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  • 51.
    Lowden, Arne
    et al.
    IPM—National Institute for Psychosocial Medicine, Karolinska Institutet, Stockholm, Sweden.
    Holmbäck, Ulf
    Department of Medical Sciences, Nutrition, Uppsala University Hospital, Uppsala, Sweden.
    Åkerstedt, Torbjörn
    IPM—National Institute for Psychosocial Medicine, Karolinska Institutet, Stockholm, Sweden.
    Forslund, Jeanette
    Department of Medical Sciences, Nutrition, Uppsala University Hospital, Uppsala, Sweden.
    Lennernäs, Maria
    Department of Medical Sciences, Nutrition, Uppsala University Hospital, Uppsala, Sweden.
    Forslund, Anders
    Department of Medical Sciences, Nutrition, Uppsala University Hospital, Uppsala, Sweden.
    Performance and sleepiness during a 24 h wake in constant conditions are affected by diet2004In: Biological Psychology, ISSN 0301-0511, E-ISSN 1873-6246, Vol. 65, no 3, p. 251-263Article in journal (Refereed)
    Abstract [en]

    This study investigated the effects of high-carbohydrate (HC) and high-fat (HF) diet on cognitive performance, and subjective and objective sleepiness. Seven male participants were kept awake for 24 h in a metabolic ward. Meals were given every 4 h and cognitive performance and sleepiness ratings were assessed hourly. The Karolinska Drowsiness Test (KDT, EEG derived) was performed twice after meal. Performance in simple reaction time showed a significant interaction of diet and the post-prandial period, a slower reaction time was observed for the HC-diet 3.5 h after meal intake. Diet did not affect EEG measures but a general post-prandial increase of objective sleepiness was observed 3.5 h after meal servings. The HC-diet was significantly associated with an increase of subjective sleepiness. The study demonstrated that the HC-diet caused larger oscillation in performance and increased sleepiness as compared to HF-diet throughout day and night.

  • 52.
    Lundberg, Kristina
    et al.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Husum Health Center, Västernorrland County Council, Husum, Sweden.
    Jong, Miek C.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Louis Bolk Institute, Driebergen, The Netherlands; National Information and Knowledge Center for Integrative Medicine, Amsterdam, The Netherlands.
    Kristiansen, Lisbeth Porskrog
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Jong, Mats
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Health Promotion in Practice - District Nurses Experiences of Working with Health Promotion and Lifestyle Interventions among Patients at Risk of Developing Cardiovascular Disease2017In: Explore: The Journal of Science and Healing, ISSN 1550-8307, E-ISSN 1878-7541, Vol. 13, no 2, p. 108-115Article in journal (Refereed)
    Abstract [en]

    Objective

    Health Promotion Practice (HPP) has the objective to promote a healthier lifestyle and reduce the risk of disease. The aim of this study was to examine district nurses׳ experiences of working with health preventive actions among patients with risk factors for cardiovascular disease (CVD), and to identify facilitators and obstacles in HPP.

    Design/Setting

    The study was carried out with a qualitative approach where individual semistructured interviews were performed with a total of 12 district nurses in primary care. Data transcripts were analyzed with a manifest content analysis.

    Findings

    Five categories were identified. Firstly, informants regarded HPP as the core essence of their work. Secondly, counseling and coaching were reported as crucial elements in working with HPP. Thirdly, informants identified tools such as motivational interviewing (MI) to facilitate HPP. In the fourth category facilitators and barriers of HPP appeared, consisting of both positive and negative attitudes and presence as well as lack of organizational culture and structure. Finally, some informants were dissatisfied with HPP and viewed it as compulsory or as a burden, while others were satisfied and experienced it as a stimulating challenge.

    Conclusion

    This study identified that HPP is the core of the district nurses׳ work to promote a healthier lifestyle in individuals with CVD. Organizational structures and culture need to be improved in order to support district nurses to successfully work with HPP. To optimize health promotion and strengthen patients׳ self-care, it is recommended that HPP include holistic elements of care.

  • 53.
    Lyskov, Eugene
    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.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Sakajev, Eduard
    Ermakova, I
    Stress and work-related musculoskeletal disorders. Long-term monitoring of physiological and behavioral data in real-life studies2012In: 8th International Interdisciplinary Congress “Neuroscience for Medicine and Psychology”, 2012, p. 258-Conference paper (Refereed)
  • 54. Löf, C.M.
    et al.
    Forinder, Ulla
    Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    Winiarski, J.
    Risk factors for lower health-related QoL after allogeneic stem cell transplantation in children2007In: Pediatric Transplantation, ISSN 1397-3142, E-ISSN 1399-3046, Vol. 11, no 2, p. 145-151Article in journal (Refereed)
    Abstract [en]

    To explore risk factors affecting HrQoL, we analyzed data from patients (n = 51) at least three yr beyond SCT and their parents (n = 41), who responded to the SCHQ, to a subjective symptom inventory and to a sense of coherence instrument, in parallel with a physician-rated scoring of late effects. Children with leukemia rated a lower HrQoL than children with non-malignant disease only in subscale RE, limitations in role socially because of the emotional difficulties (p < 0.05) but had more severe late effects (p < 0.05). Parents of children with leukemia rated their children's HrQoL overall lower in both the psychosocial area and physical area (p < 0.01) and the child's condition also had a greater impact on parents' emotional situation (p < 0.05), compared with parents of children with non-malignant diagnosis. The psychosocial HrQoL was more affected in recipients of an unrelated than of a sibling graft, according to both child (p < 0.01) and parent (p < 0.05). In the multiple regression analysis, however, late effects remained the only independent factor, contributing to low parental psychosocial (p < 0.05) and physical (p < 0.001) HrQoL ratings, while leukemia, unrelated donor and TBI did not. To conclude, parent-reported HrQoL was lower in SCT patients with leukemia, mainly due to a higher impact of late effects in this group.

  • 55.
    Lönn, Emelie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Användning av kosttillskott bland styrketränande motionärer i MellanSvergie: Guds gåva eller djävulens spratt?2015Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka om vuxna styrketränande personer i Mellansverige hade kunskap om de kosttillskott de konsumerade samt att undersöka den vanligaste anledningen för konsumtionen. För att besvara detta syfte blev metoden av kvantitativ ansats med enkät. Enkäten som användes till denna studie kom ifrån två olika, redan gjorda, studier med redan testade frågor. De frågor som stämde bäst emot studiens syfte togs ur dessa enkäter och sattes ihop till den enkät som användes till denna studie. Tjugosju enkäter besvarades och av dessa kunde tjugo användas och analyseras. Det huvudsakliga resultatet påvisar att kunskap finns bland de svarande respondenterna och att de har stor förståelse för sina kosttillskott samt att kvinnor och män har en viss skillnad i sin konsumtion. Slutsatsen blev att kostkomplimentering är den största anledningen till konsumtion av kostillskott. 

  • 56.
    Magnusson, Peter
    et al.
    Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden; Cardiology Research Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kihlström, Gabriella
    Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Wallhagen, Marita
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science.
    Rambaree, Komalsingh
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Criminology, Social Work.
    Life‐threatening peripartum cardiomyopathy — Not expected when expecting2019In: Clinical Case Reports, E-ISSN 2050-0904, Vol. 7, no 6, p. 1127-1132Article in journal (Refereed)
    Abstract [en]

    Peripartum cardiomyopathy is challenging to diagnose as it mimics symptoms present in normal pregnancy. The clinical course and prognosis are various. In selected cases, a cardioverter implantable defibrillator with/without cardiac resynchronization therapy, mechanical ventricular assist device treatment, and transplantation is indicated.

  • 57.
    Maria, Karlsson
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Joanna, Gustafsson
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Sjuksköterskors upplevelser av att vårda patienter då det saknas ett gemensamt språk för verbal kommunikation: Empirisk intervjustudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    För att information ska kunna förmedlas behövs ett gemensamt språk att kommunicera på mellan sjuksköterska och patient. Kommunikationsproblem uppstår när gemensamt språk saknas och det blir omöjligt att kommunicera verbalt. Studiens syfte var att beskriva sjuksköterskors upplevelser av att vårda patienter när det inte finns ett gemensamt språk för verbal kommunikation och hur det upplevs att kommunicera via en mellanhand på akutmottagning. Studiens metod var av kvalitativ ansats med beskrivande design. Undersökningsgruppen bestod av åtta sjuksköterskor från en akutmottagning i Mellansverige. Semi-strukturerade intervjuer användes och det insamlade materialet analyserades utifrån en kvalitativ innehållsanalys. Resultatet visade att när den verbala kommunikationen uteblev upplevde flera sjuksköterskor att det kunde leda till missförstånd. I dessa situationer behövs en tolk och samtliga sjuksköterskor upplevde att det inte var optimalt med en anhörig som tolkade. Flera sjuksköterskor uttryckte en osäkerhet när professionella tolkar anlitades då de ansåg att kulturella värderingar kunde påverka tolkkvalitén. Samtliga sjuksköterskor ansåg att det krävdes mer arbete och fler undersökningar när det inte fanns ett gemensamt språk. Slutsatsen var att situationer där gemensamt språk saknas beskrevs som hanterbara då det skedde dagligen men att det fortfarande var ett problem. När det inte finns ett gemensamt språk ökar risken för missförstånd och patientens säkerhet och behandling blir lidande. Tolk upplevdes som det bästa hjälpmedlet, dock är kommunikation via en mellanhand alltid en tolkning och den blir inte detsamma som att tala direkt till patienten. I situationer då gemensamt språk saknas ställs högre krav på sjuksköterskans kompetens.

  • 58.
    Mossberg, Hanna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Lundgren, Anneli
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Kvinnors problem efter en hjärtinfarkt samt deras behov av stöd från sjukvård och sociala nätverk - En litteraturstudie2013Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Syfte: Syftet med föreliggande litteraturstudie var att beskriva behov av stöd hos kvinnor som drabbats av hjärtinfarkt samt deras upplevelser av problem i det dagliga livet. Ett ytterligare syfte är att bedöma kvaliteten på studiernas urvalsmetod.

    Metod: Författarna gjorde en beskrivande litteraturstudie som är baserad på elva vetenskapliga artiklar som söktes i databaserna Pubmed och Cinahl. Artiklarnas urvalsmetod granskades ur en kvalitetsaspekt.

    Huvudresultat: Studier visade att det var vanligt att kvinnor upplevde oro, osäkerhet och rädsla inför livet efter en hjärtinfarkt. Rädslan att råka ut för en ny hjärtinfarkt visade sig vara en stark känsla hos många. Dessa känslor upplevdes som stora problem för kvinnorna. Den fysiska energin efter sjukdomen var tydligt försämrad och begränsade kvinnorna vardagligen.Något tydligt framträdande var hur viktigt det är att få stöd efter en hjärtinfarkt. Inte bara stödet från sin familj och sina vänner i sitt dagliga liv utan också det professionella stödet från sjukvården. Studien belyser också att rehabilitering var ett gott stöd för dessa kvinnor. Med den hjälpen upplevde kvinnorna sig själva säkrare. Slutsats: Att insjukna i hjärtinfarkt kan för de allra flesta kvinnor vara svårt och medföra en stor livsförändring. Stora problem i nuvarande forskning kan ses i form av att många kvinnor inte får den information eller det stöd som krävs för att lyckas. Stödet från familj och närstående är minst lika viktigt som stödet från sjukvården. Hjärtinfarktdrabbade kvinnor efterfrågar adekvat information om sin hjärtinfarkt, samt att deras anhöriga får den rätta informationen för att de tillsammans ska kunna fullfölja förändringarna som bör göras för att livet ska bli lättare att leva. Detta medför att mer forskning behövs för att sjuksköterskor ska kunna tillgodose kvinnornas behov.

    Nyckelord: Hjärtinfarkt, kvinnor, socialt stöd, dagligt liv och patienters upplevelser

  • 59.
    Mårtensson, Gunilla
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Carlsson, Marianne
    Uppsala University, Sweden.
    Lampic, Claudia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Is nurse-patient agreement of importance to cancer nurses satisfaction with care?2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, no 3, p. 573-582Article in journal (Refereed)
  • 60.
    Nordlund, Gerhard
    et al.
    Umeå universitet.
    Lennernäs, Maria
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Norberg, Helena
    Karolinska institutet.
    Måltider och dryck, särskilt mjölk, hos högstadieelever: med uppdelning på kön, morgon- och kvällsmänniskor2004Report (Other (popular science, discussion, etc.))
  • 61.
    Nyberg, Madelen
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    En undersökning kring äldres upplevelser av äldreomsorgen: En intervjuundersökning2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to examine how older individuals over 80 years without dementia in a nursing home experience their daily routines, the physical living environment, meal situations and opportunities for physical activity indoors and outdoors. The method for the study was semi-structured interviews with four voluntary elderly living in a nursing home. The results were divided into three main themes which demonstrate the experiences that were raised during the interviews. Regarding physical activity and outdoor stay, the informants reported unstimulating gymnastics, helpful staff, and requests for more needlework. Regarding meal situations the respondents mentioned nice decoration in the dining room, a desire for sleep before breakfast and too large portion sizes. Regarding the living environment the informants reported a pleasant environment, good service and demented elderly who interfere. The conclusion of the study was that the older individuals generally felt well-being in the nursing home. Some experiences suggest that there was a lack of attention from the nursing staff to take account the older people’s wishes regarding for example portion sizes. The interviews also showed that the social interaction between some of the older people could have been better.

  • 62.
    Olofsson, Lena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Hur sjuksköterskor hanterar patienter med akuta smärttillstånd och postoperativ smärta: en observationsstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Att ge adekvat smärtlindring inom en rimlig tid för att minska patienters lidande är av vikt för en god omvårdnad. Att använda smärtskattningsinstrument som är individanpassat i kombination med att lyssna på patientens beskrivning av smärtan anses vara en fungerande åtgärd gällande smärthantering. Det är därför viktigt att studera hur detta fungerar i praktiken, för att kunna belysa de problem som uppstår och öka medvetenheten hos sjuksköterskor om de brister som finns i omvårdnadsarbetet hos patienter med smärtproblematik. Syfte: Syftet med studien var att utforska och beskriva sjuksköterskors omvårdnadsarbete hos patienter med akuta smärttillstånd och postoperativ smärta. Metod: Studien är en fokuserad etnografisk observationsstudie med deskriptiv design, och genomfördes med innehållsanalys med deduktiv ansats. Studien genomfördes genom deltagande observation med efterföljande intervjufrågor av 10 st sjuksköterskor på en kirurgisk vårdavdelning. Resultat: Studien resulterade i att sjuksköterskor i regel alltid gjorde en skattning och bad patienterna beskriva sin smärta vid det första mötet. Smärtskattning gjordes i de flesta fall med någon form av smärtskattningsskala, genom samtal med patienten samt vid fysiska tecken till smärta. I studien framkom att arbetsmiljön var en faktor som påverkade både sjuksköterskornas förmåga och möjlighet att bemöta patienternas smärta, samt påverkade tiden till administrering av smärtstillande läkemedel. Slutsats: Sjuksköterskor utför oftast en smärtbedömning samt ger smärtstillande läkemedel omgående. I vissa fall är dock smärtan svår att skatta då patienten ej påvisar fysiska tecken till smärta, vilket gör att sjuksköterskor ibland har svårt att tro på patienten. Samtliga sjuksköterskor ansåg att smärta var ett högprioriterat omvårdnadsbehov som behöver snabb åtgärd.

  • 63.
    Olsson, Annakarin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Åsenlöf, Pernilla
    Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden .
    Skovdahl, Kirsti
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden ; Faculty of Health Sciences, Buskerud University College, Drammen, Norway.
    Lampic, Claudia
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
    Effects of Tracking Technology on Daily Life of Persons With Dementia: Three Experimental Single-Case Studies2015In: American Journal of Alzheimer’s Disease and Other Dementia, ISSN 1533-3175, E-ISSN 1938-2731, Vol. 30, no 1, p. 29-40Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the effects of using tracking technology on independent outdoor activities and psychological well-being in 3 persons with dementia (PwDs) and their spouses.

    Methods: Three experimental single-case studies with an A1B1A2B2 design. The intervention entailed access to a passive positioning alarm and technical support. Continual daily measures of independent outdoor activities among PwDs’ and spouses’ worries about these activities were made during all phases.

    Results: Access to a tracking technology consistently increased the independent outdoor activities of 2 PwDs. One of the spouses consistently reported decreased worry during B phases, another’s worry decreased only in B2, and the third showed little variability in worrying across all phases.

    Conclusion: Tracking technology may support PwDs to engage in independent outdoor activities and decrease spouses’ worries; however, randomized controlled group studies are needed to investigate whether these results can be replicated on a group level.

  • 64.
    Olsson, Annakarin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Skovdahl, Kirsti
    Buskerud and Vestfold University College, Kongsberg, Norway.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Using diffusion of innovation theory to describe perceptions of a passive positioning alarm among persons with mild dementia: a repeated interview study2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 3Article in journal (Refereed)
    Abstract [en]

    Background

    Problems with memory and decline in cognitive abilities are common during development of dementia. Different kinds of technologies may be useful in supporting persons with dementia and their relatives in daily life. Tracking technologies have the potential to improve independence among persons with dementia. Consequently, the aim of the present study was to describe perceptions of a passive positioning alarm (PPA) among persons with mild dementia.

    Methods

    A repeated interview study was conducted in Sweden with a strategic sample of 11 persons with mild dementia. Roger’s Diffusion of Innovation Theory was used to deductively analyse the data.

    Results

    Regarding the advantages of the PPA, participants described perceived safety and security for, both themselves, and their relatives, as well as freedom and independence. However, they also expressed concern about the cost of the PPA, reflected on who might be the receiver of the alarm from the PPA, emphasized the importance of opportunities to test the device before becoming a user and early introduction before their problems start, thus allowing them to decide for themselves.

    Conclusions

    Supporting persons with dementia in their own homes using, e.g., a PPA may enable them and their relatives to remain longer in their own homes and be safer in their own neighbourhoods.

  • 65.
    Olsson, Helen
    et al.
    School of Education, Health and Social Studies, Dalarna University, Sweden .
    Kristiansen, Lisbeth Porskrog
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Nursing Sciences, Mid Sweden University, Sweden.
    Violence risk assessment in clinical practice: How forensic nurses experience violence risk assessment in daily work -A qualitative interview study2017In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 9, no 12, p. 56-63Article in journal (Refereed)
    Abstract [en]

    Background: The legislation of Swedish forensic psychiatric care states that the risk of further violence must be assessed before a patient is granted release from a forensic psychiatric hospital. The aim of the study was to describe the experiences of forensic nurses with in-patient risk assessment processes, and their implication for daily clinical forensic praxis.

    Method: Semi-structured interviews with staff who were involved in the patients risk assessment process. The interview texts were analyzed using qualitative latent content analysis.

    Discussion: The forensic nursing staff has to deal with many contradictory realities. The description was about being able to balance between supporting their work with an EBP approach of risk assessment while trying to establish interpersonal relationships and to allow for positive meetings with the patient. The study indicated that staff used a multiple sources of knowledge in order to make credible and accurate risk assessments.

    Conclusions: If the risk assessment process are to be used in a legally secure manner, the staff must receive regular support from team leadership that can provide both guidance and training. Based on a holistic approach, the link between the instinct of staff and their work with structured risk assessment must be founded on routines and solid platforms.

  • 66.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall; Sundsvall Forensic Psychiatric Hospital, Sweden.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Sjöling, Mats
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Decreased risk for violence in patients admitted to forensic care, measured with the HCR-202013In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 4, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Aim: To explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the Clinical (C) and Risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.

    Methods: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.

    Results: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.

    Conclusion: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.

  • 67.
    Persson, Elene
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Linda, Söderqvist
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Patienters upplevelser av delaktighet inom slutenvård: - En litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Communication, learning and social relations are three elements contained in the concept of participation. The opportunity to take part in their care may influence health care in a way that is more beneficial to the patient. The keystone in nursing is SOC. The aim of this study was to describe inpatients experience of participation by using the concept of SOC. Another aim of this study was to examine the samplings and data collection of the scientific articles used to collect data in this study. A descriptive literature review was used to answer the aim. Articles were searched systematically, compiled, examined critically and then compiled the results. Articles were searched in the databases Cinahl, PsycInfo and PubMed. 11 articles were included in the results. The result shows that to have control over their situation was considered an essential part of participation. Understandable information, to be involved in decisions about their care, dedicated nurses, mutual respect and communication between patients and nurses was important for patients to experience security and gain control over the situation. Though empathetic, motivating and attentive nurses, to be heard and wishes fulfilled and the limited amount of nurses contributed to a sense of security and control of the patients' situation. Sampling and data analysis presented in 10 of the 11 scientific articles. The conclusion was that patients experienced participation as a meaningful part of their care situation. Intelligible information was an essential component to manage their situation. If nurses could use a comprehension offense language when communicating favored the inclusion and patients became more confident.

  • 68.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Economics.
    Marginal socio-economic effects of an employer's efforts to improve the work environment2018In: Annals of Occupational and Environmental Medicine, ISSN 2052-4374, Vol. 30, no 1Article in journal (Refereed)
    Abstract [en]

    Background

    Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed.

    Methods

    Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money.

    Results

    The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL.

    Conclusion

    Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.

  • 69.
    Richter, Hans
    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. Högskolan i Gävle.
    Domkin, Dmitry
    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.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science. 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.
    Andersson, H. W.
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Englund, Martin
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    A Comparison of Mental and Visual Load Resulting from Semi-automated and Conventional Forest Forwarding: An Experimental Machine Simulation Study2019In: Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018): Volume X: Auditory and Vocal Ergonomics, Visual Ergonomics, Psychophysiology in Ergonomics, Ergonomics in Advanced Imaging / [ed] Bagnara S., Tartaglia R., Albolino S., Alexander T., Fujita Y., Cham, 2019, 827, Vol. X, p. 199-208Conference paper (Refereed)
    Abstract [en]

    The purpose of the present study was to extend the knowledge offunctional linkages between visual and mental load, performance, and prefrontalcortex (PFC) activity, during forestry forwarding work. Eleven healthy participants,range 21–51 years old, with a minimum of 1-year work experience,carried out the task of loading logs along a standardized path in a machinesimulator during two counterbalanced test conditions: (i) conventional cranecontrol, and; (ii) semi-automated crane control. Mental load was assessed byquantification of oxygenated hemoglobin (HbO2) concentration changes overthe right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional nearinfrared spectrometry (fNIRS). Visual, autonomic, and motoric control variableswere measured and analyzed in parallel along with the individual level of performance.Linear Mixed Models (LMM) analysis indicated more mental loadduring conventional crane work. Collectively, our data suggest that fNIRS is aviable tool which can be used in neuroergonomic research to evaluate physiologicalactivity levels in PFC.

  • 70.
    Richter, Hans
    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.
    Domkin, Dmitry
    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.
    Forsman, Mikael
    Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institute.
    Ciliary muscle contraction force and trapezius muscle activity during manual tracking of visual targets2014In: The Association for Research in Vision and Ophthalmology Annual Meeting: ARVO 2014, 2014, p. 263-Conference paper (Refereed)
  • 71.
    Rönngren, Ylva
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Björk, Annette
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Haage, David
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Audulv, Åsa
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Kristiansen, Lisbeth Porskrog
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support2017In: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, Vol. 54, no 2, p. 309-316Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the present study was to describe the acceptability of the lifestyle program PHYS/CAT and to get information about the tools used for assessment of functional exercise capacity, cognitive performance, and self-health-related quality of life.

    Design and Methods: The findings are based on focus groups and the researchers’ experiences of conducting the program as well as using the assessment tools.

    Findings: The acceptability of the program and the assessment tools was mainly satisfactory.

    Practice Implications: The program with relational, educational, and supportive dimensions may be a promising tool to be integrated into daily nursing care.

  • 72.
    Salzmann-Erikson, Martin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Eriksson, Henrik
    Department of Nursing and Care, The Swedish Red Cross University College, Stockholm, Sweden.
    Absorbability, applicability and availability in nursing and care robots: A thematic analysis of Twitter postings2018In: Telematics and informatics, ISSN 0736-5853, E-ISSN 1879-324X, Vol. 35, no 5, p. 1553-1560Article in journal (Refereed)
    Abstract [en]

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

  • 73.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Possmark, Sofie
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Ghaderi, Ata
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    A dissonance-based randomized intervention study to improve quality of life and physical activity 24 months post roux-en-y gastric bypass surgery2018In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 28, p. 224-224Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 74.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.
    Possmark, Sofie
    Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Tynelius, Per
    Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Persson, Margareta
    Department of Nursing, Umeå University, Umeå, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.
    Meeting physical activity recommendations is associated with health-related quality of life in women before and after Roux-en-Y gastric bypass surgery2019In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, no 6, p. 1497-1507Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Meeting physical activity (PA) recommendations is positively associated with health-related quality of life (HRQoL), but it is still unclear whether PA (specifically objectively measured) is associated with HRQoL in bariatric surgery candidates, both before and after surgery. Thus, the aim of this study was to examine the cross-sectional association between meeting objectively measured PA recommendations and HRQoL before and after Roux-en-Y gastric bypass (RYGB) surgery.

    METHODS: Sixty-six women undergoing RYGB with pre-surgery and 62 women with post-surgery valid PA and HRQoL data were included from the control group of a RCT study aiming at improving HRQoL and PA post-RYGB surgery. Measures before and 12 months after RYGB included the Short Form Health Survey (SF-36) and objectively measured PA, sedentary time (ST), and step counts with GT3X+ accelerometers. Multiple linear regression models were used to analyze the associations between PA and HRQoL.

    RESULTS: Participants who engaged in more than 150 min of moderate to vigorous PA (MVPA)/week (PA recommendations) had considerably higher SF-36 scores (HRQoL) than those who did not, both pre and 12-month post-surgery, with greatest difference in the subscale bodily pain, 15.5 (p = 0.021) higher score (higher scores means less pain) pre-surgery and a 19.7 (p = 0.004) higher score post-surgery. Higher LPA and step counts and lower ST also showed positive associations in some of the subscales of SF-36.

    CONCLUSIONS: Meeting the PA recommendations and overall engaging in more PA was associated with higher HRQoL, pre-, and post-RYGB surgery, highlighting the importance of PA both pre- and post-surgery.

  • 75.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden; Centre for Sellberg etal.BMCSurgery (2017) 17:133 Page 6 of 7 Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden.
    Four years' follow-up changes of physical activity and sedentary time in women undergoing roux-en-Y gastric bypass surgery and appurtenant children2017In: BMC Surgery, ISSN 1471-2482, E-ISSN 1471-2482, Vol. 17, no 1, article id 133Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 76.
    Sellert-Rydberg, Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Hypotermibehandling efter hjärtstopp: Kognitiv och fysisk funktion samt självskattad hälsa efter 6 månader relaterat till tidsåtgång i vårdkedjan och primär hjärtrytm2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Aim of the study: Aim of the study was to investigate whether there were any connections in time between different parts of care in patients with cardiac arrest and hypothermia treatment and cognitive and physical function six months after cardiac arrest and to investigate neurological outcome related to primary registered cardiac arrest rhythm after six months and if there were any changes in cognitive and physical functions as well as self-related health between discharge from hospital and six months after cardiac arrest.

    Method: The study included 39 patients admitted to three Swedish hospitals between 2008-2011. Cognitive and physical function was evaluated with Cerebral Performance Cathegory, CPC completed with Mini Mental State Examination, MMSE for cognitive function and Bartels Index, BI for physical function and Euroqol-VAS for evaluating the self-related health.

    Result:  A significant connection was shown between time to start hypothermia treatment and BI, patients with longer time showed improved physical function after six months.

    Majority of the participants (66,7 %) had Ventricular fibrillation/Ventricular tachycardia, VF /VT, as primary registered cardiac arrest rhythm and in this group CPC and BI was significant better compared with the asystole /Pulsless Electrical Aktivity, PEA group.

    CPC, MMSE, BI and Euroqol-VAS were all improved over time.

    Conclusion: Participants with VF /VT as primary registered cardias arrest rhythm had significant better cognitive and physical function 6 months after hypothermia-treated cardiac arrest compared with participants with asystole/PEA as primary registered rhythm. This shows the importance of access to defibrillators in public places in the society and in hospitals and optimal education of lay people and medical staff. Cognitive and physical function and self-rated health improves over time, which might be a very important reason to convey patients, relatives and medical staff to continue cognitive and physical rehabilitation.

     

    Keywords: Cardiac arrest, hypothermia, cognitive and physical function, wellbeeing

  • 77.
    Sepp, H.
    et al.
    Uppsala universitet, Institutionen för hushållsvetenskap (IHV).
    Abrahamsson, L.
    Lennernäs, Maria
    Hagman, U.
    Pettersson, R.
    Pre-school children's nutrient intake at pre-school and home2000Conference paper (Other academic)
    Abstract [en]

    A pre-school-based dietary survey, using seven-day records, was carried out in the Greater Stockholm area. The aim was to assess the intake of food and the quality of diet of 109 pre-school children aged 3-5 years, and to compare the dietary intake to the

  • 78.
    Sepp, Hanna
    et al.
    Uppsala universitet, Institutionen för hushållsvetenskap (IHV).
    Lennernäs, Maria
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Abrahamsson, Lillemor
    Uppsala universitet, Institutionen för hushållsvetenskap (IHV).
    Preschool children´s meal patterns analysed using the Food-Based Classification of Eating Episodes model2006In: Scandinavian Journal of Food and Nutrition, ISSN 1748-2976, E-ISSN 1748-2984, Vol. 50, no 3, p. 131-138Article in journal (Other (popular science, discussion, etc.))
  • 79.
    Silén, Marit
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, China.
    Relationships between structural and psychological empowerment, mediated by person-centred processes and thriving for nursing home staff2019In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 40, no 1, p. 67-71Article in journal (Refereed)
    Abstract [en]

    Person-centred care has been shown to have positive outcomes for patients and for staff. However, the complexity of the link between structural conditions, work in a person-centred manner and outcomes for staff is insufficiently described. We tested the relationship between structural empowerment and psychological empowerment, as mediated by nursing home staff members’ self-ratings of working in a person-centred manner, the person-centred climate and thriving. Questionnaires were distributed to staff working in 12 nursing homes in Sweden. A serial mediation model was tested. The results showed that higher access to structural empowerment was related to higher psychological empowerment mediated by staff working in a more person-centred manner, improved person-centred climate, and improved staff ratings of thriving. These results point to the importance of strengthening the preconditions for staff to work in a person-centred manner and nursing home managers play an important role in this.

  • 80.
    Sjölund, Britt-Marie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science. Karolinska Institutet, Inst för neurobiologi, vårdvetenskap och samhälle.
    Physical functioning in old age: Temporal trends and geographical variation in Sweden2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    ADL disability is an age-related condition that leads to poor quality of life, increased health-related care costs, and increased mortality. The proportion of older adults are increasing worldwide, and it is therefore important both for society and the individual that research provide us with information about the process leading to ADL disability and how to identify persons at risk. The most effective design for following the aging process is found in population-based studies that include all older persons, both those living at home and those in residential care. This thesis uses data from three populationbased studies: the Kungsholmen Project (KP), the Nordanstig Project (NP) and the SNAC-N study. The aims of the thesis was to examine temporal changes in physical functioning in older adults, to identify underlying development of new disability and functional decline, as well as to explore geographical variation in physical functioning between urban and rural elderly habitats. We also wanted to describe the amount of informal and formal care in relation to levels of ADL disability. The ultimate aim was to identify factors suitable for prevention. Study I: We I compared two populations of older adults, 75 years and older (the KP and the NP) from different living areas (urban and rural) and found differences in ADL disability, morbidity and disease patterns. The most common health problem in both areas was cardiovascular diseases (39.9% in the urban area and 45.2% in the rural area). There were great differences, urban vs rural, in the prevalence of stroke (7.4% vs 14.0%), diabetes mellitus (6.3% vs 16.1%), and Parkinson’s disease (1.0% vs 3.7%). Having two or more diseases vs. no disease was more common in the rural area than in the urban area, odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.4-2.4. Living area differences (urban vs rural) were found in population attributable risk (PAR) for disability due to stroke (5.6 vs 32.2), diabetes mellitus (1.2 vs 6.1), fractures (1.4 vs 10.7), and hearing impairment (8.7 vs 22.0). Study II: Data were gathered from a population-based study of adults 60 years and older, the SNAC-Nordanstig (SNAC-N), and the study explored the association between ADL disability, muscle strength, disease severity and mortality. Upper and lower muscle strength decreased with increasing age, with a tendency for lower performance in women than in men. A significant association was found between ADL disability and having reduced lower muscle strength. Having an increased number of diseases increased the risk of being ADL disabled. Diseases with the greatest impact on ADL disability were musculoskeletal diseases, hypertension and dementia. ADL disability and being unable to perform the gait speed test were factors that increased the risk of death. Inability to perform the chair stand test or weaker grip strength increased the risk of death for men. Study III: Data from two populations, 78 years and older, the NP (1995-1998) and the SNAC-N study (2001-2003), were used to study time trends in the prevalence of ADL disability and survival, comparing two cohorts. The prevalence of ADL disability was stable from 1995-1998 to 2001-2002 for men, while women became more disabled in ADL over the time period, (OR 2.36; CI 1.12-4.94). No significant difference was found in survival time between the cohorts in either ADL-disabled or non-disabled persons. There was a tendency for increased survival for non-disabled persons in the SNAC-N study compared with the NP, although it was not significant; this was particularly true for women. In general, women survived longer than men did regardless of whether they were ADL disabled or not. Study IV: The aims were to examine the incidence of ADL disability, to explore whether being physically active earlier in life is a significant predictor of being disability free at follow-up, and to describe the amount of informal and formal care received in relation to ADL disability. Data were gathered from persons 78 years and older in the SNAC-N study. The incidence rates for men were almost the same in the age group 78-81 compared with the age group 84 years and older, 42.3 vs. 42.5/1000 person-years. For women the incidence rate for ADL disability increased significantly from the age group 78-81 to the age group 84 years and older, 20.8 vs. 118.3/1000 person-years. In the age group 78-81 years, being physically active earlier (aOR 6.2) and during the past 12 months before the baseline examination (aOR 2.9) were both significant preventive factors for ADL disability. The amount of both informal and formal care increased with the number of ADL activities the persons were dependent on and the amount of informal care was greater than the amount of formal care. Conclusions: This thesis shows an increase in ADL disability due to increased age, and that women are more ADL disabled than men, but also shows how diseases affect ADL disability. The diseases that negatively affect ADL are often due to unhealthy lifestyle, e.g. physical inactivity, obesity and smoking, etc. The results show the importance of prevention of the factors that cause ADL disability, preferably already in midlife. The amount of both informal and formal care increased significantly with the number of ADL activities the persons required help with. Regarding prevention of becoming ADL disabled, it is of importance to find ways to postpone the onset of ADL disability so that we can live longer without disability.

  • 81.
    Sjölund, Britt-Marie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Wimo, Anders
    Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    von Strauss, Eva
    The Swedish Red Cross University College, Stockholm, Sweden; Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Incidence of ADL Disability in Older Persons, Physical Activities as a Protective Factor and the Need for Informal and Formal Care: Results from the SNAC-N Project2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 9, article id e0138901Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 82.
    Skytt, Bernice
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Ljunggren, Birgitta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Nursing science.
    Carlsson, Marianne
    Uppsala universitet.
    Different development programmes: does it make a difference?2011In: Leadership in Health Services, ISSN 1751-1879, Vol. 24, no 1, p. 29-50Article in journal (Refereed)
  • 83. Soares, Joaquim J. F.
    et al.
    Barros, Henrique
    Torres-Gonzales, Francisco
    Ioannidi-Kapolou, Elisabeth
    Lamura, Giovanni
    Lindert, Jutta
    Dios Luna, Juan de
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Melchiorre, Maria Gabriella
    Stankūnas, Mindaugas
    Abuse and Health Among Elderly in Europe2010Book (Other academic)
  • 84.
    Stake-Nilsson, Kerstin
    et al.
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för medicinsk vetenskap.
    Söderlund, Maud
    University of Gävle, Department of Education and Psychology, Ämnesavdelningen för pedagogik.
    Hultcrantz, Rolf
    Karolinska sjukhuset.
    Unge, Peter
    FSCO, Norvatis, Basel, Switzerland.
    A Quality Study of Self-Care use in patients with dyspepsia2006Conference paper (Refereed)
  • 85.
    Strandell, Lina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Mårtensson, Lena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Sjuksköterskans roll i omvårdnaden till patienter med tuberkulos och deras närstående.: En litteraturstudie.2013Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Tuberkulos (TB) är en infektionssjukdom som dödar nära två miljoner människor varje år och utgör ett stort lidande för de människor som är drabbade. Sjukdomen är en av de vanligaste i världen och fortsätter att växa globalt.Syfte: Syftet med denna litteraturstudie var att beskriva sjuksköterskans roll i omvårdnaden till patienter med TB och deras närstående. Syftet varockså att granska kvalitén på de i studien ingående artiklarna avseende urval.Metod: Studien genomfördes som en beskrivande litteraturstudie där 13 artiklar granskades. Varav nio kvantitativa, tre kvalitativa och en med både kvantitativ och kvalitativ ansats. Resultat: Sjuksköterskan har ett ansvar i omvårdnaden av patienter med TB och deras närstående. Sjuksköterskans roll är att ge stöd och informera om behandling, läkemedel och smittspridning på ett sätt så att patienten kan ta till sig den informationen. Deltagarna i de ingående artiklarna hade valts ut genom slumpmässigt och strategisk urval. De utvalda deltagarna var sjuksköterskor, sjuksköterskestudenter och annan vårdpersonal. Deltagarna rekryterades från privata och offentliga sjukhus, vårdcentraler, hushåll och MDR-program, vilket är ett samhällsbaserat för behandling av multiresistent TB. Slutsats: Föreliggande studie visar att sjuksköterskan har en viktig roll i omvårdnaden av TB patienter och deras närstående. Om sjuksköterskan brister i kunskap, information och stöd till patieneten, kan det påverka patientens beslut till att fullfölja behandlingen. Patienter behöver mer information och stöd gällande sjukdom , behandling och dess biverkningar, så de kan grunda sitt beslut på relevant kunskap. Om sjuksköterskan kan motivera fler TB patienter till att genomgå behandling, kan det leda till minskad smittspridning.

  • 86.
    Sundbom Thunander, Lena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Hedborg, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Association between prescribed antidepressants and other prescribed drugs differ by gender: a nationwide register-based study in Sweden2019In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 73, no 1, p. 73-79Article in journal (Refereed)
    Abstract [en]

    Background: People with depression are prescribed more drugs than people in general,partly due to comorbidity with other conditions. However, little research has been done on depression-related drug use from a gender perspective.

    Aim: Examine the association between antidepressants, other types of prescribed drugs, and polypharmacy, by gender.

    Methods: Data on drugs dispensed October to December 2016 to all Swedish citizens aged 18-84 years were collected from the Swedish prescribed drug register. Logistic regression analyses were performed to examine the associations between antidepressantsand other drugs, by gender.

    Results: For both men and women, associations were found between antidepressants and drugs for alimentary tract problems, respiratory problems, blood, nervous system, analgesics, and polypharmacy. However, for women, but not men, associations were alsofound for drugs for diabetes, musculoskeletal problems, dermatological problems, and systemic hormones. 

    Conclusions: Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions.Further, several of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus,physicians need to be aware of that the association between antidepressants and other types of drugs are more common among women than men.

  • 87.
    Sundin, Sofia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    The association between visual ergonomics and visual performance: Are visual well-being and health a mediator in this association or not2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to investigate if there is an association between perceived visual ergonomics work conditions, visual well-being and health and visual performance at the Swedish Tax Agency by a digitalized questionnaire. The questionnaire was sent to ninety-four respondents. Out of them, eighty-six participants, 54 women (63%), 31 men (36 %) and 1 person (1%) who did not want to be identified with any gender answered the questionnaire. Multiple regressions analysis investigated the association between visual ergonomics work conditions and visual performance, with and without visual well-being and health used as a mediator. Screen time outside of work was used as a covariate in all analysis. Descriptive results reported visual ergonomics (M=8.86, SD=2.06), visual well-being and health (M=10.40, SD=11.02) and visual performance (M=15.72, SD=9.51). Results from the multiple regression analysis displayed a significant association between visual ergonomics and visual well-being and health (r2=.098, β=.254, p<0.05) and between visual ergonomics and self-rated visual performance (r2=.304, β=.307, p<0.01). When visual well-being and health was used as a mediator, the association between visual ergonomics and self-rated visual performance remained the same (r2=.310, β=.295, p<0.01). Conclusion drawn from this study was that a reduction in visual performance seemed to occur in isolation from any impact of visual well-being and health.

  • 88.
    Svedmark, Åsa
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Sandsjö, Leif
    Borås Universitet.
    Häger, Charlotte
    Umeå Universitet.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF.
    Progressive Individualized EMG Biofeedback Training for Women2012Conference paper (Other academic)
    Abstract [en]

    INTRODUCTION: The use of EMG biofeedback in workplace ergonomic intervention is well established. Its systematic application in tailored neck pain rehabilitation is, however, less developed.

    AIM: To introduce a tailored and gradually progressive biofeedback training program for trapezius myalgia and to assess the feasibility and the subjective experience of the program.

    METHODS: The study  sample was a subgroup in an ongoing randomized controlled trial (RCT) to evaluate 11- weeks of individualized neck pain rehabilitation in women  with  at least six weeks of work related nonspecific neck pain (target number of participants 105, ISRCTN49348025). The intervention period included 27 treatment sessions. The treatment decision model for the individualization of the RCT included five main treatment components of which biofeedback training was one. Each subject  was assigned two treatment components at minimum. Criterion for being assigned biofeedback training was a diagnosis of trapezius myalgia and a cut off level of pain pressure threshold, defined by previous cross sectional data. The biofeedback treatment program consisted of eight standardized exercises with  gradual progression of difficulty level followed by functional training in specific tasks individualized for each subject. The latter were disentangled with the Problem Elicitation Technique  (Bakker et al. 1995) and indicated the a ctivities that  were most important to the individual and most difficult to do because of the neck pain. In the functional training, principles of motor learning  were applied in order to enhance retention of the training tasks and transfer to new tasks and environments. The ability to perform three  standardized biofeedback exercises and the elinica I applicability of the individualized program was evaluated by subjects and therapists (n=4).

    RESULTS: Preliminary result from the therapist evaluation shows a positive opinion about  the biofeedback program. To date, 60% of the 105 subjects planned for the RCT have been recruited. Based on the number of subjects fulfilling the criterion so far for biofeedback training, we expect the final sample to be around 18 subjects. Results will be ready in June 2012.

    CONCLUSION: This study will provide valuable information on the feasibility and applicability of gradually progressive biofeedback training as part of an intervention program addressing work related non-specific neck pain.

    REFERENCE:

    Bakker C., van der Linden S., van Santen-Hoeufft M., Bolwijn  P., Hidding A. Problem elicitation to assess patient priorities in ankylos ing spondylitis and fibromyalgia. J. Rheumatol. 1995 Jul;22(7):1304-1

     

  • 89.
    Svensson, Sven
    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.
    Stubbs, Jonathan
    Nordic Occupational Safety and Rehabilitation Institute.
    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.
    The association between subordinate perception of task and relation oriented leadership behaviors and sense of coherence among a sample of Swedish white-collar workers2018In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 61, no 2, p. 327-336Article in journal (Refereed)
    Abstract [en]

    Evidence suggests that leadership behaviours and sense of coherence influences subordinate health. The influence of leadership behaviours on subordinate sense of coherence has not been investigated in any detail. This cross-sectional quantitative study of managers and subordinates in a large governmental organisation focus on this potential association. The study used two common and empirically tested leadership styles: task oriented leadership and relations oriented leadership. In a logistic regression analysis, the association between types of leadership behaviour and SOC were analysed while controlling for age, gender, income, type of employment and organisational tenure. It was hypothesized that both task and relation oriented leadership behaviours would be positively associated with SOC, whereas a laissez faire leadership would be negatively associated with SOC. The hypotheses were not supported. Several implications for further research are discussed including capturing data about both subordinates’ preferred and perceived leadership behaviours.

  • 90.
    Svensson-Lundh, Linda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Bemötande och omhändertagande av närstående vid plötsligt dödsfall inom akutsjukvården sett ur sjuksköterskans och närståendes perspektiv.2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    The aim of this literature review was to describe the experience and needs of sudden bereaved family members who lost a loved one in a sudden and unexpected death. The aim   is furthermore to depict the experience of unexpected and sudden death from the nurse´s point of view. Method: The literature review study has been carried out with a descriptive design. The result of the study was based on 14 scientific articles with quantitative and qualitative approach. The articles were searched in the databases PubMed and Cinahl and through manual search.Results: A majority of close relatives that experience a sudden bereavement are dissatisfied with the way they have been encountered by the staff. They experienced a lack of recognition and that they were left with many unanswered questions about the situation. They required more information and a frank dialogue between the staff and the relatives. Also, it was of great importance to witness the deceased as soon as possible. Sudden and unexpected death is also considered as mentally demanding by the nurses and their wish is to obtain clearer guidelines for the situation. Conclusion: The nurse shall be a professional leader in nursing care. By encountering patients and bereaved family members with respect and empathy, the nurses can decrease suffering for bereaved family members.

     

     

     

     

     

     

     

     

     

     

     

     

     

    Keywords: Grief, death, sudden, emergency service, spouses.

     

  • 91.
    Söderberg, Malin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Patienters upplevelser och erfarenheter av fysisk aktivitet i grupp efter hjärtinfarkt2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of the study was to describe patients' experiences and perceptions of physical activity in a group after myocardial infarction. The study was conducted as a qualitative interview and had a descriptive design. By a purposive sampling ten patients were interviewed who participated in cardiac exercise team at a hospital in central Sweden. Data were collected through semi-structured interviews. The collected data were analyzed using qualitative content analysis. The results are reported based on two themes; well-being through a sense of security and control, and increased motivation for an active lifestyle. Patients described that physical activity in the group has been a security after the myocardial infarction. To be able to test the limits in safe conditions, have an exchange between individuals, a sense of belonging in the group and experience the mental and physical health. Furthermore, patients experienced important to have a meaningful activity, that they felt a need to come to the training sessions and the organized training was varied and gave a chance to try new things. To encourage and persuade patients who had a myocardial infarction to participate in physical activity in a group should be of great importance to both healthcare professionals and patients themselves.

  • 92.
    Thunander Sundbom, Lena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Förskrivning och följsamhet av antidepressiva hade koppling till kön2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 51-52Article, book review (Other (popular science, discussion, etc.))
    Abstract [sv]

    Avhandling. Kvinnor diagnostiseras med depression dubbelt så ofta som män och förskrivs antidepressiva betydligt oftare. Syftet med denna avhandling var att studera hur psykisk ohälsa och kön påverkar läkemedelsanvändning när det gäller följsamhet respektive förskrivning.

    Vi lät 16 000 slumpmässigt utvalda personer mellan 18 och 84 år (svarsfrekvens 48 procent) skatta depression genom formuläret HADS (Hospital anxiety and depression scale). Männen hade rapporterad depression i något högre utsträckning än kvinnorna. Dessa data kopplades sedan på individnivå till förskrivna antidepressiva via Läkemedelsregistret. En högre andel av männen än kvinnorna hade rapporterad depression utan att använda antidepressiva, vilket kan bero på att män inte söker vård vid psykisk ohälsa eller på att mäns psykiska besvär inte upptäcks då symtomen ofta avviker från vårdens diagnoskriterier.

    Kvinnorna däremot använde antidepressiva utan att ha rapporterad depression betydligt oftare än männen, vilket kan bero på tillfrisknande från depressionen eller på att kvinnor förskrivs antidepressiva redan vid mycket lindriga besvär. Vi lät även 7 985 slumpmässigt utvalda personer mellan 18 och 84 år (svarsfrekvens 61 procent) svara på frågor gällande följsamhet.

    Kvinnorna rapporterade betydligt oftare än männen att de avstod från att ta sina läkemedel på grund av läkemedelsbiverkningar, medan männen oftare än kvinnorna rapporterade att de ändrade doserna och glömde att ta sina läkemedel. Resultaten tyder på att kön bör beaktas i riktlinjer för diagnostik och behandling av depression och vid bristande följsamhet: även om studiedesignen i form av tvärsnittsstudier inte möjliggör fastställande av orsakssamband belyser denna avhandling könsskillnader, vilka bör beaktas såväl inom klinisk praxis som framtida studier.

  • 93.
    Thunander Sundbom, Lena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science. Uppsala universitet.
    The influence of gender and psychological distress on adherence to prescribed medication2014Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: The lack of adherence to drug therapy is a major problem; it can contribute to significant deterioration of disease and increased health-care costs. Improving medication adherence is a big challenge; there is no simple solution to the problem. It is thus essential to improve our knowledge of non-adherence (NA) and its causes.

    Aims: The aims of the thesis were to study the influence of gender and psychological distress on self-reported, intentional and unintentional non-adherent behaviour, and to investigate the reasons for NA.

    Methods: A population-based study that included a postal questionnaire was carried out in a cross-section of the general Swedish population (n=7,985, aged 18-84 years). The response rate was 61.1% (n=4,875) and current prescription drug use was reported by 2,802 participants. The questionnaire covered use of prescription drugs, NA to the drug regimens, reasons for NA, economic status, attitudes to drugs, and the presence of somatic or mental problems, and also included the Hospital Anxiety and Depression Scale questionnaire.

    Results: The results showed differences in various self-reported non-adherent behaviour patterns and reasons for NA between the genders. In most cases, these remained after controlling for confounders such as socioeconomic factors and attitudes to drugs that are known to differ between women and men. Associations were also found between symptoms of anxiety and/or depression and the presence of intentional or unintentional non-adherent behaviour (with a stronger average association for intentional NA), and between anxiety/depression and some of the reasons given for NA, e.g. adverse drug reactions (ADRs).

    Conclusions: Although it was not possible to confirm causal relationships, this thesis emphasises the effects of gender and psychological distress on NA. In summary, both gender and anxiety and/or depression influenced non-adherent behaviour and the reasons given for NA. For instance, ADRs seemed to influence the decision not to take the drug as prescribed, especially among women and participants under psychological distress. It is suggested that a deep understanding of the causes of NA and of the impact of gender and psychological distress on the outcomes would help those aiming to improve adherence to prescribed medication.

  • 94.
    Thunander Sundbom, Lena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Medical science. Department of Pharmacy, University of Uppsala, Uppsala, Sweden.
    Bingefors, Kerstin
    Department of Pharmacy, University of Uppsala, Uppsala, Sweden.
    Women and men report different behaviours in, and reasons for medication non-adherence : a nationwide Swedish survey [Hombres y mujeres comunican diferentes comportamientos y razones para el incumplimiento de la medicación: Encuesta nacional Sueca]2012In: Pharmacy Practice, ISSN 1885-642X, E-ISSN 1886-3655, Vol. 10, no 4, p. 207-221Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study was to analyse gender differences in self-reported non-adherence (NA) to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA.

    Methods: A questionnaire was mailed to a cross-sectional, random, national sample of people aged 18-84 years in Sweden (n=7985). The response rate was 61.1% (n=4875). The questionnaire covered use of prescription drugs, NA behaviour and reasons for NA.

    Results: Use of prescription drugs was reported by 59.5% (n=2802) of the participants, and 66.4% (n=1860) of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR 0.77 (95% CI 0.65:0.92)], changing the dosage [OR 0.64 (95% CI 0.52:0.79)] and that they had recovered [14.3%, (OR 0.71 (95% CI 0.56:0.90)] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR 1.25 (95% CI 1.02:1.54)] and reported the development of adverse drug reactions (ADRs) [OR 1.89 (95% CI 1.37:2.59)] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs.

    Conclusions: Women and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes.

  • 95.
    Valan, Lotha
    et al.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Department of Research and Development, Hälsocentralen Bjästa, Västernorrland County Council, Bjästa, Sweden.
    Karin, Sundin
    Department of Nursing, Umeå University, Örnsköldsvik, Sweden.
    Kristiansen, Lisbeth Porskrog
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Jong, Mats
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Child health nurses’ experiences and opinions of parent Internet use2017In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275Article in journal (Refereed)
    Abstract [en]

    Background: On the basis of parents’ growing use of the Internet as a resource for health-related information, and the total lack of scientific literature about how nurses in child healthcare experience how their work is affected, further information is needed.

    Purpose: This study describes child health nurses’ (CHN) experiences and opinions of parent Internet use.

    Design and methods: Using a qualitative descriptive approach, CHNs (n = 20) working at Health Centres in northern Sweden were interviewed.

    Results: An overarching theme named ‘Parents’ use of Internet has influenced Nurses’ work’ was identified. The theme comprises three categories; ‘Internet facilitating care, access, and provision’; ‘The Internet complicating the professional role and performance’; and ‘Sensing an imperative for a new role as a CHN.

    Conclusions: These findings add a fresh perspective to understanding the new and transformed professional role of CHNs.

  • 96.
    Voraroon, Supaporn
    et al.
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden; Boromarajonani College of Nursing, Suphanburi, Thailand.
    Hellzen, Ove
    Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.
    Enmarker, Ingela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Sciences, Caring Science.
    Meebunmak, Yaowaluck
    Boromarajonani College of Nursing, Ratchaburi, Thailand.
    Devik, Siri Andreassen
    Centre for Care Research Mid-Norway, Steinkjer, Norway.
    The impact of shareholding networks for facilitating care in rural Thailand.2019In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984Article in journal (Refereed)
    Abstract [en]

    This study explored the existential meaning of being a participant in shareholding networks for the care of older people in Thailand. Ten older persons were interviewed about their experiences of participating in the networks. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that participating in shareholding network activities entails an always-present existence of aging intertwined with life. Its constituents further describe the essential meaning of the phenomenon: "experience of improved self-management", "feeling of increased self-esteem", and "bridging a gap in the care of older people". Participation in shareholding network activities means keeping contact with oneself and being able to have a life that corresponds to how one perceives oneself to be and must therefore be understood from a holistic perspective. The present study recommends that older persons' need for support include places where safe and profound reflection on existential issues.; Copyright © 2019. Published by Elsevier Inc.

  • 97.
    Wiesinger, Birgitta
    et al.
    Dept. of Odontology, Clinical Oral Physiology, Umeå University.
    Häggman-Henrikson, Birgitta
    Dept. of Odontology, Clinical Oral Physiology, Umeå University.
    Hellström, Fredrik
    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.
    Wänman, Anders
    Dept. of Odontology, Clinical Oral Physiology, Umeå University.
    Experimental masseter muscle pain alters jaw-neck motor strategy2013In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 17, no 7, p. 995-1004Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    A functional integration between the jaw and neck regions has been demonstrated during normal jaw function. The effect of masseter muscle pain on this integrated motor behaviour in man is unknown. The aim of this study was to investigate the effect of induced masseter muscle pain on jaw-neck movements during a continuous jaw opening-closing task.

    METHODS:

    Sixteen healthy men performed continuous jaw opening-closing movements to a target position, defined as 75% of the maximum jaw opening. Each subject performed two trials without pain (controls) and two trials with masseter muscle pain, induced with hypertonic saline as a single injection. Simultaneous movements of the mandible and the head were registered with a wireless optoelectronic three-dimensional recording system. Differences in movement amplitudes between trials were analysed with Friedman's test and corrected Wilcoxon matched pairs test.

    RESULTS:

    The head movement amplitudes were significantly larger during masseter muscle pain trials compared with control. Jaw movement amplitudes did not differ significantly between any of the trials after corrected Wilcoxon tests. The ratio between head and jaw movement amplitudes was significantly larger during the first pain trial compared with control.

    CONCLUSIONS:

    Experimental masseter muscle pain in humans affected integrated jaw-neck movements by increasing the neck component during continuous jaw opening-closing tasks. The findings indicate that pain can alter the strategy for jaw-neck motor control, which further underlines the functional integration between the jaw and neck regions. This altered strategy may have consequences for development of musculoskeletal pain in the jaw and neck regions.

  • 98.
    Wiitavaara, Birgitta
    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.
    Rissén, Dag
    Region Gävleborg.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Psychometric testing of a short form questionnaire for measurement of health experiences among people with musculoskeletal disorders undergoing multimodal rehabilitation2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e025103Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of present study was to assess if a previously suggested short-form questionnaire tested among women with non-specific neck-shoulder pain is suitable also for use among men and women with non-specific musculoskeletal disorders in any part of the body, by testing its construct validity by a confirmatory factor analysis. If not, the secondary aim was to investigate the evolving factor structure when performing an explorative factor analysis of data in the expanded sample.

    Methods

    Questionnaire data was collected in three different contexts, in primary care via eight different multimodal rehabilitation teams, in specialised care via two different specialist care centres. The sample consisted of 116 participants, male (n=29) and female (n=87) with non-specific musculoskeletal disorders.

    Data was analysed using confirmatory and exploratory factor analysis and a visual comparison between the result of the Principal Component Analysis in present study, and the results attained in a previous study with a similar aim and design.

    Results

    The confirmatory factor analyses did not end up in a model with acceptable measures for validity. Three models were tested, none of them met the criterion for an acceptable model and the goodness-of-fit statistics were not fully acceptable. The exploratory factor analysis had an only partly comparable result, compared to previous study.

    Conclusion

    The results of present study did not prove the suggested short form questionnaire to be suitable for evaluation of symptoms among men and women with non-specific musculoskeletal disorders in any part of the body. Further studies including larger samples are recommended.

  • 99.
    Wiker, Beatrice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Rehabilitering av äldre inom slutenvård: Vad händer sedan?2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Idag är 20 procent av Sveriges befolkning över 65 år. Många av dessa lider av fysisk, psykisk eller social ohälsa, samtidigt som vård och omsorg inte kan bemöta deras behov. Med stigande ålder förändras kroppens sammansättning och kroppens funktioner försämras. Äldres ohälsa blir ett ännu större problem vid sjukhusvistelse då äldre människor generellt sett är mer inaktiva och muskelstyrkan minskar. För att motverka försämrad hälsa efter utskrivning har fysisk aktivitet visat sig vara en möjlig behandlingsform. Men hur stor betydelse har den fysiska aktiviteten efter utskrivning från slutenvården?

     

    Syfte: Syftet med denna studie var att undersöka vilken betydelse fortsatt rehabilitering genom fysisk aktivitet har för äldre personers hälsa efter utskrivning från slutenvård.

     

    Metod: En deskriptiv litteraturstudie genomfördes och vid litteratursökningen användes de akademiska databaserna PubMed och Cinahl. Samtlig litteratur bestod av vetenskapligt granskade artiklar publicerade i fulltext och tillgängliga från Högskolan i Gävle.

    Resultat: Samtliga 14 studier beskrev förbättringar på fysisk hälsa genom fortsatt fysisk aktivitet efter utskrivning från slutenvården hos äldre. Gällande psykisk och social hälsa var resultaten dock inte lika tydliga vilket påvisade att mer forskning behövs. Regelbundna motivationshöjande insatser genom återkopplingar påvisades vara viktiga All fysisk aktivitet förbättrade hälsan. Högintensiv träning påvisades dock vara mest effektiv på vissa parametrar. Aktivitet i hemmiljö visade sig vara minst lika effektiv som aktivitet inom vården samtidigt som studierna dock visade att andelen olycksfall var något högre vid obevakad aktivitet i hemmiljö än inom den bevakade slutenvården.   

     

    Slutsatser: Fortsatt fysisk aktivitet är viktigt för äldres fortsatta fysiska, psykiska och sociala hälsa. Fysisk aktivitet bör därför implementeras i de äldres vardag efter utskrivning. Regelbundenhet gällande den fysiska aktiviteten för äldre efter utskrivning är viktigt för bibehållen god hälsa och ett hälsosamt liv. Kunskap finns till viss del på området men mer forskning behövs.

  • 100.
    Willmer, Mikaela
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    ‘The only chance of a normal weight life’: A qualitative analysis of online forum discussions about bariatric surgery2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 10, article id e0206066Article in journal (Refereed)
    Abstract [en]

    Background

    The only effective weight loss treatment for severe obesity is bariatric surgery, with Roux-en-Y gastric bypass being the most common method. Patients often have unrealistic expectations of surgery and expect a “miracle cure” even though the procedure requires major lifelong lifestyle changes. Most patients access information about the procedure online, and come into contact with others who have had the surgery.

    Objective

    The objective of this study was to describe shared values, feelings, and thoughts among visitors to a web-based forum for those undergoing bariatric surgery.

    Methods

    In this cross-sectional observation study using qualitative contents analysis, the material consisted of an online discussion forum thread about bariatric surgery, with 498 posts. These were saved in a document, read and re-read. Through coding of meaningful units of text, themes were established.

    Results

    Four themes were constructed during data analysis: a) A new life-anticipating dramatic changes of body and mind; b) Negotiating the system and playing the waiting game; c) A means to an end-managing the pre-operative diet; and d) Managing the attitudes of others. Posters described the process of bariatric surgery as a journey, riddled with roadblocks, setbacks and trials, but also with joy and expectations of a new life.

    Conclusion

    Professionals who encounter this group should be aware of their need for support throughout the process, and investigate the possibility of both pre- and postoperative support groups, either online or face-to-face. The results also show that the posters on the forum had very high, and often unrealistic, expectations on how the surgery would change their lives. It is important for those who encounter this group before surgery to be aware of this tendency and to take measures to ensure that patients undergo the surgery with realistic expectations.

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