir ett snabbt beslutsfattande viktigt för patientens överlevnad. Syfte: Syftet var att beskriva hur anestesisjuksköterskor skattar teamdynamiken, tillit till sin egen förmåga och psykologisk empowerment i en klinisk situation med ofri luftväg utanför operationsavdelningen. Ytterligare ett syfte var att undersöka samband mellan självskattningar av teamdynamik, tillit till sin egen förmåga och psykologisk empowerment. Metod: Ett frågeformulär angående teamdynamik, tillit till sin egen förmåga samt psykologisk empowerment delades ut till anestesisjuksköterskor på två sjukhus i Mellansverige. Frågeställningarna besvarades med deskriptiv statistik och Spearmans korrelation. Huvudresultat: Teamdynamiken och tilliten till sin egen förmåga vid en ofri luftväg utanför operationsavdelningen skattades högt av anestesisjuksköterskorna. Det fanns samband mellan teamdynamik, tillit till sin egen förmåga och psykologisk empowerment. Slutsats: Anestesisjuksköterskorna skattade att teamarbetet fungerar bra vid händelse av ofri luftväg utanför operationsavdelningen med en förbättringspotential kring kommunikationen i teamet. Simuleringsträning skattades som ett viktigt verktyg i att öva färdigheter och därmed rekommenderar författarna att simuleringsträning och utbildning i standardiserade kommunikationsmetoder kontinuerligt erbjuds för anestesisjuksköterskor.

  • 205.
    Billingsley, Jennifer
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjuksköterskors upplevelse av att vårda människor med depression: En beskrivande litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Depression is a mental illness that relapses and is different from person to person in how long it lasts and how serious the depression is considered. For each new relapse a person has the risk of future relapses increased which can become more serious and more difficult to recover from. Considering that depression is a common disorder that is becoming more common, there is no place in health care where a nurse will not meet these people.

     

    Aim: To describe how nurses experience caring for people who have depression. The aim is also to describe the study groups of the selected articles.

     

    Design: A descriptive study of literature.

     

    Findings: Nurses felt confident in recognizing symptoms of depression, but many depressions remained undiagnosed and untreated. Frustration towards the disease and its treatment were experienced since there was no time or the right knowledge to be able to handle depressed patients. The desire to learn more and be empathetic to the needs of patients was present which supported the need for a good relationship between the nurse and the patient. There was a dominance of women in the 10 selected articles. Everything from newly hired nurses to nurses who've worked for several years participated although most of them were middle-aged.

     

    Conclusion: Nurses are experiencing frustration and powerlessness when they care for people with depression, which leads to the feeling of stigmatization and poor relationships between nurse and patient. The desire to become better at recognizing depression and be a support for people with the disease exists, but the lack of time, knowledge and communication makes nurses feel insecure in their role as caregivers.

  • 206.
    Billmark Elfstrand, Kristina
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Patientutbildning för personer med typ 2 diabetes. En kartläggning inom primärvården i Sverige2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Patient education is an important part of the treatment in type 2 diabetes. Today there is no collected survey of patient education. The aim of the study was to survey how patient education for persons with type 2 diabetes was carried out within the primary care in Sweden and study if there was some relation between how patient education was carried out and persons' HbA1c, BMI and physical activates. Totally 684 health care centres participated. Data was received from a questionnaire and the national diabetes register that covered 91637 patients with type 2 diabetes. Data was analyzed through qualitative content analysis and with multiple linear regression analysis. The result showed that most common form of education was "Patient education with a predestined content", that was practiced individually in 362 of the health care centres, 108 of these also practiced complementary group education.  "Patient education based on the patients needs" was carried out individually at 55 health care centres, 12 were also carried out complementary group education. "Unspecified patient education" was practiced in 267 health care centres. A statistical significant relation was found indicating that patients  receiving individual education based on the patient's needs HbA1c was lower (55 health care centres). The most common procedure was a checklist in which the care provider decided what the patient needed to know.  Most of the care providers in patient education disregarded the patient's needs and interest.

  • 207.
    Birath, Diana
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Olsson Kalmering, Katarina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Humor i vårdmötet- skämtar du eller?: en litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 208.
    Bjerén, Rasmus
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Brelin, Andreas
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Ambulanspersonals följsamhet till basala hygienrutiner: En observationsstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: According to the Swedish National Board of Health and Welfare, compliance to hygiene routines is important to prevent healthcare-associated infections (HCAI). HCAI are a threat to patient safety and may increase patient suffering and costs for the society.

    Aim: To describe compliance to hygiene routines within ambulance care in a number of given situations.

    Method: A descriptive quantitative study with data collection through structured observation. Convenience sampling was used and 68 observations in total were made on two ambulance stations.

    Main result: Varying compliance to hygiene routines was found, with highest compliance to the routine stating that hair should be short or up (87%) and the routine about use of gloves (87%). The lowest compliance was found to the routine about hand disinfection before patient contact or glove use (1%). No observation showed compliance to all seven hygiene routines covered by the study.

    Conclusion: That compliance with hygiene routines has shortcomings, especially regarding hand disinfection, which may lead to weak patient safety through a risk of HCAI and patient suffering. The shortcomings are probably grounded both on an individual and an organisational level which makes discussion of the subject in affected organisations and further studies important.

  • 209.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies.
    Palmeby, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies.
    Vårdrelationens innebörd för patienter inom psykiatrisk tvångsvård: en litteraturstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    It is the nurse's responsibility to establish a caring relationship in which the patient feels safe, therefore it was important to highlight the patient's own perception of the caring relationship and what it means to caring. The aim of this study was to investigate the meaning of the caring relationship for adult patients in compulsory psychiatric treatment. The study was a literature review with qualitative and descriptive design. The search for scientific articles was done by the databases in Cinahl and PubMed with the keywords psychiatric care, caring relationship, coercion, and patient experiences. The selected articles were quality reviewed and then a content analysis of the manifest content was made which resulted in six categories: to feel disregarded loss of dignity, powerlessness, to be taken seriously, humanity and participation. Thereafter, an interpretation of the manifest content, i.e. a latent content analysis was made. Two themes were discerned: one-sidedness and mutuality. Patients described either that they experienced a distance from the health personal or that they responded to them on an equal plane. Since patients are in a dependent position in compulsory psychiatric treatment relationship becomes uneven (asymmetrical). A mutual caring relationship can be seen as a moral standard that paves the way for the establishment of a community.

  • 210.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Westerberg Jacobson, Josefin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Women with disturbed eating behavior rate less work engagement2016Conference paper (Refereed)
    Abstract [en]

    There is a lack of research exploring emotional commitment to work in relation to eating attitudes. Since eating disorders are associated with adverse psychological and social consequences, work engagement could be affected. The purpose was to compare work engagement among women with and without disturbed eating (DE).

    A cross-sectional survey using the Utrecht Work Engagement Scale and the Eating Disorder Examination Questionnaire in a general population cohort of 26-36-year-old women (n=847). Threshold for DE was 1 SD above general population mean. Independent t-test was used to compare work engagement. Ethical approval (reg no:2014/401)

    The level of work engagement was lower (p=0.02) among women with DE (mean 3.69 +-1.43) than women without DE (mean 4.06 +-1.18). The score for dedication was also lower (p=0.02) within the DE group (mean 3.74+-1.57 vs 4.22 +-1.26). However, vigour and absorption were not different.

    The work engagement in the cohort was within the average range although women with DE had significantly lower emotional commitment to work. As work engagement is linked to business success, workplace growth and sustainability it seems important to explore tailored strategies to improve work engagement among women with DE.

  • 211.
    Bjurbo, Charlotte
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Eriksson, Ulrika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Att befinna sig i ett ingenmansland på en akutmottagning och ändå känna tillit till akutsjukvården: En kvalitativ intervjustudie med sköra äldre patienter2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    The full text will be freely available from 2020-12-31 18:25
  • 212.
    Bjurlefält, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Erfarenhet av debriefing inom akutsjukvården.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background:

    In our everyday lives worldwide, people are affected regardless of gender and age by accidents, deaths and other traumatic events. Some professions involve a greater risk of being exposed to traumatic events. Examples of these are ambulance, emergency personnel, police and health care personnel, primarily in emergency care. These events can sometimes become overpowering. One way to counteract burnout and post-traumatic stress symptom (PTSD) in healthcare professionals is to carry out debriefing talks. This is done with the healthcare staff who has participated in a traumatic event.

     

    Aim:

    The purpose of this study was to describe the experience of debriefing in healthcare professionals in emergency care in connection with traumatic events in their professional practice.

     

    Method:

    Literature study that contains a total of 10 scientific articles, five of which are qualitative and five are quantitative.

     

    Results:

    The study results show that debriefing is perceived as a positive tool when it comes to unloading after a traumatic event for the healthcare staff in emergency care. The main factors raised in the study are time and place for debriefing, debriefing impact on the communication between the healthcare staff, the choice of debriefing leader and the need for well-designed guidelines for debriefing.

     

    Conclusion:

    The present study demonstrates that debriefing should be regarded as an effective tool for counteracting mental illness in the healthcare staff and that debriefing also reinforces communication between the various professional occupational groups in emergency care. The study also shows that well-designed guidelines are important for achieving the purpose of the debriefing.

  • 213.
    Bjurs, Elisabet
    University of Gävle, Department of Caring Sciences and Sociology.
    Faktorer som patienter, anhöriga och sjuksköterskor anser viktiga i den palliativa vården i hemmet2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The aim of this study was to, on the basis of the literature, give an account of what factors patients, relatives and nurses think is important in the palliative care at home. Searches of scientific articles were done in the databases Pub Med and AcademicSearch- Elite. A limita-tion on the year of 1999 – 2007 was done and various combinations of key words was used on the basis of the words palliative care, nursing at home, caregivers, need a nurse at home, quality of life, rehabilitation and advanced nurse. Exclusion criterions were articles which in-volved children and AIDS-patients. The results exhibitioner that it was a big consensus be-tween patients, relatives and nurses concerning what characteristics of the palliative care at home. The result could categorizes as communication, support, symptom relieve and informa-tion. To allow care at home for patients who be in need of palliative care, demands that nurses have competence within those subject areas so all included will be able to manage that care at home. There is a need of competence development in palliative care for professional carers, all for the patients who chose to be take cared of at home in the palliative phase, that they can have a dignified end as possible.

  • 214.
    Bjursell, Ingrid
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Grönquist, Cecilia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Viktiga omvårdnadsfaktorer av Suicidala unga: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Suicide is today recognized as a big global health problem being one of the most common causes of death among young people in the age range of 15 to 25. In Sweden approximately 150 young persons commit suicide every year.

    Purpose: The purpose of the study was to describe factors of importance in the nursing care of young people with suicidal tendency. The further purpose was to describe the study groups of the selected articles.

    Method: 11 research articles, of both qualitative and quantitative design, where identified for this literature review searching the databases PsycINFO, PubMed and CINAHL. The articles included where reviewed according to Polit and Beck (2016).

    Findings: There is a lack of resources, such as time and knowledge, for nurses in how to respond and treat young people with suicidal tendencies, in order to provide good care. Both patients and nurses testify to the lack of skills. Many patients describe how they perceive it positively when there is someone available to listen to them and take them seriously.

    Conclusion: It is difficult to identify one single factor as the most important in the nursing care of young people with suicidal tendency. It is clear that the factors identified are depending on each other. The nurse should have a non-judging attitude, a holistic approach and should strive to build a trusting relation. It is important with education and reflection to increase the nurse’s skills and with an adapted environment. Further factors of importance in the nursing care of young persons with suicidal tendency are time and suicide screening.

  • 215.
    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.

  • 216.
    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)
  • 217.
    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.
    Occupational and Individual Determinants of Work-life Balance among Office Workers with Flexible Work Arrangements2019In: Article in journal (Other academic)
  • 218.
    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.

  • 219.
    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).

  • 220.
    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.

  • 221.
    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.

  • 222.
    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

  • 223.
    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 

  • 224.
    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.

  • 225.
    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.

  • 226. 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)
  • 227.
    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)
  • 228.
    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.

  • 229.
    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

  • 230.
    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.

  • 231.
    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.

  • 232.
    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.

  • 233.
    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.

  • 234.
    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.

  • 235.
    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.

  • 236.
    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.

  • 237.
    Björklund, Victor
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sving, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Att vara patient på akutmottagningen: En beskrivande litteraturstudie2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Akutmottagningen är en plats dit människor söker sig vid akuta besvär, de har öppet dygnet runt, det finns inga schemalagda besök och väntetiderna är långa. Kommunikation är en viktig faktor på en akutmottagning då det används för att leverera omvårdnad och för att samarbeta. Sjuksköterskan på en akutmottagning har en hög arbetsbelastning och besitter breda kunskaper för att leverera vård till de varierande sjukdomarna som förekommer. Man vet att vara patient på ett sjukhus kan innebära ett förlorat egenvärde och hopplöshet däremot finns det lite studier på hur det är att vara patient på en akutmottagning.

  • 238.
    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.
    Andersson, Kajsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Bergström, Jenny
    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. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Increased Mental Illness and the Challenges This Brings for District Nurses in Primary Care Settings2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 12, p. 1023-1030Article in journal (Refereed)
    Abstract [en]

    Patients with mental illness generally make their initial healthcare contact via a registered nurse. Although studies show that encountering and providing care to care-seekers with mental illness might be a challenge, little research exists regarding Primary Care Nurses' (PCN) view of the challenges they face. The aim of this study was to qualitatively explore PCNs' reflections on encountering care-seekers with mental illness in primary healthcare settings. The results consist of three themes: constantly experiencing patients falling through the cracks, being restricted by lack of knowledge and resources, and establishing a trustful relationship to overcome taboo, shame, and guilt.

  • 239.
    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. 

  • 240.
    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.

  • 241.
    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.

  • 242.
    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.

  • 243.
    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.

  • 244.
    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.

  • 245.
    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. 

  • 246.
    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.

  • 247.
    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.

  • 248.
    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.

  • 249.
    Blad, Linda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Forslin, Daniel
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Intensivvårds- och anestesisjuksköterskors upplevelser av sin arbetsmiljö vid ett sjukhus som saknar akutkirurgi - en intervjustudie2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Hospital care is changing and the requirements for specialist nurses are changing. The amount of patient transports from smaller hospitals are increasing and the routes are longer. The experience of the nurses work environment has proved to be important, not least with regard to the experience of patient safety. 

    Aim: To describe how intensive care and anesthesia nurses experience working in a hospital without emergency surgery, from a work environment perspective. 

    Method: The study had a qualitative approach with descriptive design. 11 semi-structured interviews were conducted with intensive care nurses (n = 6) and anesthetic nurses (n = 5). The interviews were analyzed with qualitative content analysis. 

    Main results: Through the analysis six categories emerged. 1. To experience the importance of following guidelines 2. That collaboration and personal knowledge within the hospital facilitates the workload 3. Experience of the current assignment 4. To see the importance of nearby care 5. The cooperation with other hospitals and 6. Experience of access to resources and competence. The anesthetic and intensive care nurses experienced that it was important to follow guidelines. The fact that collaboration and personal knowledge within the hospital can facilitate the workload was another experience that was described. They experienced a satisfaction with the current assignment, although a desire to get extended assignments was described. The importance of having nearby care was described and the distance to the nearest emergency hospital was described as a problem. The collaboration with other hospitals was sometimes described to work well and sometimes a struggle preceded the collaboration. The experience of access to resources and skills was described and it emerged that the lack of resources could create frustration. 

    Conclusion: Positive experience of current assignments. In emergency situations where severely injured or sick patients entered the hospital, frustration was experienced with the lack of resources that existed.

    Keywords: Intensive Care Nurse, Nurse anesthetist, Work Environment

  • 250.
    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.

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