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  • 251.
    Bergström, Sofia
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Murén, Saana
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Distriktssköterskors reflektioner kring sin roll och förutsättningar att ge god omvårdnad vid palliativ hemsjukvård2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

     

    Bakgrund: Allt fler palliativt sjuka patienter vårdas i hemmen vilket leder till ett ökat behov av palliativ vård i hemsjukvården. Distriktssköterskan har ett övergripande ansvar över dessa svårt sjuka patienter och deras närstående.

    Syfte: Syftet med studien var att undersöka hur distriktssköterskor som arbetar i den kommunala hemsjukvården reflekterar kring sin roll och förutsättningar att ge god omvårdnad vid palliativ hemsjukvård.

    Metod: Semistrukturerade intervjuer med tio distriktssköterskor. En kvalitativ innehållsanalys användes.

    Huvudresultat: Distriktssköterskorna såg arbetet med palliativ vård som sin mest prioriterade arbetsuppgift och kände ett stort ansvar över dessa patienter. Att bygga upp en relation med patienten och närstående tidigt i vårdförloppet samt kontinuitet var en förutsättning för god vård. Distriktssköterskorna beskrev ett väl fungerande samarbete med palliativa teamet, något som ofta saknades från hälsocentralerna. Arbetet var tidskrävande och i kombination med kravet på tillgänglighet ledde detta till en känsla av stress och otillräcklighet. Stöd från kollegor ansågs värdefullt då regelbunden handledning saknades. Kunskapsbrist hos omsorgspersonal försämrade omvårdnaden och försvårade distriktssköterskans arbete. Samtliga distriktssköterskor såg behovet av förbättring inom den palliativa vården och en önskan om ett speciellt palliativt team samt ett hospice framkom.

    Slutsats: Slutsatsen av studien är att det ansvarsfyllda och tidskrävande arbetet ledde till en känsla av otillräcklighet hos deltagarna. Det framkom en stark önskan från samtliga deltagare om förbättring i den palliativa vården i form av special team och hospice.

     

  • 252.
    Bergström, Tobias
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Litteraturstudie angående problem och möjligheter i samband med informationsöverföring mellan vårdgivare: En litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 5 credits / 7,5 HE creditsStudent thesis
  • 253.
    Berneholt, Emelie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Bara vara mig själv: En intervjustudie om skolmiljö och välbefinnande bland en klass mellanstadieelever i södra Norrland2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this paper was to explore the students experiences of the school climate and how it affects their well-being. Semi-structured interviews with an interview guide were used as a method. The sample was of six students in the age of 11-13 from one middle school class. The results showed among other things that almost everyone felt safe at school and expressed different definitions of safety such as feeling welcome and feeling like they can be themselves. The students felt supported by the teachers, other students and also their parents. Some things the school should change according to the students were the classrooms which were too small and with inefficient soundproofing, the school yard which was boring, and the fact that the students sometimes wanted more adult supervision during school breaks. The conclusion is that the school climate can affect student’s well-being and that a small school can have both pros and cons regarding the school climate. More qualitative research may result in a better understanding of the way the school climate affects the students.

  • 254.
    Bertelson, Jenny
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Sjuksköterskors upplevelser av att genomgå utbildning om smärta och systematisk smärtskattning hos äldre: Att bygga en relation för kommunikation – ett förhållande mellan erfarenhet och kunskap2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of the study was to by group interview view nurses’ experiences of undergoing training on pain and systematic pain assessment in the elderly and to describe how nurses perceive that they recognize and resolve pain problems in the elderly after training. The study had a descriptive design and five nurses, who worked in nursing home, participated in the interview. The material from the group interview was analyzed using qualitative content analysis method. The results are presented in five categories: Attention to expression of pain, The importance of knowledge about pain, Teamwork by pain, The importance of pain assessment instruments and Nursing and evaluation by pain. The study revealed that the nurses interpreted the elderly verbal expressions and body language, and the difficulties around communication about pain. It was revealed that the families provided information about the pain in elderly. The nurses expressed that their own experience of pain gave knowledge and they also expressed the expectations they had of the education effort. The nurses’ experiences of cooperation between different professions emerged. The nurses also expressed how the results from pain assessment in the elderly could be an aid incommunication, how drugs are used to relieve pain, as well as alternative pain relief methods. Study results showed that training in pain and pain assessment in the elderly is important for the detection of pain in the elderly and for communication about adequate pain relief.

  • 255.
    Berthilson, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Eriksson, Caroline
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Avledande icke farmakologiska metoder och metodernas effekter vid procedursmärta hos barn 2-12 år: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Children sometimes need to seek medical help in order to undergo treatment procedures of various kinds. Children's reaction to anxiety and fear are governed by age, understanding, imagination and perception of reality. Children therefore need to be prepared for unpleasant procedures that they will undergo, such as: painful examinations, venipuncture or injections. These procedures can create anxiety and fear in children.

    Purpose: The purpose of this study was to describe the various non - pharmacological istraction methods and its effects on procedural pain in children. And to describe the study groups in the included articles.

    Method: A descriptive design was used to answer the literature studies experimental purpose and questioning. The study was based on thirteen scientific articles. The papers were searched in databases Cinahl and PubMed. The articles were published between the years 2006-2016.

    Result: The study demonstrates that non - pharmacological distraction methods for example: playing with soap bubbles, looking through a kaleidoscope, listen to music and use a “Buzzy” have had a soothing effect on children’s fear, anxiety and pain. The effects have been estimated using different scales by nurses, researchers and parents' observations. The children themselves have been estimating the effects of the non - pharmacological distraction methods.

    Conclusion: In the results of the present study, the authors concluded that non-pharmacological distraction methods can ease children's fear, anxiety or pain at different nursing actions. The authors have also come to the conclusion that the distraction methods investigated can be used in everyday work in pediatric care.

  • 256.
    Bertils, Petra
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Åhlén, Camilla
    University of Gävle, Department of Caring Sciences and Sociology.
    Mödrars upplevelse av amning efter hemgång från sjukhus2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

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

  • 257.
    Beyene, Ellelta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Karelius, Matilda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Hanteringsstrategier hos personer med inflammatorisk tarmsjukdom: En beskrivande litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

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

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

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

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

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

  • 258.
    Bhambhani, Yagesh
    et al.
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
    Mactavish, Jennifer
    Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.
    Warren, Sharon
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
    Thompson, Walter R.
    Department of Kinesiology and Health, Georgia State University, Atlanta, GA, United States.
    Webborn, Anthony
    Sussex Centre for Sport and Exercise Medicine, Chelsea School Research Centre, University of Brighton, United Kingdom.
    Bressan, Elizabeth
    Department of Sport Science, Stellenbosch University, South Africa.
    De Mello, Marco Tuilo
    Medicina e Biologia Do Sono, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
    Tweedy, Sean
    School of Human Movement Studies, University of Queensland, Brisbane, Australia.
    Malone, Laurie
    Lakeshore Foundation, Research and Education, Birmingham, AL, United States.
    Fröjd, Kennet
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports and health. Swedish Development Centre for Disability and Sport.
    Van De Vliet, Peter
    International Paralympic Committee, Bonn, Germany.
    Vanlandewijck, Yves
    Faculty of Kinesiology and Rehabilitation Sciences, Catholique University, Leuven, Belgium.
    Boosting in athletes with high-level spinal cord injury: Knowledge, incidence and attitudes of athletes in paralympic sport2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 26, p. 2172-2190Article in journal (Refereed)
    Abstract [en]

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

  • 259.
    Bieber, A.
    et al.
    Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Stephan, A.
    Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Verbeek, H.
    School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
    Verhey, F.
    School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
    Kerpershoek, L.
    School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
    Wolfs, C.
    School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
    de Vugt, M.
    School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
    Woods, R. T.
    Dementia Services Development CentreWales, Bangor University, Bangor, UK.
    Røsvik, J.
    Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of GeriatricMedicine, Oslo University Hospital, Oslo, Norway.
    Selbaek, G.
    Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of GeriatricMedicine, Oslo University Hospital, Oslo, Norway.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Neurobiology, Care sciences and Society, Karolinska Institut, Stockholm, Sweden.
    Wimo, A.
    Department of Neurobiology, Care sciences and Society, Karolinska Institut, Stockholm, Sweden.
    Hopper, L.
    School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
    Irving, K.
    School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
    Marques, M. J.
    CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
    Gonçalves-Pereira, M.
    CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
    Portolani, E.
    Alzheimer’s Research Unit-Memory Clinic, Brescia, Italy.
    Zanetti, O.
    Alzheimer’s Research Unit-Memory Clinic, Brescia, Italy.
    Meyer, G.
    Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Access to community care for people with dementia and their informal carers: Case vignettes for a European comparison ofstructures and common pathways to formalcare [Zugang zu professioneller Unterstützung für Menschen mit Demenz und ihre Angehörigen: Fallvignetten für den europäischen Vergleich von Strukturen und Zugangswegen zu professioneller Pflege]2018In: Zeitschrift für Gerontologie und Geriatrie (Print), ISSN 0948-6704, E-ISSN 1435-1269, Vol. 51, no 5, p. 530-536Article in journal (Refereed)
    Abstract [en]

    Background

    People with dementia and their informal carers often do not receive appropriate professional support or it is not received at the right time.

    Objectives

    Description and comparison of common pathways to formal community dementia care in eight European countries as a part of the transnational Actifcare project.

    Materials and methods

    The German team was responsible for creating an individual case scenario as a starting point. The research teams in Ireland, Italy, the Netherlands, Norway, Portugal, Sweden, and the United Kingdom were then asked to describe a common pathway to formal dementia care by writing their own vignette using the provided individual case scenario.

    Results

    A transnational qualitative content analysis was used to identify the following categories as being the most important: involved professionals, dementia-specific and team-based approaches, proactive roles, and financial aspects. General practitioners (GPs) are described as being the most important profession supporting the access to formal care in all the involved countries. In some countries other professionals take over responsibility for the access procedure. Dementia-specific approaches are rarely part of standard care; team-based approaches have differing significances in each of the countries. Informal carers are mainly proactive in seeking formal care. The Nordic countries demonstrate how financial support enhances access to the professional system.

    Conclusion

    Enhanced cooperation between GPs and other professions might optimize access to formal dementia care. Team-based approaches focusing on dementia care should be developed further. Informal carers should be supported and relieved in their role. Financial barriers remain which should be further investigated and reduced.

  • 260.
    Bildtgard, Torbjörn
    et al.
    Stockholms universitet.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Changing sexual pracitices in intimate relationships in later life - a life course perspective2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no Suppl. 2, p. 76-76Article in journal (Other academic)
    Abstract [en]

    In late modernity sex has escaped its reproductive cage and people form pure relationships, based on mutual satisfaction (Giddens). Ironically, although older people are per definition non-reproductive, they have been neglected in studies on sexuality. The aim is to study sexual attitudes and practices among older people in life-course perspective. We present results from 1) a qualitative interview study with 28 63–91 year old Swedes currently dating or in a relationship (married, cohabiting, LAT) initiated 60+ and 2) a quantitative survey including 1225 60–90 year old Swedes (response rate 42%). The interviews revealed a normative change, from condemnation of extra-marital sex in young adulthood to encouragement of sexual relationships but not marriage in later life. Despite restrictive norms, the survey showed a majority (93%) had had their sexual debut before marriage. All informants had experienced the 1960’s sexual liberation and today liberal attitudes seem to encompass later life. Most had had rather active sexual lives. Half or the survey respondents had had ≥4 more sexual partners, and one in five ≥10. Today, an active sex-life was regarded as important for a good relationship. Many informants had interpreted sexual decline as “natural” and age-related, but re-discovered sexuality with their new partner. The survey confirmed relationship length as a better predictor of sexual activity than age. Cohort and period effects will be discussed. It has been argued that sexual practices will become more liberal in the future by cohort replacement. Our data indicates that “the future might already be here”.

  • 261.
    Bildtgård, Torbjörn
    et al.
    Stockholms Universitet.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Changing Sexual Practices in New Intimate Relationships in Later Life – A Life Course Perspective2014In: 8th International Conference on Cultural Gerontology: Programme and Abstracts, 2014, p. 138-138Conference paper (Other academic)
    Abstract [en]

    It has been argued that in late modernity sex has escaped its reproductive cage and people form pure relationships, based on mutual satisfaction. Ironically, although older people are per definition non-­‐reproductive, they have often been neglected in studies on sexuality. In this paper we present results from 1) a qualitative interview study with a strategic sample of 28 63–91 year old Swedes currently dating or in a heterosexual relationship (married, cohabiting, LAT) initiated 60+ and 2) a quantitative survey including answers from 1225 60–90 year old Swedes. The interviews revealed a clear normative  change,  from  a  cultural  context  that  condemned  extra-­‐marital  sex  in young adulthood  to  a context  encouraging  sexual  relationships  but  not  marriage in later  life.  All  had experienced  the  sexual  liberation  of  the  1960s,  and today, these liberal  attitudes  seem  to encompass later life. Today, an active sex-­‐life is regarded as important for a good relationship and sexual attraction was seen as a precondition for newrelationships. Many informants had interpreted sexual decline in former relationships as “natural ageing”, but re-­‐discovered sexuality with their new partner. In the survey, a majority (93 %) had had their sexual debut before marriage (despite the restrictive norms). Half or the respondents have had ≥ 4 sexual partners, and one in five ≥ 10. Sexual activity correlated negatively with relationship length. It has often been argued that sexual values and practices will become more liberal in the future by cohort replacement. Our data indicates that “the future might already be here”.

  • 262.
    Bildtgård, Torbjörn
    et al.
    Social Work, Stockholm University.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    New intimate relationships and informal care obligations in later life2013In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 53, no Suppl. 1, p. 413-414Article in journal (Other academic)
  • 263.
    Bildtgård, Torbjörn
    et al.
    Stockholms universitet.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    New intimate relationships as a resource for independent living in later life2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no Suppl. 2, p. 11-11Article in journal (Other academic)
    Abstract [en]

    Despite increased research interest in transitions into new intimate relationships in later life, little focus has been on how transitions affect older people’s social networks. We investigate the impact of entering into new intimate relationships in later life on interdependent lives. Results are based on both qualitative interviews with 28 Swedes (63–91 years) either dating or living in new relationships initiated 60+ (marriage, cohabitation, LAT), and a quantitative survey to 60–90 year old Swedes (n=1225; response rate 42%). A central theoretical frame is Elder’s (1994) principle of interdependent lives. A new relationship usually meant integration into the new partner’s social and filial networks (some problems will be discussed) and a restructuring of the relationship chain so that time and energy is redirected to the new partner. A new partner was described as a resource for living independent lives by the older informants, and as a way of “unburdening” the children. Finally, the qualitative interviews hinted at a hierarchy of dependencies. This was confirmed by the survey. A majority of respondents would primarily turn to their partners for social, emotional and practical support, with children as a distant second and “others” third. An exception was personal hygiene, where partners remained the first choice, but where the social services were preferred to children. This hierarchy was the same in new relationships. The results, partly contradicting previous research findings, are discussed in light of Western individualism generally and Swedish welfare-state and state supported individualism in particular.

  • 264. Bildtgård, Torbjörn
    et al.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    New sexual relationships in later life: the case of late modern Sweden2013In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 53, no Suppl., p. 300-300Article in journal (Other academic)
  • 265.
    Bildtgård, Torbjörn
    et al.
    Stockholms universitet.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    The Impact of New Intimate Relationships in Later Life on Intergenerational Exchange2014In: 8th International Conference on Cultural Gerontology: Programme and Abstracts, 2014, p. 167-167Conference paper (Other academic)
    Abstract [en]

    Much social gerontological research has focused on partner loss in later life and how it affects social, emotional and practical exchanges between generations. In this paper we instead ask how a newintimate relationship in later life affects these inter-­‐generational exchanges. The results are based both  on  qualitative  interviews  with  28  Swedes  (63–91  years)  either  dating  or  living  in  new relationships initiated after the age of 60 (marriage, cohabitation, LAT), and a quantitative survey to 60–90 year old Swedes (n=1225). In the interviews we found that the informants described changes in what we conceptualize as the ‘relationship chain’ –a hierarchy in social and care responsibilities–where the new partner stepped in at the very front of the chain. The follow-­‐up survey confirmed a hierarchy of dependencies, where partners tend to come first, followed by children, friends and the state. The interviews further showed that the informants recurrently described their partners as a resource for their own autonomy as well as that of their children and friends. We interpret these findings in light of an individualist culture of independence that characterizes the Nordic countries, aided by a strong welfare state, involving a strong ethic of not being a burden, even to your own children.

  • 266.
    Billberg, Linda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Johansson, Anton
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Luftvägshantering utanför operationsavdelningen, teamdynamik, tillit till sin egen förmåga och psykologisk empowerment – en kvantitativ studie ur anestesisjuksköterskans perspektiv2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

  • 267.
    Billingsley, Jennifer
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjuksköterskors upplevelse av att vårda människor med depression: En beskrivande litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

     

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

     

    Design: A descriptive study of literature.

     

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

     

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

  • 268.
    Billmark Elfstrand, Kristina
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Patientutbildning för personer med typ 2 diabetes. En kartläggning inom primärvården i Sverige2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

  • 269.
    Birath, Diana
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Olsson Kalmering, Katarina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Humor i vårdmötet- skämtar du eller?: en litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 270.
    Birgisdóttir, Dröfn
    et al.
    Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Institute for Palliative Care, Lunds University, Lund, Sweden.
    Bylund-Grenklo, Tove
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
    Nyberg, Tommy
    Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Caring Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Steineck, Gunnar
    The Sahlgrenska Academy, Department of Oncology, Division of Clinical Cancer Epidemiology, University of Gothenburg Institute of Clinical Sciences, Gothenburg, Sweden.
    Fürst, Carl J.
    Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Institute for Palliative Care, Lunds University, Lund, Sweden.
    Losing a parent to cancer as a teenager: Family cohesion in childhood, teenage, and young adulthood as perceived by bereaved and non-bereaved youths2019In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate levels of perceived family cohesion during childhood, teenage years, and young adulthood in cancer-bereaved youths compared with non-bereaved peers.

    METHODS: In this nationwide, population-based study, 622 (73%) young adults (aged 18-26) who had lost a parent to cancer 6 to 9 years previously, when they were teenagers (aged 13-16), and 330 (78%) non-bereaved peers from a matched random sample answered a study-specific questionnaire. Associations were assessed using multivariable logistic regression.

    RESULTS: Compared with non-bereaved youths, the cancer-bereaved participants were more likely to report poor family cohesion during teenage years (odds ratio [OR] 1.6, 95% CI, 1.0-2.4, and 2.3, 95% CI, 1.5-3.5, for paternally and maternally bereaved youths, respectively). This was also seen in young adulthood among maternally bereaved participants (OR 2.5; 95% CI, 1.6-4.1), while there was no difference between paternally bereaved and non-bereaved youths. After controlling for a number of covariates (eg, year of birth, number of siblings, and depression), the adjusted ORs for poor family cohesion remained statistically significant. In a further analysis stratified for gender, this difference in perceived poor family cohesion was only noted in females.

    CONCLUSION: Teenage loss of a parent to cancer was associated with perceived poor family cohesion during teenage years. This was also noted in young adulthood among the maternally bereaved. Females were more likely to report poor family cohesion. Our results indicate a need for increased awareness of family cohesion in bereaved-to-be families with teenage offspring, with special attention to gender roles.

  • 271.
    Bjerke, Sofia
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Nordling, Åsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Livskvalitet hos personer som lever med en implanterbar defibrillator (ICD), ur ett köns- och åldersperspektiv: En beskrivande litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The ICD controls the heart rhythm and reacts to serious heart rhythm abnormalities and trigger, if necessary, a defibrillation to restore the heart to normal rhythm. Living with an ICD can provide major changes in everyday life. Nurse´s important role regards to provide relevant patient education to include promoting the health and quality of life (QOL) for these individuals. Purpose: To describe QOL for people living with an ICD, from a gender and age perspective, and to examine the included articles selection strategy and research group. Method: The result of this descriptive literature review compiled from eleven quantitative scientific articles, sought in PubMed and Scopus. Main Results: Women reported lower QOL then men linked to impaired mental, physical and social function. Also a greater concern and anxiety were found in women. Mental illness affected mainly young people, who also experienced a lower acceptance to the device than older ICD- receivers. Older people reported less concern that the ICD would deliver a shock. However, a reduced QOL related to higher incidence of physical impairment, were noticed in the elderly ICD- receivers compared to the younger. Four articles specified their selection strategy. All reported the number of participants and how many were men and women. The age range of participants was specified in five articles. Conclusion: Impacts on QOL could be discerned to different gender and ages. These findings confirmed the need for health professionals to access more holistic patient- education programs that focus not only on the technical aspects of living with an ICD but more on the individual impact.

  • 272.
    Bjerén, Rasmus
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Brelin, Andreas
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Ambulanspersonals följsamhet till basala hygienrutiner: En observationsstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

  • 273.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies.
    Palmeby, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies.
    Vårdrelationens innebörd för patienter inom psykiatrisk tvångsvård: en litteraturstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

  • 274.
    Bjuhr, Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Westerberg Jacobson, Josefin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Women with disturbed eating behavior rate less work engagement2016Conference paper (Refereed)
    Abstract [en]

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

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

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

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

  • 275.
    Bjurbo, Charlotte
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Eriksson, Ulrika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Att befinna sig i ett ingenmansland på en akutmottagning och ändå känna tillit till akutsjukvården: En kvalitativ intervjustudie med sköra äldre patienter2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    The full text will be freely available from 2020-12-31 18:25
  • 276.
    Bjurlefält, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences.
    Erfarenhet av debriefing inom akutsjukvården.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background:

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

     

    Aim:

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

     

    Method:

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

     

    Results:

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

     

    Conclusion:

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

  • 277.
    Bjurs, Elisabet
    University of Gävle, Department of Caring Sciences and Sociology.
    Faktorer som patienter, anhöriga och sjuksköterskor anser viktiga i den palliativa vården i hemmet2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

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

  • 278.
    Bjursell, Ingrid
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Grönquist, Cecilia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Viktiga omvårdnadsfaktorer av Suicidala unga: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

  • 279.
    Bjärntoft, Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    Uppfattningar kring hälsofrämjande ledarskap: En mixad studie om jämförelsen mellan första linjens chefers och medarbetares uppfattning av hälsofrämjande ledarskapsaspekter och dess relation till medarbetarnas välbefinnande2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

  • 280.
    Bjärntoft, Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Flexible work: Occupational determinants of work-life balance2018Conference paper (Refereed)
  • 281.
    Bjärntoft, Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Occupational and Individual Determinants of Work-life Balance among Office Workers with Flexible Work Arrangements2019In: Article in journal (Refereed)
  • 282.
    Björck, Madelené
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Haagensen, Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Erfarenheter av dialysbehandling: En litteraturstudie ur ett patientperspektiv2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Varje år behandlas ungefär 2900 personer med hemodialys, vilket innebär att blodet renas från slaggprodukter via en dialysmaskin. När en person påbörjar en dialysbe-handling förändras hela deras liv och de behöver finna sätt att hantera det på. Copingstrategier kan vara till hjälp för patienten i den jobbiga processen. Det är också viktigt för patienten att sjuksköterskan finns där och ger stöd samt anpassad information.

    Syfte: Att beskriva patienter med njursjukdomars erfarenheter av att leva med dialysbehand-ling, samt att beskriva de inkluderade artiklarnas datainsamlingsmetoder.

    Metod: En beskrivande design har använts i denna litteraturstudie. 14 vetenskapliga artiklar med kvalitativ ansats har använts.

    Huvudresultat: Dialysbehandling är en tuff process som påverkar patienten både fysiskt, psykiskt och existentiellt. Tiden som patienten tvingas lägga ner tillsammans med dialysma-skinen inkräktar på patientens vardag såpass att de inte har möjlighet att resa bort längre än ett par dagar. Patienten måste genomgå dialysbehandlingen för att överleva, trots den upplevda rädslan och smärtan. Ett sätt att hantera alla känslor och den trötthet patienten upplever är genom att använda sig av copingstrategier. Artiklarna som använts i studien är kvalitativa där intervjuer använts för att få fram deltagarnas erfarenheter.

    Slutsatser: Patienterna påverkas mycket av den tuffa dialysbehandlingen. Det krävs att pati-enten klarar av att hantera den tuffa processen för att överleva sin sjukdom, oavsett alla nega-tiva och påfrestande konsekvenser som det medför. Sjuksköterskan kan utgöra stöd och hjälpa patienten med att ge den information samt hitta de resurser som patienten behöver för att han-tera situationen.

  • 283.
    Björk Brämberg, Elisabeth
    et al.
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm; Institutionen för medicin, Enheten för allmänmedicin, Göteborgs universitet .
    Axén, Iben
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm .
    Strömberg, Carl
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm .
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm; Centrum för Arbets - och Miljömedicin, Stockholms läns landsting, Stockholm.
    Insatser via företagshälsan för att minska eller förebygga psykisk ohälsa: En kartläggning av forskningen - uppdatering 20182018In: FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? Gävle 10-12 juni 2018: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 71-72Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

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

    Syfte

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

    Metod

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

    Resultat

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

  • 284.
    Björk Brämberg, Elisabeth
    et al.
    Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Närhälsan, Region of Västra Götaland, Hisings-Backa, Sweden .
    Holmgren, Kristina
    Närhälsan, Region of Västra Götaland, Hisings-Backa, Sweden; Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden .
    Bültmann, Ute
    Department of Health Sciences, University Medical Center Groningen, Community and Occupational Medicine, Groningen, Netherlands.
    Gyllensten, Hanna
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Hagberg, Jan
    Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sandman, Lars
    National Centre for Priorities in Health, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Increasing return-to-work among people on sick leave due to common mental disorders: Design of a cluster-randomized controlled trial of a problem-solving intervention versus care-as-usual conducted in the Swedish primary health care system (PROSA)2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 889Article in journal (Refereed)
    Abstract [en]

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

  • 285.
    Björk, David
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Larsson, Henrik
    University of Gävle, Department of Caring Sciences and Sociology.
    Upplevelser av sjuksköterskerollen och konflikthantering i anhörigkontakten på äldreboenden - en intervjustudie.2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

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

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

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

  • 286.
    Björk, Ingela
    et al.
    University of Gävle, Faculty of Health and Occupational Studies.
    Leitzig, Andrea
    University of Gävle, Faculty of Health and Occupational Studies.
    Sömnförändringar, sömnpåverkande faktorer samt sömnförbättrande omvårdnadsåtgärder för IVA-patienter: - en litteraturstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Människan tillbringar en tredjedel av sitt liv i sömn det är ett behov vilket hon inte kan vara utan. Patienter som vårdas på IVA drabbas frekvent av sömnstörningar och därmed sömnbrist. Tidigare gjorda studier tyder på att IVA patienter upplever sömnstörningar som ett stort problem. Syfte: Att beskriva sömnförändringar, sömnpåverkande faktorer och sömnförbättrande omvårdnadsåtgärder för IVA-patienter. Metod: Databassökning gjordes och nyckelord har identifierats. Studier som inkluderar vuxna patienter som vårdats på en IVA har valts för denna beskrivande litteraturstudie. Resultat: IVA-patienter drabbas av fragmenterad sömn uppdelad i korta abnorma perioder. Sömnen påverkas av mänsklig intervention, diagnostiska tester samt miljöbetingad ljus och ljud. Minskning av ljud- och ljusnivån samt sammanhängande vilotid utan intervention var de främst undersökta sömnfrämjande omvårdnadsåtgärder i de granskande artiklarna. Slutsats: Alla IVA-patienter upplevde störd sömnrytm. I vilken utsträckning sömnrytm stördes berodde på ålder, sjukdom, erfarenhet av IVA-vård och respiratorvård. Omvårdnadsåtgärder som planerad vilotid, sänkningar av ljud och ljus förbättrade sömnmönstret och skapade möjlighet till förbättrad sömn.

  • 287.
    Björk, Madelen
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Wiker, Jennifer
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Den fysiska belastningen och skador hos kvinnliga fotbollsspelare: Finns det ett samband?2018Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

  • 288.
    Björk, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Liendeborg, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Vårdpersonalens och ledningsgruppens beskrivning av verksamheten med vårdhund samt deras erfarenheter om vårdhundens betydelse för personer med demenssjukdom och äldre somatiskt sjuka samt deras vård2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

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

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

  • 289.
    Björklund, AnnCharlott
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Krigh Brodin, Pernilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Sjuksköterskans omvårdnad och barns upplevelser vid stickprocedurer : – En litteraturstudie2010Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

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

     

     

     

     

     

     

     

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

  • 290.
    Björklund, Erika
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för pedagogik.
    Constituting the Healthy Employee?: Governing gendered subjects in workplace health promotion2008Doctoral thesis, monograph (Other academic)
    Abstract [en]

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

  • 291.
    Björklund, Erika
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Education.
    Nordlöf, Hasse
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Discourses about electricians in vocational education2018Conference paper (Refereed)
    Abstract [en]

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

  • 292.
    Björklund, Malin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Larsson, Sandra
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Familjers uppfattningar relaterat till sitt barns övervikt eller fetma: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:Overweight and obesity among children has increased, this is seen to be due to genetic causes in combination with environmental factors. Overweight and obesity is a contributing factor due to diseases such as type 2 diabetes and cardiovascular disease and psychological stress of the individual.

    Aim: The aim of the present study was to describe the families' perceptions related to their child being overweight or obese. Furthermore, the aim has been to describe the articles included data collection method.

    Method: Twelve pieces of scientific papers were used as a basis for a literature study with a descriptive design.

    Main results:This literature study shows that families rarely perceive their child's proper weight. In most cases families underestimated child obesity because they considered them as normal weight. Difference between girls and boys was something that emerged, it turned out that the parents had a higher acceptance regarding overweight boys related to girls being overweight. Socioeconomic differences were also significant when one clearly saw a higher acceptance regarding obesity in parents with low income. The parents felt that in the preventive work with overweight children, it was important that the focus would be on the whole family and not just the overweight child. Articles data collection method consisted of interviews and questionnaires.

    Conclusion: Families often underestimated their child's obesity. Parents felt that in the preventive work with overweight or obese children, it was important that the focus would be on the whole family and not just on the child. Knowledge of how families perceive their child's overweight and obesity are important to increase understanding of how prevention work should be improved and be made by health care professionals.

  • 293. Björklund, Martin
    The ProFitMap-neck questionnaire.2014In: Neck pain : new perspectives : 14th Physiatric Summer School : 15.-16.08.2013, Helsinki / [ed] Lindgren Karl August, Helsinki: Rehabilitation Orton, Invalid Foundation , 2014, 1, p. 61-68Chapter in book (Other academic)
  • 294.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Institutionen för samhällsmedicin och rehabilitering, fysioterapi, Umeå universitet.
    What works for whom:challenges in personalising physical therapy: Discussion panel2015Conference paper (Other academic)
  • 295.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Djupsjöbacka, Mats
    University of Gävle, Centre for Musculoskeletal Research.
    Crenshaw, Albert G
    University of Gävle, Centre for Musculoskeletal Research.
    Acute muscle stretching and shoulder position sense2006In: Journal of athletic training, ISSN 1062-6050, E-ISSN 1938-162X, Vol. 41, no 3, p. 270-274Article in journal (Refereed)
    Abstract [en]

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

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

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

    Setting: A university human research laboratory.

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

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

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

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

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

  • 296.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Svedmark, Åsa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Häger, Charlotte
    Inst samhällsmedicin och rehabilitering, sjukgymnastik, Umeå univeristet.
    Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial2012In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, no 75Article in journal (Refereed)
    Abstract [en]

    Background

    A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU) on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU.

    Methods

    120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20-65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T), non-tailored treatment (NT) or treatment-as-usual (TAU). Treatment is given to the groups T and NT for 11 weeks (27 sessions evenly distributed). An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to the each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index) and average pain intensity last week (Numeric Rating Scale). Secondary outcomes are general improvement (Patient Global Impression of Change scale), symptoms (Profile Fitness Mapping neck questionnaire), capacity to work in the last 6 weeks (quality and quantity) and pressure pain threshold of m. trapezius. Primary and secondary outcomes will be reported for each group with effect size and its precision.

    Discussion

    We have chosen not to include women with psychological ill-health and focus on biomedical aspects of neck pain. Future studies should aim at including psychosocial aspects in a widened treatment decision model. No important adverse events or side-effects are expected. Trial registration: Current Controlled Trials registration ISRCTN49348025. Key words: Neck, trapezius, myalgia, neck-shoulder pain, RCT, individualized treatment, rehabilitation, physiotherapy, tailored

  • 297.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Djupsjöbacka, Mats
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Svedmark, Åsa
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Häger, Charlotte
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with nonspecific neck pain: a randomized controlled trial2014Conference paper (Refereed)
    Abstract [en]

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

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

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

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

  • 298.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research. Alfta Research Foundation, Alfta, Sweden.
    Hamberg, Jern
    Alfta Research Foundation, Alfta, Sweden.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Barnekow-Bergkvist, Margareta
    University of Gävle, Centre for Musculoskeletal Research.
    The assessment of symptoms and functional limitations in low back pain patients: validity and reliability of a new questionnaire2007In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 16, no 11, p. 1799-1811Article in journal (Refereed)
    Abstract [en]

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

  • 299.
    Björklund, Martin
    et al.
    University of Gävle, Centre for Musculoskeletal Research.
    Hamberg, Jern
    Alfta Research Foundation, Alfta, Sweden.
    Heiden, Marina
    University of Gävle, Centre for Musculoskeletal Research.
    Barnekow-Bergkvist, Margareta
    University of Gävle, Centre for Musculoskeletal Research.
    The profile fitness mapping scales, validity of a new back-specific questionnaire2009Conference paper (Refereed)
    Abstract [en]

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

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

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

  • 300.
    Björklund, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Hamberg, Jern
    Alfta Research Foundation.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Barnekow-Bergkvist, Margareta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    The ProFitMap-neck: reliability and validity of a questionnaire for measuring symptoms and functional limitations in neck pain2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 13, p. 1096-1107Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess overall reliability and validity of a neck-specific questionnaire, the Profile Fitness Mapping neck questionnaire (ProFitMap-neck), on three chronic neck pain groups. Method: Participating groups were as follows: whiplash associated disorders, inpatient care (IP-WAD, n = 127); nonspecific neck pain, inpatient care (IP-NS, n = 83) and nonspecific neck pain subjects (non-IP-NS, n  = 104). All groups answered the ProFitMap-neck and the SF-36, whereas non-IP-NS also answered the Neck Disability Index (NDI) and the Functional Self-Efficacy Scale (SES). Internal consistency, test–retest reliability and components of convergent construct, face and content validity were determined for the ProFitMap-neck. Results: The ProFitMap-neck showed good internal consistency in all three groups, and ICC test–retest reliability (0.80–0.91). Good correlation (0.66–0.78) and highest agreement was reached with NDI. According to the International Classification of Functioning, Disability and Health, the symptom scale of the ProFitMap-neck was mainly classified to the domain of impairments–body functions, and the functional limitation scale to the activity limitation domain. Conclusion: The results indicate that the ProFitMap-neck is valid for measuring symptoms and functional limitations in people with chronic neck pain. The combination of a composite total score of symptoms and function as well as separate scores of each domain makes ProFitMap-neck suitable for research as well as in clinical practice.

    Implications for Rehabilitation

    • The ProFitMap-neck can be used as a valid self-assessment tool for measuring symptoms and functional limitations in people belonging to the most prevalent categories of neck pain.

    • The combination of the symptom and functional limitation questionnaire scores in a total score can be used for an overall clinical judgment.

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