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  • 201.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Are nurses superfluous in PICUs?2015Ingår i: Journal of Psychiatric Intensive Care, ISSN 1742-6464, E-ISSN 1744-2206, Vol. 11, nr s1, artikel-id e4Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Comments on an article What are PICUs for? by Len Bowers (2012). Len Bowers held that traditional psychiatric intensive care units (PICUs) are under threat due to organisational changes in the health care system. In addition, PICUs are often assessed when exploring cost-cutting measures, since a traditional 10-bed PICU is almost never occupied by ten patients with a need for PICU environment. The author argues that developing a PICU cultural-specific language and teaching nurses to become more self-reflective in their roles in the PICU care culture may not only justify the existence of PICU; it may also shift the view of PICU as a whole, from being 'the punitive ward' to becoming 'the elite ward' where competence flourishes.

  • 202.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Fra rigiditet til fleksibilitet2015Konferensbidrag (Övrigt vetenskapligt)
  • 203.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
    Limiting patients as a nursing practice in psychiatric intensive care units to ensure safety and gain control2015Ingår i: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, Vol. 51, nr 4, s. 241-252Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    The aim of this study was to describe how the limitation of patients is being practiced in psychiatric intensive care units.

    Design and Methods

    A focused ethnographic methodology was applied. To gather data, the author conducted fieldwork involving participant observation.

    Findings

    The results of the study are presented in two categories, which describe the limited access patients had to items and in the ward environments.

    Practice Implications

    It is advisable for practitioners to critically reflect upon local regulations and policies related to the practice of limiting patients during the worst phase of their mental illness.

  • 204.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Mental health nurses’ use of Twitter for professional purposes during conference participation #acmhn20162018Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 2, s. 804-813Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Scholars across different disciplines use Twitter to promote research and to communicate with society. Most conferences nowadays have their unique hashtag in which participants can communicate in real time. Previous research has reported on conference participants' use of Twitter, but no such studies are available in the field of mental health nursing. Thus, the explicit aim of the present study was to examine conference participants' use of Twitter during the 42nd International Mental Health Nursing Conference. Freely-accessible data were mined via a social media platform under the hashtag #acmhn2016. The total dataset consisted of 1973 tweets, and was analysed with descriptive statistics and a directed content analysis. The results demonstrated that 37% of the tweets were original posts, and 63% were engagements. In total, 184 individual accounts engaged in Twitter during the conference, and 16.4 tweets were posted hourly. Most tweets were categorized as conference/session-related content, but Twitter was also used for socializing with other participants. The most frequently-used words mirror a clear connection to a person-centred approach, and deviate from the biomedical terminology. However, not all of the conference participants engaged on Twitter, and might thereby risk being excluded from this backchannel.

  • 205.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Moral mindfulness: ethical concerns in the work life of health care professionals in a psychiatric intensive care unit2018Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 6, s. 1851-1860Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Healthcare professionals working on inpatient wards face the externalizing or challenging behaviour of the patients who are admitted. Ethical values and principles in psychiatric nursing have been reported to be important when approaching patients during the most acute phase of deterioration in their mental health. Hence, the aim of this study was to discover and describe staff members' ethical and moral concerns about their work as healthcare professionals in a psychiatric intensive care unit. The study has a qualitative descriptive design and makes use of Framework Analysis. Registered nurses and psychiatric aides in a psychiatric intensive care unit in Sweden were observed during ethical reflection meetings. Four to six staff attended the 90-min meetings. The data comprise observations from six meetings, which provided 94 pages of text. The results demonstrate that the work was described as being both motivating and exhausting. The staff faced ethical concerns in their daily work, as patients often demonstrated challenging behaviours. Three themes were identified as follows: (i) concerns about the staff impacting on patients' experience of care, (ii) concerns about establishing a safe working environment, and (iii) concerns about becoming unprofessional due to expectations and a high workload. Ethical concerns included simultaneously taking into account both the patients' dignity and safety aspects, while also being exposed to high workloads. These elements of work are theorized as influencing complex psychiatric nursing. If we are to bring these influential factors to light in the workplace, advanced nursing practice must be grounded in moral mindfulness.

  • 206.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Omvårdnad i intensiv- och akutpsykiatri - ta del av senaste forskningen och utveckla ditt bemötande och förhållningssätt!2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    • Akut omvårdnad – ta del av konkreta åtgärder att ta till i olika situationer

    • Hur kan du arbeta för att reducera tvångsåtgärder?

    • Hur bemöter och hanterar du olika tillstånd – ta del av olika exempel!

    • Att skapa en hållbar relation genom flexibilitet

  • 207.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Space invaders: A netnographic study of how artefacts in nursing home environments exercise disciplining structures2016Ingår i: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 23, nr 2, s. 138-147Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aims to present culturally situated artefacts as depicted in nursing home environments and to analyze the underlying understandings of disciplining structures that are manifested in these kinds of places. Our personal geographies are often taken for granted, but when moving to a nursing home, geographies are glaringly rearranged. The study design is archival and cross-sectional observational, and the data is comprised of 38 photos and 13 videos showing environments from nursing homes. The analysis was inspired by the methodological steps in Roper’s and Shapira’s description of conducting an ethnography. The results are presented in four categories: 1) public areas, 2) orderliness, 3) staff’s places and 4) devices. The rearrangement of geography implies a degrading of agency and loss of authority over one’s place. The places should be understood in their relation to the agents and their temporarily claims upon them. The material and immaterial artefacts, that is the items, people and behaviours, transform the nursing staff into “space invaders”. Future inquiries may take into consideration the ways that space invasion in participative space intersect and construct the identities of the agents it invades upon.

  • 208.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Spice up your life: virtual communication on the experiences from using synthetic cannabinoids2016Ingår i: Sestrinski glasnik/Nursing Journal, ISSN 1331-7563, Vol. 21, nr 2, s. 112-116Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The body of evidence about synthetic cannabinoids and their harmful physiological and psychological effects is increasing due to laboratory research and clinical case reports. However, little attention in research has been paid to users’ perceived intoxication experiences. Therefore, the insider perspective is accounted in this paper. Purpose: The study aims to explore and describe anecdotal communication about “spice”, a synthetic cannabinoid, among users. Methods: A netnographic methodology was applied using data from forum discussions. Results: The findings are presented in two categories: 1th) communication sharing experience-based knowledge from intoxication and 2nd) communication sharing attitudes, norms and values. The analysis that follows posits that there is near-consensus among the posters (users who has submitted a message) that synthetic cannabinoids are associated with negative experiences and should be avoided. Conclusions: The performativity of interactivity may be pivotal in helping frightened users make sense of their experiences. Therefore, a platform for communication among Spice users has important intrinsic value.

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  • 209.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Talking about “the problematic patient” does not benefit recovery2016Ingår i: SESTRINSKI GLASNIK / Nursing Journal, ISSN 1331-7563, Vol. 21, s. 82-Artikel i tidskrift (Refereegranskat)
  • 210.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Using focused ethnography to explore and describe the process of nurses' shift reports in a psychiatric intensive care unit2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 15-16, s. 3104-3114Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore and describe the cultural routine of shift reports among nursing staff in a psychiatric intensive care unit, and further to develop a taxonomic, thematic and theoretical understanding of the process.

    BACKGROUND: Lack of communication among healthcare staff is associated with risks for medical errors. Thus, handovers and shift reports are an essential and integral routine among nurses in order to pass on information about the patients' health status. Previous studies within the field have highlighted the benefits of structured reporting tools. However, shift reports as a cultural activity within the nursing tradition have been given less attention, not the least in psychiatric care.

    METHODS: Focused ethnography was used. The data comprised 20 observational sessions. The observations ranged over a time span of 5 months and were conducted in a psychiatric intensive care unit in Sweden.

    RESULTS: The process of shift reports encompassed the following three phases: 1) getting settled, 2) giving the report and 3) engaging in the aftermath. The results demonstrate that the phases entails different cultural activities, which take place in different areas of the ward and that the level of formality varied.

    CONCLUSIONS: Shift reports are not an isolated event with clear boundaries. The study enriches the understanding of shift reports as a 'fuzzy process'. The individual phases were found to be tied to cultural connotations, such as activities, places and roles with certain meanings for staff members.

    RELEVANCE TO CLINICAL PRACTICE: The new insights are useful for nurses in overcoming an uncritical adoption of the biomedical tradition regarding pace and tone during shift reports. The reporting nurse has the potential to transform shift reports from a monologue with a foreclosed style to a more dialogical interaction with colleagues that focuses on the patients' needs rather than the needs of staff.

  • 211.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Using participatory action research to develop a work model that enhances psychiatric nurses' professionalism: the architecture of stability2017Ingår i: Administration and Policy in Mental Health, ISSN 0894-587X, E-ISSN 1573-3289, Vol. 44, nr 6, s. 888-903Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Ward rules in psychiatric care aim to promote safety for both patients and staff. Simultaneously, ward rules are associated with increased patient violence, leading to neither a safe work environment nor a safe caring environment. Although ward rules are routinely used, few studies have explicitly accounted for their impact. To describe the process of a team development project considering ward rule issues, and to develop a working model to empower staff in their daily in-patient psychiatric nursing practices. The design of this study is explorative and descriptive. Participatory action research methodology was applied to understand ward rules. Data consists of audiorecorded group discussions, observations and field notes, together creating a data set of 556 text pages. More than 100 specific ward rules were identified. In this process, the word rules was relinquished in favor of adopting the term principles, since rules are inconsistent with a caring ideology. A linguistic transition led to the development of a framework embracing the (1) Principle of Safety, (2) Principle of Structure and (3) Principle of Interplay. The principles were linked to normative guidelines and applied ethical theories: deontology, consequentialism and ethics of care. The work model reminded staff about the principles, empowered their professional decision-making, decreased collegial conflicts because of increased acceptance for individual decisions, and, in general, improved well-being at work. Furthermore, the work model also empowered staff to find support for their decisions based on principles that are grounded in the ethics of totality.

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  • 212.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Virtual communication about psychiatric intensive care units: social actor representatives claim space on Twitter2017Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 26, nr 4, s. 366-374Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Psychiatric intensive care units (PICU) provide care for those with the worst phases of mental illness. What defines a PICU is often decided locally at hospitals. The aim of the present study was to explore and describe a contemporary discourse on how PICU are socially constructed from virtual discussions. An explorative and descriptive study design was applied for this qualitative inquiry using discourse methodology. The data were collected in Twitter's search string and consists of 215 Twitter postings. A framework of social actor representatives that form the discourse was established and presented in three categories: (i) hospital and agencies communicating about PICU; (ii) health-care professionals communicating about PICU; and (iii) service users and relatives communicating about PICU. Hospitals, agencies, and health-care professionals hold great power and responsibility for informing the public about PICU. 

  • 213.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Work life and family life collide: new fathers seek online support about concerns related to parental leave2017Ingår i: Workplace Health & Safety, ISSN 2165-0799, Vol. 65, nr 6, s. 248-252Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this investigation was to analyze online discussions about parental leave in relation to the work lives and private lives of new fathers. A netnographic study of nearly 100 discussion threads from a freely accessible online forum for fathers was conducted.  Data were coded, sorted and categorized by qualitative similarities and differences. The results of the study indicate that new fathers seek Internet forums to discuss work-related topics. Parental leave can provoke worries and anxiety related to management and co-worker attitudes which can provoke concern that they should be back at work. The results are presented in two categories: (1) Attitudes expressed by employers and colleagues, and (2) Leaving work but longing to be back.  The phenomenon of parental leave for fathers is more complex than simply “for” or “against” attitudes. Fathers can use Internet forums to discuss their experiences, fears and anxiety and provide reasonable accommodations for both work and family life. 

  • 214.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Bjuhr, Marie
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Developing, Implementing, and Evaluating the Educational Module Students Active Learning via Internet Observations (SALIO) in Undergraduate Nursing Education2017Ingår i: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, Vol. 53, nr 2, s. 104-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    This study aimed not only to describe the development and implementation of the module but also to evaluate the nursing students' perceptions.

    Design and Methods

    A cross-sectional design including 101 students who were asked to participate and answer a survey. We describe the development of the pedagogic module Students Active Learning via Internet Observations based on situated learning.

    Findings

    The findings show that learning about service users' own lived experiences via web-based platforms was instructive according to the students: 81% agreed to a high or very high degree. Another important finding was that 96% of students responded that the module had clinical relevance for nursing work.

    Practice Implications

    We argue that learning that engages students with data that are contextually and culturally situated is important for developing competence in caregiving.

  • 215.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Björkman, Annica
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Mental illness in the population is increasing: a challenge for telephone advice nurses2017Ingår i: Journal of social service research, ISSN 0148-8376, E-ISSN 1540-7314, Vol. 43, nr 3, s. 432-432Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mental illness is a term that includes everything from mild symptoms of anxiety and depression to more serious mental illnesses such as schizophrenia, depression, and suicide. Reports indicate a negative trend, where rates of mental illness in the population are increasing, especially among children and adolescents and among the elderly. This negative trend in Swedish society requires not only preventive measures to stem the negative trend but also ongoing community resources to assist, support, and advise people with mental illness who seek care.

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  • 216.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Dahlén, Jeanette
    Child and Adolescent Psychiatry Outpatient Clinic, Stockholm County Council, Stockholm, Sweden; Ersta Sköndal University College, Institution for Caring Science, Stockholm, Sweden.
    Nurses' establishment of health promoting relationships: a descriptive synthesis of anorexia nervosa research2017Ingår i: Journal of Child and Family Studies, ISSN 1062-1024, E-ISSN 1573-2843, Vol. 26, nr 1Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Qualitative values that address personal and interpersonal dimensions are often overlooked in research that examines mental well-being among young patients with anorexia nervosa. The aim of this study was to identify and describe factors that promote and impede the relationships between nurses and the children, adolescents and young adults who are diagnosed with anorexia nervosa and also to explore and describe how those relationships benefit the patients' processes toward increased health and well-being. A descriptive literature synthesis was conducted following the four steps as described by Evans. The three databases Cinahl, PsycINFO and PubMed were used to search for qualitative articles. Fourteen articles met the criteria for inclusion and were analyzed. Key findings were identified, and categories and themes were formulated and compared across the studies. Four themes are presented in the results: 1) The essentials in a relationship; 2) The person at the centre, 3) The nurses' attitudes; and 4) Knowledge. In addition to the contribution to the knowledge of how anorexia is manifested, our findings demonstrate the necessity for nurses to be person-centred in their relationships with patients and to have attitudes characterised by presence, genuine commitment and motivation. Nurses are more likely to convey a sense of trust and safety when they communicate with openness and honesty. Our study suggests that the motivation for patients to adhere to treatment is likely to increase when nurses approach patients with these characteristics and attitudes. We argue that the findings are relevant for nurses in their everyday practices.

  • 217.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Department of nursing and care, The Swedish red cross university college, Stockholm, Sweden.
    A descriptive statistical analysis of volume, visibility and attitudes regarding nursing and care robots in social media2018Ingår i: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 54, nr 1 (SI), s. 88-96Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Technology in the healthcare sector is undergoing rapid development. One of the most prominent areas of healthcare in which robots are implemented is nursing homes. However, nursing and technology are often considered as being contradictory, an attitude originating in the view of ?the natural? versus ?the artificial?. Social media mirror this view, including in attitudes and societal debates regarding nursing and care robots. However, little is known about this topic in previous research. Objectives: To examine user behaviour in social media platforms on the topic of nursing and care robots. Design: A retrospective and cross-sectional observation study design was applied. Methods: Data were collected via the Alchemy streaming application programming interface. Data from social media were collected from 1 January 2014 to 5 January 2016. The data set consisted of 12,311 mentions in total. Results: Nursing and care robots are a small-scale topic of discussion in social media. Twitter was found to be the largest channel in terms of volume, followed by Tumblr. News channels had the highest percentage of visibility, while forums and Tumblr had the least. It was found in the data that 67.9% of the mentions were positive, 24.4% were negative and 7.8% were neutral. Discussion: The volume and visibility of the data on nursing robots found in social media, as well as the attitudes to nursing robots found there, indicate that nursing care robots, which are seen as representing a next step in technological development in healthcare, are a topic on the rise in social media. These findings are likely to be related to the idea that nursing care robots are on the breakthrough of replacing human labour in healthcare worldwide.

  • 218.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Department of Nursing and Care, The Swedish Red Cross University College, Stockholm, Sweden.
    Absorbability, applicability and availability in nursing and care robots: A thematic analysis of Twitter postings2018Ingår i: Telematics and informatics, ISSN 0736-5853, E-ISSN 1879-324X, Vol. 35, nr 5, s. 1553-1560Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nursing and care robots (NCR) have become an important technological innovation in various areas in the medical discipline. Previous studies have found that implementation of robots in healthcare is both associated with positive and negative attitudes. This study aims to improve the understanding of the general public's communication about nursing and care robots through analyzing the content of posts in social media. An advanced social intelligence platform was used to mine Twitter content. From the platform, data were collected historically. An archival and cross-sectional observational study was conducted online. The data set comprising of 5954 tweets were thematically analyzed. Tweets under the theme of absorbability show that nursing and care robots are considered to be a part of users’ lives, either now or sometime in the future for Twitter users, and the topic is tackled as a fact but with humor, skepticism and enthusiasm. Tweets falling under applicability show that potential nursing and care robots usage covers a range of arenas in everyday life. Results thematized as availability show sincere concern about how the accessibility of nursing and care robots in everyday life will affect costs and other economic aspects, both on a global and an individual level as well as on micro and macro levels of economies. Twitter offers a window into attitudes and ideas as well as fundamental beliefs and practices. Thus, monitoring Twitter discussions on social media can provide valuable insights into current attitudes as well as forecasting coming trends. The data includes information about Twitter users’ anxious relationships with nursing and care robots. We raise important questions about the nature of nursing and care robots and their implementations, both in health care but also in everyday living.

  • 219.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Röda Korsets Högskola.
    Empatiska robotar förändrar vårdvetenskapen2015Ingår i: Vårdfokus, ISSN 2000-5717, Vol. 12, s. 26-27Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Vi vill lyfta fram en till synes uppenbar 
vårdvetenskaplig paradox, den 
empatiska roboten, och vad en sådan paradox kan vara bra för.

  • 220.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Röda Korsets Högskola, Sweden.
    Forskningsdata från cyberrymden: analys och vägledning utifrån vårdvetenskaplig kunskapsteori [Research data from Cyberspace: Analyses and guidelines from caring science epistemology]2015Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, nr 2, s. 91-97Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim was to identify how ethical issues have been handled in theses written by undergraduate students in the field.

    Background: The act of gathering information online to become an ‘‘expert’’ by locating useful advice for oneself – and others - is a fairly new phenomenon. How virtual caring and nursing can contribute to people’s health as a resource is growing as an area of interest within the field of caring sciences. 

    Methods: A qualitative content analysis of 21 bachelor theses in nursing science was conducted. The analysis focused on how ethical issues concerning gathering data in cyberspace werehandled.

    Findings: The results show that the students chose very complex health issues when gathering data in cyberspace. The results reveal asymmetries between the researcher and subjects behind the data (the bloggers), both in terms of knowledge as well as in relation to the resources available to them.

    Conclusions: There is a need to discuss cyberspace as a source of data, including ethical, ontological, and epistemological issues. Based on the findings we provide a tentative outline of how data from cyberspace can be used by nursing researchers and instructors at all levels in the field.

  • 221.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Department of Health Sciences, The Swedish Red Cross University College, Stockholm, Sweden.
    PhD students' presenting, staging and announcing their educational status - An analysis of shared images in social media2018Ingår i: Computers and education, ISSN 0360-1315, E-ISSN 1873-782X, Vol. 116, s. 237-243Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Little research has been conducted on the question of academics' use of social media. The effects of social media on the educational environment of postgraduate students need to be further explored. The purpose of this study was to investigate the underlying values and ideas of being in postgraduate education by analysing 176 posted photos on social media. The findings show that PhD students manifest their educational status by presenting themselves as being in a process, staging academic artefacts and announcing important achievements towards the goal of earning their degree. These activities represent a global understanding of being a PhD student, that exists regardless of nation, gender or ethnicity and as such represents a “meta curricula” that exists above and beyond any locally defined PhD syllabus. It should be considered that the constant mirroring of PhD student life that has been made possible via social platforms seems to gain in importance and that the enculturation into the academic culture that exists among postgraduate students' own activities on social media needs to be taken into account when addressing postgraduate education, in practice as well as in research. © 2017 Elsevier Ltd

  • 222.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Department of Nursing and Care, The Swedish Red Cross University College.
    Prosperity of nursing care robots: an imperative for the development of new infrastructure and competence for health professions in geriatric care2017Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, nr 6, s. 486-488Artikel i tidskrift (Refereegranskat)
  • 223.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    The Swedish Red Cross University College, Stockholm, Sweden.
    Tech-resistance: the complexity of implementing nursing robots in healthcare workplaces2016Ingår i: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 52, nr 5, s. 567-568Artikel i tidskrift (Refereegranskat)
  • 224.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Eriksson, Henrik
    Röda Korsets Högskola.
    The rise of the avatar: virtual dimensions of 'the human' in nursing science2015Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, nr 3, s. 158-164Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this theory article, we discuss the virtual dimensions of the human, the avatar, in relation to ontological assumptions within nursing science. Assumptions in nursing science promote a ‘wholistic’ perspective of the human in terms of body, mind and spirit in relation to the environment. However, due to the enhanced technological development and the invention of cyberspace, we pose the critical question of whether the virtual dimension of identity really implicates a ‘wholistic’ view of human kindness or if this has been neglected. Furthermore, we suggest an ontological understanding that grasps new dimensions of humanity. In the article, we discuss the virtual dimensions of the human in relation to ontological assumptions within nursing science under the three headings of The techno-self and virtual identitiesTechno-therapy and cyber nursing, and Becoming homo technicus. Due to these reflections, this article contributes to the debate on a postmodern understanding of human living conditions in society. We suggest further theoretical discussions to explore the conceptual and theoretical levels of nursing knowledge as new realities of human existence are introduced in the field. The transition into the digital age of the Internet, with the existence of cyborgs and avatars, is an ontological and epistemological challenge for nursing science that needs to be further investigated.

  • 225.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Hiçdurmaz, Duygu
    Hacettepe University Faculty of Nursing, Ankara, Turkey.
    Use of social media among individuals who suffer from post-traumatic stress: a qualitative analysis of narratives2017Ingår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, nr 2, s. 285-294Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Suffering from post-traumatic stress impacts and restricts the life situation of the individual on several levels, not least regarding social difficulties. Social media on the Internet facilitate new possibilities for interaction and communication. Earlier research has demonstrated that people use social media to seek support and to discuss health-related issues. The current study aimed to describe how individuals suffering from post-traumatic stress use social media to convey authentic narratives of their daily lives, including illness, and further, to analyze the content of this media use. The data comprised YouTube videos, blogs, and forum discussions. Five categories cover the findings: (a) structure of the narrative, (b) narrating the trauma, (c) restrictions in life, (d) strategies in everyday living, and (e) online interaction. We stress that sharing narratives online facilitates a "verbalizing" of the life conditions of the sufferers and can be used as a self-care activity.

  • 226.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Lagerqvist, Linda
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap.
    Pousette, Sandra
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap.
    Keep calm and have a good night: nurses' strategies to promote inpatients' sleep in the hospital environment2016Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 2, s. 356-364Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patients in the hospital environment are suffering from disrupted sleep, which adversely affects their recovery process, health and well-being. The aim of this study was to explore nurses' experiences and their strategies to promote inpatients' sleep. An empirical qualitative design was applied. Eight nurses at a hospital in Sweden were purposefully selected to be included in semi-structured interviews. Burnard's method for inductively analysing interview transcripts was applied. The findings are presented in four categories: (i) prevention and planning as a sleep-promoting nursing strategy; (ii) adaptation of the environment as a sleep-promoting nursing strategy; (iii) use of drugs as a sleep-promoting nursing strategy; and (iv) caring conversation as a sleep-promoting nursing strategy. Using strategies to promote sleep is important as it affects the recovery of the patients. We argue for the use of simple strategies of sensory reduction as cost-effective sleep-promoting measures that also reduce the use of sedative drugs.

  • 227.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Rydlo, Cecilia
    School of Health, Care and Social Welfare, University of Mälardalen, Västerås, Sweden.
    Wiklund Gustin, Lena
    School of Health, Care and Social Welfare, University of Mälardalen, Västerås, Sweden; Department of Health and Care Sciences, UiT/The Arctic University of Norway, Campus Narvik, Norway.
    Getting to know the person behind the illness: the significance of interacting with patients hospitalised in forensic psychiatric settings2016Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 9-10, s. 1426-1434Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings.

    BACKGROUND: Relationships between staff and patients in forensic psychiatric settings should be grounded in trust and confidence, and the patients need opportunities for emotional reconciliation. However, relationships can be challenging for nurses, who sometimes distance themselves from patients' expressions of suffering. The role of forensic mental health nurses is nebulous, as are the prescriptives and the implementation of nursing practices.

    DESIGN: Qualitative descriptive design.

    METHODS: In-depth interviews with five nurses who all work in forensic psychiatric settings.

    RESULTS: We present a descriptive analysis of what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. The results are presented in two main categories: (1) getting to know the person behind the illness and (2) making a difference.

    CONCLUSION: Care in forensic psychiatry needs to shift towards a more long-term view of the role of nursing, focusing less on the traditional and stereotypical identity of the productive nurse and more on the care given when nurses slow down and take the time to see the patients as individuals. Establishing trusting relationships with patients in forensic psychiatric settings is viewed as a less oppressive way to control patients and guide them in directions that are preferable for the nurses and for the society.

    RELEVANCE TO CLINICAL PRACTICE: Nurses may use simple strategies in their daily practice such as sitting on the sofa with patients to establish trust. We stress that nurses should abandon policing roles and custodial activities in favour of guiding principles that promote individual recovery, treatment and health-promoting care.

  • 228.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Sjödin, Marie
    Northern Stockholm Psychiatry, Section for Affective Disorders, Inpatient care unit for patients with bipolar disorder, Stockholm, Sweden.
    A narrative meta-synthesis of how people with schizophrenia experience facilitators and barriers in using antipsychotic medication: implications for healthcare professionals2018Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 85, s. 7-18Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It is recognized that people who are diagnosed with schizophrenia often do not fully adhere with their antipsychotic prescription. The vast majority of previous research on the topic of medical adherence is limited to quantitative research methods, and in particular, to determining correlations.

    OBJECTIVES: The present review was designed to describe how people who are diagnosed with schizophrenia experience and narrate pharmacological treatment with antipsychotic medication.

    DESIGN: A narrative meta-synthesis.

    DATA SOURCES/REVIEW METHOD: A search was conducted in three databases, PubMed, CINAHL and PsycINFO, to identify qualitative original research. Nine articles met the criteria for inclusion and were subjected to a qualitative interpretive meta-synthesis.

    RESULTS: The findings showed that patients were uninformed about medication but valued talks about medication with professionals. The findings also demonstrated that patients are motivated to take medication in order to gain stability in their life and to be able to participate in life activities and in relationships. Good support, both from relatives and professionals, also motivates them to continue taking medication. The obstacles were side-effects, pressure and compulsion, and rigid organizations.

    CONCLUSIONS: We advise professionals to adopt a person-centered approach to healthcare when encountering these patients and to transform the language used to describe patients from terms denoting compliance and adherence to terms denoting cooperation and alliance. Labeling patients as compliant or non-adherent may risk fortifying preconception of patients as static beings and obscure the patients' individual recovery process.

  • 229.
    Salzmann-Erikson, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Söderqvist, Cecilia
    School of Health, Care and Social Welfare, University of Mälardalen, Västerås, Sweden; Centre for Clinical Research, Västmanland County Hospital, Västerås, Sweden .
    Being subject to restrictions, limitations and disciplining: a thematic analysis of individuals’ experiences in psychiatric intensive care2017Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 38, nr 7, s. 540-548Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe individuals' experiences of being hospitalized in psychiatric intensive care units (PICUs). Four participants who had previously been admitted in a PICU were interviewed using open-ended questions. The data were analyzed using thematic analysis. Analysis resulted in a synthesis of the various ways patients experienced limitations: (1) Descriptions of Being Limited in the Environment, (2) Descriptions of being Limited in Interactions with Staff, (3) Descriptions of Being Limited in terms of Access to Information, and (4) Descriptions of Having Limited Freedom and Autonomy. Hospitalization is experienced as a life-changing event that shows a kaleidoscopic view of limitation. We stress that the conceptualization of limitation must be considered due to its historical origins, sociopolitical aspirations, and philosophy of care. Thus, nurse practitioners and nursing leaders are advised to put the patient's experience at the center of care, and to involve and integrate patients throughout the recovery process.

  • 230.
    Sandberg, Charlotte
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Söderlind, Jenny
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Att leva med fibromyalgi: En litteraturstudie2017Självständigt arbete på grundnivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Background: About 2 percent of people in the world suffers from Fibromyalgia, out of them about 80 percent are women. Common symptoms are pain over a long period of time. Why this illness occurs is still unknown. Other characteristic features of this illness is fatigue, soreness and cognitive problems, such as forgetfulness.  

    Aim: The aim of this literature review was to describe the experience of living with fibromyalgia and to describe the method of data collection in the included articles.

    Method: Literature review with descriptive design. 13 qualitative articles were included. The articles were acquired through searches in the databases Cinahl and Medline by PubMed.  

    Main Results: People with fibromyalgia experienced that the pain and fatigue, that their illness caused, changed just about everything in their daily life. Most of them experienced that their psychological well being and social life were affected negatively by the illness. To not be believed or received well by people they met or by healthcare professionals was described as a big problem that happened far too often. This literature review also describe the method of data collection used in the included articles. Eleven out of thirteen articles used interviews as the method for data collection. One article used a questionnaire, and one article used focus group discussion.

    Conclusions: Descriptions of experiences of living with fibromyalgia has shown that it affects these persons on many levels of their life, both physically, psychologically and socially. The pain and fettique hinders them in their day to day life.  They experience that they are not believed or taken seriously in their daily life, nor in the encounters with healthcare professionals. 

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  • 231.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Social Medicine, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Ghaderi, Ata
    epartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Change in Children's Self-Concept, Body-Esteem, and Eating Attitudes Before and 4 Years After Maternal RYGB2018Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 28, nr 10, s. 3276-3283Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: The aim of the present study was to look at longitudinal changes in children's self-concept, body-esteem, and eating attitudes before and 4 years after maternal RYGB surgery.

    METHODS: Sixty-nine women and 81 appurtenant children were recruited from RYGB waiting lists at 5 hospitals in Sweden. Families were visited at home pre-surgery, 9 months, and 4 years post-maternal RYGB to measure BMI. Furthermore, all participating family members completed questionnaires. Mothers' questionnaires measured eating behavior, depression, anxiety, and sleep quality, and children's questionnaires measured body-esteem, self-concept, and eating attitudes.

    RESULTS: Thirty-five/sixty-nine mothers and 43/81 children participated in all 3 measurements. Mothers reduced their BMI from pre-surgery (39.2) to 9 months (27.0) and 4 years post-surgery (27.4). Children's prevalence of overweight/obesity was lower 9 months post-surgery (48.8%) but at the same levels again 4 years post-surgery (58.1%), compared to pre-surgery (58.1%). The same rebound pattern was seen among children's eating attitudes, mothers' symptoms of depression and anxiety, and sleep quality. We found no correlations between mothers' BMI or eating behavior and children's BMI or eating behavior.

    CONCLUSION: Children's prevalence of overweight/obesity and eating attitudes improves soon after their mothers' RYGB, but then return to pre-surgery levels at 4 years post-surgery, as do mothers' sleep quality and symptoms of depression and anxiety, even though their weight loss was maintained.

  • 232.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Possmark, Sofie
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Ghaderi, Ata
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Näslund, Erik
    Division of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Thorell, Anders
    Department of Clinical Science at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden.
    Sundbom, Magnus
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Uddén, Joanna
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Endocrine and Obesity, Capio st Görans Hospital, Stockholm, Sweden.
    Szabo, Eva
    Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    A dissonance-based intervention for women post roux-en-Y gastric bypass surgery aiming at improving quality of life and physical activity 24 months after surgery: study protocol for a randomized controlled trial2018Ingår i: BMC Surgery, ISSN 1471-2482, E-ISSN 1471-2482, Vol. 18, nr 1, artikel-id 25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery is the most common bariatric procedure in Sweden and results in substantial weight loss. Approximately one year post-surgery weight regain for these patient are common, followed by a decrease in health related quality of life (HRQoL) and physical activity (PA). Our aim is to investigate the effects of a dissonance-based intervention on HRQoL, PA and other health-related behaviors in female RYGB patients 24 months after surgery. We are not aware of any previous RCT that has investigated the effects of a similar intervention targeting health behaviors after RYGB.

    METHODS: The ongoing RCT, the "WELL-GBP"-trial (wellbeing after gastric bypass), is a dissonance-based intervention for female RYGB patients conducted at five hospitals in Sweden. The participants are randomized to either control group receiving usual follow-up care, or to receive an intervention consisting of four group sessions three months post-surgery during which a modified version of the Stice dissonance-based intervention model is used. The sessions are held at the hospitals, and topics discussed are PA, eating behavior, social and intimate relationships. All participants are asked to complete questionnaires measuring HRQoL and other health-related behaviors and wear an accelerometer for seven days before surgery and at six months, one year and two years after surgery. The intention to treat and per protocol analysis will focus on differences between the intervention and control group from pre-surgery assessments to follow-up assessments at 24 months after RYGB. Patients' baseline characteristics are presented in this protocol paper.

    DISCUSSION: A total of 259 RYGB female patients has been enrolled in the "WELL-GBP"-trial, of which 156 women have been randomized to receive the intervention and 103 women to control group. The trial is conducted within a Swedish health care setting where female RYGB patients from diverse geographical areas are represented. Our results may, therefore, be representative for female RYGB patients in the country as a whole. If the intervention is effective, implementation within the Swedish health care system is possible within the near future.

    TRIAL REGISTRATION: The trial was registered on February 23th 2015 with registration number ISRCTN16417174.

  • 233.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Possmark, Sofie
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Ghaderi, Ata
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    A dissonance-based randomized intervention study to improve quality of life and physical activity 24 months post roux-en-Y gastric bypass surgery2018Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 28, nr S2, s. 224-224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Roux-en-Y gastric bypass (RYGB) surgery is usually followed by great weight loss and improved health related quality of life (HRQoL). However, weight regains are seen in some patients approximately 1-2 years post-surgery, associated with a decrease in HRQoL and physical activity (PA).

    Objectives: To investigate if a dissonance-based group intervention post RYGB surgery has an effect on women’s HRQoL, PA and other health-related behaviors: a protocol paper.

    Methods: The ongoing RCT is a dissonance-based intervention for female RYGB patients from five Swedish hospitals. Participants are randomized to either control (usual follow-up care) or intervention group (4 sessions, 3 months post-surgery). Main topics of intervention sessions are (1) PA, (2) eating behavior, (3) social and (4) intimate relationships. Participants are asked to wear an accelerometer and complete questionnaires measuring HRQoL (SF-36), social adjustment, eating behavior and body esteem, pre-surgery and 6, 12 and 24 months post-surgery. Planned analysis includes intention to treat and per protocol analysis on differences between intervention and control group. Trial registration number: ISRCTN16417174.

    Results: We recruited 259 women (156 intervention and 103 controls). Mean BMI was 40.9 ± 4.7, mean SF36 score was 42.1 ± 9.5 (physical component summary score) and 45.8 ± 11.1 (mental component summary score). Mean time spent in moderate to vigorous PA was 28.8 ± 19.4 min/day and sedentary was 458.3 ± 100.4 min/day.

    Conclusions: This trial aims to improve outcomes after RYGB. If the intervention is effective, implementation within the Swedish health care system is possible within the near future.

  • 234.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden.
    Willmer, Mikaela
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden; Centre for Sellberg etal.BMCSurgery (2017) 17:133 Page 6 of 7 Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden.
    Four years' follow-up changes of physical activity and sedentary time in women undergoing roux-en-Y gastric bypass surgery and appurtenant children2017Ingår i: BMC Surgery, ISSN 1471-2482, E-ISSN 1471-2482, Vol. 17, nr 1, artikel-id 133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Objectively measured levels of physical activity (PA) in patients undergoing Roux-en-Y Gastric Bypass (RYGB) surgery remain essentially unchanged from before to one year after surgery. Effects from RYGB on objectively measured levels of PA among women undergoing RYGB and appurtenant children beyond one year post-surgery are unknown. The aim of the present study was to objectively assess longitudinal changes in PA and sedentary time (ST), among women undergoing RYGB and appurtenant children, from three months before to nine and 48 months after maternal surgery.

    METHODS: Thirty women undergoing RYGB and 40 children provided anthropometric measures during home visits and valid accelerometer assessed (Actigraph GT3X+) PA data, three months before and nine and 48 months after maternal RYGB surgery.

    RESULTS: Women undergoing RYGB decreased time spent in moderate to vigorous PA (MVPA) with 2.0 min/day (p = 0.65) and increased ST with 14.4 min/day (p = 0.35), whereas their children decreased time spent in MVPA with 13.2 min/day (p = 0.04) and increased ST with 110.5 min/day (p < 0.001), from three months before to 48 months after maternal surgery. Twenty, 27 and 33% of women, and 60, 68 and 35% of children reached current PA guidelines three months before and nine and 48 months after maternal RYGB, respectively.

    CONCLUSIONS: Objectively measured PA in women remains unchanged, while appurtenant children decrease time spent in MVPA and increase ST, from three months before through nine and 48 months after maternal RYGB. The majority of both women undergoing RYGB and children are insufficiently active 48 months after maternal RYGB.

  • 235.
    Silén, Marit
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, Institute of Gerontology/Department of Nursing, Jönköping, Sweden .
    Aims and theoretical frameworks in nursing students' Bachelor's theses in Sweden: a descriptive study2016Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 37, s. 91-96Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Nursing students' independent projects in Sweden not only provide an opportunity to receive a professional qualification as a nurse but also gain a Bachelor's degree in nursing. The aim of these projects is to demonstrate knowledge and understanding within the major field of the education. Objectives: This study aimed to describe and analyze the topics as well as theoretical frameworks and concepts in nursing students' independent projects, which lead to a Bachelor's degree, in a Swedish context. Design: A total of 491 independent projects, written by nursing students in Sweden, were included in the study. Methods: Topics together with theoretical frameworks and concepts in the projects were identified. Similar topics and theoretical frameworks and concepts, respectively, were grouped into subcategories, and similar subcategories were then merged into a main category. The number of entries in each category was counted for descriptive statistics in order to allow for the demonstration of magnitude. Results: The most common topics concerned experiences and managing when having an illness, experiences of care and of being a caregiver, and healthcare staff's care and knowledge. The nursing theories/models that were most often used were Eriksson's Theory of Caritative Caring, Travelbee's Human-to-Human Relationship Model, and Orem's Self-care Theory. Among the non-nursing theories/models, perspectives and concepts lifeworld, ethical values and principles, existential concepts and quality of life/health-related quality of life, were most often used by these students. Conclusion: There may be some difficulty in finding a topic for the project that is relevant for both a professional qualification as a nurse, as well as for achieving the requirements of a Bachelor's degree in nursing. The study indicates that there is a need to widen the student's understanding of different nursing theories/perspectives/models/concepts during nursing education so that students are familiar with a broad range of these when conducting their independent project.

  • 236.
    Silén, Marit
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Svantesson, Mia
    Örebro universitet.
    James, Inger
    Örebro universitet.
    Vad diskuteras under svenska moralfallsöverläggningar?2015Konferensbidrag (Refereegranskat)
  • 237.
    Sjöberg, Fredric
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap.
    Schönning, Emil
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap.
    Salzmann-Erikson, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Nurses' experiences of performing cardiopulmonary resuscitation in intensive care units: a qualitative study2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 17-18, s. 2522-2528Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: To describe the nurses' experiences of performing cardiopulmonary resuscitation in intensive care units.

    Background: Research in the area of resuscitation is primarily concentrated on medical and biophysical aspects. The subjective experiences of those who perform cardiopulmonary resuscitation and their emotions are more seldom addressed. Design: Qualitative descriptive design.

    Methods: Qualitative semi-structured interviews were used (n = 8). Data were analysed with content analysis.

    Results: Three categories describe the experiences of nurses: training and precardiopulmonary resuscitation; chaos and order during cardiopulmonary resuscitation; and debriefing postcardiopulmonary resuscitation. The study results indicate that the health care staff find it necessary to practice cardiopulmonary resuscitation, as it provides them with a basic feeling of security when applying it in actual situations.

    Conclusion: We argue that postcardiopulmonary resuscitation debriefing must be viewed in the light of its eigenvalue with a specific focus on the staff's experiences and emotions, and not only on the intention of identifying errors.

    Relevance to clinical practice: Debriefing is of the utmost importance for the nurses. Clinical leaders may make use of the findings of this study to introduce debriefing forums as a possible standard clinical procedure. 

  • 238.
    Sjölund, Britt-Marie
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Wimo, Anders
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    von Strauss, Eva
    The Swedish Red Cross University College, Stockholm, Sweden; Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Incidence of ADL Disability in Older Persons, Physical Activities as a Protective Factor and the Need for Informal and Formal Care: Results from the SNAC-N Project2015Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 10, nr 9, artikel-id e0138901Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The aim of the study was to examine 1) the incidence of disability in Activities of Daily Living (ADL), in persons 78 years and older 2) explore whether being physical active earlier is a significant predictor of being disability free at follow-up and 3) describe the amount of informal and formal care in relation to ADL-disability.

    METHODS: Data were used from a longitudinal community-based study in Nordanstig (SNAC-N), a part of the Swedish National Study on Aging and Care (SNAC). To study objectives 1) and 2) all ADL-independent participants at baseline (N = 307) were included; for objective 3) all participants 78 years and older were included (N = 316). Data were collected at baseline and at 3- and 6-year follow-ups. ADL-disability was defined as a need for assistance in one or more activities. Informal and formal care were measured using the Resource utilization in Dementia (RUD)-instrument.

    RESULTS: The incidence rates for men were similar in the age groups 78-81and 84 years and older, 42.3 vs. 42.5/1000 person-years. For women the incidence rate for ADL-disability increased significantly from the age group 78-81 to the age group 84 years and older, 20.8 vs.118.3/1000 person-years. In the age group 78-81 years, being physically active earlier (aOR 6.2) and during the past 12 month (aOR 2.9) were both significant preventive factors for ADL-disability. Both informal and formal care increased with ADL-disability and the amount of informal care was greater than formal care. The incidence rate for ADL-disability increases with age for women and being physically active is a protective factor for ADL-disability.

    CONCLUSION: The incidence rate for ADL-disability increases with age for women, and being physical active is a protective factor for ADL-disability.

  • 239.
    Skytt, Bernice
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Mårtensson, Gunilla
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Mamhidir, Anna-Greta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    A longitudinal qualitative study of health care personnel’s perceptions of simultaneous implementation of three risk assessment scales on falls, malnutrition and pressure ulcers2016Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 13/14, s. 1912-1922Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives

    In this study, the aim was to understand health care personnel's expectations and experiences of participating in an intervention aimed at the implementation of three assessment scales for fall injuries, malnutrition and pressure ulcers, and the performance of preventive measures in these areas over the period of 18 months.

    Background

    Fall injuries, malnutrition and pressure ulcers among older people are challenging issues for caregivers at different levels in the health care system.

    Design

    A descriptive design with a qualitative approach was used to follow health care personnel before, during and after implementation of a care prevention intervention.

    Methods

    Twelve health care personnel with different professions at the hospital, primary care and municipal care levels participated in a preventive care introduction. Seminars were held at four occasions, with assignments to be completed between seminars. Lectures and group discussions were performed, and three risk assessment scales were introduced. The participants were interviewed before, during and after the introduction. Manifest and latent content analysis were used.

    Results

    The main results are presented in the theme ‘Patient needs are visualised through a gradually developed shared understanding’ and in five categories. The work approach of performing three risk assessments simultaneously was perceived as positive and central to ensuring quality of care; it was not, however, perceived as unproblematic.

    Conclusion

    The participants as well as health care team members showed a positive attitude towards and described the advantages of being given opportunities for shared understanding to improve patient safety and to provide structure for the provision of good care.

    Relevance to clinical practice

    The managerial approach of listening to and acting on issues stressed by health care personnel is important to ensure ongoing and future improvement initiatives.

  • 240.
    Skytt, Bernice
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Hagerman, Heidi
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Strömberg, Annika
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    First-line managers' descriptions and reflections regarding their staff's access to empowering structures2015Ingår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, nr 8, s. 1003-1010Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To elucidate first-line managers' descriptions and reflections regarding their staff's access to empowering structures using Kanter's theory of structural empowerment. Background: Good structural conditions within workplaces are essential to employees' wellbeing, and their ability to access empowerment structures is largely dependent on the management. Method: Twenty-eight first-line managers in elderly care were interviewed. Deductive qualitative content analysis was used to analyse data. Results: Managers perceived that staff had varying degrees of access to the empowering structures described in Kanter's theory - and that they possessed formal power in their roles as contact persons and representatives. The descriptions mostly started from the managers' own actions, although some started from the needs of staff members. Conclusion: All managers described their staff's access to the empowering structures in Kanter's theory as important, yet it seemed as though this was not always reflected on and discussed as a strategic issue. Implications for nursing management: Managers could make use of performance and appraisal dialogues to keep up to date on staff's access to empowering structures. Recurrent discussions in the management group based on such current information could promote staff's access to power through empowering structures and make job definitions a strategic issue in the organisation.

  • 241.
    Stenberg, Jenny
    et al.
    Department of Medical Sciences, University Hospital, Uppsala, Sweden.
    Henriksson, Catrin
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Furuland, Hans
    Department of Medical Sciences, University Hospital, Uppsala, Sweden.
    Perspectives on clinical use of bioimpedance in hemodialysis: focus group interviews with renal care professionals.2018Ingår i: BMC Nephrology, ISSN 1471-2369, E-ISSN 1471-2369, Vol. 19, nr 1, artikel-id 121Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals' perceived barriers and facilitators for use of bioimpedance in clinical practice.

    METHODS: Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device. The participants were connected to each other and a moderator via equipment for telemedicine and the sessions were recorded. The interviews were semi-structured, focusing on the participants' perceptions of use of bioimpedance in clinical practice. Thematic content analysis was performed in consecutive steps, and data were extracted by employing an inductive, interactive, comparative process.

    RESULTS: Several barriers and facilitators to the use of bioimpedance in clinical practice were identified, and a multilevel approach to examining barriers and incentives for change was found to be applicable to the ideas and categories that arose from the data. The determinants were categorized on five levels, and the different themes of the levels illustrated with quotations from the focus groups participants.

    CONCLUSIONS: Determinants for use of bioimpedance were identified on five levels: 1) the innovation itself, 2) the individual professional, 3) the patient, 4) the social context and 5) the organizational context. Barriers were identified in the areas of credibility, awareness, knowledge, self-efficacy, care processes, organizational structures and regulations. Facilitators were identified in the areas of the innovation's attractiveness, advantages in practice, and collaboration. Motivation, team processes and organizational capacities appeared as both barriers and facilitators.

  • 242.
    Stenberg, Jenny
    et al.
    Department of Medical Sciences, University Hospital, Uppsala, Sweden.
    Lindberg, Magnus
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Furuland, Hans
    Department of Medical Sciences, University Hospital, Uppsala, Sweden.
    Clinical praxis for assessment of dry weight in Sweden and Denmark: a mixed-methods study2016Ingår i: Hemodialysis International, ISSN 1492-7535, E-ISSN 1542-4758, Vol. 20, nr 1, s. 111-119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Overhydration is an independent predictor of mortality in hemodialysis (HD) patients. More than 30% of HD patients are overhydrated, motivating the development of new methods for assessing hydration status. This study surveyed clinical praxis and local guidelines for dry weight (DW) assessment in Swedish and Danish HD units, and examined if differences in routines and utilization of bioimpedance spectroscopy (BIS) and other assistive technology affected frequency of DW adjustments and blood pressure (BP) levels. Cross-sectional information on praxis, guidelines and routines, plus treatment-related data from 99 stratified patients were collected. Qualitative data were analyzed with content analysis and interpreted in convergence with statistical analysis of quantitative data in a mixed-methods design. Local guidelines concerning DW existed in 54% of the units. A BIS device was present in 52%, but only half of those units used it regularly, and no correlations to frequency of DW adjustments or BP were found. HD nurses were authorized to adjust DW in 60% of the units; in these units, the frequency of DW adjustments was 1.6 times higher and systolic BP pre-HD 8 mmHg lower. There is a wide variation in routines for DW determination, and there are indications that authorization of HD nurses to adjust DW may improve DW assessment. BIS is sparsely used; its implementation may have been delayed by uncertainty over how to manage the device and interpret measurements. Hence, better methods and guidelines for assessing DW and using BIS need to be developed.

  • 243.
    Stephan, Astrid
    et al.
    Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Bieber, Anja
    Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Hopper, Louise
    School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
    Joyce, Rachael
    School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
    Irving, Kate
    School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
    Zanetti, Orazio
    Alzheimer Unit, Brescia (BS), Italy.
    Portolani, Elisa
    Alzheimer Unit, Brescia (BS), Italy.
    Kerpershoek, Liselot
    Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
    Verhey, Frans
    Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
    de Vugt, Marjolein
    Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
    Wolfs, Claire
    Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
    Eriksen, Siren
    Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
    Røsvik, Janne
    Department of Geriatric Medicine, Oslo University Hospital, Aldring og Helse, Oslo, Norway.
    Marques, Maria J.
    Chronic Diseases Research Center, Nova Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portuga.
    Gonçalves-Pereira, Manuel
    Chronic Diseases Research Center, Nova Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portuga.
    Sjölund, Britt-Marie
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Jelley, Hannah
    Dementia Services Development Centre Wales, Bangor University, Bangor, UK.
    Woods, Bob
    Dementia Services Development Centre Wales, Bangor University, Bangor, UK.
    Meyer, Gabriele
    Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Broda, A. (Medarbetare/bidragsgivare)
    Bartoszek, G. (Medarbetare/bidragsgivare)
    Orrell, M. (Medarbetare/bidragsgivare)
    Wimo, A. (Medarbetare/bidragsgivare)
    Sköldunger, A. (Medarbetare/bidragsgivare)
    Engedal, K. (Medarbetare/bidragsgivare)
    Selbæk, G. (Medarbetare/bidragsgivare)
    Michelet, M. (Medarbetare/bidragsgivare)
    Irving, K. (Medarbetare/bidragsgivare)
    Conceição Balsinha, M. (Medarbetare/bidragsgivare)
    Bárrios, H. (Medarbetare/bidragsgivare)
    Machado, A. (Medarbetare/bidragsgivare)
    Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries2018Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, nr 1, artikel-id 131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: People with dementia and informal carers often access formal care late in the process of dementia. The barriers and facilitators to service use from the perspectives of different stakeholders involved are not well understood. Thus, we aimed to explore the barriers and facilitators of access to and utilisation of formal care from the perspectives of people with dementia, their informal carers and health and social care professionals.

    METHOD: Focus groups with people with dementia, informal carers and professionals were conducted in eight European countries. Recruitment targeted people with dementia, informal carers with experience of formal care and professionals involved in providing (access to) formal care. Qualitative content analysis using open coding was used on a national level. Cross-national synthesis was based on the translated national reports.

    RESULTS: Overall, 55 focus groups with 261 participants were conducted, involving 51 people with dementia, 96 informal carers and 114 professionals. Sixteen categories describing barriers and facilitators were identified, referring to three global themes: Aspects related to 1) individuals involved, 2) the system or 3) overarching aspects. The attitudes and beliefs of people with dementia and their carers may have a major impact, and they often serve as barriers. Formal care was perceived as a threat to the individual independence of people with dementia and was thus avoided as long as possible. A healthcare professional serving as a constant key contact person could be an essential facilitator to overcome these barriers. Contact should be initiated proactively, as early as possible, and a trusting and consistent relationship needs to be established. Beyond that, the findings largely confirm former research and show that barriers to accessing and using formal care still exist across Europe despite a number of national and European initiatives.

    CONCLUSION: Further investigations are needed to elaborate how the concept of a key contact person could be integrated with existing case management approaches and how the independence and autonomy of people with dementia can be strengthened when formal care needs to be accessed and used. These may be meaningful facilitators regarding enhanced access to formal care for people with dementia and their families.

  • 244.
    Ström, Joel
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Intensivvårdssjuksköterskors uppfattning och bedömning av IVA-delirium i jämförelse med bedömning av sederingsdjup: en kvantitativ studie2017Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund.

    Patienter som vårdas inom intensivvården har ofta drabbats av kritisk sjukdom med svikt i vitala organ som följd. Understödjande behandling av dessa organ är en viktig del i arbetet inom intensivvården. En förbisedd komplikation hos patienten är sviktande kognitiva funktioner på grund av kritisk sjukdom, även benämnt intensivvårdsdelirium (IVA-delirium). Patienter med IVA-delirium har tidigare forskning visat ge längre vårdtider och ökad mortalitet.

    Syfte 

    Syftet med studien var att beskriva intensivvårdssjuksköterskans uppfattning om och hur IVA-delirium bedöms. Syftet var också att jämföra hur ofta bedömning av IVAdelirium sker med hur ofta bedömning av sederingsdjup sker.

    Metod

    En beskrivande och jämförande studie med kvantitativ ansats. Enkäter (n=112) delades ut till intensivvårdssjuksköterskor där 45 besvarades.  Huvudresultat 45 intensivvårdssjuksköterskor svarade att IVA-delirium kräver aktiva åtgärder från vårdpersonalen. 43 ansåg att IVA-delirium är en vanlig respons på miljön vid en intensivvårdsavdelning. En del (n=40) angav att deras avdelning har en rutin angående sedering men 21 uppger att protokollet inte anger hur ofta IVA-delirium ska bedömas. Den vanligaste metoden för att bedöma IVA-delirium var att se om patienten kan följa instruktioner (n=19) och om patienten har ett utåtagerande beteende (n=10). 42 angav att IVA-delirium är ett underdiagnosticerat problem och 40 angav att det är en utmaning att bedöma hos patienten. Studien visade en signifikant skillnad (p=.0001) mellan hur ofta intensivvårdssjuksköterskor bedömer sederingsdjup och hur ofta IVA-delirium bedöms. 

    Slutsatser

    Slutsatsen är att bedömning av sedering utförs oftare än bedömning av IVA-delirium. Mer utbildning inom ämnet och mer djupgående forskning rekommenderas.

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  • 245.
    Sundbom Thunander, Lena
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Bingefors, Kerstin
    Department of Pharmacy, University of Uppsala, Uppsala, Sweden.
    Isacson, Dag
    Department of Pharmacy, University of Uppsala, Uppsala, Sweden.
    Self-reported depression and prescription of antidepressants: Does gender matter?2015Ingår i: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 18, nr 3, s. A116-, artikel-id PMH12Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    OBJECTIVES

    Women are diagnosed with depression twice as often as men. Concerning self-reported depression though, gender differences are not that distinct. Prescription of antidepressants (ADs) has increased considerably the past decades, especially for women. This study aimed to examine gender differences in self-reported depression and the relation to prescribed ADs and also in the prescription of various types of ADs.

    METHODS

    Data from the population-based cross-sectional survey “Public Health in Sweden 2012” was used (n=16,000 aged 18-84 years, response rate 49.3%). Symptoms of depression were measured with the Hospital Anxiety Depression Scale (HADS, cut-off score ≥8). Self-reported use of ADs two weeks prior to receiving the questionnaire was supplemented with prescription data (ATC-codes) from the national Swedish Prescribed Drug Register.

    RESULTS

    Men and women reported depression to similar extent (men 12.3%, women 11.2%). However, women were more often prescribed ADs compared to men (men 3.7%, women 6.8%; p<0.0001). Nine per cent of all women in the study population reported depression but had no AD treatment, 2.1% reporting depression and used ADs, and 4.7% used ADs but reported no depression. The corresponding figures for men were 10.8%, 1.5% and 2.2% (p<0.0001). Selective serotonin reuptake inhibitors (SSRIs, N06AB) were the most commonly prescribed ADs for both men (74.8%) and women (79.2%). As for the SSRIs, no statistical significant gender difference was found for the tricyclic antidepressants (TCAs, N06AA; men 9.5%, women 6.7%). However, men were prescribed “Other ADs” (N06AX) significantly more often than women (men 43.3%, women 29.2%; p<0.005).

    CONCLUSIONS

    Although women and men reported depression to similar extent, women were prescribed ADs almost twice as often as men. Also, women used ADs without being currently depressed more often than men. Further, men were prescribed “Other ADs” more frequently than women.

  • 246.
    Sundin, Ida
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Koplik, Ida
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Kvinnors upplevelser av mastektomi till följd av en bröstcancerdiagnos2019Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
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  • 247.
    Sunnvius, Louise
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Angermund, Hanna
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Mammors tillit till sin förmåga att amma2017Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Antalet ammande mammor sjunker i Sverige, en bidragande faktor till den sjunkande amningsfrekvensen kan vara bristen på tillit till sin förmåga att amma. Det är viktigt att identifiera mammor med låg tillit till sin förmåga att amma för att göra det möjligt att vända den sjunkande amningsfrekvensen och för distriktssjuksköterskan att kunna stärka kvinnan i rollen som ammande mamma.

    Syfte: Syftet med studien var att beskriva och jämföra mammors tillit till sin förmåga att amma.

    Metod: Med enkäten, The breastfeeding self-efficacy scale - short form (BSES-SF) som mäter tillit till sin förmåga att amma, samlades data in för att kunna identifiera mammor med låg eller hög tillit.

    Resultat: Mammorna i åldersgrupperna 18-25 år och 35-45 år, oberoende av barnets ålder, skattade den lägsta tilliten till sin förmåga att amma gällande att de alltid kunde genomföra varje amning på ett för dem tillfredställande sätt. Den högst skattade tilliten hos samtliga mammor, oberoende av deras egen ålder eller barnets ålder, var att de alltid kan komma fram till att de vill fortsätta att amma. Mammor som ammade barn mellan 10 veckor (v) – 17 v + 6 dagar (d) skattade totalt enligt BSES-SF sin tillit till sin förmåga att amma signifikant högre än mammor som ammade barn mellan 0 v – 9 v + 6 d.

    Slutsats: Mammorna i föreliggande studie som ammade barn mellan 10 v – 17 v + 6 d skattar sin tillit till sin förmåga att amma högre, än mammorna som ammade barn mellan 0 v – 9 v + 6 d. Nyckelord: Amning, distrik

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  • 248.
    Svantesson, Mia
    et al.
    Örebro University, Örebro, Sweden; University of Warwick, Coventry, West Midlands, England.
    Silén, Marit
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala university, Uppsala, Sweden.
    James, Inger
    Örebro University, Örebro, Sweden.
    It’s not all about moral reasoning: Understanding the complex content of Moral Case Deliberation2018Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 25, nr 2, s. 212-229Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain.

    Objective:

    To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces.

    Methods:

    A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority.

    Ethical considerations:

    No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation.

    Findings:

    Other than ‘moral reasoning’ (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of ‘reflections on the psychosocial work environment’ to a varying extent (md: 29%). Additional content comprised ‘assumptions about the patient’s psychosocial situation’ (md: 6%), ‘facts about the patient’s situation’ (md: 5%), ‘concrete problem-solving’ (md: 6%) and ‘process’ (md: 3%).

    Conclusion:

    The findings suggest that a restorative function of staff’s wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants’ own emotional needs and to develop the use of their emotional knowing to focus on the ethically difficult patient situation.

  • 249.
    Svennberg, Lena
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Idrottsvetenskap. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Högberg, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
    Who gains?: Sociological parameters for obtaining high grades in physical education2018Ingår i: Nordic Journal of Studies in Educational Policy, ISSN 2002-0317, Vol. 4, nr 1, s. 48-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate factors contributing to higher grades in Swedish physical education (PE) by analysing register data from the Swedish National Agency for Education for all students graduating from compulsory school in 2014 (n = 95,317). The results show that the chances of gaining a high grade in PE are affected by (in decreasing order) migration background, parents? education, attending an independent or a municipally operated school and gender, and that this also holds true after controlling for the other background factors. The results also show that PE grade differences between boys and girls are bigger in the group that moved to Sweden after school start than in the group that had lived in Sweden since school start. In addition, the results point to substantial inequalities between students with a combination of the highest odds and those with a combination of the lowest odds. Bernstein?s concept of the pedagogic device is used to discuss ways of understanding what knowledge becomes valued in PE and which groups have better possibilities to assimilate this valued knowledge.

  • 250.
    Sving, Eva
    et al.
    Clinical Training Centre, Region Gävleborg, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg; Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden.
    Frediksson, Lennart
    Centre for Research & Development, Uppsala University/Region Gävleborg.
    Gunningberg, Lena
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden.
    Mamhidir, Anna-Greta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden.
    Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multi-faceted intervention in a hospital setting2017Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, nr 19-20, s. 3200-3211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    The aim of the present study was to describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multi-faceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention.

    BACKGROUND:

    Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes.

    DESIGN:

    A descriptive qualitative approach.

    METHOD:

    Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used.

    RESULT:

    The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as 'Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements.

    CONCLUSION:

    The multi-faceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feed-back discussions among the staff regarding the results of the care provided also appear to be vital.

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