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  • 251.
    Jonsson, Pernilla
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nilsson, Agneta
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Stomiopererades upplevelse av livskvalitet och sexualitet:  en litteraturstudie2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Each year stoma surgery approximately 20 000 persons in Sweden, of various underlying causes. The individual’s quality of life and sexuality are influenced of this kind of surgery often fear of odour and leakage. For nurses it´s important to have a sound of knowledge of being colostomy carriers life situation to identify problems and to see the patients need of care. Aim: of this study is to describe the life situation in patients with stoma, with focus on aspects of quality of life, coping and sexual life. Method: A descriptive literature review using the key terms was used as a method to answer the purpose. Searches were conducted in the databases CINAHL and Pub Med. The articles were reviewed and analyzed. Results: People with a stoma are experiencing problems with odour, gas and leakage. The problems create constraints in the loss of professional identity and social life and as well many felt prevented to participate in activities and travels. Stoma also leads to changes in diet and choice of clothes. Altered body image reduces the experience of being attractive and sexual life is affected. Women and men experience different situation. The nurse's ability to provide information is relevant to quality of life in everyday life. Conclusion: To obtain a stoma involves major change in life, including the underlying reason for an ostomy. If the stoma patients experience a good quality of life and sexual function depended on the nurse's ability to convey relevant information.

  • 252.
    Jonsson, Susanne
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Helgesson, Yvonne
    University of Gävle, Department of Caring Sciences and Sociology.
    Demens före 65 års ålder: Anhörigas erfarenheter av närståendes sjukdom och senare placering2009Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Syftet med vår studie är att undersöka anhörigas erfarenheter från det att deras närstående personlighetsförändras på grund av sin demenssjukdom tills de anhöriga accepterar en placering för dem på ett särskilt boende. När vi talar om anhöriga avser vi informanterna och när vi talar om närstående avser vi de demenssjuka. Den grupp av demenssjuka vi inriktar oss på är yngre dementa personer som fått diagnosen demens före 65 års ålder. I våra yrkesarbeten har vi kunnat se att dessa personer och deras anhöriga genomgår en annan process än vad som är fallet när individer har åldersdemens. Det vi bland annat kunnat se är att både anhöriga och de personer som får diagnosen ofta tappar tron på framtiden för att sjukdomen gör att det sociala livet och det egna förhållandet stannar av beroende på att vänner och andra anhöriga har svårt att hantera det nya beteendet som glömska, aggressivitet och oro. De anhöriga känner sig även lurade av att deras närstående i så tidig ålder blev sjuka och att de inte fick uppleva ålderdomen tillsammans.

     

    Vi har i vår studie kunnat se hur de anhöriga har pendlat mellan makt, vanmakt och till slut motmakt under processen som de genomgått tillsammans med sina närstående. I vår studie gjordes fyra intervjuer med anhöriga som har en närstående i gruppen yngre dementa.

  • 253.
    Joof Forsgren, Erika
    University of Gävle, Department of Caring Sciences and Sociology.
    Förändringsarbete inom äldreomsorgen: - ett kostprojekt2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In one district of Sweden, improvements in the diets of the older people in a nursing home are being implemented by staff.  The staff included managers, nurses, dietary assistants and development workers. Aim: To explore nursing assistant perceptions of the advantages, disadvantages and influence around the meal environment after implementing new guidelines. Method: A descriptive design with a qualitative approach Twenty-five nursing assistants were interviewed about their perceptions. Results: It was found that the perceptions of the majority of the nursing assistants’ were some improvement in the wake of the new dietary guidelines. Furthermore, it was reported that the guidelines had appeared to affect the elderly in a positive fashion by improving the meal time environment, by providing healthier and better quality food, shortening the period between meals at night and increased their autonomy. The disadvantages of the new guidelines were that some staff found the new approach stressful owing to an increased amount of cleaning and longer meal times. In addition, the majority of staff felt that they were not included in the creation of the guidelines and there were also difficulties in implementing them across all staff members. Conclusion: According to the author this study shows that it is possible to work for change to the better in the care for older people.

  • 254.
    Kaltenbrunner Nyqvist, monica
    University of Gävle, Department of Caring Sciences and Sociology.
    Hälsa och psykosocial arbetsmiljö bland sjuksköterskor och skötare inom den psykiatriska vården2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den psykosociala arbetsmiljön har inverkan på vår psykiska och fysiska hälsa. Fysiska hälsobesvär kan vara i form värk från nacke och rygg. Psykiska hälsobesvär kan bland annat handla om trötthet, sömnproblem eller oro. Syftet med föreliggande studie var främst att bedöma hur omvårdnadspersonal inom psykiatrisk vård upplevde sin psykosociala arbetsmiljö och hälsa, men även att beskriva eventuella samband mellan dessa. Studien är av tvärsnittskaraktär och bygger på enkätsvar från 395 personer (sjuksköterskor n= 166, skötare n= 229) från en nationell studie. Resultatet visade att sjuksköterskorna i högre grad uppgav stöd från kollegor, inflytande över arbetstider och hur arbetet skulle utföras jämfört med skötarna. Skötarna skattade lägre angående psykisk trötthet, lärande samt arbetstid vid datorn än sjuksköterskorna. Värk från nacke förekom oftare hos sjuksköterskorna. Signifikanta samband fanns mellan att ha värk i nacken och att känna sig psykiskt trött. Inga samband sågs mellan besvär från nacken och krav på att arbeta fort eller arbetstid vid datorn. Konklusioner som kan dras av resultatet är att sjuksköterskorna uppgav mer kontroll, lärande, stöd och inflytande på arbetet än skötarna samt upplevde de oftare psykisk trötthet och värk från nacken. Skötarna rapporterade värk i lägre utsträckning trots att de skattat lägre på inflytande, krav och stöd.

  • 255.
    Kaltenbrunner, Petra
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Sjuksköterskans arbete och upplevelser av arbetet med att motivera patienter att göra livsstilsförändringar.2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Syftet med studien var att beskriva hur sjuksköterskor på diabetes- och blodtrycksmottagningar på vårdcentraler arbetar med att motivera patienter att göra livsstilsförändringar och att beskriva sjuksköterskornas upplevelser av arbetet med att motivera patienter att göra livsstilsförändringar. Ännu ett syfte var att beskriv vilka hinder och möjligheter de upplever i det arbetet. Tio sjuksköterskor på sex hälsocentraler i Mellansverige intervjuades. Intervjuerna analyserades utifrån kvalitativ innehållsanalys. Resultatet redovisas i fem kategorier och 14 subkategorier. Kategorin att identifiera livsstil beskriver hur sjuksköterskorna identifierade patienternas livsstil och riskbeteenden. Kategorin behandlingsstrategi beskriver hur sjuksköterskorna arbetade utifrån patientcentrerade samtal, motiverande samtal, förskrivning av fysisk aktivitet på recept, samarbetet med sjukgymnast, dietist och arbetsterapeut och uppföljning av patienterna. Kategorierna hinder och möjligheter beskriver hur patientens motivation och arbetsmetoder kan vara både hinder och möjlighet. Att verksamheten inte kunde erbjuda patientgrupper beskrev som ett hinder. Kategorin en utmaning beskriver sjuksköterskornas upplevelser av arbetet.

    Nyckelord; livsstilsförändring, motivation, sjuksköterska, motiverande samtal

  • 256. Karlsson, Bengt
    et al.
    Gustafsson, Jan
    Hedov, Gerth
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Ivarsson, S A
    Annerén, Göran
    Thyroid dysfunction in Down's syndrome: relation to age and thyroid autoimmunity.1998In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 79, no 3, p. 242-245Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prevalence of thyroid disease is increased in Down's syndrome. Most available data come from cross sectional studies. AIMS: To study longitudinally thyroid function in patients with Down's syndrome in Uppsala county (85 patients) up to the age of 25 years. METHODS: Observational study based on yearly follow up in a children's clinic. Thyroid function tests were performed at each visit to the clinic. RESULTS: Hypothyroidism was found in 30 and hyperthyroidism was found in two of the 85 patients. No sex difference was seen. Half of the patients with hypothyroidism acquired the condition before the age of 8 years, but only one of them displayed thyroid autoantibodies at diagnosis. Most patients who developed hypothyroidism after this age had thyroid autoantibodies. In the prepubertal patients with hypothyroidism, growth velocity was lower during the year before the start of thyroxine treatment than during the year after treatment began; it was also lower than that of sex and age matched euthyroidic children with Down's syndrome. CONCLUSION: Thyroid dysfunction in patients with Down's syndrome is common in childhood. Consequently, annual screening is important. Autoimmune thyroid disease is uncommon in young children with Down's syndrome but is common after 8 years of age.

  • 257.
    Keinström, Emelie
    University of Gävle, Department of Caring Sciences and Sociology. University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    How the nurses in Kilifi (Kenya) experience their work with children that suffer from severe disease/illness: A Minor Field Study at a sub-Saharan district hospital in Kenya2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 258.
    Keinström, Emelie
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    How the nurses in Kilifi (Kenya) experience their work with children that suffer from severe disease/illness: A Minor Field Study at a sub-Saharan district hospital in Kenya2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 259.
    Kejerfors, Johan
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Parenting in urban slum areas: families with children in a shantytown of Rio de Janeiro2007Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This is a study of parenting and child development in a slum area in a developing part of the world. The aims of the study were threefold. The first aim was to explore the physical and social contexts for parenting in a shantytown in Rio de Janeiro using an ecological perspective. The second aim was to examine parenting and subsequent child outcomes among a sample of families living in the shantytown. The third aim was to explore what factors contribute to differences among parents in how they nurture and protect their children. The theoretical framework of the study was an updated version of Bronfenbrenner’s bioecological model of human development. Using self-report questionnaires developed by Rohner, data on perceived parental acceptance–rejection were collected from 72 families with adolescents 12–14 years old, representing approx. 75% of all households with children in this age group in the shantytown. Besides self-report questionnaires, each adolescent’s main caregiver replied to several standardized questionnaires developed by Garbarino et al., eliciting demographic and social-situational data about the family, neighborhood, and wider community. The results of the study paint a complex portrait of the social living conditions of the parents and children. Despite many difficulties, most parents seemed to raise their children with loving care. The results from the self-report questionnaires indicate that the majority of the adolescents perceived substantial parental acceptance. The adolescents’ experience of greater or lesser parental acceptance–rejection seems to influence their emotional and behavioral functioning; it also seems to be related to their school attendance. Much of the variation in degree of perceived acceptance–rejection seems to be related both to characteristics of the individual adolescents and their main caregiver(s) and to influences from the social and environmental context in which they and their caregivers interact and live their lives.

  • 260.
    Kejerfors, Johan
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Parenting in urban slum areas: families with children in a shantytown of Rio de Janeiro2007Book (Other academic)
    Abstract [en]

    This is a study of parenting and child development in a slum area in a developing part of the world. The aims of the study were threefold. The first aim was to explore the physical and social contexts for parenting in a shantytown in Rio de Janeiro using an ecological perspective. The second aim was to examine parenting and subsequent child outcomes among a sample of families living in the shantytown. The third aim was to explore what factors contribute to differences among parents in how they nurture and protect their children. The theoretical framework of the study was an updated version of Bronfenbrenner’s bioecological model of human development. Using self-report questionnaires developed by Rohner, data on perceived parental acceptance–rejection were collected from 72 families with adolescents 12–14 years old, representing approx. 75% of all households with children in this age group in the shantytown. Besides self-report questionnaires, each adolescent’s main caregiver replied to several standardized questionnaires developed by Garbarino et al., eliciting demographic and social-situational data about the family, neighborhood, and wider community. The results of the study paint a complex portrait of the social living conditions of the parents and children. Despite many difficulties, most parents seemed to raise their children with loving care. The results from the self-report questionnaires indicate that the majority of the adolescents perceived substantial parental acceptance. The adolescents’ experience of greater or lesser parental acceptance–rejection seems to influence their emotional and behavioral functioning; it also seems to be related to their school attendance. Much of the variation in degree of perceived acceptance–rejection seems to be related both to characteristics of the individual adolescents and their main caregiver(s) and to influences from the social and environmental context in which they and their caregivers interact and live their lives.

  • 261.
    Kempe-Kropf, maria
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Peltonen, Satu
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Följsamhet gällande handhygien bland vårdpersonal: - en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna litteraturstudie var att beskriva varför följsamheten gällande handhygien ofta är låg bland vårdpersonal, samt hur man kan öka följsamheten för handhygien bland vårdpersonal. Metoden som använts var en litteraturstudie. Datainsamling skedde via databaserna Medline (PubMed), Cinahl (EBSCO host) och Academic Search Elite. Sökorden som använts: prevention, hand disinfection, hand washing, infection control, nosocomial infection och education. Totalt användes 15 vetenskapliga artiklar. Resultatet delades in i två huvudrubriker: Orsaker till att följsamheten ofta är låg bland vårdpersonal och faktorer som kan öka följsamheten gällande handhygien bland vårdpersonal. De två huvudrubrikerna delades in i sex underrubriker: tidsbrist, hudbekymmer, kunskapsbrist, utbildning, affisch/posters och tillgänglighet. Resultatet visade att det finns många anledningar till att följsamheten för handhygien är låg. Studien visar att tidsbrist, hudbekymmer samt kunskapsbrist gällande hand hygien är de vanligaste orsakerna. Utbildning tillsammans med affischer/posters samt ökad tillgänglighet vad gäller material har visat sig vara det mest effektiva sättet att öka följsamheten av handhygien.

    Nyckelord

    .

    : prevention, hand disinfection, hand washing, infection control, nosocomial infection och education.

  • 262.
    Kihlander, karin
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Persson, stina
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Hur kvinnor med fibromyalgi upplever sin livskvalitet- en litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 263.
    Kjettselberg, Madelene
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Qvarnström, Anna
    University of Gävle, Department of Caring Sciences and Sociology.
    Musikens inverkan på personer med demenssjukdom: -en litteraturstudie2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    As the population are getting older the number of people suffering from dementia is increasing. To be diagnosed with dementia means that cognitivie abilities are decreasing. Communication problems, problems with activities in daily living, changes in personality, lack of empathic ability and difficulties in controlling feelings are the characteristics of the disease. There is a need for non-pharmacological treatment when medication does not give the wanted effect.

    The aim of this literature review was to get an increased knowledge about how music effects elderly persons with dementia. The search of scientific articles was carried out through the databases MedLine (via PubMed), Blackwell-Synergy and Cinahl. The search resulted in 21 articles of which 14 was included in the study result. The result showed that music was used to calm, increase cognitive ability and well-being in persons with dementia. This study showed that music has a positive influence regardless of cognitive ability. It is a costeffective, non-pharmacologic treatment which is easy to implement.

  • 264.
    Knapp, anna
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Kavallin-Eklund, Maria
    University of Gävle, Department of Caring Sciences and Sociology.
    Hur påverkas personalens arbetsglädje i ett förändringsarbete?2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna undersökning behandlar ett ämne som i samhället är väldigt aktuellt. Syftet med undersökningen är att ta reda på hur omsorgspersonal kan uppleva arbetsrelaterade förändringar och med fokus på hur dessa upplevelser relaterar till personalens arbetsglädje. Undersökningen utgörs av en kvalitativ studie i form av intervjuer. I undersökningen ingår fyra informanter, alla arbetar inom äldreomsorgen som omsorgspersonal. Informanterna arbetar på två olika arbetsplatser där dessa nyligen har genomfört större organisatoriska förändringar.

     

    Resultatet visar att arbetsglädje för personalen är att ”vara glad på arbetet”, att tycka arbetet är ”roligt”, samt att känna att man gör någonting meningsfullt. Men också att få vara ”delaktig”, att få ”stöttning” och ”uppskattning” av arbetskamrater och chef. Informanterna upplevde att arbetsglädjen påverkades negativt under förändringsprocessen men efter att förändringen genomförts upplever man arbetsglädje i större utsträckning än tidigare. Den främsta anledningen till att arbetsglädjen minskade under förändringsprocessen var att personalen inte kände sig delaktig i beslutet om förändring.

  • 265.
    Krantz Johansson, Anneli
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Mattsson, Tina
    University of Gävle, Department of Caring Sciences and Sociology.
    Sjuksköterskan inom kommunal äldreomsorg -en intervjustudie om yrkesval och yrkesroll2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Sammanfattning

    Syftet med den här studien var att beskriva hur sjuksköterskor inom kommunal äldreomsorg ser på sin profession med tyngdpunkt på eget yrkesval, vad som får dem att stanna kvar, synen på yrkesrollen och vad som förväntas befrämja

    Studien har genomförts som en kvalitativ beskrivande intervjustudie. Materialet analyserades med hjälp av innehållsanalys. Resultatet visade att yttre omständigheter gjorde att sjuksköterskorna valde att arbeta med äldreomsorg.

  • 266.
    Krekula, Clary
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    The intersection of age and gender: reworking gender theory and social gerontology2007In: Current Sociology, ISSN 0011-3921, E-ISSN 1461-7064, Vol. 55, no 2, p. 155-171Article in journal (Refereed)
    Abstract [en]

    This article discusses the position of older women in gender theory and in social gerontology. It shows how older women are made invisible in gender theory through the selection of arenas and themes, by model monopoly and by a lack of problematization of age. In the social gerontological field, older women have frequently been objects of research. However, double jeopardy assumptions have resulted in a perspective that foregrounds misery. Results from focus group interviews with women aged 75 and over, shed light on ageing as a process of development and on twofold bodily meanings, such as on-stage-body and off-stage-body. Thus, based on an approach of age and gender as intertwining systems, the article argues for a more complex understanding of the intersection of age and gender.

  • 267.
    Kristofferzon, Marja-Leena
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Commentary on Kristofferzon M-L, Lofmark R & Carlsson M (2007) Striving for balance in daily life experiences of Swedish women and men shortly after a myocardial infarction. Journal of Clinical Nursing 16, 391-401 - Response2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 8, p. 1106-1106Article in journal (Refereed)
  • 268.
    Kristofferzon, Marja-Leena
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Health-related quality of life over the first year after myocardial infarction2006In: New Frontiers in Cardiac Care: Bergen, Norway 5–6th May 2006, 2006, p. s40-s41Conference paper (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to compare healthrelated quality of life (HRQoL) in patients 1, 4 and 12 months after myocardial infarction with regard to (1) differences over time and (2) differences between younger (42–64 years old) and older (65–90 years old) patients.

    Methods: A longitudinal, descriptive and comparative design was used for the study, which included 69 younger (39% women) and 79 older (42% women) patients. Data were collected with the SF-36 Health Survey during the period 1999–2001.

    Results: Table 1 displays main effects of time and groups. No group-by-time interaction effects emerged. HRQoL increased in younger patients for physical functioning, bodily pain, vitality and social functioning scales between 1 and 4 months, which remained at 12 months. There was also an increase for role-physical and role-emotional scales between 1 and 4 months and a further increase between 4 and 12 months. In older patients the increase for rolephysical, vitality, social functioning and role-emotional scales was found between 1 and 4 months, which remained at 12 months. Moreover, an improvement in the physical functioning scale was found between 4 and 12 months and for the bodily pain scale between 1 and 4 months. An increase for mental health scale in the study group was evident between 4 and 12 months, but when the study group was divided into younger and older patients the change over time disappeared. The general health scale was stable over time. Compared with older patients, younger patients rated higher HRQoL for the physical functioning scale at 1, 4 and 12 months, for the social functioning scale at 1 and 12 months, for the roleemotional scale at 4 and 12 months and for the rolephysical scale at 12 months.

    Conclusion: There was an improvement in HRQoL in both younger and older patients, but the improvement was more obvious in younger patients. In addition, younger patients perceived higher HRQoL than older patients in several dimensions and at several points in time. This was most evident at 12 months.

  • 269.
    Kristofferzon, Marja-Leena
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Life after myocardial infarction in women and men: coping, social support and quality of life over the first year2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aims : The general aim of this thesis was to describe the life situation of women and men during their first year after myocardial infarction (MI) with regard to problems in daily life, how they coped with them, the social support available and the patients’ perceived quality of life (QoL). An additional aim was to examine differences over time and between women and men in coping, social support and QoL.

    Methods : A consecutive series of 74 women and 97 men were selected 1 month after MI and followed over the first year. A qualitative approach was used to describe experiences of everyday life of 20 women and 19 men from the study group, from the onset of MI through the first months after the event (retrospectively). Focus was on managing problems and support from the network (I). Also experiences at 4 to 6 months and expectations of the future were explored (II). Coping, social support and QoL were compared between women and men both with a cross-sectional (at 1 month; 74 women and 97 men; III) as well as with a longitudinal design (at 1, 4 and 12 months; 60 women and 88 men; IV).

    Findings : Physical symptoms and emotional distress were the most commonly described problems during the first months after MI. The patients managed the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviour and taking their own decisions. The network was generally supportive but also communication problems were described (I). Many of the patients had not established a stable health condition after 6 months. They managed the consequences of their disease, found a meaning in what had happened, and confidence in the future. The support from their social network encouraged them to move on (II). Women used more evasive and supportive coping than men 1 month after MI. More women perceived support being available from grandchildren and friends and more men from their partners. Compared with men, women rated lower health-related QoL and QoL (III). Coping and social support were stable over time, women used more evasive coping than men and health-related QoL increased for both women and men. (IV).

    Conclusions : The first month after MI seems to be a vulnerable period especially for women. They had difficulties interpreting their heart symptoms, did not want to bother others with their worries and rated lower QoL than men. Patients redefined normal life, found hopes for the future and women did not demonstrate a poorer QoL profile than men over time.

  • 270.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Lindqvist, Ragny
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Nilsson, Annika
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Living with chronic illness2009In: The 2nd International Research Seminar on Salutogenesis: Helsinki, May 14-16, 2009, 2009Conference paper (Refereed)
    Abstract [en]

    Aim: To study differences between two groups, end-stage renal disease (ESRD) and chronic heart failure (CHF), regarding sense of coherence (SOC), General Self-efficacy (GSE), and quality of life (QoL) as well as relationships between these variables. 

    Design: Descriptive, comparative and correlative design.  

    Sample: A Swedish sample of 100 patients (59 CHF and 41 ESRD) was included. The mean age was 68 years (46 – 80 years).  

    Measures: Data were collected with the SOC, the GSE and the Life Satisfaction Questionnaire (LSQ). Age, sex, educational level and living area were also examined.    

    Data analysis: Differences were tested with chi-square and Mann-Whitney U-test and correlations with Pearson’s correlation coefficient. 

    Results: Both SOC (r=0.58, P<0.01) and GSE (r=0.46, P=<0.01) were positively correlated with LSQ. No significant differences between the two groups were found for the study variables. Older persons (>65 years) rated their personal relationships within QoL higher (P=0.045) and older ESRD patients their SOC stronger (P=0.049). Men with CHF rated their self-efficacy higher (P=0.034).

    Conclusions: Our preliminary results indicate that it seems more important how the individual tackle their present situation than what chronic illness they have.  

     

  • 271.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Löfmark, Rurik
    Länssjukhuset Gävle-Sandviken.
    Carlsson, Marianne
    Uppsala universitet.
    Coping, social support and quality of life over time after myocardial infarction2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 52, no 2, p. 113-124Article in journal (Refereed)
    Abstract [en]

    Aim. This paper describes gender differences in perceived coping, social support and quality of life 1, 4 and 12 months after myocardial infarction.

    Background. There is a shortage of studies with a longitudinal research design investigating coping, social support and quality of life in women and men after myocardial infarction.

    Methods. A longitudinal, descriptive and comparative design was used for the study, which included 74 women and 97 men. At 12 months, 60 women and 88 men remained. Data were collected using the Jalowiec Coping Scale, a social support questionnaire, the SF-36 Health Survey (health-related quality of life) and the Quality of Life Index-Cardiac version (quality of life). The data were collected during the period 1999–2001.

    Results. No statistically significant changes over time in coping assessments emerged in the study group, except for fatalistic coping, which diminished over time in men. Women used more evasive coping than men at 4 and 12 months. The perceived efficiency in coping with physical aspects of the heart disease increased. More women than men perceived available support from grandchildren and staff of the church. Health-related quality of life increased in women and men in physical functioning, role-physical, vitality, social functioning, and role-emotional scales.

    Moreover, an improvement in the mental health scale was evident in women and a reduction in pain in men. No statistically significant gender differences were found for quality of life at any point in time.

    Conclusions. The findings can be used to inform caregivers that optimistic, selfreliant and confrontational coping were the most frequently used by both women and men over the first year after myocardial infarction, and that confrontational coping has been shown to have positive outcomes in the longer term. Nurses should tell women about the importance of seeking prompt treatment and discuss health problems with caregivers and significant others. Care planning should include family members and significant others so that they can support and encourage patients to cope with problems in daily life.

  • 272.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Löfmark, Rurik
    Centre for Bioethics, Karolinska Institutet, Uppsala University, Solna, Sweden.
    Carlsson, Marianne
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Managing consequences and finding hope: experiences of Swedish women and men 4-6 months after myocardial infarction2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 367-375Article in journal (Refereed)
    Abstract [en]

    Research has focused more on symptoms, risk factors and treatment, than on individuals’ experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4–6 months after MI and their expectations for the future. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, ‘Managing consequences of MI’ and ‘Finding a meaning in what had happened’, were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients’ needs of support both in a short- and long-term perspective.

  • 273.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Löfmark, Rurik
    Länssjukhuset Gävle-Sandviken.
    Carlsson, Marianne
    Uppsala universitet.
    Myocardial infarction: gender differences in coping and social support2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 44, no 4, p. 360-374Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this review is to summarize current knowledge about gender differences in perceptions of coping and social support among patients who have experienced myocardial infarction.

    Rationale. Women with coronary heart disease have physical, social and medical disadvantages compared with their male counterparts, which can influence their perception of recovery after cardiac events. No review has been found which focuses

    on gender differences in coping and social support in myocardial infarction patients.

    Method. A computerized search was conducted using the keywords ‘myocardial infarction’, ‘coping’, ‘gender differences’ and ‘social support’. Forty-one articles, published between 1990 and October 2002, were scrutinized.

    Findings. Two studies report that women used more coping strategies than men. Several qualitative studies found that women used a variety of coping strategies. Women minimized the impact of the disease, tended to delay in seeking treatment

    and did not want to bother others with their health problems. Household activities were important to them and aided their recovery. Men were more likely to involve their spouses in their recovery, and resuming work and keeping physically fit were

    important to them. Women tended to report that they had less social support up to 1 year after a myocardial infarction compared with men. They received less information

    about the disease and rehabilitation and experienced lack of belief in their heart problems from caregivers. Further, they received less assistance with household duties from informal caregivers. Men tended to report more support from their

    spouses than did women.

    Conclusions. Traditional gender-role patterns may influence the recovery of patients who have experienced myocardial infarction. Caregivers may need to be more sensitive to gender-specific needs with regard to risk profiles, social roles, and the patient’s own role identity. For many women, especially older ones, household duties and family responsibilities may be an opportunity and a base for cardiac rehabilitation.

  • 274.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Löfmark, Rurik
    Länssjukhuset Gävle-Sandviken.
    Carlsson, Marianne
    Uppsala universitet.
    Perceived coping, social support, and quality of life 1 month after myocardial infarction: A comparison between Swedish women and men2005In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 34, no 1, p. 39-50Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The study objective was to compare coping, social support, and quality of life in Swedish women and men 1 month after myocardial infarction.

    DESIGN: The study design was cross-sectional and descriptive-comparative.

    SETTING: The study took place in 1 hospital service area in the middle of Sweden.

    SUBJECTS: The sample consisted of 74 women and 97 men.

    INSTRUMENTS: The Jalowiec Coping Scale, the Social Network and Social Support Questionnaire, the Short Form-36 Health Survey, and the Quality of Life Index-Cardiac Version were used.

    RESULTS: Compared with men, women used more evasive and supportive coping and rated psychologic aspects of the heart disease as more problematic to manage. More women perceived available support from friends and grandchildren, and more men perceived available support from their partner. Women rated lower levels in physical and psychologic dimensions of quality of life.

    CONCLUSION: The first month after myocardial infarction is a susceptible period especially for women. They used more evasive and supportive coping and experienced a lower quality of life compared with men.

  • 275.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Löfmark, Rurik
    Centre for Bioethics at Karolinska Institutet and Uppsala University, Solna, Sweden.
    Carlsson, Marianne
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Striving for balance in daily life: experiences of Swedish women and men shortly after myocardial infarction2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 2, p. 391-401Article in journal (Refereed)
    Abstract [en]

    Aim: The aim is to describe experiences of daily life of women and men during the first four to six months after a myocardial infarction. The focus is on problems, managing problems and support from their network.

    Background: A cardiac event is traumatic and may influence well-being during a significant period of time. Few qualitative studies have investigated experiences of both women and men after a myocardial infarction and remarkably little research has been conducted on men’s experiences.

    Design: The study design was descriptive, retrospective and qualitative.

    Methods: Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed using qualitative content analysis.

    Results: Three themes were generated from the analysis; ‘Threatening ordinary life’, ‘Struggling for control’ and ‘The ambiguous network’. Physical symptoms and emotional distress were the most commonly described problems during the first months after a myocardial infarction. The informants manage the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviours and taking their own decisions and actions. The network was generally supportive but rather often the informants also experienced communication problems when they interacted with their network.

    Conclusions: Women and men strive for balance between problems and resources in daily life after a myocardial infarction. How well they succeeded depends on how secure they feel how well they communicate their needs to their network and how sensitive their network is to their spoken and unspoken needs.

    Relevance to clinical practice: The findings provide an insight into what kind of problems women and men may experience after myocardial infarction and how caregivers can aid them to increase security in their daily life. Some risk characteristics that may have increased their problems in daily life are suggested, for women and men respectively.

  • 276.
    Käll, stefan
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Leinonen, Fredrik
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Samband mellan bmi och långvarig smärta hos patienter som genomgått ett beteendemedicinskt rehabiliteringsprogram: en beskrivande studie2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Purpose: The purpose of this study was to see if there was any correlation between BMI and chronic pain among participants who underwent a behavioural medicine rehabilitation program at a pain clinic in the central part of Sweden. Method: The study was conducted as a quantitative descriptive study context and has used medical records with documented data from the participants who were part of a pain clinic rehabilitation programs in the years 2004-2005. Altogether there were 76 participants in these years and excluded was nine participants with BMI measurements were not included in the documentation. Main Results: Regarding the relationship between BMI and chronic pain there was no significant relationships. Participants who completed the behavioural medicine rehabilitation program, however, showed a lower value of BMI and the estimated pain in VAS from the first to the third which is the last time of measuring. The estimated pain and the BMI measurements among the participants with chronic pain show compliance without that no significant relationships could be seen.

     

    Keywords: BMI, VAS, Chronic pain.

  • 277.
    Kårlin, Carina
    et al.
    University of Gävle, Department of Caring Sciences and Sociology. University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Stenling, Sofia
    University of Gävle, Department of Caring Sciences and Sociology. University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Hur ledarskap påverkar personal under en omorganisering2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to examine the influence of leadership on co-workers during a re-organization. Our framing of the problem is based on a book written by Lee G. Bolman and Terrence E. Deal (2007) “Reframing organizations – artistry, choice and leadership” and their four perspectives on leadership. The questions that our study is based on are:

    • What leadership perspective was characteristic for the chief of staff during the re-organization?
    • How did the employees experience the leadership of the chiefs during the re-organization?
    • In what way do the chiefs of staff feel that their leadership affected the employees during the re-organization?

     

    To get a deeper understanding in this subject we conducted interviews with the two chiefs of staff and their employees in a small suburb to Stockholm, Sweden. In our background we described the history of the suburb and why this re-organization is taking place. Thereafter we account for research in this area of expertise. In chapter five we account for the four perspectives and organization culture. We analyzed our interviewed material from these four perspectives and organization culture. Thereafter we conducted a conclusion based on the analyzed material. We concluded that both chiefs of staff were influenced by all four perspectives and this influence had different impacts on their employees. One chief were influenced by a Human Resource-perspective and a perspective focusing on structure. The second chief was also influenced by a perspective focusing on structure but also the perspective that focuses on politics.

  • 278.
    Lagergren Strindberg, Sofie
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Mohamed Farah, Asha
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Vårdpersonalens kommunikation och bemötande av personer med demenssjukdom: En Litteraturstudie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att utifrån vetenskaplig litteratur beskriva hur vårdpersonalen på ett professionellt sätt kan bemöta och kommunicera med personer med demenssjukdom. Metoden var en beskrivande litteraturstudie. Artiklarna analyserades beroende på om de handlade om Verbal och Icke-verbal kommunikation och bemötande samt Faktorer som påverkar kommunikation. I resultatet framkom det att när vårdgivaren visade respekt, omtanke, såg patienten som en individ, stöttade dess förmågor, gav kort och tydlig information, använde ögonkontakt, hade kunskap om patientens livshistoria och intressen samt använde sig av beröring ledde det till en förbättring av kommunikation och bemötande. Episoder av klarhet ledde till en tillfällig förbättrad kommunikation. Men när vårdgivaren ljög, var stressad, ställde för svåra frågor, ändrade samtalsämne för hastigt och gav för många olika budskap påverkade det kommunikationen med patienten med demenssjukdom på ett negativt sätt. Faktorer som påverkade kommunikationen var stunder av klarhet, resurser, tid och bakgrundsmusik. Slutsatsen var att det krävs en speciell kunskap, tålamod samt att yttre faktorer spelade in för att kunna bemöta och kommunicera med patienter med demenssjukdom på ett professionellt sätt. 

                                                       

     

                                                       

  • 279.
    Lampic, Claudia
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Livskvalitet och Response shift2007In: Psykosocial cancervård, Lund: Studentlitteratur , 2007, p. 75-96Chapter in book (Other (popular science, discussion, etc.))
  • 280.
    Lampic, Claudia
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skoog Svanberg, Agneta
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Sydsjö, Gunilla
    Division of Obstetrics and Gynaecology, Linköping University, Linköping, Sweden.
    Attitudes towards gamete donation among IVF doctors in the Nordic countries - are they in line with national legislation?2009In: Journal of Assisted Reproduction and Genetics, ISSN 1058-0468, E-ISSN 1573-7330, Vol. 26, no 5, p. 231-238Article in journal (Refereed)
    Abstract [en]

    Purpose: To compare attitudes towards gamete donation between IVF doctors in the Nordic countries, and to determine whether attitudes are in correspondence with national legislation. Materials and methods: A study-specific questionnaire was used to study attitudes of 108 IVF doctors (92% response). Participants constituted 78% of all IVF doctors in Sweden, Denmark and Norway and 15% of IVF doctors in Finland. Results: Despite similar legislation regarding offspring right to learn his/her donor's identity, IVF doctors from Norway reported significantly more negative attitudes towards disclosure than did Swedish physicians. A majority from all countries demonstrated positive attitudes towards embryo donation and allowing sperm donation for lesbian couples. Physicians reported strong support for anonymous donation but less support for 'known' donation. Conclusion: There are discrepancies between IVF doctors' attitudes towards gamete donation and national legislation in four Nordic countries. Negative attitudes towards disclosure to offspring may counteract legislative intentions.

  • 281.
    Lampic, Claudia
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Svanberg, A Skoog
    Karlström, P
    Tydén, T
    Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics2006In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 21, no 2, p. 558-64Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Postponing childbirth is becoming increasingly common in Western countries, especially among groups with higher education qualifications. It is relatively unknown to what extent women and men are aware of the age-related decline in female fertility. The aim was to investigate university students' intentions and attitudes to future parenthood and their awareness regarding female fertility. METHODS: Postal survey of a randomly selected sample of 222 female (74% response) and 179 male (60% response) university students. RESULTS: Female and male university students in Sweden have largely positive attitudes towards parenthood and want to have children. Women, in comparison to men, were significantly more concerned about problems related to combining work and children. Both women and men had overly optimistic perceptions of women's chances of becoming pregnant. About half of women intended to have children after age 35 years and were not sufficiently aware of the age-related decline of female fecundity in the late 30s. CONCLUSIONS: University students plan to have children at ages when female fertility is decreased without being sufficiently aware of the age-related decline in fertility. This increases the risk of involuntary infertility in this group, which is alarming in view of the great importance they put on parenthood.

  • 282.
    Landström Sandberg, Maj
    University of Gävle, Department of Caring Sciences and Sociology.
    Sjuksköterskans möjlighet att identifiera och stödja äldre med depression: En litteraturstudie2009Independent thesis Advanced level (degree of Master (One Year)), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna litteraturstudie var att belysa faktorer som kan ge sjuksköterskan vägledning i att identifiera depression hos äldre, samt hur sjuksköterskan på bästa sätt kan stödja äldre personer som drabbats av depression. Studien är en systematisk litteraturstudie och innehåller 20 vetenskapliga artiklar. Sökning genomfördes i Pubmed och Chinal samt i viss mån manuellt med sökorden nurse, depression, care, geriatric, affective disorders, failed age, recognice och support. Av resultatet framgick att riskfaktorer för att drabbas av depression är  kön, kroniska sjukdomar samt avsaknad av socialt stöd. Tecken på depression som sjuksköterskan bör observera är smärta, sömnsvårigheter, humörsvängningar och hypokondri. För att underlätta identifiering av depression hos äldre kan sjuksköterskan ta hjälp av skattningsinstrument. Ytterligare en faktor som påverkar identifieringen av depression är sjuksköterskans yrkeserfarenhet. Stöd till äldre med depression grundar sig i kommunikationen, som skall vara rak och ärlig dessutom ska sjuksköterskan visa tydligt att han/hon tar patientens känslor på allvar.  Stödet bör omfatta både fysiska och sociala aspekter. Här har anhöriga en viktig roll att vara ett stöd till äldre med depression.

     Eftersom symtombilden av depression hos äldre kan vara atypisk d v s med symtom som t e x smärta. Då det finns en underdiagnostik och därmed underbehandling är det av största vikt att sjuksköterskor kan identifiera depression hos äldre. Detta bidrar till bättre möjligheter att behandla depressioner och ger de äldre bättre levnadsvillkor.

  • 283.
    Larsson, Anna
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Jacobsson, Carina
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Kostrekommendationer till personer med övervikt och diabetes typ 2 - Litteraturstudie2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this literature review was to describe if the nutritional balance of the fats, carbohydrates, proteins and fibers can lead to weight reduction and to improve glucos-/blood lipid for individuals with obesity and type 2 diabetes. The method used was a literature review. Twenty-two scientific articles were chosen, which were consistent with the study purpose and questions. The articles were selected based on searches in the Medline database by PubMed. The keywords used were type 2 diabetes mellitus, diet, obesity, comparative, fat, carbohydrate, low carbohydrate, high fat and saturated fat. The articles were reviewed critically to assess their quality. In most of the studies, it turned out that the cost recommendations all resulted in different results of reduced weight, BMI and waistlines irrespective of which diet you choose. Some studies showed changes in blood sugar / blood lipid values, primarily that high intake of fat increased blood fat values. The conclusion of this study is that changes in dietary habits can result in increased weight loss and improved blood sugar / blood lipid values.

  • 284.
    Larsson, Helena
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Sjöö, Anna
    University of Gävle, Department of Caring Sciences and Sociology.
    Upplevelse av stress: Biståndshandläggares upplevelser i två kommuner i Mellansverige2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    This study deals with one of the most discussed work environmental issues in the modern society of Sweden today - work related stress, its causes and how stress can affect people in their working situation. Our study is based on a questionnaire among aid handling officers in two municipalities of the middle of Sweden, and two interviews with their directors. We found that aid handling officers has a complex occupational role. We also found that the officers in these two municipalities experiences about the same level of stress.

    Further in the study, we will deal with whatever could be the cause of the stressful situation, using the demand/control model of Karasek and Theorell. The result shows that despite the similarity of the stress experience, the cause was shown to be different. The study shows that the stress sometimes leads to rash decisions and also that reviews may be less prioritized. We also studied the social coherence on the workplace and its meaning to the stress experience.

    Earlier studies, our empirical result and Karaseks and Theorells demand/control model shows that depending on how good workgroups are able to function, may have significance on the experience of stress at work. The result also shows that it may be hard, or maybe impossible, to create a work environment that is completely free from stress.

  • 285.
    Larsson, Maria
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Närståendes skattningar av vårdkvaliteten på en intensivvårdsavdelning2009Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

     

    Sammanfattning 

    Syftet med studien var att värdera närståendes skattning av vårdkvaliteten på en 

    intensivvårdsavdelning med hjälp av frågeformuläret KUPP (Kvalitet Ur Patientens 

    Perspektiv). Antalet respondenter uppgick till 33 personer (10 män och 23 kvinnor) som 

    valdes konsekutivt. Designen var en deskriptiv och komparativ studie med kvantitativ ansats. 

    Den före detta intensivvårdspatienten vårdades på avdelningen 24 timmar eller mer. 

    Resultatet visade att närstående skattade balans i vårdkvaliteten inom frågor som belyste 

    vilken vårdutrustning som fanns tillgänglig, patientens medicinska vård, sjuksköterskors och 

    undersköterskors engagemang, sjuksköterskors och undersköterskors empatiska och 

    personliga förhållningssätt samt hela personalgruppens respekt i bemötandet av patienten. 

    Bemötandet av släkt och vänner värderades också högt. Bristande vårdkvalitet skattades inom 

    frågor som belyste information efter åtgärder, information om patientens vårdförlopp och 

    vilken person som var ansvarig för patientens vård. Vissa intensivvårdsspecifika frågor som 

    belyste möjligheten att få diskutera med personalen om otrygghet, mardrömmar och slem i 

    luftvägar skattades som bristande vårdkvalitet. Slutsatsen blev att närstående var generellt 

    nöjda med vårdkvaliteten men att det fanns faktorer som behövde förbättras t.ex. information 

    om resultat efter undersökningar. 

     

  • 286.
    Larsson, Mari-Anne
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Schmidt, Eva-Lena
    University of Gävle, Department of Caring Sciences and Sociology.
    Hur sjuksköterskor kan förebygga och lindra i samband med smärtsamma procedurer hos barn - en litteraturstudie2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Sammanfattning

    Syftet med denna studie var att beskriva hur sjuksköterskor kan förebygga och lindra smärta i samband med smärtsamma procedurer hos skolbarn 7-12 år. Metoden som användes var en beskrivande litteraturstudie. Litteratur har sökts i databaserna Medline via PubMed, Academic Search Elite och Blackwell Synergy. Materialet i litteraturstudien begränsades till 14 artiklar. I resultatet presenteras de faktorer som påverkar barns upplevelser av smärtlindring i två kategorier: ”Förberedelser inför smärtsamma procedurer” och ”Lindring av smärta under proceduren”. I kategorin ”Förberedelser inför smärtsamma procedurer” framkom det att sjuksköterskor bör skapa en trygg och pålitlig relation till barn och föräldrar, informera och att göra barn och föräldrar delaktiga i både förberedelser inför procedurer och även i smärtlindringen. Midazolam® nässpray och EMLA® har visat god smärtförebyggande effekt. I kategorin ”Lindring av smärta under proceduren” framkom det att under smärtsamma procedurer behövs en öppen och god kommunikation mellan sjuksköterska, barn och föräldrar för att öka förståelsen av behandlingen, samt att en vänlig och lugn inställning kan upplevas som mycket positivt. Sjuksköterskor kan använda sig av farmakologiska smärtlindrings-metoder men också icke-farmakologiska metoder, såsom anpassning av miljön, vila och sömn, distraktion i form av t.ex. tv-tittande, att läsa och spela spel.

    Resultatet belyser även att föräldramedverkan har en stor del i barnets sjukhusvistelse och smärtbehandling, då det hade en lugnande effekt på barnet.

  • 287.
    Larsson, Rigmor Birgitta
    University of Gävle, Department of Caring Sciences and Sociology.
    Kunskap om multiresistenta bakterier och hygienrutiner bland vårdpersonal i primärvården.2008Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att beskriva och jämföra vårdpersonalens kunskaper om MRSA och ESBL samt kunskaper om hygienrutiner inom primärvården före och efter en hygienutbildning.

  • 288.
    Larsson, Sam
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Samhällsvetenskapliga och rättsvetenskapliga teorier och metoder i socialt arbete2009In: Juridik och rättsvetenskap i socialt arbete / [ed] A. Hollander och K. Alexius Borgström, Lund: Studentlitteratur , 2009, p. 77-102Chapter in book (Other academic)
  • 289.
    Larsson, Sam
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Ungdomars användning av alkohol och droger i socialpsykologiskt perspektiv2009In: Alkohol och droger – Samhällsvetenskapliga perspektiv / [ed] K. Billinger och L. Hubner, Malmö: Gleerups förlag , 2009, p. 101-122Chapter in book (Other academic)
  • 290. Larsson, Sam
    et al.
    Goldberg, Ted
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Närvarande och frånvarande berättelser: ”frontstage”- och ”backstage”-analyser2008In: Narrativa metoder i socialt arbete / [ed] Sam Larsson, Yvonne Sjöblom, John Lilja, Lund: Studentlitteratur , 2008, p. 153-185Chapter in book (Other academic)
  • 291.
    Larsson, Ulla-Karin
    et al.
    University of Gävle, Department of Caring Sciences and Sociology.
    Axlund, Marie
    University of Gävle, Department of Caring Sciences and Sociology.
    Lika för alla2009Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
  • 292.
    Lassas, Anna
    University of Gävle, Department of Caring Sciences and Sociology. University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    "LIA eller morfin spinalt vid primär total höftplastik".: en långtidsuppföljning av effekter för postoperativ smärta och mobilisering.2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    There are several methods for postoperative pain treatment after primary total hip replacement. It was shown in a earlier study at a Swedish hospital (below named as "the hip project") that "Local infiltration analgesia" (LIA) decreased pain, facilitated early postoperative mobility and earlier discharge from the hospital, compared with spinally administered morphine. Present study is a long term follow up of the hip project with two measures at 6 and 12 weeks. The study group was given LIA towards the end of the operation while the control group were given spinal morphine at the induction. Both groups had spinal analgesia during the surgery. The long term follow up was conducted by a comparative design and the data was collected from the patient’s charts and files. The variables were pain measured by Visual Analogous Scale (VAS), need of pain relieves and general mobility. The study group contained of 40 patients and the control group of 11. The result relived no significant differences between the two groups regarding long term mobility. There was, however, a significant difference in pain after 12 weeks; the study group had less pain that the control group.

     

     

  • 293.
    Lekkos, Marie
    University of Gävle, Department of Caring Sciences and Sociology.
    Sjuksköterskors medverkan vid livstilsförändringar bland kvinnor med hjärt och kärlsjukdomar2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Syftet med föreliggande studie var att med hjälp av litteratur beskriva hur sjuksköterskor kan medverka till att livsstilsförändringar efterlevs bland kvinnor med hjärt- och kärlsjukdomar.

    Metoden som användes var en deskriptiv litteraturstudie och sökningarna gjordes i Pub Med och Academic Search. Slutligen valdes 20 artiklar ut att ingå i resultatet. Resultatet av sjuksköterskors arbete att medverka och låta kvinnorna vara delaktiga presenteras under rubriker: vägleda, ge stöd och undervisa. Det är de tre sätt som sjuksköterskan handlar efter utifrån Orhems teori om omvårdnadssystem.

    Det som framkom i artiklarna var att vägledning stöd och undervisning från sjuksköterskor kan hjälpa patienterna att hitta en balans i sin egenvård och införa olika livsstilsförändringar i sin vardag. Det framkom även att utbildning och stöd till familjen var lika viktigt som att få stöd av dessa eller signifikanta andra. Behovet av stöd i olika former var slutligen det som genomsyrade hela undersökningen.

  • 294.
    Levay, Manosh
    University of Gävle, Department of Caring Sciences and Sociology.
    Distriktssköterskors upplevelser av att handleda distriktssköterskestuderande2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att beskriva hur distriktssköterskor upplever att handleda distriktssköterskestuderande. Studien hade en beskrivande design med kvalitativ ansats. Urvalet bestod av tio distriktssköterskor från sju hälsocentraler i Mellansverige. Datainsamlingen gjordes med semistrukturerade intervjuer och data analyserades genom kvalitativ innehållsanalys. Analysen resulterade i ett tema: Ständig interaktion mellan tre aktörer, detta tema bestod av kategorierna: Handledaren, Studenten och Organisationen. Handledarna beskrev hur de upplevde att de hade ett krav från organisationen där hon arbetade att handleda studenter. Handledarna beskrev hur de upplevde det som att organisationen inte gav dem den tid som handledningen krävde. Handledarna beskrev även hur de upplevde att studenterna var i beroende ställning till distriktssköterskorna.

  • 295.
    Lidberg, Ulrika
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Muutra, Robert
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Fluid Intake and Quality of Sleep in Hemodialysis Patients - a Correlational Study2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: The objective of this study was to describe the correlation between the fluid intake of hemodialysis patients and their self-assessed quality of sleep. Methods: A cross-sectional, correlational study, with explorative traits was performed as a quantitative multi-centre study. Data were analyzed for (n=180) patients. Interdialytic Weight Gain (IDWG) and a self-assessment of Pittsburgh Sleep Quality (PSQI) were used to estimate fluid intake and sleep quality. Results: There was no significant difference in fluid intake between male and female subjects. PSQI component scores for the entire study group (n=180) were poorest in Sleep Latency and Sleep Disturbance. When comparing PSQI components for male (n=116) and female (n=64) subjects, Use of Sleep Medications, global PSQI, Sleep Latency, and Daytime Dysfunction were significant, with poorest sleep quality for females. The correlation analysis between the PSQI components and IDWG (n=180) displayed significant correlations for Sleep Duration, Subjective Sleep Quality, and global PSQI. Conclusion: This study indicates there is a need for continued and improved fluid restriction compliance for both male and female hemodialysis patients. The appearent deficit in sleep quality in female patients compared to male patients needs to be further investigated in future studies.

  • 296. Lidskog, Marie
    et al.
    Löfmark, Anna
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Ahlstrom, Gerd
    Learning through participating on an interprofessional training ward.2009In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 23, no 5, p. 486-497Article in journal (Refereed)
    Abstract [en]

    Learning in clinical education can be understood as a process of becoming a legitimate participant in the relevant context. Interprofessional training wards (IPTWs) are designed to give students from educational programmes in health and social care a realistic experience of collaboration for the purpose of developing teamwork skills. IPTWs have been found to be appreciated by the students and to influence students' understanding of each other's professions. The aim of this study was to describe and analyse the students' learning on an interprofessional training ward in care for older persons through focusing on the students' ways of participating in the communities of practice on the ward. A case study design was chosen. Multiple data sources were used. The findings show that the students engaged as active participants in the care. At the same time there was sometimes a discrepancy between on the one hand expectations and goals, on the other hand actual participation. There were difficulties in making the training relevant for all the student groups involved. The findings indicate that in the planning of interprofessional education the choice of setting and learning situations is crucial with regard to the learning that will occur.

  • 297.
    Lidskog, Marie
    et al.
    Department of Health Sciences, Örebro University, Örebro, Sweden.
    Löfmark, Anna
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Ahlström, Gerd
    Department of Health Sciences, Örebro University, Örebro, Sweden; School of Health Sciences, Jönköping, Sweden.
    Interprofessional education on a training ward for older people: students' conceptions of nurses, occupational therapists and social workers2007In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 21, no 4, p. 387-399Article in journal (Refereed)
    Abstract [en]

    Collaboration between professionals in health and social care is essential to meet the needs of the patient. The collaboration is dependent on knowledge and understanding of each other's roles. One means of improving communication and collaboration among professionals is interprofessional education. The aim of this study was to describe the variation in how students in nursing, occupational therapy and social work perceived their own and the other professions. Over a three-week period two interviews were conducted with each of 16 students who were on an interprofessional training ward for older people in a municipal setting in Sweden. A phenomenographical approach was used in the analysis of the interviews. The findings showed great variation in how the students perceived the professions, from simplistic in terms of tasks to a more complex conception in terms of knowledge, responsibility and values. Differences in the ways professions were described concerning their professional stance towards the patients were especially accentuated. The findings indicate that the students need opportunities for reflection on and scrutiny of each other's beliefs and knowledge. The influence of interprofessional education involving reflection on the different health-care professions needs to be explored in future research.

  • 298.
    Lidskog, Marie
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro.
    Löfmark, Anna
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Ahlström, Gerd
    School of Health Sciences, Jönköping University, Örebro University, Örebro, Sweden.
    Learning about each other: students´conceptions before and after interprofessional education on a training ward2008In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 22, no 5, p. 521-533Article in journal (Refereed)
    Abstract [en]

    In interprofessional work the striving of the members of each profession to establish their own positive in-group identity can be a source of conflict and have a negative effect on care. To counteract this, interprofessional training wards (IPTWs) have been developed in Sweden. The aim of the present study was to investigate similarities and differences in how student nurses, student occupational therapists and student social workers perceived their own and the other two professions before and after clinical education on an IPTW. Sixteen students were interviewed before and after the training on an IPTW in municipal care for older people in Sweden. A coding scheme developed in an earlier study was used in the analysis of the interviews. The findings indicate that there are changes in the students' stereotyped views, enhancing understanding of each other's professions after three weeks' clinical education on the IPTW. In some areas, however, there are still discrepancies between the description of own profession and the others' understanding of this profession that need to be confronted. In interprofessional training during education in social and health care there needs to be a balance between on the one hand the particular professional identity, on the other the shared identity implied by membership of the health-care team focusing on a common goal.

  • 299. Lidskog, Marie
    et al.
    Löfmark, Anna
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för vårdvetenskap.
    Ahlström, Gerd
    Students´ learning experiences from interprofessional collaboration on a training ward in municipal care.2008In: Learning in Health and Social Care, ISSN 1473-6853, E-ISSN 1473-6861, Vol. 7, no 3, p. 134-145Article in journal (Refereed)
  • 300.
    Lidén, Anna Maria
    University of Gävle, Department of Caring Sciences and Sociology.
    Skillnader i följsamhet och förutsättningar för basala hygienrutiner mellan personal inom kommunal- och sjukhusvård samt tillgången av skyddsmaterial2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    The purpose of this study was to describe and compare the degree of selfreporting succession to the basal hygienic routines of emplyees working in municipal old peoples care versus hospital care. It is also to describe the access of material available in prevention of cross infections. The study was also carried out with a comparative and quantitative run up design. The study is based on a questionnaire in the district of Gävleborg in the spring of 2009. Nurses, auxiliaries and carers whom were in close contact with patients were asked to join the study. In total 134 participated, 67 within municipal care and 67 from hospital care. The result showed that there was a lack of compliance of routines in both areas. The most significant difference was to be seen in the compliance of using hand disinfectant before close contact with the patients. The result proved also that there was a lack of access to the material needed to obtain a hygienic environment. In further it showed that there was a vast difference in the access to clean working clothes and protective aprons. Employees within the municipal care stated a higher access to these things. There was also a significant difference in the use of protective aprons and gloves, here again employees within the municipal care stated a higher compliance in the use of these. The conclusion of the study showed a clear difference in compliance of routines in hygiene and also access to materials needed in the basal routines of hygiene both in municipal and hospital`s care of elders.

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