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  • 101.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    En pilotstudie om nya universitetslärares erfarenheter av kollegial handledning2015Conference paper (Refereed)
    Abstract [sv]

    Kollegial handledning är det mest omfattande praktiska momenten i Uppsala universitets högskolepedagogiska grundkurs. En kurs där den bärande idén är att ge kursdeltagarna möjligheter att reflektera över sin praktik som universitetslärare utifrån antagandet att reflektion är en förutsättning för att kunna utvecklas i sin lärarroll. Handledningen har en direkt koppling till kursdeltagarnas egen undervisning med ett strukturerat möte mellan kursdeltagaren (adepten), som i de flesta fall är relativt ny som lärare, och en mer erfaren lärarkollega. Mentorn ger återkoppling före och efter ett undervisningspass som kursdeltagaren har valt ut. Målet är att den kollegiala handledningen ska hjälpa adepten att utveckla en mer reflekterad praktik där erfarenheter belyses ur olika perspektiv och ombildas till kunskap. För närvarande finns det 150 mentorer representerande universitetets samtliga fakulteter och varje år ges cirka 250 handledningstillfällen.

    Under åren 2012-2014 har trettio adepters synpunkter samlats in om hur de upplevt sin mentorshandledning. De har beskrivit vad de tyckte var viktigt att prata om och om samtalen gett nya tankar och dimensioner. Vår analys visar att både frågor om undervisnings VAD; att göra intresseväckande presentationer, aktivering av studenter och att vara seminarieledare, liksom frågor om undervisningens HUR; den nya lärarens känslor som rädsla och tvivel, självkännedom, nya tankar om undervisningen var viktigt för de nya lärarna att ventilera. Fler detaljer och exempel från pilotstudiens analys kommer redovisas och diskuteras under konferensen. Vi efterlyser ett diskussionsutbyte och synpunkter från erfarna kollegor om denna typ av kollegial handledning då vi under 2015 ska genomföra ett större projekt där hela mentorsverksamheten vid Uppsala universitet ska beskrivas, diskuteras och utvecklas.

     Uppsala 19 april 2015 Anna Hofsten

    mentor och forskare vid Uppsala universitet/Institutionen för Folkhälso- och vårdvetenskap/Allmänmedicin och lektor i medicinsk vetenskap vid Högskolan i Gävle

     

  • 102.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Seminarier på tavlan2015In: Seminariet i högre utbildning: erfarenheter och reflektioner / [ed] Lotta Jons, Lund: Studentlitteratur AB, 2015, p. 45-66Chapter in book (Other (popular science, discussion, etc.))
  • 103.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Studenters erfarenheter av lärande i det goda seminariet i ”omvänd ordning”2015Conference paper (Refereed)
    Abstract [sv]

    Hur kan vår undervisning på forskarförberedande nivå öka studenternas tilltro till att själva söka kunskap, värdera den och dra egna slutsatser? I vården är sjuksköterskans roll fortfarande mycket att invänta läkarens bedömning och följa ordinationer mer än att analysera situationen och ta egna beslut. Men efter en akademisk utbildning på avancerad nivå förväntar sig samhället mer och i distriktssköterskans nya roll som receptförskrivare av läkemedel har ansvaret förändrats. Skulle inte också dessa studenter uppleva det som lärorikt att skriva texter och diskutera i seminarier istället för att alltid först styras av föreläsningar?

    Som läkare och lärare till distriktssköterskor på avancerad nivå kunde jag förändra undervisningen och vända på den traditionella, förväntade ordningen. Studenterna fick nu istället först självständigt sammanställa texter om hur man känner igen och behandlar vanliga hudsjukdomar. Därefter diskuterade vi deras olika texter i ett seminarium, de gjorde förändringar och tillägg i sina sammanställningar för att först avslutningsvis möta en expert på hudsjukdomar. Det vi prövade var en ”omvänd ordning” som mer fokuserar på studentaktivitet, mycket inspirerat av Kolbs tankar om aktiva lärprocesser (Kolb 1984).

    Mitt bidrag till konferensen är att redovisa en empirisk studie där dessa tjugofyra erfarna sjuksköterskor i vidareutbildning hösten 2014 beskriver sittlärande i ”omvänd ordning” i det som vi uppfattar det goda seminariet. En innehållsanalys visar att studenterna lär sig av att

    - leta kunskap och skriva egna sammanfattande texter

    - träna tilltron till egna slutsatser och att argumentera för och emot

    - vara aktiva i diskussionerna vid seminariet där det är tillåtande atmosfär

    - revidera eller komplettera en tidigare uppfattning

    Jag vill också föra en diskussion om hur vi kan ge studenterna större tilltro till egna bedömningar i mötet med experter en undervisning på avancerad nivå som är mer forskarförberedande och lockar nya studentgrupper att söka forskarutbildning.

    Referens: Kolb, D.A., 1984. Experiential learning: experiences as the source of learning anddevelopment. New Jersey: Englewood Cliffs.

  • 104.
    Hofsten, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Studenters erfarenheter av lärande i ”omvänd ordning””2016In: Studenters erfarenheter av lärande i ”omvänd ordning””, 2016Conference paper (Refereed)
  • 105.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Education in reverse: student activity first, lecture last2016In: Education in reverse: student activity first, lecture last, 2016Conference paper (Refereed)
    Abstract [en]

    3 key points

    • In this way of flipped classroom students valued first seeking the knowledge before the expert came to present and discuss the subject.

    • Our analysis revealed that students learn when they overcome difficulties, when they seek facts themselves and discuss in seminars and when their own knowledge is challenged.

    • In planning their courses, teachers must give students opportunities to be active learners instead of passive listeners and knowledge consumers.

    When students come to university for advanced studies, there must be challenges. The academic environment should provide opportunities for students to develop important metacompetencies such as problem-solving abilities for tackling unfamiliar problems, training in oral and written communication, and self-regulated planning of their work and studies (Lizzio 2002). The question is if we, the teachers who plan the courses, use the short time allotted to teaching and learning in the best way possible?

    To become a specialized primary care nurse in Sweden, students have one year of primary care (with a Master´s paper) and two months of specialized pharmacology. One aim of the pharmacology course is for students to learn about nursing care for patients with common skin diseases, examine them and prescribe simple medications. For years, the traditional teaching approach in this course has been to invite a medical doctor to give a lecture and then to have seminar discussions and an exam. Inspired by the pedagogical discussion of “flipped classroom” (Gerstein 2011) we asked ourselves whether it would be more instructive for students to begin by searching for relevant information on skin disorders instead of by being passive listeners during a lecture?

    Aim/focus of the innovation

    To give students the opportunity to be more active in their own learning, we reversed the traditional order of learning methods.

    Implementation of the innovation                                                                                               

    The students first had to find information on how to examine skin disorders and nursing care for patients with common skin diseases, and then write a text that would be discussed in a seminar prior to meeting the lecturer. In this new arrangement, we hoped students would become more active, practice evaluating knowledge and prepare themselves before the lecture.

    Methods used to assess the innovation

    To understand more about how students learn in this reversed teaching order, we asked all students in the course to voluntarily write a paper about their learning experiences. All 23 students decided to participate in the study. Their mean age was 38 years and mean time working as a nurse, prior to the Master’s Programme in Primary Care, 7 years. In 2015, two researchers jointly conducted a content analysis of all written data, using Graneheim and Lundman’s (2004) approach.

    Key findings

    Our analysis revealed four categories concerning how students experienced learning in this reversed order. They described they learn when they seek facts themselves, when they overcome difficulties, when their own knowledge is challenged and when they are able to prepare and think before they meet an expert. The analysis and our findings will be presented in detail, including codes and quotations, at the conference. We will also offer a theoretical discussion of Kolb´s Learning Circle, applying the concepts Concrete Experience, Active Experimentation, Reflective Observation and Abstract Conceptualization to our findings (Kolb 1984).

    References

    Gerstein, J. (2011). The Flipped Classroom Model: A Full Picture. Retrieved January 15, 2015, from http://usergeneratededucation.wordpress.com/2016/01/21/the-flipped-classroom-model-a-full-picture.

    Graneheim, U.H. & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, vol. 24, 105-112.

    Kolb, D.A. (1984). Experiential learning: experiences as the source of learning and development. New Jersey: Englewood Cliffs

    Lizzio, A., Wilson, K. & Simons, R. (2002). University students’ perceptions of the learning environment and academic outcomes: implications for theory and practice. Studies in Higher Education, vol. 27, no. 1, 27-52.

  • 106.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Reversed order: student activity first and lecture last2015In: AMEE 2015 Abstract Book, Glasgow, 2015, p. 42-Conference paper (Refereed)
    Abstract [en]

    Abstract:

    Background When students return to university for continued education, there must be challenges. When becoming a specialized primary care nurse in Sweden, students learn to examine common skin diseases and prescribe pharmaceuticals to treat them. The traditional teaching approach is to first have a medical doctor give one or two lectures and to perhaps, later, have discussions in small groups before an exam.

    Summary of work To give students the opportunity to be more active, we reversed the above order of learning methods. The students first had to find facts about skin diseases themselves and write a text to be discussed in a seminar. In this new arrangement, the students had to seek knowledge themselves before meeting the expert in a lecture.

    Summary of results All 23 students in the course were asked to voluntarily write about their learning experience in the above reversed order. Their mean age was 38 years and mean time working as a nurse was 7 years. A content analysis was conducted by two researchers. Findings showed that students learn when they: seek knowledge themselves and write it down, practice trusting in their own conclusions and arguing for and against various claims, and are prepared with knowledge of their own when they meet the expert.

    Conclusions Students value seeking knowledge on their own, writing it down and discussing among themselves before meeting the expert.

    Take-home message Students learn better when they are active. Experiment with letting students engage in their own activity and learning before the experts come to tell their versions of truth.

     

     

  • 107.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för Hälso- och vårdvetenskap, Uppsala universitet, Uppsala.
    Schnaas, Ulrike
    Universitetspedagogik, Uppsala universitet, Uppsala.
    Kollegial handledning – nya universitetslärare möter mer erfarna kollegor i samtal om undervisning2018Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    I den högskolepedagogiska grundkursen vid Uppsala universitet ingår s.k. mentorshandledning, som bygger på idén om reflekterande handledning (Handal & Lauvås 1999; Handal & Lauvås, 2015, Lindenmo, 2014). Nya universitetslärare får stöd och utmaningar av en erfaren kollega kring ett fritt valt undervisningsmoment med återkoppling före undervisningspasset, auskultation och återkoppling efteråt. Grundtanken är att samtalen ska föras utifrån den nya lärarens behov och mentorn är fri att använda sin erfarenhet, kollegiala förmåga och känslighet. Alla mentorer har gått en mentorsutbildning och ingår i ett nätverk med regelbundna träffar och fortbildningsmöjligheter.

    År 2015 startade ett pedagogiskt forsknings- och utvecklingsprojekt för att öka vår förståelse av vad mentorshandledning betyder för både de nya lärarna och mentorerna.

    Syfte

    Att beskriva nya universitetslärares och mentorers upplevelser av och uppfattningar om mentorshandledning och vidareutveckla olika former av kollegial handledning.

    Frågeställningar

    • Vad uppfattar mentorer respektive adepter som viktiga inslag i mentorsmötet?
    • Vad är utmaningar och drivkrafter för mentorsengagemang?
    • Vad är de mest angelägna frågorna för adepterna att ta upp?

    Metod

    Under hösten 2015 skickades en kvalitativt inriktad enkät till mentorer och nya lärare som haft mentorshandledning under året. Enkäten hade en svarsfrekvens på 92/169 för de nya lärarna och 60/130 för mentorerna. För att fördjupa bilden genomfördes sedan fokusgruppsintervjuer med sammanlagt 16 mentorer med olika kön, ålder, erfarenhet och fakultetstillhörighet. Enkäterna och intervjuerna har tolkats med kvalitativ innehållsanalys (Granheim & Lundman 2004; Cousin, 2008). I design och analys har vi bidragit med våra olika perspektiv som pedagogisk utvecklare och universitetslektor/mentor.

    Resultat

    Mentorshandledningen är mycket uppskattad av de nya lärarna och fokuserar till skillnad från en bedömning av undervisningsskickligheten på bekräftelse, stöd och inspiration. Handledningssamtalen ger de nya lärarna en möjlighet att diskutera angelägna frågor rörande hela undervisningsprocessen med förankring i den egna ämneskontexten utifrån ett konkret undervisningsmoment. Enkätsvaren visar att samtalen förutom nya tankar för den egna undervisningen och konkreta tips även ger en ökad trygghet som lärare, en bekräftelse att det aktuella upplägget fungerar och en uppmuntran att pröva nya saker. Mentorerna å sin sida betonar att handledning inte bara är ett tillfälle att stödja nya lärare som ger stor arbetsglädje, utan även en möjlighet till egen kontinuerlig självreflektion och till att aktivt ta del i universitetets pedagogiska utvecklingsarbete. Många lyfter att uppdraget innebär ett välkommet avbrott i den akademiska vardagen och bland det roligaste de gör.

    Slutsatser och diskussion

    Den kollegiala handledningen är ett stöd åt nya lärare i akademin som kan ventilera sina frågor och farhågor med en mer erfaren kollega. De är därmed en form av praktik som enligt Riis bör förstärkas i högskolepedagogisk utveckling. (Riis, 2016) Ett för oss förvånande och intressant resultat är hur mentorshandledningen på ett mångfacetterat sätt bidrar till mentorernas egen utveckling. I motsats till mer tidsbegränsade insatser som pedagogiska kurser innebär mentorsuppdraget en kontinuerlig pedagogisk reflektion, där mentorn inte bara ger stöd, utan också själv får ompröva och sätta ord på pedagogiska resonemang. Handledningen ger en möjlighet att ta del av helt olika undervisningskulturer och skapar ett levande pedagogiskt samtal över hela universitetet.

     

    Referenser

    Cousin, Glynis (2008). Researching learning in higher education - an introduction to contemporary. David Fulton Publishers Ltd

    Graneheim, U.H., Lundman, B. (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24, 105-112.

    Handal, G. (1999) Consultation using critical friends. New directions for teaching and learning, Vol. 1999, issue 79, 59-70.

    Lauvås, Per & Handal, Gunnar (2015). Handledning och praktisk yrkesteori. 3., uppdaterade uppl. Lund: Studentlitteratur, s. 231-257.

    Lindenmo, B. (2014) Att besöka varandras undervisning – om auskultationer som utvecklingsmöjlighet I högskolan. Centrum för undervisning och lärande. Linköpings universitet.

    Riis, U. På vilken vetenskaplig grund och utifrån vilken beprövad erfarenhet? Utvecklingsbehov inom högskolepedagogiken. Högre utbildning, 6(1), 91-92.

  • 108.
    Hofsten, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Schnaas, Ulrike
    Uppsala universitet.
    Reinholdsson, Peter
    Uppsala universitet.
    "Mentored teaching" as a practice of care in educational development2016In: "Mentored teaching" as a practice of care in educational development, 2016Conference paper (Refereed)
    Abstract [en]

    Peer development has been recognized as a key for the professional enhancement of university teachers. At Uppsala University, Sweden, mentored teaching offers a structure for peer reflection and collegial support. During the "Academic Teacher Training Course", every participant reflects on a specific teaching activity together with an experienced university teacher.

    Currently, a research project is addressing what mentored teaching means to course participants / mentees as well as to mentors. Our findings – based on detailed questionnaires with 60 mentors and 92 mentees as well as focus interviews – clearly show that mentored teaching can be linked to an ethos of care in two senses.

    On the one hand, the mentors provide a supportive space for the mentees that - unlike assessment – focuses on confirmation, encouragement and inspiration being particularly important for new academics. On the other hand, the network for mentors as well as the mentoring itself provides a similar space for the mentors. Being a mentor offers not only an opportunity to contribute to the mentees learning, but also a possibility for continuous self-reflection and self-development. Specific training and networking activities organized by the Unit of Academic Teaching and Learning contribute to a shared mentoring ethos of care for each other as colleagues. Aligned to that, becoming a member of the mentors´ network is based on strong commitment for teaching and education rather than on academic merits. In conclusion, this non-competitive community maintains an ethos of care and collegiality across the university that is beneficial for both mentees and mentors.

  • 109.
    Holmberg, Jörgen
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Curriculum studies.
    Masoumi, Davoud
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Curriculum studies.
    Elm, Annika
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Curriculum studies.
    Fransson, Göran
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Curriculum studies.
    Westelius, Claes
    University of Gävle, Faculty of Education and Business Studies, Department of Educational sciences, Educational science, Curriculum studies.
    Björkman, Annica
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Stake-Nilsson, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Toratti-Lindgren, Monique
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Teachers’ and students’ understanding and use of ICT for teaching and learning – Combining different perspectives and methodologies in research on technology-enhanced learning2017Conference paper (Refereed)
    Abstract [en]

    More than half of the 14,000 students currently studying at the University of Gävle (HiG) are enrolled in courses that are totally or partly online based.  In 2015, a university-wide project on technology enhanced learning (TEL) (Steffens et al 2015) was initiated. The project focuses on course and programme development and is divided into four sub-projects, all of which contribute to the overall goals of project.

    AIMS of the project

    The aims of the project are to: (a) restructure teaching facilities and integrate digital technologies, (b) develop technology supported teaching methods, (c) integrate campus and distance education, (d) enhance teachers' and students' digital skills and (f) increase collaboration with relevant external actors.

    These aims are achieved through the work of four project groups.

    The digital environment group's (1) main focus is on digital tools for learning and the physical arrangement of learning spaces. The collaboration group's (2) main focus is on the maintenance and development of collaborative relationships and connections with communities in higher education for e-learning. The education and professional development group (3) focuses on issues such as professional development, learning design and the implementation of ICT in different courses and subjects. The research group (4) focuses on different issues connected to TEL.

    One of the main principles of the project is that the above areas are interlinked and interdependent and that the different experiences and skills of each group and its members contribute to a broader perspective of TEL.

    This poster focuses on the research conducted by the project's research group. Taking a multidisciplinary approach, the research focuses on issues and aspects of teaching and learning in higher education that contribute to multifaceted knowledge. The overall aim of the research is to generate knowledge about how conditions for teaching and learning change when the use of technology increases. The four research studies that are initiated are described below.

    Study 1: Lecturers’ and students’ agency in encounters with digital media in higher education

    This research study focus on issues related to lecturers’ digital teaching practices and students’ digital technological use in their everyday lives and for learning purposes.

    Digital practices are defined as the different contexts in which lecturers teach and students participate in digital media (such as learning management systems, forums, communities etc.). Previous research shows that students’ own digital practices are not always made use of in higher education (Buzzard et al., 2011; Kelm, 2011).

    A controversial issue in the Swedish higher education context is the discourse on students as customers. The perception of students as customers and “buyers” of ready-packaged content from lecturers is problematic. This view of what higher education stands for clashes with traditional academic views emphasizing critical thinking, reflection, self-directed learning, collaborative and individual learning etc.

    In this study, the concept of agency is important in that it reflects “the capacity of actors to critically shape their own responsiveness to problematic situations” (Emirbayer & Mische, 1998, p. 971). In the different perceptions of students’ and lecturers’ tasks and roles in teaching and learning, especially in TEL, all the actors have to display agency in order to manoeuvre in the educational and digital contexts. Notably, agency is not something that people have, but is something that people achieve (Biesta & Tedder, 2006).

    Aim

    The aim of the research project is to study: (a) students’ use of digital technology in their everyday practices and in relation to teaching situations and (b) how lecturers’ agency is played out in teaching and learning when trying to facilitate TEL.

    Methodology

    In spring 2017 an online survey involving up to 200 students will be conducted in order to generate knowledge about (a) students’ everyday experiences of digital practices and how these are utilized in higher education and (b) how higher education challenges and develops students’ digital skills and knowledge. In the same period, interviews with lecturers at the university will be conducted in order to generate knowledge about lecturers’ (c) everyday teaching practices with digital technologies and (d) the perceived challenges and development of teaching in relation to their use.

    Study 2: Teachers’ understanding and enactment of practice in online and blended educational contexts

    The knowledge that teachers need to develop is referred to as a ‘didaktik’ knowledge in the German/European tradition (cf. Kansanen 2009) and as pedagogical content knowledge (PCK) in the Anglo-Saxon literature (Shulman 1986; 1987). However, in what Castells (2011) describes as a network society, teachers are faced with new challenges and opportunities. Koehler et al (2014) argue that teachers’ development and integration of a new knowledge domain is not simply a matter of adding this “technology knowledge” to existing knowledge, but involves a reframing and reconceptualization of their existing professional practices and knowledge. They refer to this amalgam knowledge as technological pedagogical content knowledge (TPACK). The TPACK framework has been widely accepted as a useful theoretical construct. However, there is a need for research on the development and manifestation of TPACK in different disciplinary contexts (Koehler et al 2014).

    Aim

    The aim of this sub-project is to study: a) how teachers reframe and reconceptualize their practices and the kind of knowledge that is needed in online contexts b) how teachers practices are manifested when ICT is used to create (intended) added pedagogical values in educational designs c) the characteristics of educational designs regarded as adding pedagogical value

    Methodology

    Three higher education teachers of different courses and subjects in three different departments participate in the study. A design-based research approach is applied, where one of the participating researchers engages in so-called design conversations with the teachers. As is characteristic of DBR, this researcher does not only observe and interview, but also acts as a “co-designer” on the understanding that the teachers are the context experts and the final decision makers (McKenney & Reeves 2012; Plomp & Nieveen 2013).

    The data consists of recorded design conversations, educational designs and the artefacts used in the educational designs, the researcher’s/co-designer’s field notes and recorded “field-note conversations” between the researcher/co-designer and the other researcher.

    Expected outcomes

    The study is expected to contribute knowledge about how teachers’ knowledge and practices are understood and manifested in online and mixed higher educational contexts.

    Study 3: Researching and developing student nurses’ drug calculation skills in an explorative design comprising digital technologies

    This study is partly experimental in nature. It focuses on the challenges involved in student nurses’ development of accurate drug calculation skills. Challenges like this are not specific to nurse education at the University of Gävle, but appear to be universal (cf. Wright, 2009). However, it has also been claimed that written drug calculation tests do not accurately evaluate the skills involved in drug calculation, in that they are decontextualized from healthcare settings (Wright, 2005; 2012). It has also been claimed that this problem is more imaginary than factual, given that in practice nurses have been shown to handle drug calculation well (Wright, 2009).

    Aim

    The aims of this sub-project are to: (a) deepen the understanding of the challenges and mistakes that student nurses make in drug calculation exams, why they occur and how they might be prevented, (b) explore how the teaching and examination of drug calculation can be made more effective and contextualized and whether digital technologies can help in this.

    Methodology

    A multiple design method is employed using empirical data from written examinations, analyses of the set tasks and interviews with student nurses.

    Expected outcomes

    It is expected that the study will contribute knowledge about why (some) student nurses find it difficult to pass exams and that sufficient knowledge will be developed to facilitate the exploration of an experimental design for teaching and learning that includes digital technologies.

    Study 4: Situating ICT in teacher education programmes at the University of Gävle

    Integrating ICT as an integral part of teacher education programmes has been addressed as the most significant factor in determining the future level of ICT use in teaching and learning practices (Davis, 2010). According to the Swedish Higher Education Act, ICT should be embedded across entire educational practices in teacher education programmes (Government Bill, 2009/10:89). Numerous teacher educationprogrammes have made extensive efforts to prepare and empower teacher education students’ ICT competences so that ICT-based technologies are seamlessly woven into the teaching and learning process. Most schools try to enhance teachers’ digital competences by in-service education and expect newly qualified teachers to be adequately trained to use digital technologies in their educational practices. However, in reality it would seem that many newly qualified teachers do not have the necessary skills for this (see Chigona, 2015; Koehler, Mishra, Akcaoglu, & Rosenberg, 2013). 

    Aims

    This study focuses on understanding why a large number of the newly qualified teachers in teacher education institution remain underprepared to use digital technologies in their educational practices, despite an increased investment in the provision of digital technologies in these institutions.

     Methodology

    In order to explore how digital technologies are integrated into teacher education in higher education institutions, a sequential explanatory multiple sources design consisting of two distinct phases will be implemented (Creswell, 2012). In this design, a number of course syllabi in a programme will be analyzed. Interviews with key actors, including students, teacher educators and gatekeepers, will be conducted in order to contextualize and deepen the analysis of the syllabi.

    Expected outcomes

    The study is expected to deepen the understanding of how student teachers are pedagogically trained in ICT in teacher education institutions.

    Concluding remarks

    The four research studies in the project investigate how students and teachers understand and use educational ICT. This is done by using different methodologies and from different perspectives. It is expected that the research studies will contribute to the broader and more inclusive project perspective by their specific aims and generate knowledge that will contribute to the multifaceted field of TEL.

    References

    1. Biesta, G. & Tedder, M. (2006). How is agency possible? Towards an ecological understanding of agency-as-achievement. Working paper 5, Learning Lives: Learning, Identity and Agency in the Life Course, University of Exeter, England.
    2. Buzzard, C., Crittenden, V.L., Crittenden, W.F. & McCarty, P. (2011). The Use of Digital Technologies in the Classroom: A Teaching and Learning Perspective. Journal of Marketing Education. 33 (2), 131-139.
    3. Buzzard, C., Crittenden, V.L., Crittenden, W.F. & McCarty, P. (2011). The Use of Digital Technologies in the Classroom: A Teaching and Learning Perspective. Journal of Marketing Education. 33 (2), 131-139.
    4. Castells, M. (2011) The Rise of the Network Society: The Information Age: Economy, Society, and Culture, 2nd edn (Vol. 1). Malden, MA: John Wiley & Sons. 
    5. Chigona, A. (2015). Pedagogical shift in the twenty-first century: Preparing teachers to teach with new technologies. Africa Education Review, 12(3), 478-492. doi:10.1080/18146627.2015.1110912
    6. Davis, N. (2010). Technology in Preservice Teacher Education. In P. Editors-in-Chief:  Penelope, B. Eva, E. B. Barry McGawA2 - Editors-in-Chief:  Penelope Peterson, & M. Barry (Eds.), International Encyclopedia of Education (Third Edition) (pp. 217-221). Oxford: Elsevier.
    7. Emirbayer, M., & Mische, A. (1998). What is agency? American Journal of Sociology, 103(4), 962-1023.
    8. Kansanen, P. (2009). The curious affair of pedagogical content knowledge. Orbis Scholae, 3(2), 5-18.
    9. Kelm, R. (2011). Social Media. It’s what students do. Business Communication Quarterly. 74, (4), 505-520.
    10. Koehler, M. J., Mishra, P., Akcaoglu, M., & Rosenberg, J. (2013). The technological pedagogical content knowledge framework for teachers and teacher educators. In R. Thyagarajan (Ed.), ICT integrated teacher education: A resource book. New Delhi, India: CEMCA.
    11. Koehler, M. J., Mishra, P., Kereluik, K., Shin, T. S., & Graham, C. R. (2014). The technological pedagogical content knowledge framework. In J.M. Spector, M.D. Merrill, J. Elen, & M.J. Bishop (Eds.), Handbook of research on educational communications and technology (pp. 101-111). Springer New York.
    12. McKenney, S., & Reeves, T. C. (2012). Conducting educational design research. London: Routledge.  
    13. Plomp, T. & Nieveen, N. (Eds.). (2013) Educational Design Research: Introduction and Illustrative Cases.  Enschede, Netherlands; SLO Netherlands Institute for Curriculum Development.
    14. Regeringens proposition, (2009/10:89) Regeringens proposition 2009/10:89 om lärarutbildning m.m. [Government Bill, 2009/10:89 regarding teacher education etc.]  (Stockholm, Gotab) (in Swedish).
    15. Shulman, L. S. (1986). Those who understand: Knowledge growth in teaching. Educational Researcher, 15, 4–14.
    16. Shulman, L. S. (1987). Knowledge and teaching: Foundations of the new reform. Harvard Educational Review, 57, 1–22.  
    17. Steffens, K., Bannan, B., Dalgarno, B., Bartolomé, A. R., Esteve-González, V., & Cela-Ranilla, J. M. (2015). Recent Developments in Technology- Enhanced Learning: A Critical Assessment. RUSC. Universities and Knowledge Society Journal, 12(2). pp. 73-86.
    18. Wright, K. (2005). An exploration into the most effective way to teach drug calculation skills to nursing students. Nurse Education Today, 25, 430–436. 
    19. Wright, K. (2009). The assessment and development of drug calculation skills in nurse education – A critical debate. Nurse Education Today, 29, 544–548. Doi: 10.1016/j.nedt.2008.08.019 
    20. Wright, K. (2012). Editorial. Drug calculation skills – Are we running scared? Nurse Education Today, *. Doi: 10.1016/j.nedt.2011.06.001 
  • 110.
    Holmström, Inger K.
    et al.
    School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Kaminsky, Elenor
    School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Höglund, Anna T.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nursing students' awareness of inequity in healthcare - An intersectional perspective.2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 48, p. 134-139Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The overall aim of the present study was to explore awareness of inequity in healthcare and the intersection between different structures of power among nursing students. Another aim was to delineate the knowledge and use of Swedish Healthcare Direct in this group.

    DESIGN: The study had a descriptive design with a quantitative approach.

    PARTICIPANTS: The sample consisted of 157 nursing students from three universities in central Sweden.

    METHODS: The students filled out a study specific questionnaire in class. The questionnaire consisted of short descriptions of twelve fictive persons who differed in gender, age, and ethnicity, with questions about their life situation. The mean was calculated for each assessed fictive person for every item. In the next step, the assessments were ranked from the lowest probability to the highest probability. A 'Good life-index' consisting of quality of life, power over own life, and experience of discrimination, was also calculated. Free text comments were analysed qualitatively.

    RESULTS: People with Swedish names were assessed to have the highest probability of having a good life. Among those with Swedish names, the oldest woman was assessed as having the lowest probability of a good life. All students had knowledge about Swedish Healthcare Direct, but more female students had used the service compared to male students.

    CONCLUSIONS: The results indicate that the nursing students had awareness of how power and gender, ethnicity and age, are related. Based on the free text comments, the questions and the intersectional perspective seemed to evoke some irritation which points to their sensitive nature. Therefore, the questionnaire could be used as a tool to start a discussion of equity in healthcare and in interventions where the aim is to raise awareness of inequality and intersectionality.

  • 111.
    Holmén, Matilda
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Kropf Kempe, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Telefonsjuksköterskors erfarenheter av uppringare med psykisk ohälsa: En intervjustudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Sjukvårdsrådgivning via telefon har funnits i Sverige sedan slutet på 90-talet. Det är en tjänst som erbjuds för alla i hela landet, dygnet runt, året om. 1177 är det nationella numret och årligen besvaras 4.5 miljoner samtal av legitimerad personal (telefonsjuksköterskor). Uppringare med psykisk ohälsa beskriver ett behov av att bli lyssnade på och tagna på allvar.

    Syfte: Att beskriva telefonsjuksköterskors erfarenheter av uppringare med psykisk ohälsa och strategier för att hantera dessa. För att besvara syftet användes 3 frågeställningar.

    Metod: Data har samlats in mellan maj-oktober 2016 via telefonintervjuer. Semistrukturerad intervjuguide användes. Telefonsjuksköterskor med variation på tjänstgöringsort och tid i yrket inkluderas. De skulle ha besvarat ett samtal de senaste 6 månaderna från en uppringare med psykisk ohälsa. Totalt 21 deltagande telefonsjuksköterskor varav 14 av intervjuerna är inkluderad i föreliggande examensarbete. Data analyserades utifrån Elo och Kyngäs metod för innehållsanalys samt kompletterande tabell för överskådlighet.

    Huvudresultat: Orsakerna till samtal varierar. Telefonsjuksköterskor inom 1177 använder sig av olika strategier för att hantera samtalen från uppringare med psykisk ohälsa. Viktigt att snabbt ringa in problemen. Samtalen med uppringare som lider av psykisk ohälsa tar lång tid. De använder sig av rådgivningsstödet i den mån de upplever att stödet fungerar samt följer samtalsprocessen som metod. Telefonsjuksköterskorna saknar utbildning inom psykiatri. De har ett gott stöd av varandra inom arbetsgruppen.

    Slutsats: Telefonsjuksköterskorna beskrev erfarenhet av uppringare med psykisk ohälsa. De beskrev även att de har strategier för att besvara samtalen men saknar uppgifter om psykisk ohälsa i rådgivningsstödet samt utbildning inom området.

  • 112.
    Högberg Eriksson, Rebecca
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Linde, Amanda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Musikens betydelse i omvårdnaden av personer med demenssjukdom: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The number of people with dementia increases in the world, is a progressive disease and gives a fatal outcome. The most important measure is to provide good care. The nurse's role includes the overall responsibility for the care and the implementation of new methods. Studies have shown that alternative care can be a good complement to ordinary care for this group of patients. In previous studies music has shown positive results in promoting health in humans.

  • 113.
    Höglund, Anna T.
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Marianne
    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.
    Holmström, Inger K.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; School of health, care and social welfare, Mälardalen University, Västerås, Sweden.
    Kaminsky, Elenor
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; School of health, care and social welfare, Mälardalen University, Västerås, Sweden.
    Impact of telephone nursing education program for equity in healthcare2016In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, no 1, article id 152Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person's human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare among telephone nurses.

    METHODS: The study had a quasi-experimental design, with one intervention group and one control group. A base-line measurement was performed before an educational intervention and a follow-up measurement was made afterwards in both groups, using a study specific questionnaire in which fictive persons of different age, gender and ethnicity were assessed concerning, e.g., power over one's own life, quality of life and experience of discrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, covering aspects of inequality in healthcare related to gender, age and ethnicity, and gender and intersectionality theories as explaining models for these conditions.

    RESULTS: The results showed few significant differences before and after the intervention in the intervention group. Also in the control group few significant differences were found in the second measurement, although no intervention was performed in that group. The reason might be that the instrument used was not sensitive enough to pick up an expected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create a sort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higher Good life-index than the fictive persons born outside Europe and of higher age in all assessments.

    CONCLUSION: The results are an imperative that equity in healthcare still needs to be educated and discussed in different healthcare settings. The intervention and questionnaire were designed to fit telephone nurses, but could easily be adjusted to suit other professional groups, who need to increase their awareness of equity in healthcare.

  • 114.
    Höglund, Anna T.
    et al.
    Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Carlsson, Marianne
    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.
    Holmström, Inger K.
    Department of Public Health and Caring Sciences, Uppsala, Sweden; School of health, care and social welfare, Mälardalen University, Västerås, Sweden.
    Lännerström, Linda
    Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Kaminsky, Elenor
    Department of Public Health and Caring Sciences, Uppsala, Sweden.
    From denial to awareness: a conceptual model for obtaining equity in healthcare.2018In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, no 1, article id 9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation.

    METHOD: A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively.

    RESULTS: Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare.

    CONCLUSION: A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach equity in healthcare, action is also needed, and that concept was therefore added to the model. The result can be used as a starting point when developing educational interventions for healthcare personnel.

  • 115.
    Hökdahl, Lina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Wålstedt, Linnea
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjuksköterskans omvårdnadsåtgärder vid övervikt och fetma bland barn: En deskriptiv litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight and obesity among children is a growing problem both globally and in Sweden. The main reasons being an increased intake of energy dense foods and reduced physical activity with an increased risk of complications such as diabetes and cardiovascular disease.

    Aim: To describe the nurses nursing interventions in overweight and obesity among children and to describe the data collecting methods of the included literature.

    Method: A descriptive literature study that includes ten articles, five with a qualitative approach and five with a quantitative approach.

    Main result: Counseling sessions between nurses and overweight or obese children and/or their parents are presented under two headings. Under the first heading counseling regarding diet and meal patterns are described. The nurses believe that diet counseling is an important part of their work with overweight and obesity among children. The second heading describes counseling sessions where the nurses encourage increased physical activity and reduced sedentary behavior among the children. The nurses interaction with the children's parents is described as one of the most important parts of the nursing interventions. To support the nursing interventions aids, instruments and resources in the form of other professions are used by the nurses.

    Conclusion: In collaboration with children and their parents the nurses primary mission is to inform, motivate and implement nursing interventions. Ultimately this gives the families the ability to implement nursing actions on their own. The focus should primarily be on the interaction with the parents as no child should be held responsible for these behavioral changes.

  • 116.
    Israelsson, Johan
    et al.
    Kalmar County Hospital, Kalmar, Sweden.
    Bremer, Anders
    University of Borås, Borås, Sweden.
    Axelsson, Åsa
    University of Gothenburg, Gothenburg, Sweden.
    Cronberg, Tobias
    Lund University, Lund, Sweden.
    Djärv, Therese
    Karolinska Institutet, Stockholm, Sweden.
    Herlitz, Johan
    University of Borås, Borås, Sweden.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Larsson, Ing-Marie
    Uppsala University, Uppsala, Sweden.
    Lilja, Gisela
    Lund University, Lund, Sweden.
    Sunnerhagen, Katarina S.
    University of Gothenburg, Gothenburg, Sweden.
    Wallin, Ewa
    Uppsala University, Uppsala, Sweden.
    Ågren, Susanna
    Linköping University, Linköping, Sweden.
    Åkerman, Eva
    Skane University Hospital, Malmö, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Kalmar, Sweden.
    Neurologic outcome, health-related quality of life, anxiety and symptoms of depression among in-hospital cardiac arrest survivors2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Suppl. 1, p. 101-101, article id AP143Article in journal (Other academic)
    Abstract [en]

    Purpose: Most cardiac arrest research has focused on survival inan out-of-hospital context. The knowledge of health and quality of life is sparse, especially regarding in-hospital cardiac arrest (IHCA) survivors. The aim of the current study was therefore to describe neurologic outcome, health-related quality of life (HRQoL), anxiety and symptoms of depression among IHCA survivors.

    Materials and methods: This study has a cross-sectional design. Data from the Swedish Register of Cardiopulmonary Resuscitation was used. In the register, data is collected 3–6 months after resuscitation by using a questionnaire including two questions about activities in daily life and mental/intellectual recovery, theEQ-5D-5L and the Hospital Anxiety and Depression Scale (HADS). In addition, Cerebral Performance Category (CPC)-scoring is performed.

    Results: Between the 11th of June 2013 and the 7th of May 2015, 488 IHCA survivors with a mean age of 69±13 were included. A majority were men (62%), had a cerebral function of CPC 1 (87%) and no need of assistance from other people in daily life (71%). A large proportion had not made a complete mental/intellectual recovery (27%). Pain/discomfort was the dimension in EQ-5D-5L where most survivors reported problems (64%), while least problems were reported in the dimension self-care (24%). The individual variations of present health state (EQ-VAS) were substantial (range 0–100), with a mean value of 66±22. Anxiety and symptoms of depression were reported by 16% and 15% respectively.

    Conclusions: Although the majority of the IHCA survivors reported good neurologic outcome, satisfactory HRQoL, no anxiety or symptoms of depression, the results indicate major individual differences, with a substantial group reporting serious problems. Our findings stress the importance of structured post resuscitation care and follow-up, in order to identify and support those in need.

  • 117.
    Israelsson, Johan
    et al.
    Department of Internal Medicine, Division of Cardiology, Kalmar County Hospital, Kalmar, Sweden; Kalmar Maritime Academy, Linnaeus University, Kalmar, Sweden; Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden .
    Bremer, Anders
    Department of Acute and Prehospital Care and Medical Technology and PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden; Division of Emergency Medical Services, Kalmar County Hospital, Kalmar, Sweden .
    Herlitz, Johan
    Department of Acute and Prehospital Care and Medical Technology and PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Axelsson, Åsa B.
    Institute of Health and Care Sciences, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden.
    Cronberg, Tobias
    Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden.
    Djärv, Therese
    Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Kristofferzon, Marja-Leena
    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.
    Larsson, Ing-Marie
    Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, Uppsala, Sweden.
    Lilja, Gisela
    Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden.
    Sunnerhagen, Katharina S.
    Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Sweden.
    Wallin, Ewa
    Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, Uppsala, Sweden.
    Ågren, Susanna
    Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Cardiothoracic Surgery, County Council of Östergötland, Linköping, Sweden .
    Åkerman, Eva
    Department of Perioperative Medicine and Intensive Care, Skane University Hospital, Malmö, Sweden; Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Stockholm, Sweden .
    Årestedt, Kristofer
    Department of Health and Caring Science, Linnaeus University, Kalmar, Sweden; Department of Health Care Science, Ersta Sköndal University College, Stockholm, Sweden; Kalmar County Hospital, Kalmar, Sweden .
    Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 114, p. 27-33Article in journal (Refereed)
    Abstract [en]

    AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.

    METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).

    RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.

    CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.

  • 118.
    Jakobsson, Vendela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Effekten av antiseptiska och mikrobreducerande förband på svårläkta bensår: en systematisk litteraturstudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction A considerable part of the district nurse's working time consists of wound care. Approximately two percent of the population will sometime be affected by hard to heal leg ulcers which is the cause of physical as well as psychic suffering for these people. Studies of other wound types shows that the usage of antiseptic and microbe reducing wound dressings have a positive effect on wound healing. This study review studies about the effect of wound dressings with honey, silver, iodine, PHMB and DACC on hard to heal leg ulcers.  

    Aim To review studies that examines the effect of antiseptic and microbe reducing wound dressings that are being used in today’s health care to treat hard to heal leg ulcers.

    Method Systematic review. Searches were made in databases Pubmed, Cinahl and Cochrane as well as manually among references in review articles that were found through the searches. After a selection process 15 studies were found which proved to be relevant to the study’s aim.  

    Results The included studies gave no coherent result. Honey dressings improved healing or were equivalent to standard care in the included studies. Silver dressings had a positive effect on wound healing in the predominant proportion of the included studies. In one study, another antiseptic substance had better results than silver, in another study silver dressings turned out to be equivalent to standard care. Iodine dressings turned out to be equivalent to silver dressings in the case of healing and PHMB dressings were equivalent to standard care.

    Conclusion The majority of the included studies indicates that antiseptic wound dressings have a positive effect on healing of hard to heal leg ulcers. None of the included studies showed that the examined wound dressings were less effective than standard care or had any negative effects on wound healing. Therefore, it can be considered safe and compatible with evidence-based nursing to use the antiseptic dressings on hard to heal leg ulcers.

  • 119.
    Jansson, Johanna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Jansson, Matilda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Personers upplevelser efter bariatrisk kirurgi2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Fetma är en sjukdom och ett växande folkhälsoproblem. Bariatrisk kirurgi är ett samlingsnamn för kirurgiskt ingrepp i mag-tarmkanalen avseende viktminskning och en behandlingsmetod för fetma. Syfte: Att beskriva personers upplevelser efter bariatrisk kirurgi. Metod: En beskrivande litteraturstudie med elva vetenskapliga artiklar varav åtta hade kvalitativ ansats, två hade mixad metod och en hade kvantitativ ansats. Huvudresultat: Resultatet av studien visade att personerna upplevde att bariatrisk kirurgi förändrade dem psykiskt, fysiskt och socialt. De upplevde att operationen bidrog till en bättre hälsa och ett ökat självförtroende. Den hastiga viktnedgången gjorde det svårt för personerna att identifiera sig med den nya kroppen, men de kände sig mer bekväma i kroppen. Matsituationen förändrades, matvanorna blev bättre men utmaningar upplevdes då de var tvungna att lära känna den lilla magsäcken. Kroppen blev rörligare och livet mer aktivt. Överflödig hud var problem på det fysiska och psykiska planet. De upplevde sig själva ha blivit mer sociala. Slutsats: Bariatrisk kirurgi utförs med inriktning på viktnedgång, men studien visade att den förändrar människorna mer än att de får en lättare kropp. Eftersom fetma ökar i förekomst och åtskilliga bariatrisk kirurgier genomförs årligen bör sjuksköterskan ha en god insikt i personers upplevelse efter bariatrisk kirurgi för att kunna ge en personcentrerad omvårdnad, men för att kunna tillämpa en holistisk vård krävs mer forskning på det existentiella planet.

  • 120.
    Johansson, Ida
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Kommunsjuksköterskors erfarenheter av att vårda äldre personer i livets slut2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Caring for an elderly person at the end of life means a complex care situation

    for healthcare professionals. There are several factors to consider in this regard; the patient's,

    relatives and healthcare staff as described in this work from the nurse.

    Aim:

    The purpose of the study was to describe municipality nurses' experiences of caring for

    older people in the final stages of life.

    Method:

    The study had a descriptive design with a qualitative approach. Data were collected

    through eight interviews and analyzed using a qualitative manifest content analysis, whereas

    five categories and ten sub-categories emerged.

    Results:

    The result is that the nurse practitioners saw this work as meaningful but also

    emotional stress. Feelings like insufficiency, participation, adequacy and existential issues

    were raised at the nurse's nurse. The palliative care complexity was visualized as the patient's

    self-determination, relatives, and nursing staff's needs were made visible and met.

    Conclusion:

    Palliative care is a person-centered care based on patient needs, which proved to

    be complex. Corresponding to these expectations and implementing the required care creates

    experiences, good and less good, with nurses who consciously or not, affect them regardless

    of patient or care opportunity and give a chance of reflection, further experience and

    opportunity to grow as a person and in profession.

    Keywords: C

    aring, end-of-life care, elderly care, nurses’ experience, palliative care

  • 121.
    Johansson, Justine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindkvist, Ann-Christin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Att beskriva hur personer med multipel skleros upplever sin livssituation och livskvalité2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Multipel skleros (MS) är en kronisk autoimmun sjukdom som påverkar det centrala nervsystemet. I Sverige diagnostiseras cirka 1000 personer per år med MS och antalet personer som lever med sjukdomen uppges vara mellan 17 500 - 18 500. Att leva med MS kan innebära fysiska, psykiska och sociala begränsningar. Sjuksköterskan har det största omvårdnadsansvaret och det bör baseras på patientens grundläggande behov.

    Syfte: Att beskriva hur personer med multipel skleros upplever sin livssituation och livskvalité, samt att beskriva undersökningsgruppen i artiklarna.

    Metod: Litteraturstudien bygger på tolv vetenskapliga artiklar. Sökningarna gjordes via Cinahl och PubMed. Resultatet sammanställdes under en huvudrubrik och tre underrubriker.

    Huvudresultat: Resultatet visade att stöd från familj och omgivning var av betydelse. Både fysiska och psykiska symtom kan ge betydande sociala begränsningar och försämrad trygghet. Arbete och sysselsättning var viktigt men familj och socialt stöd var mer avgörande för livssituation och livskvalité. Sjukdomen medförde både en positiv och negativ syn på livssituationen. Samtal med sjuksköterskor och läkare gav ett gott stöd.

    Slutsats: Resultatet visade att MS hade en stor inverkan på livssituationen och livskvalitén. Fysiska och psykiska symtom till följd av MS kan ge betydande sociala begränsningar. Stöd från familj och omgivning var av stor betydelse. Att ha någon form av sysselsättning kan bidra till en ökad livskvalité. Fortsatt forskning om sjukdomen och hur den påverkar personernas livssituation och livskvalité anses vara av betydelse.

     

    Nyckelord: Livskvalité, Livssituation, Multipel skleros

  • 122.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, Institute of Gerontology, Aging Research Network-Jönköping, Jönköping, Sweden.
    Silén, Marit
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Research methods in nursing students' Bachelor's theses in Sweden: a descriptive study2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 66, p. 187-193Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: During the nursing programme in Sweden, students complete an independent project that allows them to receive both a professional qualification as a nurse and a Bachelor's degree. This project gives students the opportunity to develop and apply skills such as critical thinking, problem-solving and decision-making, thus preparing them for their future work. However, only a few, small-scale studies have analysed the independent project to gain more insight into how nursing students carry out this task.

    OBJECTIVES: The aim of the present study was to describe the methods, including ethical considerations and assessment of data quality, applied in nursing students' independent Bachelor's degree projects in a Swedish context.

    DESIGN: A descriptive study with a quantitative approach.

    METHODS: A total of 490 independent projects were analysed using descriptive statistics.

    RESULTS: Literature reviews were the predominant project form. References were often used to support the analysis method. They were not, however, always relevant to the method. This was also true of ethical considerations. When a qualitative approach was used, and data collected through interviews, the participants were typically professionals. In qualitative projects involving analysis of biographies/autobiographies or blogs participants were either persons with a disease or next of kin of a person with a disease.

    CONCLUSIONS: Although most of the projects were literature reviews, it seemed unclear to the nursing students how the data should be analysed as well as what ethical issues should be raised in relation to the method. Consequently, further research and guidance are needed. In Sweden, independent projects are not considered research and are therefore not required to undergo ethics vetting. However, it is important that they be designed so as to avoid possible research ethics problems. Asking persons about their health, which occurred in some of the empirical projects, may therefore be considered questionable.

  • 123.
    Jonsson, Annika
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Östergårds, Sofie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Att leva med KOL: En deskriptiv litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: COPD is a relative common and incurable disease that causes a progressive deterioration of breathing. How to experience the disease may differ between individuals and between different stages of the disease. It is therefore essential that nurses gain insight into these experiences to provide good care to these people.

    Aim: The aim of this study was to describe people's experiences of living with COPD. Furthermore, the aim of this study was to describe the included articles data collection method.

    Method: A literature study with a descriptive design. The 12 included articles are of qualitative approach and sought out through the databases CINAHL and PubMed. The contents of the articles results were reviewed to identify similarities and differences and also the included articles data collection method.

    Main result: The results of the literature study showed that people with COPD experienced psychological, physical and social aspects that affect people's lives. The psychological impact was that the people had to make many changes in life. Breathing difficulties made the physical ability to reduce. The disease also affected the social affinity with other people. To manage and facilitate life with COPD people used different strategies. The most common data collection method that emerged in the articles were semi-structured interviews.

    Conclusion: The people with COPD were affected psychologically, physically and socially to live with the disease. The people used different strategies to manage their life with the disease. It is important that nurses having knowledge of people´s experience of living with COPD because it makes it easier to preserve people´s integrity, dignity, and autonomy that can increase people's well-being.

  • 124.
    Kabir, Fahmida
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindroth, Betty
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Vuxna personers hanterande av livets slut med hjälp av coping strategier vid obotlig cancersjukdom: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cancer is a major health problem worldwide and more than every third person has got the risk to get cancer during their lifetime. The number of people getting diagnosed with cancer is increasing, but the survival rate is increasing as well.

    Aim: To describe how adults with incurable cancer manage their lives with the help of coping strategies at the end of life as well as methodologically review how the selection of the study group and the selection method in the reviewed articles were described.

    Method: A literature study with a descriptive design based on ten articles with both qualitative and quantitative approach. The articles were found in the database PubMed.

    Findings: Family, friends and religious beliefs were important sources for people with terminally ill cancer to cope with the fact that life was about to come to an end. Social support and religious beliefs were the main important facts for the people who were facing end of life to be able to cope with their situation, either trying to find meaning in the current situation or through support from loved ones. The findings were based on four quantitave articles and six qualitative articles. The selection of the study group and the selection method in the reviewed articles were described in each article. The data collection methods that the included articles used were semistructed interwievs, unstructed interwievs and surveys.

    Conclusion: Coping strategies as in social support and religious support were the main facts for people to cope with end of life. People had different views on both of the facts, which coping strategies they used and which ones that worked, but also what kind of support that was more important. Most of the people felt that support from family and friends were important to have so that they could cope with the end of life, but religious support was just as much important.

  • 125.
    Kaltenbrunner, Monica
    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.
    Bengtsson, Lars
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Development, IT and Land Management, Industrial economics. University of Gävle, Center for Logistics and Innovative Production.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui Shi, China.
    A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 235Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    During the past decade, the concept of Lean has spread rapidly within the healthcare sector, but there is a lack of instruments that can measure staff's perceptions of Lean adoption. Thus, the aim of the present study was to develop a questionnaire measuring Lean in healthcare, based on Liker's description of Lean, by adapting an existing instrument developed for the service sector.

    METHODS:

    A mixed-method design was used. Initially, items from the service sector instrument were categorized according to Liker's 14 principles describing Lean within four domains: philosophy, processes, people and partners and problem-solving. Items were lacking for three of Liker's principles and were therefore developed de novo. Think-aloud interviews were conducted with 12 healthcare staff from different professions to contextualize and examine the face validity of the questionnaire prototype. Thereafter, the adjusted questionnaire's psychometric properties were assessed on the basis of a cross-sectional survey among 386 staff working in primary care.

    RESULTS:

    The think-aloud interviews led to adjustments in the questionnaire to better suit a healthcare context, and the number of items was reduced. Confirmatory factor analysis of the adjusted questionnaire showed a generally acceptable correspondence with Liker's description of Lean. Internal consistency, measured using Cronbach's alpha, for the factors in Liker's description of Lean was 0.60 for the factor people and partners, and over 0.70 for the three other factors. Test-retest reliability measured by the intra-class correlation coefficient ranged from 0.77 to 0.88 for the four factors.

    CONCLUSIONS:

    We designed a questionnaire capturing staff's perceptions of Lean adoption in healthcare on the basis of Liker's description. This Lean in Healthcare Questionnaire (LiHcQ) showed generally acceptable psychometric properties, which supports its usability for measuring Lean adoption in healthcare. We suggest that further research focus on verifying the usability of LiHcQ in other healthcare settings, and on adjusting the instrument if needed.

  • 126.
    Kaltenbrunner, Monica
    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.
    Bengtsson, Lars
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Development, IT and Land Management, Industrial economics. University of Gävle, Center for Logistics and Innovative Production.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet, Uppsala, Sverige; Nursing Department, Medicine and Health College, Lishui University, China.
    Lean i primärvården - en bild av hur Lean tillämpas2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 112-Conference paper (Other academic)
    Abstract [sv]

    Bakgrund

    Lean har sitt ursprung i bilindustrin och har spridits till andra sektorer såsom hälso-och sjukvård. Implementering av Lean syftar vanligtvis till att öka vårdkvaliten. Vid utvärderingar av Lean saknas ofta en beskrivning av vilka principer av Lean som implementeras och i vilken utsträckning. Föreliggande studie utgår från Likers beskrivning av Lean. Liker beskriver Lean i fyra övergripande grupper kallad 4P modellen; philosophy, processes, people and partners, och problem-solving (filosofi, processer, anställda och partners, och problemlösning), som består av ett antal principer. Att implementera alla principer och involvera alla medarbetare är ovanlig, vilket Liker menar är avgörande om organisationen ska nå de mål de satt med att införa Lean.

    Syfte

    Syftet med studien var att illustrera hur Lean praktiseras inom primärvården. 

    Metod

    Studien utgår från ett större forskningsprojekt där både privata och landstingsägda primärvårdsenheter deltog. All personal vid enheterna fick 2016 besvara en enkät om Lean-principer, svarsfrekvens 35% (298 medarbetare vid 45 enheter). Höga Lean skattningar indikerade hög mognad av Lean vilket innebar att medarbetarna var kunniga rörande den efterfrågade Lean-principen; låg mognad av Lean innebar att man helt saknade principen på sin arbetsplats eller hade implementerat den i liten utsträckning av ett fåtal medarbetare. Baserat på enkätsvaren valdes fyra enheter ut för observationer, två med hög mognad av Lean och två med låg mognad. Observationerna inkluderade intervjuer och fältanteckningar som illustrerade hur 4P-modellen praktiserades på enheterna. Hälso- och sjukvårdspersonal med olika professioner deltog (n=28).

    Resultat

    Rörande filosofi ansåg medarbetarna vid alla fyra enheter att den närmaste chefen, återkommande men i varierande utsträckning, kommunicerade gemensamma mål. Patienternas behov styrde planeringen av vården. Processer kunde innefatta att medarbetarna baserade sin planering av vården på statistik. För vissa patientgrupper eller symtom fanns generella ordinationer, d.v.s. utan kontakt med läkare, t.ex. på vilka prover som skulle tas. Rörande anställda och partners var det vanligt att arbeta i team både inom och utanför sin enhet. Men det framkom även att medarbetarna inte arbetade tillsammans fast de borde det. Problemlösning förekom men ofta ostrukturerat med brister på uppföljning. En enhet hade påbörjat utvecklande av problemlösning genom dagliga möten och strullistor att dokumentera problemen på.

    Konklusion

    Tillämpning av Lean varierar i stor utsträckning mellan vårdcentralerna. Ett par enheter hade implementerat Lean i större utsträckning och dessa enheter var mer strukturerade rörande t.ex. problemlösning och teamarbete.

     

  • 127.
    Kaminsky, Elenor
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Röing, Marta
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Björkman, Annica
    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.
    Holmström, Inger K.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Telephone Nursing in Sweden: a narrative literature review2017In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 19, no 3, p. 278-286Article, review/survey (Refereed)
    Abstract [en]

    elephone nursing services are expanding globally. Swedish Healthcare Direct is the largest healthcare provider in Sweden. This paper provides a comprehensive understanding of telephone nursing, as reflected by research on Swedish national telephone nursing, and discusses the findings in relation to international literature. A descriptive, mixed-studies literature review was conducted. Twenty-four articles from January 2003 to April 2015 were identified from PubMed, Scopus, and CINAHL, and included. The issues explored in this study are how telephone nursing is perceived by callers, telephone nurses, and managers, and what characterizes such calls. Callers value reassurance, support, respect and satisfaction and involvement in decisions can increase their adherence. The telephone nurses' perspective focused on problems and ethical dilemmas, communication, the decision support tool, and working tasks. The managers' perspective focused on nursing work goals and malpractice claims. Concerning call characteristics, authentic calls, incident reports, and threats to patient safety were considered. Telephone nursing seems safe, but gender can play a role in calls. Future research on caller access, equity, and efficiency, healthcare cost-effectiveness, distribution, and patient safety is needed.

  • 128.
    Karlsson, Rebecca
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Skog, Sandra
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Hur ambulanspersonal upplever och hanterar sin arbetssituation: en litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One million emergency cases, which includes any type of ambulance transportation, are handled each year in Sweden. Ambulance personnel are required to have the ability and knowledge to identify all patients’ individual needs in different environments. Therefore, the ambulance nurse holds a great responsibility in the ambulance service whereby incorrect treatment could result in a catastrophic outcome.

    Aim: To describe how ambulance personnel experience and cope with their work situation. Another purpose was to review the sampling of the studies.

    Methods: This descriptive literature review is based on twelve scientific articles which was searched through the databases Cinahl and PubMed, and then compiled under three main themes and six sub-categories.

    Main results: Ambulance personnel use to a large extent their experiences based on prior knowledge and experiences to cope. Ability to interact and co-operate with other was elementary, both before, during and after the encounter with the patient. The ability of maintaining a balance between presence and distance, which is required to nurture the patient in an integrated way, was difficult in demanding situations. Through reflection, especially with the support of others, difficult experiences could be processed, resulting in both professional and personal development.

    Conclusion: Ambulance personnel meet and take care of their patients based on their previous knowledge and experiences. Therefore, further research should aim at finding how lived experiences could be transformed into valuable knowledge.

  • 129.
    Karlsson, Sophie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Stenberg, Johanna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Den ständiga väntan på en livsförändring: Patienters erfarenheter av att vänta på en organtransplantation - en litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of patients waiting for an organ transplant has increased steadily for the past decades. A prerequisite for a successful transplantation program is of course that the demand for organs gets saturated by a steady supply of the same. This is unfortunately not the case as the gap between supply and demand is increasing, hence prolonging waiting times and negatively effecting the patients’ health and overall prognosis.

    Aim: Portrait the experiences of patients waiting for an organ transplant as well as conducting a methodological examination of the data collection method used in a selection of articles.

    Method: A descriptive literature that has examined 13 articles, the majority of articles were qualitative design.

    Results: Patients' experiences when waiting for an organ transplant is often associated with feelings such as anxiety and depression. Patients experiencing the waiting time to get an organ transplant as long and the experience is that the patient’s life is paused. Experiences which patients describes is that support from family and healthcare professionals are of great importance. Even to meet with other patients waiting for an organ transplant was considered as a support for patients. Patients described that experience of getting information from medical staff about his health situation was important for the patients. The articles selected data collection method consisted of 11 qualitative interview study. Two of the articles had quantitative design where surveys have been used.

    Conclusion: Patients waiting to undergo an organ transplant often have experience of waiting times are long and with time these patients are anxious and fearful. The patients experienced the support from medical staff is important to the care process and that nurses therefore have an important responsibility to adapt care to individual patient needs.

  • 130.
    Khayyer, Zahra
    et al.
    Educational Sciences & Psychology Department, University of Isfahan, Isfahan, Iran.
    Ngaosuvan, Leonard
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sikström, Sverker
    Department of Psychology, Cognitive Division, Lund University, Sweden.
    Ghaderi, Amir Hossein
    University of Tabriz, Tabriz, Iran.
    Transcranial direct current stimulation based on qEEG combining positive psychotherapy for major depression2018In: Journal of Integrative Neuroscience, ISSN 0219-6352, E-ISSN 1757-448X, Vol. 17, no 2, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Frontal cortex activity in the left hemisphere during depression is reduced. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that can increase frontal cortex activity. Therapy based on tDCS and positive psychology (PP) therapy was applied improving patients' quality of life. The present study compared three conditions participants with clinical depression; (a) tDCS therapy, (b) positive psychotherapy, and (c) combined treatment. Hamilton Depression Rating Scale (HDRS), Adult State Hope Scale and Optimism/Pessimism Scale (OPS) was used at baseline, 2 weeks, 4-weeks and 3-months follow-up. Combined condition participants showed greater reduction in depressed mood, improved hope and optimism after 4-weeks as well as during 3-months follow-up than the other conditions. The results are discussed in terms of additive or synergistic relation between tDCS and PP treatment. Future studies should (a) use larger sample-sizes, (b) include no-treatment control conditions, (c) include double-blind designs, (d) control for previous or on-going drug therapy, (d) control for previous or ongoing psychotherapy. Furthermore, future studies should aim to increase theoretical understanding by investigating whether the relation between tDCS and psychotherapy are additive or synergistic.

  • 131.
    Knudsen, Kati
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Airway management in anaesthesia care: professional and patient perspectives2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Careful airway management, including tracheal intubation, is important when performing anaesthesia in order to achieve safe tracheal intubation. Aim: To study airway management in anaesthesia care from both the professional and patient perspectives. Methods: 11 RNAs performed three airway tests in 87 patients, monitored in a study-specific questionnaire. The tests usefulness for predicting an easy intubation was analysed (Study I). 68 of 74 anaesthesia departments in Sweden answered a self-reported questionnaire about the presence of airway guidelines (Study II). 20 anaesthesiologists were interviewed; a phenomenographic analysis was performed to describe how anaesthesiologists' understand algorithms for management of the difficult airway (Study III). 13 patients were interviewed; content analysis was performed to describe patients' experiences of being awake fiberoptic intubated (Study IV). Results: The Mallampati classification is a good screening test for predicting easy intubation and intubation can be safely performed by RNAs (Study I). The presence of airway guidelines in Swedish anaesthesia departments is poorly implemented (Study II). Algorithms can be understood as law-like rules, a succinct plan to follow in difficult airway situations, an action plan kept in the back of one's mind while creating flexible and versatile personal algorithms, or as consensus guidelines based on expert opinion in order to be followed in clinical practice (Study III). One theme emerged describing experiences of being awake intubated; feelings of being in a vulnerable situation but cared for in safe hands, described in five categories: a need for tailored information, distress and fear of the intubation, acceptance and trust of the staff's competence, professional caring and support, and no hesitation about new awake intubation (Study IV). Conclusions: The Mallampati classification is a good screening test for predicting easy intubation, when the airway assessment is performed in a structured manner by RNAs. The presence of airway guidelines in Swedish anaesthesia departments was poorly implemented and should receive higher priority. Algorithms need to be simple and easy to follow and based on the best available scientific evidence. Tailored information about what to expect, ensuring eye contact, and giving breathing instructions during the procedure may reduce patients' feeling distress.

  • 132.
    Knudsen, Kati
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nilsson, Ulrica
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Högman, Marieann
    Centre for Research & Development, Uppsala University/Region Gävleborg, 801 88 Gävle, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden .
    Pöder, Ulrika
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Awake intubation creates feelings of being in a vulnerable situation but cared for in safe hands: a qualitative study2016In: BMC Anesthesiology, ISSN 1471-2253, E-ISSN 1471-2253, Vol. 16, no 1, article id 71Article in journal (Refereed)
    Abstract [en]

    Background

    Awake fiberoptic intubation is an alternative procedure for securing the airway and is a recommended option when a difficult airway is expected. The aim of the present study was to describe patient experiences with this procedure.

    Methods

    A qualitative, descriptive design was used and patients were recruited from three county hospitals and one university hospital in Sweden. Data was collected by semi-structured interviews with 13 patients who underwent awake fiberoptic intubation. A qualitative content analysis extracted theme, categories, and subcategories.

    Results

    From the patient statements, one main theme emerged, feelings of being in a vulnerable situation but cared for in safe hands, which were described in five categories with 15 subcategories. The categories were: a need for tailored information, distress and fear of the intubation, acceptance and trust of the staff’s competence, professional caring and support, and no hesitation about new awake intubation. The patients felt they lacked information about what to expect and relied on the professionals’ expertise. Some patients felt overwhelmed by the information they were given and wanted less specific information about the equipment used but more information about how they would be cared for in the operating room. Undergoing awake intubation was an acceptable experience for most patients, whereas others experienced it as being painful and terrifying because they felt they could not breathe or communicate during the procedure itself.

    Conclusions

    Tailored information about what to expect, ensuring eye contact and breathing instruction during the procedure seems to reduce patient distress when undergoing awake fiberoptic intubation. Most of the patients would not hesitate to undergo awake intubation again in the future if needed.

  • 133.
    Knudsen, Kati
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Pöder, Ulrika
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Nilsson, Ulrica
    Institutionen för hälsovetenskaper, Örebro universitet .
    Högman, Marieann
    Uppsala universitet, Institutionen för medicinska vetenskaper.
    Larsson, Anders
    Uppsala universitet, Institutionen för kirurgiska vetenskaper.
    Larsson, Jan
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    How anaesthesiologists understand difficult airway guidelines: an interview study2017In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 4, p. 243-248Article in journal (Refereed)
    Abstract [en]

    Background: In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms.

    Methods: A qualitative phenomenographic design was chosen to explore anaesthesiologists’ views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted.

    Results: Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts’ consensus, a set of scientifically based guidelines for handling the difficult airway.

    Conclusions: The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently.

  • 134.
    Koyi, Hirsh
    et al.
    Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden; Karolinska Institutet, Stockholm, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Hillerdal, Gunnar
    Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna, Stockholm, Sweden.
    Andersson, Olov
    Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna, Stockholm, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Brandén, Eva
    Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden; Karolinska Institutet, Stockholm, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Lung cancer among native and foreign-born Swedes: histopathology, treatment, and survival2016In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, no 11, p. 1344-1348Article in journal (Refereed)
    Abstract [en]

    Background: Lung cancer (LC) is the leading cause of cancer-related death worldwide, including Sweden. Several studies have shown that socioeconomic status affects the risk, treatment, and survival of LC. Due to immigration after Second World War, foreign-born people constitute 12.5% of the Swedish population. We wanted to investigate if there were any differences in LC management, treatment and survival among the foreign-born Swedes (FBS) compared to the native Swedish population (NatS) in Stockholm. Material and methods: A retrospective analysis of all patients diagnosed with non-small cell lung cancer (NSCLC) at the Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna from 1 January 2003 to 31 December 2008 was made. In all, 2041 cases of LC were diagnosed, thereof 1803 with NSCLC. Of these, 211 (11.7%) were FBS. Results: The mean age of NatS and FBS patients was 69.9 years, median 70 (range 26–96) and 66.0 years, median 66 (range 38–94), respectively (p < 0.001). In all, 89.8% of NatS and 90.0% of FBS were either smokers or former smokers. Adenocarcinoma was the most common subtype in both groups (NatS 54.7%, FBS 48.3%). In 140 (8.8%) of the NatS and 17 (8.1%) of the FBS the diagnosis was clinical only. There were no significant differences in stage at diagnosis, nor in performance status (PS) or different therapies between the groups. The median overall survival time for the NatS was 272 days and for FBS 328 days, again no significant difference. However, the median overall survival time for female NatS was 318 days and for female FBS 681 days (p = 0.002). Conclusion: FBS patients were significantly younger than NatS at diagnosis, and female FBS lived longer than female NatS, but otherwise there were no significant differences between NatS and FBS patients with LC regarding diagnosis, treatment, and survival. 

  • 135.
    Kristofferzon, Marja-Leena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China.
    Nilsson, Annika
    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.
    Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study2018In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 27, no 7, p. 1855-1863Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus’ and Folkman’s stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status.

    Methods

    The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS.

    Results

    The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL.

    Conclusions

    Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus’ and Folkman’s stress and coping theory.

  • 136.
    Lennernäs Wiklund, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Gard, Gunvor
    Hälsovetenskaper, Medicinska fakulteten Lunds Universitet .
    Lindberg, Per
    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.
    Olofsson, Niclas
    Region Västernorrland FoU.
    Risberg, Anitha
    Institutionen för Hälsovetenskap, Luleå Tekniska Universitet.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Hann du äta?: En enkät och intervjustudie av arbetsmåltidens förutsättningar och betydelse för hälsa och välbefinnande vid skift- och schemalagt arbete med nattarbete2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 129-Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    Ohälsosamma matvanor och stress bidrar till sjukskrivningar och nedsatt arbetsförmåga genom övervikt, hjärtkärlsjukdom, diabetes typ 2 och psykisk ohälsa. Slimmade organisationer och flexibla arbetstider begränsar möjligheten att äta hälsosamt i samband med arbete. Särskilt utsatt är personal med skift- och schemalagt arbete. Att inte kunna på-verka när man äter under arbetspasset kan öka stress och irritation, med risk för sänkt prestations- och koncentrationsförmåga. Arbetsmiljöverkets föreskrifter om organisatorisk och social arbetsmiljö (AFS 2015:4) syftar till att främja en god arbetsmiljö och förebygga ohälsa på grund av organisatoriska och sociala förhållanden i arbetsmiljön. Det finns ingen lagstiftning angående matrastens längd eller utformningen av matrum. Arbetsgivaren har rätt att byta ut raster mot måltidsuppehåll, det senare innebär måltid om arbetssituationen medger det. Personal med ständig larmberedskap kan arbeta en hel natt utan möjlighet att äta. Detta är tveksamt med hänsyn till hälsa, säkerhet och arbetsförmåga.

    Syfte

    Studiens syfte är 1) att få en bättre förståelse av de faktorer som påverkar möjligheten och formerna för att äta i samband med natt- och skiftarbete och de val anställda gör utifrån de förutsättningar som finns 2) att öka förståelsen av hur arbetsmåltiden påverkas av organisatoriska och psykosociala förhållanden, och måltidens betydelse för återhämtning, välbefinnande och hälsa.

    Frågeställningar

    Hur gestaltas arbetsmåltider för personal med skift- och schemalagt arbete? Vilka strat-egier och handlingsutrymmen har personalen för att planera sina arbetsmåltider? Vi kommer särskilt att uppmärksamma vad personalen äter, under vilka omständigheter de äter samt vilken betydelse måltiden har för välbefinnande och gemenskap.

    Urval och metod

    Enkät riktas till anställda med dag-, skift- och schemalagt arbete inom industri och hemtjänst. Intervjuer genomförs med chefer inom dessa verksamheter.

    Resultat

    Studien startar våren 2018 med inledande intervjuer och test av enkät till målgrupper efter arbetsplatsbesök. Under konferensen kommer vi att kortfattat sammanfatta den forskning som finns inom ramen för våra frågeställningar samt att redovisa resultat från några intervjuer med chefer.

    Genom vårt deltagande vill vi bidra till att sätta arbetsmåltiden på agendan inom arbetsmiljöforskning och diskutera med andra forskare hur de ser på arbetsmåltiden ur ett arbetsmiljöperspektiv.

  • 137.
    Liljekvist Södergren, Frida
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Första linjens chefers erfarenheter och reflektioner kring sitt arbete med strukturella förutsättningar till distriktssköterskor: en intervjustudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: First line managers' support and understanding for district nurses is important to promote good work environment and satisfaction at the workplace. Factors that may affect: resources, feeling involved, knowing what's happening, development opportunities. Aim: The aim of this study was to describe experiences and reflections first-line managers’ had concerning their work on structural empowerment for district nurses in primary care. Method: The study had a qualitative approach with descriptive design. Semi-structured interviews, with eight first-line primary care managers, were performed and analyzed through qualitative content analysis based on an inductive approach. Result: Information was highlighted as difficult. Most common way to convey information were by mail. It was important to give district nurses opportunity of seeking information themselves. The managers held different meetings, which took a lot of time. The managers did their utmost to ensure that there were enough staff. The managers trusted the district nurses' assessments regarding materials, equipment and planning their time. The managers expressed that the time of district nurses was scarce. The managers felt they’d high attendance and availability. Feedback was given in different ways, managers would like to improve on this. The managers were positive about education and felt that opportunities for development were available. Conclusion: First-line managers in primary care experienced themselves as good support to district nurses and their intentions were to provide opportunities for structural empowerment. Sometimes they experienced being controlled from top. They found that some district nurses didn’t share the same interest as the organization, which may make it difficult to adjust at individual level.

  • 138.
    Liljén, Stina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Närståendes upplevelser av möten med vårdpersonal på intensivvårdsavdelningen: Kvalitativ studie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In the intensive care unit, patients are often so ill that communication with nursing staff can be difficult. Relatives in the intensive care unit have an important role in nursing care. The studies show that relatives have a large need for information and that communication, patient protection, participation and support are important, but none of the studies have been based on the meeting with nursing staff.

    Aim: The purpose of the study was to describe experiences of relatives' meetings with nursing staff at the intensive care unit.

    Method: A descriptive design with qualitative approaches and semi-structured interviews with nine relatives were conducted. Qualitative content analysis with inductive approaches was used.

    Main results: Four categories emerged: To feel secure was about gaining confidence in the nursing staff, that the nursing staff showed care, were courteous and professional. To feel insecure was about experiencing insufficient confidence in the nursing staff, feeling uncertainty when meeting and being unprofessional. Needing information aims to that relatives wished for information that was clear, understandable, continuous, current and honest. To experience lack of information emerged as uncertainty in the information and an unwillingness of the nursing staff to provide information existed.

    Conclusion: Nursing staff should gain insight into how to meet relatives' needs and to gain increased awareness that both uncertainty and lack of information exists. It is important that they do something about it to increase the safety of the relatives.

  • 139.
    Lind, Charlotte
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Vårdavdelningssjuksköterskors upplevelser vid kontakt med MIG-team.: En intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mobile Emergency Teams (MET) consisting of an anesthetist and an intensive care nurses is a way of working in an emergency phase within the hospital organization. The purpose is to identify critically ill patients in care departments with the help of a nurse. MET is based on predicting, preventing and treating severely ill patients according to a structured prioritization approach. Aim: The purpose of the study was to describe nurse’s experiences of contacting Mobile Emergency Teams (MET). Method: Interview study with descriptive design. Nine interviews were conducted. Results: Nurses in healthcare departments experiences the presence and the knowledge that they could contact MET as a high level of security. Getting help quickly felt important to safety and nurses felt that they trusted the MET. However, feelings of stress, concern and insecurity were also included in the picture. In the majority of meetings with MET, the participants felt that they received a good response, that they had a team feeling of working together. Something that also was found in the study was that nurses in healthcare departments used MET too seldom.

    Conclusion: MET was experienced as a positive asset in health care for both nurses and patients. Nurses in healthcare departments felt safe to call an MIG team, but the safety was mixed with a sense of stress when these situations occurred.

  • 140.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Evidence-based Renal Care: Does it Matter2018In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 44, no 2, p. 63-64Article in journal (Other academic)
  • 141.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Fluid removal in haemodialysis - is yours too fast?2017In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 43, no 2, p. 71-72Article in journal (Other academic)
  • 142.
    Lindberg, Magnus
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    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.
    Wågström, Britt-Mari
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Arvidsson, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindberg, 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; Centre for Research and Development, Uppsala University / County Council of Gävleborg, Gävle, Sweden.
    Risk behaviours for organism transmission in daily care activities: a longitudinal observational case study2018In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 100, no 3, p. e146-e150Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To understand healthcare personnel's infection prevention behaviour has long been viewed as a key factor in preventing healthcare-associated infections. Suboptimal hand hygiene compliance and handling of materials, equipment and surfaces present the main risks for potential organism transmission. Further exploration is needed regarding the role of context-specific conditions and the infection prevention behaviours of healthcare personnel. Such knowledge could enable the development of new intervention strategies for modifying behaviour.

    AIM: To describe risk behaviours for organism transmission in daily care activities over time.

    METHODS: Unstructured observations of healthcare personnel carrying out patient related activities were performed on 12 occasions over a period of 18 months.

    FINDINGS: Risk behaviours for organism transmission occur frequently in daily care activities and the results shows that the occurrence is somewhat stable over time. Interruptions in care activities contribute to an increased risk for organism transmission that could lead to subsequent healthcare-associated infection.

    CONCLUSION: Interventions aimed at reducing the risks of healthcare-associated infections need to focus on strategies that address: hand hygiene compliance; the handling of materials, equipment, work clothes and surfaces; as well as the effects of interruptions in care activities if they are to alter healthcare personnel's infection prevention behaviour sufficiently.

  • 143.
    Lindberg, Maria
    et al.
    Centre for Research and Development, Uppsala University County Council of Gävleborg, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    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.
    Risk behaviours for organism transmission in health care delivery: A two month unstructured observational study2017In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 70, p. 38-45Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Errors in infection control practices risk patient safety. The probability for errors can increase when care practices become more multifaceted. It is therefore fundamental to track risk behaviours and potential errors in various care situations.

    OBJECTIVE: The aim of this study was to describe care situations involving risk behaviours for organism transmission that could lead to subsequent healthcare-associated infections.

    DESIGN & SETTING: Unstructured nonparticipant observations were performed at three medical wards.

    PARTICIPANTS & METHODS: Healthcare personnel (n=27) were shadowed, in total 39h, on randomly selected weekdays between 7:30 am and 12 noon. Content analysis was used to inductively categorize activities into tasks and based on the character into groups. Risk behaviours for organism transmission were deductively classified into types of errors. Multiple response crosstabs procedure was used to visualize the number and proportion of errors in tasks. One-Way ANOVA with Bonferroni post Hoc test was used to determine differences among the three groups of activities.

    RESULTS: The qualitative findings gives an understanding of that risk behaviours for organism transmission goes beyond the five moments of hand hygiene and also includes the handling and placement of materials and equipment. The tasks with the highest percentage of errors were; 'personal hygiene', 'elimination' and 'dressing/wound care'. The most common types of errors in all identified tasks were; 'hand disinfection', 'glove usage', and 'placement of materials'. Significantly more errors (p<0.0001) were observed the more multifaceted (single, combined or interrupted) the activity was.

    CONCLUSION: The numbers and types of errors as well as the character of activities performed in care situations described in this study confirm the need to improve current infection control practices. It is fundamental that healthcare personnel practice good hand hygiene however effective preventive hygiene is complex in healthcare activities due to the multifaceted care situations, especially when activities are interrupted. A deeper understanding of infection control practices that goes beyond the sense of security by means of hand disinfection and use of gloves is needed as materials and surfaces in the care environment might be contaminated and thus pose a risk for organism transmission.

  • 144.
    Lindström, Sara
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Nordwall, Rebecca
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Kvinnors upplevelse av psykisk hälsa i samband med och efter missfall2017Independent thesis Basic level (university diploma), 180 HE creditsStudent thesis
    Abstract [en]

    Background: Miscarriage is when a pregnancy ends before the fetus is able to survive outside the uterus. Out of every established pregnancies, 10 - 20% ends in miscarriage. Women who experienced miscarriage needs support and information and that’s why nurses needs to give a psychological support trough the whole nursing process.

     

    Aim: The aim of this study was to illustrate women’s experience of psychological health in conjunction with and after miscarriage and to describe the participants in the included articles.

     

    Method: This study has a descriptive design where 10 articles with qualitative approach makes the final result.

     

    Results: The majority of women experienced miscarriage as a crisis, characterized by grief and emptiness. The need of support by family, friends and healthcare was considered to be a crucial part for their psychological health. Women considered support as well as adapted healthcare information as important, however, women felt lack of information, and this created insecurity. The women experienced the psychological health improved with time, the distance gave them opportunity to find meaning through the incident. In the study groups 6 - 23 women participated, the age varied between 18 - 60 years and the women had experienced 1 - 8 miscarriage in pregnancy week 5 - 20.

     

    Conclusion: The majority of women who experienced miscarriage got negative impact on their psychological health. The most central aspect is support, most from the healthcare. If the nurses can get a deeper understanding and identify women’s emotional experience of miscarriage, a better nursin care can be taken into practice, which can improve the women’s psychological health.

  • 145.
    Lucas, Therese
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Pettersson, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Hur föräldrar till barn med ADHD upplever bemötandet av vårdpersonal inom hälso-och sjukvården: En beskrivande litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: About five percent of Swedish children have been diagnosed with ADHD until 2016. Living with ADHD can involve multiple trials both for the child and the parents. Upon investigation and diagnosing of the ADHD the parents of these children have to face various health personnels with different skills in health care.

    Aim: To describe how parents of children with ADHD experience the interactions with the health personnels in healthcare and to review the study groups in the included articles.

    Method: A literature study with a descriptive design based on 12 scientific articles. The articles were found in the MEDLINE database through PubMed and in the database CINAHL.

    Results: Parents of children suspected of having or had already been diagnosed with ADHD experienced feelings of guilt, helplessness, the feeling of being questioned as a parent and a lack of support and understanding in the encounter with health personnel. The results also showed that many parents felt that they had insufficient information and knowledge about ADHD. Helath personnel could also show an authoritarian attitude which could create feelings of inferiority and being neglected. Survey teams reported a total number of 703 participants. Mothers were overrepresented as guardians. Only three of the articles declared age of the participants. Countries that were represented in the articles were the US, Britain, Italy, China, Taiwan, Norway, Germany, Spain, France, the Netherlands, Finland and Sweden.

    Conclusion: Parents need support, understanding and information from health personnel to more easily handle the child's ADHD diagnosis and the familys situation. If health personnel obtain knowledge about how parents experience the encounter with health personnel nursing care of the child can be improved.

  • 146.
    Ludvigsen S, Mette
    et al.
    Department of Renal Medicine, Aarhus University Hospital.
    Hermansen M, Hanne
    Department of Renal Medicine, Aarhus University Hospital.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet; Gävle sjukhus.
    The quality of nursing care during intradialytic fluid removal in haemodialysis: time to change practice?2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 11/12, p. 1733-1736Article in journal (Refereed)
  • 147.
    Lund, Rebecca
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Listam, Sophia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Personers psykosociala upplevelser efter en överviktskirurgi: en litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Obesity is an endemic disease that increases globally, and it brings risk for other diseases. There are differently surgical methods implement to help patients to lose weight when they can't handle it by themselves. There are some complications that can arise after the surgery that the patients have not seen before surgery, that's why it is important for the nurse to give the patients information before they decide to go through with the surgery.

    Aim: The aim of the study was to describe adult’s psychosocial experiences after gastric bypass and find the data collection methods that was used in the selected articles.

    Method: The study was formed after a descriptive design and compiled by 13 scientific articles, eight quantitative and five qualitative articles retrieved from the database PubMed. The articles have been reviewed by the two authors and then compiled.

    Main Results: The study showed that people felt positive experience after the obesity surgery but many had negative experience, that they did not expect. The participants experienced improved mental wellbeing and felt attractive again and they felt more socially accepted in the society. They also felt negative changes with the new body that affects them psychosocial.

    Conclusion: Weight loss after an obesity surgery experienced in both positive and negative ways. People in this study was dependent of what other people thought about their body image. These experiences was a problem and it creates an even worse mental health and it inhibits people psychosocially.

  • 148.
    Lundberg, Astrid
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Quakkelaar, Linda
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Familjens erfarenheter av djurs betydelse för barn med autism: en litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research has shown that Animal Assisted Therapy (AAT) is an efficient method to increase the Sense of Coherence and Quality of Life in pediatric- and geriatric care. A person with autism needs to have an adapted environment to maintain cognitive functions which can promote health and promote Quality of Life. In this case, animals could be a means to create environmental adaptation for a child with autism, since animals have proven to have a positive effect on patients in other areas of care. The main purpose of the AAT is to reduce social, emotional and cognitive problems in the care-plan of the child. When a child has some kind of diagnosis, the whole family gets involved in the caring process. The child with autism also have difficulties to share feelings and life experiences. Therefore the present study is based on the experience of families regarding the importance of animals.

    Aim: To describe families experiences of the importance of animals for children with autism. The aim was also to describe the methodological aspect study group in the included articles.

    Method: A descriptive literature study was conducted. By using inclusion- and exclusion criterias and limits, eleven articles were chosen – nine with quantitative approach and two with interdiciplinary approach – and were reviewed on the basis of the chosen questions.

    Main result: The result has shown that AAT is of great importance for the childs social abilities. Also, positive results were shown in communication, problem solving skills, repetative behaviour, physical strength and motor skills. The study groups were uneven, as they had a gender bias.

    Conclusion: The results showed that AAT have had a positive effect for children with autism and their social life. More research is needed to make AAT an evidential form of treatment in the future.

  • 149.
    Lundebring, Louise
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Nilsson, Ida
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    HIV-positiva patienters erfarenheter av sin hälsorelaterade livskvalité: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: HIV is an incurable virus disease that mainly spreads through blood and sexual contact. The treatment of HIV focus on preventing disease progression, extend the symptom free periods, and relieve symptoms. Approximately 6500 people live with HIV in Sweden today. Globally, around 30-35 million people lives with the disease. The most common symptoms that occur during an HIV-infection is bloatedness, abdominal pain, diarrhea, loss of appetite, nausea, vomiting, weight loss, muscle and joint pain, fatigue, depression, anxiety, numbness and/or pain in the feet and sleeping difficulties.

    Aim: To describe HIV positive patients’experiences of their health-related quality of life (HRQL) and to describe the chosen article’s data collection.

    Method: The present study is a descriptive literature study based on 14 scientific article’s content, which have been reviewed and categorized based on common themes.

    Results: Patients with HIV experienced lower HRQL following the first year of treatment compared to before starting the treatment. The patient’s experiences more pain, worse physical activity, and more disability. Knowledge about HIV improved the physical aspect of HRQL, although many of the patients lacked this kind knowledge. Social support was positively associated with both physical and mental aspects of HRQL. Depression or depressive symptoms commonly occurred among patients with HIV and negatively affected HRQL. The data collection, in all articles, consisted of surveys.

    Conclusion: HIV affectsall aspects of HRQL among the effected patients.

  • 150.
    Löfmark, Anna
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Stord/Haugesund University College, Norway.
    Lindaas, Ingrid
    Stord/Haugesund University College, Norway.
    Berland, Astrid
    Stord/Haugesund University College, Norway.
    Vae, Karen Johanne
    Stord/Haugesund University College, Norway.
    Bentsen, Signe Berit
    University of Stavanger, Norway.
    The Norwegian version of The Assessment of Clinical Education tool (AssCE) A translation and cross-cultural equivalence study2016In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 6, no 4, p. 342-351Article in journal (Refereed)
    Abstract [en]

    The aims of this paper are to describe the Assessment of Clinical Education tool (AssCE) and the translation process and cross-cultural adaption of the AssCE tool into Norwegian. Developed in Sweden, the AssCE tool comprises 21 factors to support the assessment dialogue among students, preceptors (supervising nurses) and lecturers at the specialist nursing level. The AssCE tool was translated into Norwegian using standard procedures for forward and back-translation. In the translation process, different steps were integrated to secure cross-cultural equivalence using an expert committee of seven intensive and critical care nursing students and seven intensive and critical care nurses. The committee reviewed the AssCE tool and examined whether the tool is understandable and usable for the assessment of dialogue during students' clinical practice. The rigorous steps to ensure cross-cultural adaptation support the conclusion that the AssCE tool can be used in other countries for intensive and critical care nursing education and to create support in the dialogue between students, preceptors and lecturers.

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