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  • 51.
    Erikson, Henrik
    et al.
    Department of Nursing and Care, Swedish Red Cross University College, Stockholm, Sweden.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Future Challenges of Robotics and Artificial Intelligence in Nursing: What Can We Learn from Monsters in Popular Culture?2016In: The Permanente Journal, ISSN 1552-5767, E-ISSN 1552-5775, Vol. 20, no 3, article id 15-243Article in journal (Refereed)
    Abstract [en]

    It is highly likely that artificial intelligence (AI) will be implemented in nursing robotics in various forms, both in medical and surgical robotic instruments, but also as different types of droids and humanoids, physical reinforcements, and also animal/pet robots. Exploring and discussing AI and robotics in nursing and health care before these tools become commonplace is of great importance. We propose that monsters in popular culture might be studied with the hope of learning about situations and relationships that generate empathic capacities in their monstrous existences. The aim of the article is to introduce the theoretical framework and assumptions behind this idea. Both robots and monsters are posthuman creations. The knowledge we present here gives ideas about how nursing science can address the postmodern, technologic, and global world to come. Monsters therefore serve as an entrance to explore technologic innovations such as AI. Analyzing when and why monsters step out of character can provide important insights into the conceptualization of caring and nursing as a science, which is important for discussing these empathic protocols, as well as more general insight into human knowledge. The relationship between caring, monsters, robotics, and AI is not as farfetched as it might seem at first glance.

  • 52.
    Eriksson, Annelie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences. Vestre Viken HF, Baerum, Norway.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Distriktssköterskors beskrivningar av sjukdomsförebyggande arbete i daglig verksamhet och strukturella förutsättningar för detta arbete: [District nurses’ perceptions of their preventive work and structural conditions for this work]2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 2, p. 77-84Article in journal (Refereed)
    Abstract [en]

    Background There is much research about district nurses’ preventive work, effects of it and their perceptions of the preventive work. Less is known about how district nurses perceive their preventive work in relation to structural conditions for this work.

    Aim The aim was to describe district nurses’ perceptions of their preventive work in daily practice; and structural conditions for this using Kanter’s theory of structural empowerment.

    Methods Interviews were conducted 2012 with nine Swedish district nurses. Data were analysed using qualitative content analysis.

    Findings The analysis resulted in one theme; ‘To experience stimulation versus frustration; a consistency versus a discrepancy between will and structural conditions’. District nurses who worked with specialized tasks felt that they mostly had the structural conditions required to work in a preventive manner and that they could prioritize which unhealthy living habits to discuss with their patients. District nurses without specialized tasks described that their structural conditions for preventive work was limited in the present streamlined organization. This in turn led to a feeling of frustration.

    Conclusion Preventive work is described as stimulating when district nurses have the conditions required, yet the conditions required are sometimes lacking and especially for district nurses without specialized tasks. There is a will to work in a preventive manner but structural conditions need to be improved.

  • 53.
    Eriksson, Elin
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Häglund, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Organisatoriska orsaker till vårdtagares missnöje med vården2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    The health care system is an complex structure with many different actors and professions, who are subject to different management and different conditions. Within this organisation, many situations may arise that can cause dissatisfaction among care recipients.

     

    Aim

    To describe organisational factors in healthcare that cause dissatisfaction with carers, as well as to describe the selection processes for the selected articles' sample groups.

     

    Design

    Literature review based on twelve articles, both quantitative and qualitative, from 2007-2017.

     

    Main results

    The main problem area for patients was accessibility. Waiting times of various kinds were common: waiting to get an appointment, long time in the waiting room, waiting for treatment, and more. Specific to primary care were difficulties in getting appointments at all, and perceptions in patients that primary care could not help them with their problems. Dissatisfaction with the physical care environment was mentioned mainly in the form of understaffing and unavailability of hospital beds, but there were also other complaints related to the physical environment. Lack of coordination between different actors cause discontent in some patients, for instance due to poor continuity of care.

     

    Conclusions

    There are a number of reasons for care recipients’ dissatisfaction that have their foundation in the health care organization. Focusing on the patient's emotions, the nurse can help the patient in developing and improving the handling of the problematic situation and the feelings that arise. This is facilitated by the nurse having knowledge of how the organisation is structured, and understanding of its complexity. This knowledge and understanding is also a good prerequisite for organisational improvement.

  • 54.
    Eriksson, Elisabet
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Berg, Sören
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Internationally educated nurses' and medical graduates' experiences of getting a license and practicing in Sweden - a qualitative interview study2018In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, no 1, article id 296Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized.

    METHOD: A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis.

    RESULTS: Three main themes were identified: 'Getting a license - a different story,' 'The work is familiar, yet a lot is new,' 'Trying to master a new language.' The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs.

    CONCLUSIONS: Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.

  • 55.
    Eriksson, Elisabet
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country’s health care context2018In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 26, no 7, p. 866-873Article in journal (Refereed)
    Abstract [en]

    AIM:

    To examine internationally educated nurses' experiences of empowerment structures using Kanter's theory of structural empowerment.

    BACKGROUND:

    There has been an increase in the number of nurses working in other countries worldwide and concerns have been raised regarding their working conditions.

    METHOD:

    Semi-structured interviews were conducted with a purposive sample of 11 internationally educated nurses. Directed content analysis was used to analyse the data and Kanter's theory of empowerment was used as a framework.

    RESULTS:

    Access to information was generally good. Access to support for their relationship with their managers varied. Regarding access to resources, nurses unfamiliar with clinical leadership found team leadership challenging. Access to in-house learning opportunities were reported as good. Access to informal power was more common than access to formal power.

    CONCLUSIONS:

    The findings support Kanter's theory and demonstrate that internationally experienced nurses encountered varying degrees of access to empowering structures. Access to information and formal power was more general and related to the unit. Access to resources, support, opportunities and informal power were related to both the unit and the informants' specific situation as IENs.

    IMPLICATIONS FOR NURSING MANAGEMENT:

    Managers need to support IENs when having a team leadership role, facilitate encounters between IENs and ordinary staff, and establishing mentorship for IENs.

  • 56.
    Eriksson, Elisabet
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    The challenges of interviewing internationally educated nurses and doctors in another language than their native language2018Conference paper (Other academic)
    Abstract [en]

    Background: Globalization has increased the migration of internationally educated nurses’ (IENs) and International Medical Graduates (IMG) to high-income countries.

    Objective: To highlight the challenges of interviewing internationally educated nurses and doctors in another language than their native language regarding their working experiences in the Swedish health and social care system.

    Method: Semi-structured interviews with eleven IENs and eleven IMGs. Data were analyzed with qualitative content analysis.

    Results: Interviews with non-Swedish trained nurses and doctors provide important information about their working experiences in the host country, even if their language skills in the host country’s language can be poor. However, the data had a less nuanced language, the same word could be used repeatedly, English words were sometimes used when not finding the Swedish words and some questions were difficult for the informants to understand and had to be omitted. Performing the interview, transcribing and analyzing them took more time compared to interviews with native speakers. The informants clearly stated that they wanted the interview to be in Swedish and not in for example English.

  • 57.
    Eriksson, Henrik
    et al.
    Röda Korsets Högskola.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Cyber nursing: a conceptual framework2016In: Journal of Research in Nursing, ISSN 1744-9871, E-ISSN 1744-988X, Vol. 21, no 7, p. 505-514Article, review/survey (Refereed)
    Abstract [en]

    There have been few attempts to express in words and conceptualise ‘the Internet’ and ‘health’ within a framework. The aim of this study was to present a conceptual framework concerning virtual self-care and online caring. The results show that the concepts of virtual communities, virtual self-care and torrenting frame these very specific interactions and environments and that the concepts of keyboard cowboy, cyber aid and health interests trader stipulate different ways in which to express expertise in cyber nursing. Alongside cyber-bullying, cyber nursing is also present in virtual arenas. Nursing researchers need to explore and monitor cyber nursing activities using concepts developed within the field of nursing.

  • 58.
    Eriksson, Henrik
    et al.
    Department of Nursing and Care, The Red Cross University College, Stockholm, Sweden.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    The digital generation and nursing robotics: a netnographic study about nursing care robots posted on social media2017In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 24, no 2, article id e12165Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to present the functionality and design of nursing care robots as depicted in pictures posted on social media. A netnographic study was conducted using social media postings over a period of 3 years. One hundred and Seventy-two images were analyzed using netnographic methodology. The findings show that nursing care robots exist in various designs and functionalities, all with a common denominator of supporting the care of one's own and others' health and/or well-being as a main function. The results also show that functionality and design are influenced by recent popular sci-fi/cartoon contexts as portrayed in blockbuster movies, for example. Robots'designs seem more influenced by popular sci-fi/cartoon culture than professional nursing culture. We therefore stress that it is relevant for nursing researchers to critically reflect upon the development of nursing care robots as a thoughtful discussion about embracing technology also might generate a range of epistemological possibilities when entering a postmodern era of science and practice.

  • 59.
    Eriksson, Henrik
    et al.
    Swedish Red Cross University College.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Turning to monster to learn about humanity: presentation of findings from caring monsters - the research project2015In: Human Rights and Health and the Astrid Janzon Symposium: Abstract Book, 2015, p. 22-22Conference paper (Refereed)
    Abstract [en]

    Popular culture; literature, movies and comics, is full of monsters. Monsters that both scare and amuse. Through history people has been fascinated, feared and amused by the idea of mysterious creatures, the monsters. Passing stories and constructing the “monsters” are part of all cultures and over times, although the representation of monsters are projected in variance over time and are historical and contextual bounded. Just as monsters are the binary opposition of the ‘good citizen’, monsters also perform as embodied representations of the “Other”. Monster is therefore best understood as embodiment of difference, a breaker of categories and a resistant other. Monsters are “tricksters” challenging our coding of the world by challenging our knowledge. The monster ask us how we as humans perceive the world and about our perception of difference. The aim of this project is to explore the caring activities of monsters in popular culture. The project will catalog monsters’ caring activities around the globe and analyze why, when and under what circumstances monster characters actually do care. In this presentation the initial analyzes of data gathered from the project website (http://www.caringmonsters.com/) will be presented. The initial readings based on a straight forward content analysis of why monsters sometimes go out of character and suddenly engage in some kind of caring activities will be presented. The result will contribute to a critical discussion of the impact of caring and the ethics of caring from which we could learn about humanity, when reflecting upon it from an “outside” and monstrous perspective.

  • 60.
    Eriksson, Henrik
    et al.
    Röda Korsets Högskola.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Twitter discussions as predicament of robots in geriatric nursing and forecast of nursing robotics in older care2018In: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 54, no 1 (SI), p. 97-107Article in journal (Refereed)
    Abstract [en]

    Background: People use social media to express perceptions, attitudes and a wide range of concerns regarding human life. Aim: This study aims at analysing the ongoing discussions on the internet microblog Twitter and offers some coming predicaments regarding developments in geriatric nursing regarding nursing robots.

    Methods: Data were retrospectively collected from Twitter. 1322 mentions were included in the final analyses, where principles of interpreting data by using netnography were utilized.

    Results: Many ideas are presented expressing functional, psychological and social aspects of robots in nursing care. Most postings come from metropolitan cities around the globe. The discussion focuses on market-driven, science fiction solutions for aged care. Twitter users overall seem to be positive using various nursing robots in aged care. These discussions offer a window into the attitudes and ideas of this group of users.

    Conclusion: We suggest that monitoring Twitter discussions on social media can provide valuable insights into current attitudes as well as forecast coming trends.

  • 61.
    Eriksson, Lena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Persson, Sara
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Kunskaper om och attityder till prevention av trycksår hos distriktssköterskor och sjuksköterskor inom kommunal hälso- och sjukvård2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Pressure ulcer is a common and expensive problem for society which causes suffering and pain for the patient. Registered nurses should promote health, prevent illness and relieve suffering and is responsible for identifying risk and prescribing measures for pressure ulcer prevention. The purpose of this study was to describe and compare district nurses and registered nurses knowledge and attitude to pressure ulcer prevention in municipal health care. The method: Descriptive and comparative design with quantitative approach. A questionnaire was distributed to district nurses and registered nurses who worked in nursing homes and home healthcare in five municipalities. It was 67 out of 150 respondents who participated in the study. The result: The result showed that district nurse and registered nurse’s lack in knowledge about pressure ulcer prevention. Specific in the question about position change that reduces pressure ulcer risk the most, relief of heels on pressure-reducing mattress, the right way to reduce the pressure force when a patient slides down in a chair and that oxygen deficiency causes pressure ulcer. No significant difference between the groups knowledge on pressure ulcer prevention was found. The attitude of both the district nurse and the registered nurse was positive and a significant difference was found between the groups. The district nurse had a more positive attitude compared to the registered nurse. Nurses felt less confident of their ability to prevent pressure ulcer and district nurses responded to a greater extent that pressure ulcer prevention is an important task. Conclusion: In this study, participants have insufficient knowledge about pressure ulcers prevention and the attitude of both the district nurse and the registered nurse was positive to pressure ulcer prevention. A difference between the groups was where the district nurse had a more positive attitude compared to the registered nurse.

  • 62.
    Erlingmark, Julia
    et al.
    University Hospital, Uppsala, Sweden.
    Hedström, Mariann
    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.
    Nurse staffing and renal anaemia outcomes in haemodialysis care2016In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 42, no 3, p. 185-189Article in journal (Refereed)
    Abstract [en]

    Background

    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes.

    Objectives

    To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management.

    Design

    Cross-sectional audit. Participants Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. Measurements The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management.

    Results

    The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres.

    Conclusions

    These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation.

  • 63.
    Ernesäter, Annica
    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.
    Winblad, Ulrika
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rahmqvist, Mikael
    Department of Medical and Health Sciences, Linköping University, Linköping, 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 .
    Telephone nurses' communication and response to callers' concern: a mixed methods study2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 29, p. 116-121Article in journal (Refereed)
    Abstract [en]

    Aims

    To describe telephone nurses’ and callers’ communication, investigate relationships within the dyad and explore telephone nurses’ direct response to callers’ expressions of concern

    Background

    Telephone nurses assessing callers’ need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.

    Method

    RIAS-and content analysis was performed on a criterion sampling of calls (n=25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.

    Results

    Telephone nurses mainly ask close-ended questions, whilst open-ended questions are sparsely used. Relationships between callers’ expressions of Concern and telephone nurses responding with Disapprovalwere found. Telephone nurses mainly responded to concern with close-ended medical questions whilst exploration of callers’ reason for concern was sparse.

    Conclusion

    Telephone nurses’ reluctance to use open-ended questions and to follow up on callers’ understanding might be a threat to concordance, and a potential threat to patient safety.

  • 64.
    Essner, Ann
    et al.
    Department of Neuroscience, Faculty of Physiotherapy, Uppsala University, Uppsala, Sweden; Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Zetterberg, Lena
    Department of Neuroscience, Faculty of Physiotherapy, Uppsala University, Uppsala, Sweden.
    Hellström, Karin
    Department of Neuroscience, Faculty of Physiotherapy, Uppsala University, Uppsala, Sweden.
    Gustås, Pia
    Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjöström, Rita
    Unit of Research Education and Development, Region Jämtland Härjedalen, Östersund, Sweden; Department of Community Medicine and Rehabilitation, Faculty of Physiotherapy, Umeå University, Umeå, Sweden.
    Psychometric evaluation of the canine brief pain inventory in a Swedish sample of dogs with pain related to osteoarthritis2017In: Acta Veterinaria Scandinavica, ISSN 1751-0147, E-ISSN 1751-0147, Vol. 59, no 1, article id 44Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To evaluate intervention, implement evidence-based practice and enhance the welfare of dogs with naturally occurring osteoarthritis (OA), access to valid, reliable and clinically relevant outcome measures is crucial for researchers, veterinarians and rehabilitation practitioners. The objectives of the present study were to translate and evaluate psychometric properties, in terms of internal consistency and construct validity, of the owner-reported measure canine brief pain inventory (CBPI) in a Swedish sample of dogs with pain related to OA.

    RESULTS: Twenty-one owners of clinically sound dogs and 58 owners of dogs with pain related to OA were included in this observational and cross-sectional study. After being translated according to the guidelines for patient-reported outcome measures, the CBPI was completed by the canine owners. Construct validity was assessed by confirmatory factor analysis, by repeating the principal component analysis and by assessing for differences between clinically sound dogs and dogs with pain related to OA. Internal consistency was estimated by Cronbach's α. Confirmatory factor analysis was not able to confirm the factor-structure models tested in our sample. Principal component analysis showed a two-component structure, pain severity and pain interference of function. Two components accounted for 76.8% of the total variance, suggesting an acceptable fit of a two-component structure. The ratings from the clinically sound dogs differed from OA dogs and showed significantly lower CBPI total sum. Cronbach's α was 0.94 for the total CBPI, 0.91 for the pain severity and 0.91 for the pain interference of function.

    CONCLUSIONS: The results indicate that the translated version of the CBPI is valid for use in the Swedish language. The findings suggest satisfying psychometric properties in terms of high internal consistencies and ability to discriminate clinically sound dogs from OA dogs. However, based on the confirmatory factor analysis, the original factor structure in the CBPI is not ideally suited to measure pain related to OA in our sample and the hypothesis of the presented two-factor structure was rejected. Further research needs to be conducted to determine whether the original psychometric results from CBPI can be replicated across different target groups and particularly with larger sample size.

  • 65.
    Essner, Ann
    et al.
    Department of Neuroscience, Uppsala University, Uppsala, Sweden; Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Zetterberg, Lena
    Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Hellström, Karin
    Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Gustås, Pia
    Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjöström, Rita
    Region Jämtland Härjedalen, Unit of Research Education & Development, Östersund, Sweden.
    Validation of a translated version of the Canine Brief Pain Inventory for the measure of pain severity and functional movements in canine osteoarthritis2016In: Journal of Small Animal Practice, ISSN 0022-4510, E-ISSN 1748-5827, Vol. 57, no Suppl. 2, p. 8-9Article in journal (Refereed)
    Abstract [en]

    Reasons for performing study: The Canine Brief Pain Inventory (CBPI) is a caregiver-reported questionnaire designed to assess pain severity and the impact of pain on activities, such as functional movements, in canine osteoarthritis (OA). The English version of CBPI has displayed satisfactory psychometric properties, in canine OA. To be used in another language the CBPI has to be properly translated and tested.

    Objectives: To report some psychometric properties of a translated version of the CBPI (CBPI-S), in a group of dogs diagnosed with OA.

    Study design: Observational, cross-sectional.

    Methods: Twenty-one caregivers of clinically sound dogs and 61 caregivers of dogs with OA were prospectively included in this study. After being translated, according to recommendations for patient-reported outcome measures, the CBPI-S was completed by the caregivers. Construct validity (the ability to measure what it is supposed to measure) was assessed by repeating the principal component analysis and by assessing for differences between sound dogs and dogs with OA using Mann–Whitney U test. Internal consistency (the correlation among items) was estimated by Cronbach's α.

    Results: Principal component analysis showed a two-component structure (pain severity and impact of pain). Two components accounted for 76 · 8% of the total variance, suggesting an acceptable fit of a two-component structure. Inter-item correlations were good (overall > 0 · 39) and mean inter-item correlation was 0 · 79 for severity items and 0 · 62 for impact items. Clinically sound dogs differed from OA dogs and showed significantly lower CBPI-S total score. Cronbach's α was 0 · 94 for the total CBPI-S, 0 · 91 for the pain severity and 0 · 91 for the impact of pain.

    Conclusion: Our results supplement the knowledge with the CBPI by verifying the easy to use utility. Also, by repeating satisfying construct validity and high internal consistency of CBPI-S our results indicate that the translated version seems valid for use in another language.

    Ethical animal research: The study was approved by the Local Animal Ethics Committee in Uppsala. Informed client consent was obtained for all animals used in the study.

    Sources of funding: This study was funded by Evidensia Djursjukvård, Svelands Stiftelse, Jan Skogsborgs Stiftelse and Agria & Svenska Kennelklubbens Forskningsfond.

  • 66.
    Evensson, Nicolé
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Pettersson, Sara
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjuksköterskors upplevelse av att vara involverade i barnmisshandelsfall: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Child abuse is a huge global problem and the trend in Sweden in reporting child abuse is increasing. Swedish law obligates health care personnel to report any suspicion of child abuse to child protection services. However, research shows that reports are not happening to the extent they should. Lack in knowledge on how to identify abuse and which process to follow when reporting are the main factors. It is unclear how nurses are emotionally involved when handling a child abuse case.

    Aim: To describe how nurses experience to be involved in child abuse cases and to describe one methodological aspect of the articles this study is based on.

    Method: Descriptive literature review based on twelve qualitative studies.

    Result: Nurses felt that the initial suspicion about a child being abused was often based on gut feeling only, causing both insecurity and frustration. The feeling of insecurity followed most nurses throughout the whole case, from suspicion until investigation. Research showed that most nurses felt it was difficult to maintain a professional attitude. Moreover, nurses were scared for their own lives when dealing with child abuse. The negative emotions were often long lasting. When reporting such a case to the authorities nurses could experience both feelings of anxiety and satisfaction. Throughout the investigation resignation and frustration dominated the nurses' cooperation with child protection services due to lack of status updates, for example. One successful way to deal with insecurity was social support from colleagues, but not everyone had access to such a support network. In total, the included studies comprised 222 participants, 161 of whom were nurses, between 25-64 years old. The majority were women and the participants had work experience as a nurse between two and 38 years

    Conclusion: Dealing with child abuse cases as a nurse is mostly characterized by negative impressions. The feeling of insecurity is predominant and runs lika a red thread from suspicion to investigation. Social support is perceived as a vital resource in order to deal with child abuse cases. However many challenges remain to find more solution focused approaches. A more salutogenic view is needed in research, nursing education and on the work floor in order to improve the conditions for nurses to be able to cope with these experiences.

  • 67.
    Fjärdsmans, Tobias
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Khalaf, Ahmed
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Upplevelser av att vara anhörig till en person med demens som bor på ett äldreboende: En beskrivande litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: 35,6 million people lives with a dementia disease in the world. This number is set to be doubled by 2030 and tripled by 2050. The majority of the people with dementia (PWD) have relatives in the form of, for example, spouses and adult children. To live with a dementia disease involves intellectual difficulties such as anxiety, frustration, loss of memory and depression which effects the communication with the nursing staff.

    Aim: To describe the experiences of being a relative of a PWD who lives in a nursing home for PWD and to describe the included articles from the methodological point of view study group.

    Method: Literature review with a descriptive design based on 10 qualitative scientific articles from the search engines PubMed and Cinahl. The articles were individually processed by the authors of this literature review and during the analysis, four main themes where identified. These themes later became the basis of the result.

    Main findings: The result showed that relatives to a PWD often experiences feelings of loss and guilt. They also had difficulties in trusting the nursing staff and in making decisions for their PWD.

    In the majority of the articles in this literature review the participants were women. In some of the articles the was a more even gender variety. Most of the participants in the articles were spouses of adult children to PWD although there were also siblings and grandchildren amongst the participants. The middle age of the participants varied between 54-73 years.

    Conclusion: Relatives of a PWD often experience tough feelings such as loneliness, lost love, sorrow and guilt. They also have a hard time trusting the nursing staff and struggle to justify the decisions they make for their PWD. It is important for the nurse to have some insight in regards to what the relatives experience in order to meet and support them. This enhances the care of the PWD since the relatives can contribute with information regarding what care the PWD needs.

  • 68.
    Florin, Jan
    et al.
    Department of Health and Social Sciences, Dalarna University, Falun.
    Bååth, Carina
    Faculty of Health, Sciences, and Technology, Department of Health Sciences, Karlstad University, Karlstad; County Council of Värmland, Värmland.
    Gunningberg, Lena
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala.
    Mårtensson, Gunilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala.
    Attitudes towards pressure ulcer prevention: a psychometric evaluation of the Swedish version of the APuP instrument2016In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 13, no 5, p. 655-662Article in journal (Refereed)
    Abstract [en]

    The primary aim was to conduct a psychometric evaluation of the Attitude towards Pressure ulcer Prevention (APuP) instrument in a Swedish context. A further aim was to describe and compare attitudes towards pressure ulcer prevention between registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs). In total, 415 RNs, ANs and SNs responded to the questionnaire. In addition to descriptive and comparative statistics, confirmatory factor analyses were performed. Because of a lack of support for the instrument structure, further explorative and consecutive confirmatory tests were conducted. Overall, positive attitudes towards pressure ulcer prevention were identified for all three groups, but SNs reported lower attitude scores on three items and a higher score on one item compared to RNs and ANs. The findings indicated no support in this Swedish sample for the previously reported five-factor model of APuP. Further explorative and confirmative factor analyses indicated that a four-factor model was most interpretable: (i) Priority (five items), (ii) Competence (three items), (iii) Importance (three items) and (iv) Responsibility (two items). The five-factor solution could not be confirmed. Further research is recommended to develop a valid and reliable tool to assess nurses' attitudes towards pressure ulcer prevention working across different settings on an international level.

  • 69.
    Forsberg, Markus
    et al.
    Department of Anaesthesia, Gävle Sjukhus, Gävle, Sweden.
    Björn, Catrine
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Gävleborg, Gävle, 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.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Nurse anesthetists' reflections on caring for patients with previous substance dependence: Balancing between professionalism and preconceptions2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Purpose

    The study aim was to describe nurse anaesthetists’ reflections on provision of perioperative care to patients with previous substance dependence.

    Design

    A qualitative approach with a descriptive design.

    Methods

    Semi-structured interviews based on clinical vignettes were conducted with ten nurse anaesthetists.

    Findings

    The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group. The nurse anaesthetists felt that anesthetizing this group of patients constituted an anaesthesiological challenge with regard to knowledge, experience and time. However, the nurses also had feelings of distrust and uncertainty due to lack of knowledge.

    Conclusion

    The nurse anaesthetists strove to uphold the principle that patients who are/have been substance dependent have the same right to adequate treatment and care as all patients. If guidelines were developed for this patient group, care could be made safer and nurses’ sense of uncertainty minimized.

     

  • 70.
    Franzén, Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Ohlsson, Spire
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Upplevelser av att leva med inflammatorisk tarmsjukdom (IBD): En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Inflammatory bowel disease (IBD) includes the diseases Ulcerative Colitis and Morbus Crohn. Environmental factors and changing diets are thought to be reasons for IBD cases has increased in the US and Western Europe in a short time. It is in Sweden about 500 people affected of Morbus Crohn every year and Ulcerative colitis affects about 900 people per year. The disease has physical symptoms such as diarrhea, pain and weight loss, but also affects an individual psychosocial. Aim: The aim was to describe people's experiences of living with inflammatory bowel disease, and to present the study group as described in the included articles. Methods: This study is a descriptive literature study and 11 qualitative articles were used. PubMed and Cinahl were used to search for articles. Keywords used were: Inflammatory Bowel Diseases, Qualitative, Everyday Life and Lived Experiences. Main results: IBD is a chronic disease. Physical symptoms such as nausea, pain and fatigue which is also seen as a mental symptoms. The disease was found to influence the individual's daily life, eating habits, family life, and social relationships. All included articles presented the study group. Conclusion: IBD are becoming more common in the world. The symptoms are both physical and psychosocial and affects the afflicted person everyday life, social life and diet. Nurses face a big challenge in being able to confronting and care for these patients, since each individual has different perceptions of the same diagnosis.

  • 71.
    Friberg, Stina
    et al.
    Falu Lasarett, Infektionskliniken.
    Jansson, Josefine
    Levia hälsovård, Rättvik.
    Westergren, Eva
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Grundutbildade sjuksköterskors upplevelse att börja arbeta på en barnavdelning2016In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 6, no 1, p. 20-33Article in journal (Refereed)
    Abstract [en]

    Basic trained nurses experience to start working on a children’s ward

    The aim of the study was to describe nurses trained to a basic level experience of starting work on a children's ward. A qualitative study has been conducted with a purposively drawn sample of informants. Semi-structured interviews were conducted with eight basic trained nurses. Data were analyzed using qualitative content analysis. The results showed that respondents felt that the pediatrics course is not preparing for the professional work with children. Most felt that it was through real situations in the workplace that they gained necessary knowledge. Furthermore, it was found that only a few were satisfied with the induction. Spending time with many different supervisors was an important factor for experiencing dissatisfaction with the induction. Good support was received from employees; however the support of the organization was poor. Conclusion: Today's undergraduate education in nursing does not include enough pediatrics to prepare students for professional work with children and adolescents. Actions at individual and workplace levels are needed to increase knowledge of the basic trained nurse. Continuity and support during the induction is important for newly employed nurses to feel competent in their work.

  • 72.
    Fritzell, Kaisa
    et al.
    Department of Neurobiology, Care Sciences and Society, Div. of Nursing, Karolinska Institutet, Stockholm.
    Jervaeus, Anna
    Department of Neurobiology, Care Sciences and Society, Div. of Nursing, Karolinska Institutet, Stockholm.
    Stake Nilsson, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Hultcrantz, Rolf
    Karolinska University Hospital, Stockholm.
    Wengström, Yvonne
    Department of Neurobiology, Care Sciences and Society, Div. of Nursing, Karolinska Institutet, Stockholm.
    Translation and cultural adaption of the decisions module for colorectal cancer screening into a Swedish version - the SCREESCO questionnaire2017In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 52, no 11, p. 1248-1252Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Colorectal cancer (CRC) is suitable for population screening due to its high incidence and the recognizable and treatable prephase, and the present study is part of the larger study; Screening for Swedish Colons (SCREESCO). In Sweden, there is, to our knowledge, no questionnaire assessing shared decision making (SDM) with regard to CRC screening and, therefore, the aim of the study was to translate and culturally adapt the CRC screening module of the National Survey of Medical Decisions (DECISIONS) into a Swedish context.

    MATERIAL AND METHODS:

    A qualitative design inspired by guidelines based on methods for cross-cultural adaptation of questionnaires was used. In addition, focus group discussions, individual interviews and think-aloud (TA) sessions were performed.

    RESULTS:

    Of the 54 items included in the original DECISION survey, 32 were excluded, 22 were modified, and three were added as a result of the qualitative study. How the health care organization communicated and CRC screening knowledge was communicated were found to be the most important cultural differences between Sweden and the USA. The final questionnaire consists of 24 items.

    CONCLUSION:

    The process of translation and cultural adaptation of the CRC screening module of the DECISIONS survey resulted in the removal and modifying of a considerable number of items. The major rationale for the removal and modifying of items can be explained by the different cultural traditions between Sweden and the USA when communicating with the health care system regarding screening participation and how CRC screening information and knowledge is communicated.

  • 73.
    Fritzell, Kaisa
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Stake Nilsson, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Jervaeus, Anna
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Hultcrantz, Rolf
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wengström, Yvonne
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; Breast and Sarcoma Unit, Radiumhemmet, Karolinska University Hospital, Stockholm, Swede.
    The importance of people's values and preferences for colorectal cancer screening participation2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no 6, p. 1079-1084Article in journal (Refereed)
    Abstract [en]

    Background: To explore how individuals reason when they make decisions about participating in colorectal cancer(CRC) screening.

    Methods: Individuals randomized colorectal cancer (CRC) screeningto FIT or colonoscopy included in the Screening of Swedish Colons (SCREESCO) program was invited to focus group discussions and individual telephone interviews. The concept of shared decision-making (SDM: information; values/preferences; involvement) was used as a matrixfor the analyses. To validate findings, additional focus group discussions using the nominal group technique were performed.

    Results: Lack of knowledge of CRC and CRC screening was prominent for participants and non-participants, while the results differed between the groups in relation to their values and preferences. The influence of significant others promoted participation while it prevented it among non-participants. Those who participated and those who did not made it clear that there was no need to involve health care professionals when making the decision.

    Conclusions: Based on the results, a display of different ways to spread knowledge and communicate about CRC and CRC-screening could be applied such as, community-based information campaigns, decisions aids, interactive questionnaires, chat-functions and telephone support. The disparity in values and pref-erences between participants and non-participants may be the key to understand why non-participants make theirdecisions not to participate and warrant further exploration.

  • 74.
    Fritzell, Kaisa
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Stake-Nilsson, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Jervaeus, Anna
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Hultcrantz, Rolf
    Karolinska University Hospital, Stockholm, Sweden.
    Wengström, Yvonne
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    The importance of peoples values and preferences in promoting colorectal cancer screening participationIn: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360XArticle in journal (Refereed)
    Abstract [en]

    Background: To explore how individuals reason when they make decisions about colorectal cancer (CRC) screening participation from the perspective of participants and non-participants.

    Methods: Individuals randomized to FIT or colonoscopy included in the Screening of Swedish Colons (SCREESCO) program were invited to focus group discussions and individual telephone interviews. The concept of shared decision-making (SDM: information; values/preferences; involvement) was used as a matrix for the analyses. To validate findings, additional focus group discussions using the nominal group technique were performed.

    Results: The results covered the SDM concept. Lack of knowledge of CRC and CRC screening was prominent in both participants and non-participants, while the results differed between the groups in relation to their values and preferences. The influence of significant others promoted participation among participants while it prevented it among non-participants. Both participants and non-participants made it clear that there was no need to involve health care professionals when making their decision.

    Conclusion: Based on the results, a display of different ways to promote knowledge and communication about CRC and CRC-screening, e.g. community-based information campaigns, decisions aids, interventions, such as interactive questionnaires, chat-functions and telephone support, should be provided. The disparity in values and preferences between participants and non-participants may be the key to understand why non-participants make their decisions not to participate and should be further explored.

  • 75.
    Frykman, Madeleine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Wikström, Sofia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjuksköterskors erfarenheter av att arbeta på akutmottagning: litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The Emergency department is a part of the hospital where patients comes with a critical condition and unexpected ilness for a first judgment. The healthcare provided is intense and demanding of the nurses.

    Aim: The aim of the study was to describe the nurses experiences of working in the emergency department. Our purpose is also to describe the study participants in the selected studies.

    Methods: The present literature review has a decpriptive design. PubMed was used and 15 articles were included, eight had a qualitative approach and seven had a quantitative. The limits that were used in the data collection was years, language and access for the university of Gävle. The data were analysed by color-coding and reading and the result is presented by four themes.

    Main Results: It was revealed the emergency department nurses were affected by the experience of various forms of stress. The patient population is constantly increasing, which concerned the nurses, which in turn led to increased workload. The need of education and more resources of nurses is big, and the work enviroment is demanding with a high patient flow, violence and hectic days. In the selected articles there was in total 1492 participants.

    Conclusion: The experience of stress affected the nurses emotionally and physically, which also affected the social life. The emergency department is unorganized with a high patientflow that affects the work enviroment and the patient safety. The high patient flow contributed also to a long waiting time which increased the risk of violence. More resources of nurses and education is needed

  • 76.
    Gardulf, Ann
    et al.
    Karolinska Institutet, Stockholm, Sweden; The Japanese Red Cross Institute for Humanitarian Studies, Tokyo, Japan.
    Nilsson, Jan
    The Japanese Red Cross Institute for Humanitarian Studies, Tokyo, Japan; Karlstad University, Karlstad, Sweden.
    Florin, Jan
    Dalarna University, Falun, Sweden.
    Leksell, Janeth
    Dalarna University, Falun, Sweden; Uppsala University, Uppsala, Sweden.
    Lepp, Margret
    University of Gothenburg, Gothenburg, Sweden; Østfold University College, Halden, Norway.
    Lindholm, Christina
    Sophiahemmet University, Stockholm, Sweden.
    Nordström, Gun
    Karlstad University, Karlstad, Sweden; Hedmark University College, Hedmark, Norway.
    Theander, Kersti
    Karlstad University, Karlstad, Sweden; County Council of Värmland, Karlstad, Sweden.
    Wilde-Larsson, Bodil
    Karlstad University, Karlstad, Sweden; Hedmark University College, Hedmark, Norway.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Johansson, Eva
    Karolinska Institutet, Stockholm, Sweden.
    The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, p. 165-171Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients.

    OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors.

    METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated.

    RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs).

    SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

  • 77.
    Grudzinska, Maja
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Öberg, Johanna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Vuxna patienters upplevelser av att leva med HIV: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: HIV (Human Immunodeficiency Virus) is a disease that affect the human immune system. Around 30–35 million people are living with HIV in the world. HIV affects people, both mentally and physically.

    Aim: To describe adults/adult patients experiences of living with HIV, focusing on mental and physical aspects, and to describe how the study group looks in the selected studies.

    Method: A descriptive literature study, based on 10 scientific articles with qualitative approach. The database that was used to find the articles was Cinahl.

    Main Results: The result of this literature study shows that people living with HIV daily feel emotions of fear, depression, anxiety and stress due to living with the disease. The emotions connect directly to experiences of stigmatization and discrimination within the healthcare and community. People living with HIV are often afraid how other people will react their disease. Physical symptoms like fatigue affect their everyday life negative, and the ability to live a normal life is prevented. The study group is clearly presented based on what the authors of the audited studies describes.

    Conclusion: HIV-positive people can be found in all healthcare facilities. Emotions of guilt and shame often occure with people who are living with HIV. As a nurse, the attitude towards people with HIV is very important.

  • 78.
    Gunningberg, Lena
    et al.
    Uppsala University and University Hospital, Uppsala, Sweden; University of California San Francisco, San Francisco, CA.
    Mårtensson, Gunilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University and University Hospital, Uppsala, Sweden.
    Mamhidir, Anna-Greta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University and University Hospital, Uppsala, Sweden.
    Florin, Jan
    Dalarna University, Falun, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University and University Hospital, Uppsala, Sweden; School of Nursing, University of Adelaide, Adelaide, Australia.
    Bååth, Carina
    Department of Nursing, Karlstad University, Karlstad, Sweden; County Council of Värmland, Karlstad, Sweden.
    Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden2015In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 12, no 4, p. 462-468Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe and compare the knowledge of registered nurses (RNs), assistant nurses (ANs) and student nurses (SNs) about preventing pressure ulcers (PUs). PU prevention behaviours in the clinical practice of RNs and ANs were also explored. A descriptive, comparative multicentre study was performed. Hospital wards and universities from four Swedish county councils participated. In total, 415 participants (RN, AN and SN) completed the Pressure Ulcer Knowledge Assessment Tool. The mean knowledge score for the sample was 58·9%. The highest scores were found in the themes ‘nutrition’ (83·1%) and ‘risk assessment’ (75·7%). The lowest scores were found in the themes ‘reduction in the amount of pressure and shear’ (47·5%) and ‘classification and observation’ (55·5%). RNs and SNs had higher scores than ANs on ‘aetiology and causes’. SNs had higher scores than RNs and ANs on 'nutrition'. It has been concluded that there is a knowledge deficit in PU prevention among nursing staff in Sweden. A major educational campaign needs to be undertaken both in hospital settings and in nursing education.

  • 79.
    Gustafsson, Niclas
    et al.
    Ersta-Sköndal College University, Stockholm, Sweden.
    Salzmann-Erikson, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Effect of Complex Working Conditions on Nurses Who Exert Coercive Measures in Forensic Psychiatric Care2016In: Journal of Psychosocial Nursing and Mental Health Services, ISSN 0279-3695, E-ISSN 1938-2413, Vol. 54, no 9, p. 37-43Article in journal (Refereed)
    Abstract [en]

    Nurses who exert coercive measures on patients within psychiatric care are emotionally affected. However, research on their working conditions and environment is limited. The purpose of the current study was to describe nurses' experiences and thoughts concerning the exertion of coercive measures in forensic psychiatric care. The investigation was a qualitative interview study using unstructured interviews; data were analyzed with inductive content analysis. Results described participants' thoughts and experiences of coercive measures from four main categories: (a) acting against the patients' will, (b) reasoning about ethical justifications, (c) feelings of compassion, and (d) the need for debriefing. The current study illuminates the working conditions of nurses who exert coercive measures in clinical practice with patients who have a long-term relationship with severe symptomatology. The findings are important to further discuss how nurses and leaders can promote a healthier working environment.

  • 80.
    Gustafsson, Victoria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Holmberg, Malin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Nyutexaminerade sjuksköterskors upplevelser av sin första tid som yrkesverksam: En beskrivande litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The nursing profession is a multi-faceted profession in which the first time as a newly qualified nurse is important. There is a correlation between a good start in the profession and that newly graduated nurses stay in the profession. It is very important that graduated nurses remain in the profession to maintain continuity and experience, as this components leading to increased patient safety.

    Aim: To describe newly graduated nurses first experience as a registered nurse and to describe the included articles study-group. Method: A descriptive literature review based on twelve scientific articles. The articles were retrieved from databases CINAHL and PubMed through the University of Gävle. Results: The results of this study described the experiences of newly graduated nurses in their transition to professional. To obtain a satisfactory transition to the new profession, many details must be considered. Topics that emerged most clearly were the workplace induction, supervision, colleagues and the new professional role. Newly graduated nurses experienced workplace introduction as both positive and negative. How the supervision was experienced depended on the supervisor's professional experience and that the experience was described as significant for the development of skills. If the newly graduated nurses were integrated and accepted in a good way of new colleagues, the professional confidence increased. The newly qualified nurses experienced difficulties in dealing with their new professional role because of lack of knowledge and clinical experience. The total number of participants in the study were 396 and four continents were represented, such as Europe, Asia, Oceania and North America. Conclusion: The importance of a good workplace introduction and first time in the profession can’t be emphasized enough. Newly graduated nurses described that it was imperative that they got the support they needed and that they were permitted to be novices in their profession to have a solid foundation to stand on. Support for the newly graduated nurses should be an integrated part of healthcare.

  • 81.
    Gümüs, Alaa Salam
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Patienters upplevelser av att leva med långvarig smärta ur psykosocialt perspektiv samt sjukvårdens bemötande: en litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Chronic pain is defined as pain that has not gone over 3-6 months. Pain is an individual experience that cannot be objectively measured, but that experience knows how intense it is, and pain duration.

    Aim: The aim of this literature review was to describe patient's experiences of living with chronic pain from a psychosocial perspective. The aim was also to describe the data collection methods of scientific articles have used.

    Method: This literature review has a descriptive design. This literature review study's results are based on 12 scientific articles that have been found through the database CINAHL and PubMed.

    Result: The compilation of the included articles led to perceptions of emotional impact on patients' lives as a major suffering and negative thoughts about the future. Pain was felt also that the social constraints of working life, loss of identity and social relationships. Patients experienced a negative attitude of medical staff.

    Conclusion: Experiences of pain affect patients psychologically and socially. Pain has led to the emotional impact and led to social constraints in both working life and relationship to family, friends and children. Experience of healthcare professionals experienced negative treatment of patients where the pain is not taken seriously. This in turn affected the receive any treatment or medication. The author of this literature review means that based on present literature studies results are deficiencies in health care, this in turn may help to increase medical knowledge of these patients experience chronic pain as well as to cope with the in a dignified and respectful manner, believing the pain and to extend helping hand to patients

  • 82.
    Hagberg, Jeanette
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Jern, Ann-Christine
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Kvinnors livskvalitet vid endometrios: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Endometriosis is a gynaecological disease that affects a large number of women throughout the world. These women are often treated by the lack of knowledge, distrust and normalizing attitudes. That causes delay in diagnosis care and treatment, which creates unnecessary suffering. Nurses have an important function in the treatment of these women by supporting the woman, create a good alliance and provide relevant information.

    Aim: The aim of the study was to describe women's experiences of quality of life in endometriosis and to examine and describe the articles included data collection methods.

    Method: Literature study has a descriptive design. Data were collected through Medline / PubMed and CINAHL and twelve articles were found, all with qualitative approach. These articles were the basis for this study.

    Results: Endometriosis results in a greatly reduced quality of life that affects their partner, relationship and social life, such as work, school and hobbies. A lack of knowledge in health-care leads to normalization and delayed diagnosis that creates unnecessary suffering for these women. Many of the women created their own strategies to deal with their symptoms in daily life. All twelve articles with descriptive design have collected data by interviewing women about their experiences of living with endometriosis.

    Conclusion: Endometriosis affects significantly the women's daily lives, and all the relationships, in a negative way. Their health is affected physically, psychologically and socially with the result that they get their quality of life greatly reduced. Significant financial savings can be made by increased knowledge in the field and diagnosis at an earlier stage. Suffering from Endometriosis would be reduced, and the quality of life for those women’s will significantly increase.

  • 83.
    Hagerman, Heidi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    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.
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Wadensten, Barbro
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    Manliga första-linjenschefers upplevelser av sin arbetssituation i äldreomsorgen – med utgångspunkt i empowerment2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och Abstracts, 2018, p. 143-Conference paper (Other academic)
    Abstract [en]

    Bakgrund

    Den svenska äldreomsorgen blir allt mer ansträngande att arbeta inom. Stora organisa-toriska förändringar har lett till att arbetet upplevs som oroligt och stressfullt. Den administrativa rollen har ökat och första-linjens chefers möjligheter att delta i det dagliga arbetet har minskat. För att klara av de allt högre krav som ställs är det viktigt att cheferna känner att de har goda strukturella förutsättningar (empowerment), handlingsutrymme och känner att de har kontroll över sitt arbete.

    Syfte

    Att beskriva manliga första-linjens chefers upplevelser av sin arbetssituation i äldreomsorgen.

    Metod

    Semi-strukturerade intervjuer gjordes med fjorton manliga första-linjens chefer i äldreomsorgen i Sverige från hösten 2010 till våren 2011. Intervjuguiden var inspirerad av teorier om empowerment. Tolv chefer arbetade inom kommunal äldreomsorg och två chefer inom privat äldreomsorg. Deltagarna valdes utifrån ett ändamålsenligt urval med förhoppningen om att ge en variation i sina skildringar. De hade arbetat som chefer mellan 0.5-35 år. Intervjuerna varade mellan 1-2.5 timmar och materialet analyserades med kvalitativ innehållsanalys. Två teman och fem subteman skapades.

    Resultat

    Det första temat handlade om när organisatoriska krav var i balans med chefernas upplevda chefsansvar och strukturella förutsättningar. Där beskrevs upplevelserna av att vara ensam men inte utelämnad, att ha frihet inom givna ramar samt en känsla av tillfredsställelse och stimulans i arbetet. Det andra temat handlade om när organisatoriska krav var i obalans med chefernas upplevda chefsansvar och strukturella förutsättningar. Detta tema beskrev chefernas känsla av frustration och en känsla av uppgivenhet. Sammantaget upplevde de manliga första-linjens cheferna att arbetssituationen var både utmanande, komplex och föränderlig. Cheferna behövde bättre tillgång till strukturella förutsättningar, speciellt i form av resurser, stöd och information. Utmaningarna sågs dock som en ständig drivkraft för cheferna. De beskrev att deras arbete var ”mödan värt” även om de ibland upplevde arbetssituationen som negativ. Slutsatsen i studien var att cheferna upplevde sitt arbete som en positiv utmaning även om de beskrev brister i sitt stöd.

  • 84.
    Hagerman, Heidi
    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.
    Häggström, Elisabeth
    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.
    Wadensten, Barbro
    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.
    Male first-line managers’ experiences of the work situation in elderly care: an empowerment perspective2015In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, no 6, p. 695-704Article in journal (Refereed)
    Abstract [en]

    Aim

    To describe male first-line managers' experiences of their work situation in elderly care.

    Background

    First-line managers' work is challenging. However, less attention has been paid to male managers' work situation in health care. Knowledge is needed to empower male managers.

    Method

    Fourteen male first-line managers were interviewed. The interview text was subjected to qualitative content analysis.

    Result

    Work situations were described as complex and challenging; challenges were the driving force. They talked about ‘Being on one's own but not feeling left alone’, ‘Having freedom within set boundaries’, ‘Feeling a sense of satisfaction and stimulation’, ‘Feeling a sense of frustration’ and ‘Having a feeling of dejection and resignation’.

    Conclusion

    Although the male managers report deficiencies in the support structure, they largely experience their work as a positive challenge.

    Implications for nursing management

    To meet increasing challenges, male first-line managers need better access to supportive structural conditions. Better access to resources is needed in particular, allowing managers to be more visible for staff and to work with development and quality issues instead of administrative tasks. Regarding organisational changes and the scrutiny of management and the media, they lack and thus need support and information from superiors.

  • 85.
    Hagerman, Heidi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Wadensten, Barbro
    Häggström, Elisabeth
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Male first-line managers experiences of the work situation in elderly care: An empowerment perspective2018Conference paper (Refereed)
  • 86.
    Hagerman, Heidi
    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.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    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.
    Wadensten, Barbro
    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.
    Empowerment and performance of managers and subordinates in elderly care: a longitudinal and multilevel study2017In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, no 8, p. 647-656Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate relationships between first-line managers' ratings of structural and psychological empowerment, and the subordinates' ratings of structural empowerment, as well as their ratings of the managers' leadership-management performance.

    BACKGROUND: Work situations in elderly care are complex. To date, few studies have used a longitudinal, correlational and multilevel design to study the working life of subordinates and managers.

    METHOD: In five Swedish municipalities, questionnaires were answered twice during 2010-12 by 56 first-line managers and 769 subordinates working in nursing homes or home-help services.

    RESULTS: First-line managers' empowerment at Time 1 partially predicted subordinate's structural empowerment and ratings of their managers' leadership-management performance at Time 2. Changes over time partially revealed that the more access managers had to structural empowerment, i.e. increase over time, the higher the ratings were for structural empowerment and managerial leadership-management performance among subordinates.

    CONCLUSIONS: Findings strengthen research and theoretical suggestions linking first-line managers' structural empowerment to their subordinates' structural empowerment and ratings of their manager's leadership-management performance.

    IMPLICATIONS FOR NURSING MANAGEMENT: Managers with high access to structural empowerment are more likely to provide subordinates access to structural empowerment.

  • 87.
    Hagerman, Heidi
    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.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Högberg, Hans
    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.
    A longitudinal study of working life among first-line managers in the care of older adults2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, p. 7-13Article in journal (Refereed)
    Abstract [en]

    Aim

    To study whether the number of subordinates plays a role in first-line managers’ and subordinates’ ratings of empowerment, stress symptoms, and leadership–management performance. The aim was also to study relationships between managers’ empowerment and stress symptoms and leadership–management performance.

    Methods

    A longitudinal and correlational design was used. All first-line managers (n = 98) and their subordinates (n = 2085) working in the care of older adults in five municipalities were approached.

    Results

    With fewer (≤ 30) subordinates per manager, there were higher ratings of structural empowerment among managers and subordinates and lower stress symptoms among subordinates, than with ≥ 31 subordinates. Furthermore, structural empowerment was related to the managers’ stress symptoms and leadership–management performance, mediated through psychological empowerment. Moreover, structural empowerment can control/adjust for large numbers of subordinates in relation to stress symptoms.

    Conclusion

    The higher FLMs rated their access to empowerment, the lower stress symptoms and higher leadership–management performance they rated over time.

  • 88.
    Haglöf Bolinder, Martina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Löfström Danielsson, Martina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjuksköterskors attityder och erfarenheter av att möta personer som har ett substansmissbruk: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden it´s estimated that 29,500 people have developed a problematic drug abuse. Drugs affect the parts of the brain that affect feelings of desire and pleasure. Drugs are addictive, harmful to health and affects the whole person. The society’s stigma against people who have substance abuse can lead to alienation, inferiority and reduced tendency to seek hospital treatment.

    Aim: The aim of this literature review were to describe nurses' attitudes and their experience of meeting people who have a substance use disorder and to describe the selected articles method of data collection.

    Method: A literature study with descriptive design. Eleven articles was included in the study, 4 questionnaire, 1 questionnaire with an open question and 6 interviews. The search of the articles were carried out in the databases Cinahl and Pubmed.

    Findings: Nurses have different attitudes about the cause of substance use, some considered it to be because of lack of responsibility and others because of life circumstances. Nurses described people who have a substance use disorder as manipulative, violent and demanding, which was based on previous experiences. Other nurses had a more holistic approach and saw the person behind the substance use. Honesty and straightforwardness were important factors in meeting people with substance use disorder. Education and previous experience were important to the nurse's attitudes and experience.

    Conclusion: Experience, humanity and education played a major part in the interaction between the nurse and the person who has a substance use disorder. Where there is lack of education and experience feelings of distrust and frustration lead to rejection. Positive attitudes were linked to the nurse's ability to have a holistic approach and openness toward people who have a substance use disorder.

  • 89.
    Halvorsen, Alexander
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Preoperativ oro hos barn: Anestesisjuksköterskors erfarenhet att bemöta och lindra oro hos barn : intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction To prepare a child for anesthesia put the nurses in a complex situation. The child is worried about the unknow that is going to happen and therefore the nurse needs to reduce the child’s level of anxiety and worry. The parents are supposed to comfort the child and together with the nurse they should help the child to manage the difficult situation. Aim: Describe the anesthesia nurses experience in addressing and reducing anxiety in children who are about to undergo anesthesia. Method:A qualitative interview study of 8 nurses with different age and work experience where included and interviewed. Result: Based on the experience of the nurses it showed that the most important thing where to create comfort, use distractions and the ability to use their previous professional experience. To be able to cooperate with the parents, create a relationship with the child as well as excellent preoperative preparation seemed to create comfort in both the child and the parents. The nurses used distracting strategies to transfer the negative anxiety to something more positive.  Since there are no written guidelines of how to comfort children about to undergo anesthesia the nurses had to use and incorporate their previous experience as an anesthesia nurse. The nurses mentioned that it is crucial to be able to sense and evaluate the situation and then act based on the conclusion. The most important thing was to adapt and conform to the need of the child and not rush the process. Conclusion: The study highlighted the experience of the nurse’s preoperative care. The result showed that the nurses experienced difficulty to care for worried children as well as the complex situation they were presented with. Sometimes worried parents made the situation more complex for the anesthesia nurse since they were not able to cooperate and work together. However, the corporation could be improved if the anesthesia nurse and the parent had the same goal and a joint way of handling the situation. The anesthesia nurse were required to have high professional competence, advanced humility as well the ability to make sure that the child  is comfortable and relaxed.

  • 90.
    Hamrebjörk, Frida
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Fagerberg, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Erfarenheter av att vara närstående till personer med Huntingtons sjukdom: en beskrivande litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Huntington’s disease (HD) is a genetic neurological disease. It affects the brains nerve cells. Symptoms include involuntary spasms, inability to swallow and difficulty putting together sentences. In the latter stages of the disease patients become completely dependent on help with everyday chores like getting out of bed, using the bathroom and showering. It’s very common for close family and relatives to become carers to the patients. Purpose: The aim of the study was to research the effects HD has on immediate family and carers of an HD patient, furthermore to describe the included scientific articles study group. Method: The study is a descriptive literature study based on 11 scientific articles. The databases used for research are: PubMed and Cinahl Results: Related parties that were partners to people with HD adapted themselves to the new conditions and considered, fairly quickly if they wanted to become a caregiver or if they wanted a divorce. Children of parents with HD had no choice and had to take a lot of adult responsibilities at home. With the progression of the disease, caring became heavier and relatives put their own lives "on hold". Concerns for the future were handled by denying or preparing. Understanding and the support was received from people in similar situations. Healthcare today know little about the disease and related parties' needs, which damaged confidence.

    Conclusion: Related parties and family caregivers experienced a big change in life when the disease got worse. They worried and were stressed about the future and their relationship to the patient changed with time. They often met ignorance about the disease. Adapted information and support along the way was something related parties desired, but rarely experienced. All time and emotions were spent, taking care of and worry about the sick. The fear of the children carrying the gene were constantly recurring.

  • 91.
    Hansen, Julia
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Löfqvist, Martina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Barn och ungdomars upplevelser av att vara inneliggande på sjukhus2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year approximately 10 000 children and adolescents are given care at the hospital. The majority of children under the age of 18 are treated at special pediatric units. The aim and the primary goal with child care in Sweden is to promote the development and well- being of all children by identifying problems in its health, development and social environment, and addressing these problems to prevent ill health. Aim: The aim of the present literature study was to describe how children and adolescents experiences hospitalization and also to describe the articles choice of research groups. Mehtod: A literature study with a descriptive design. The present study is based on ten scientific articles that describe children's experiences of being in the hospital. The article searches were made via Cinahl and Medline via PubMed, where only english language was used as a restriction. The authors have reviewed the articles multiple times as well as reviewed and compared the articles' research groups. Main result: Children were found to have different experiences of being in a hospital. The majority of the children experienced hospitalization more positive when there were good communication, a good environment where there was an opportunity for activities, good relationships with healthcare staff and also space for relatives to attend. To get a better understanding of their illness or hospital stay, the children expressed that they wanted to participate in the care and they did not like when the healthcare staff spoke over their heads. The presence of family and close relatives made the children feel more confident, also good relationships with healthcare professionals made the children feel less lonely.Conclusion: Children's experiences are affected by several factors. Previous research shows that parents feel fear and concern about having their children hospitalized. It is important for the nurse and other healthcare professionals to know this in order to meet both children and their close relatives in a way that supports the whole family's experiences.

  • 92.
    Hedberg, Viktoria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Linderstam, Catherine
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Beskriva och jämföra den psykosociala arbetsmiljön hos ambulanspersonal i en region i mellan Sverige: Utifrån Distriktssköterskans profession2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The psychosocial work environment is important for the individual. Creating workplaces with a satisfactory working environment is both difficult and challenging, but with knowledge and trained staff good working environments can be created and health promotion for the staff.

    Aim: To describe and compare how ambulance staff estimated their psychosocial work environment and whether there was a difference in estimation between men and women within an operation area in a healthcare region.

    Method: A descriptive and comparative study with quantitative approach.

    Main results: The result showed that factors such as work demands, control at work, role expectations, predictability, social interactions, leadership, communication, organization culture/climate, group work and skills at work, centrality of work, interactions between work and private life/stress were factors that included the affected psychosocial work environment. There were no significant differences between men and women in the described areas of work level, social and organizational level and individual level.   

    Conclusion: The district nurse´s preventive work can provide workplaces with health promotion knowledge regarding the psychosocial work environment. Attention and maintaining factors in the workplace that make it a good healthy workplace is important. The feeling of feeling a context is important for both individual and group.      

     

     

  • 93.
    Hedborg, Kerstin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Omvårdnad vid migrän2015In: Omvårdnad vid neurologiska sjukdomar / [ed] Kristina Gottberg, Lund: Studentlitteratur AB, 2015, 1, , p. 194p. 101-124Chapter in book (Other academic)
    Abstract [sv]

    Migrän är en vanlig neurologisk sjukdom och en viktig orsak till smärta hos befolkningen. Stress anges som den viktigaste utläsande orsaken till migränanfall. Omvårdnad av migrän innebär att se till hela livssituationen hos personen med migrän och kartlägga aspekter som stress och andra faktorer som påverkar sjukdomen.

  • 94.
    Hedman, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Autonomy and Participation in Care For Older People: Descriptions by Older People, Registered Nurses, Case Managers, First Line Managers and Local Authorities Senior Medicine Advisors2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Overall aim: To describe the essence of autonomy and participation for older people in care, and how to promote this in care for them.

    Method: A descriptive design with a phenomenological approach. Sixteen older people (I) and 13 registered nurses (II) participated in individual face-to-face interviews (I and II). Twelve case/care managers and supervisors participated in a focus group interview, they were grouped by profession, case managers, first line managers and local authority senior medicine advisors, four in each group and interviewed once (III and IV). The data analyses were guided by Giorgi’s descriptive phenomenological method (I and II) and the systematic text condensation by Malterud (III and IV).

    Findings: The informants were in agreement that maintaining older people’s health and wellbeing promote autonomy and participation, and supportive relationships are relevant (I–IV). Older people focused on everyday life experiences they made by choice and managing on their own, as strengthening self-esteem and self-identity (I). The registered nurses focused on caring for frail older people and their need for acknowledgement in everyday care. They noted that of providing choices as enable older people to have joyful everyday life experiences (II). The managers and supervisors focused on informed consent, and legislation, and offered solutions to securing a meaningful everyday life by caring for older people’s wishes and needs. They also spoke of the risk the severe consequences could result from older people’s decision-making and their health conditions (III). Relatives were respected as a resource and attended to in everyday care for older people but the focus was the older person in their present life situation and their individual rights (IV).

    Conclusion: Promoting to autonomy and participation for older people were maintained health and wellbeing, and the possibility to manage on their own terms. Informed consent, shared decision-making, supportive relationships and acknowledgement of relatives in the life-changing situations were ways to promote autonomy and participation. To promote autonomy and participation in care for older people is also to provide for choices that are meaningful to the older person at end of life in a joyful and permissive atmosphere.

  • 95.
    Hedman, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Autonomy and participation in municipal care: managers and supervisors' descriptionsManuscript (preprint) (Other academic)
  • 96.
    Hedman, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Including relatives to promote autonomy and participation for older people: municipal care managers descriptionsManuscript (preprint) (Other academic)
  • 97.
    Hedman, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Pöder, Ulrika
    Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Mamhidir, Anna-Greta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Häggström, Elisabet
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Inst. för folkhälso- och vårdvetenskap, Uppsala universitet.
    Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 824-833Article in journal (Refereed)
    Abstract [en]

    There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility – still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase ‘ability to act’ in different ways, based on older people's descriptions of the meaning of autonomy and participation.

  • 98.
    Hedström, Mariann
    et al.
    Uppsala University, Department of Public Health and Caring Sciences, Section of Caring Sciences.
    Carlsson, Marianne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Department of Public Health and Caring Sciences.
    Ekman, Anna
    Uppsala University Hospital, Department of medication and patient safety.
    Gillespie, Ulrika
    Uppsala University Hospital, Department of medication and patient safety.
    Mörk, Christina
    Uppsala County Council, Pharmaceutical Committee.
    Hulter Åsberg, Kerstin
    Uppsala University, Department of Neuroscience.
    Development of the PHASE-Proxy scale for rating drug-related signs and symptoms in severe cognitive impairment2018In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, no 1, p. 53-60Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The need for assessment of possible drug-related signs and symptoms in older people with severe cognitive impairment has increased. In 2009, the PHASE-20 rating scale for identifying symptoms possibly related to medication was the first such scale to be found valid and reliable for use with elderly people. In this project, the aim was to develop and examine the psychometric properties and clinical utility of PHASE-Proxy, a similar scale for proxy use in assessing elderly people with cognitive impairment.

    METHODS: Three expert groups revised PHASE-20 into a preliminary proxy version, which was then tested for inter-rater reliability, internal consistency, and content validity. Its clinical usefulness was investigated by pharmacist-led medication reviews. Group interviews and a study-specific questionnaire with nursing home staff were used to investigate the feasibility of use.

    RESULTS: The PHASE-Proxy scale had satisfactory levels of inter-rater reliability (Spearman's rank correlation coefficient; rs = 0.8), and acceptable internal consistency (Cronbach's alpha coefficient; α = 0.73). The factor analysis resulted in a logical solution with seven factors, grouped into two dimensions: signs of emotional distress and signs of physical discomfort. The medication reviews, interviews, and questionnaires also found the proxy scale to be clinically useful, and feasible to use.

    CONCLUSION: The PHASE-Proxy scale appears to be a valid instrument that enables proxies to reliably assess nursing home residents who cannot participate in the assessment, to identify possible drug-related signs and symptoms. It also appears to be clinically useful and feasible for use in this population.

  • 99.
    Henriksen, Evelina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Holm, Jonna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Likheter och skillnader i kvinnor och mäns symtombild vid hjärtinfarkt: En beskrivande litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cardiovascular disease is a common cause of death in the world and in Sweden. Myocardial infarction is caused by atherosclerosis, which in turn leads to hypoxia in the heart muscles. The symptoms are individual and symptoms such as chest pain, nausea and respiratory effects may occur. The existence of suffering from cardiovascular disease differ between men and women.

    Purpose: The purpose of this study was to describe and compare women's and men's symptoms of myocardial infarction and to review the study groups in the selected studies.

    Method: A descriptive literature. 13 quantitative articles were selected to the present literaturestudy.

    Main Results: Chest pain was the most common symptom in both men and women with myocardial infarction. Women described more frequent back pain, pain localized to the shoulder blades and neck pain. Men reported more pain in the right side of the chest and arm. Nausea, dyspnea and weakness proved to be more common in women, while men presented more sweating. Distinct differences were found in the number of reported symptoms associated with a myocardial infarction, women reported more symptoms than men.

    Conclusion: The litteraturstudy revealed both similarities and differences in men's and women's symptoms of myocardial infarction, symptoms were variable and individual. For the nurse to meet individual patient care needs requires knowledge of myocardial infarctions varying symptoms. This is important in order to act properly and in an early stage to prevent complications and permanent damage in patients who suffer from myocardial infarction. More research in this area would empower the nurse and contribute to better care for patients who suffer from myocardial infarction.

  • 100.
    Hiswåls, Anne-Sofie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of health sciences, Mid-Sweden University, Sweden.
    Walander, Anders
    Department of health sciences, Mid-Sweden University, Sweden; Department of public health, Karolinska institute, Stockholm, Sweden.
    Soares, Joaquim F J
    Department of health sciences, Mid-Sweden University, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of health sciences, Mid-Sweden University, Sweden; Department of public health, Karolinska institute, Stockholm, Sweden.
    Employment Status, Anxiety and Depression in a Municipal Context2017In: Research in Health Science, ISSN 2470-6213, Vol. 2, no 1, p. 12-23Article in journal (Refereed)
    Abstract [en]

    Objectives:This study aimed to investigate the prevalence of anxiety and depression by employment status among a sample of the working age population residing in Gävle Municipality in Sweden.

    Methods: A total of 241 persons completed a self-administered postal questionnaire in the baseline survey of the Gävle Household, Labour Market and Health Outcomes (GHOLDH) survey, which collected information on the employment status and psychological health (anxiety and depression) among persons aged 18-65 years. Descriptive and multivariate analyses were performed.

    Results: The prevalence and risk of anxiety and depression were high among people who were out of work. In the multiple regression analysis, compared to employed people, those who were not employed had a risk of anxiety of 7.76 (5.97-9.75) and 4.67 (3.60-5.74) for depression.

    Conclusion: The prevalence of anxiety and depression was higher among those who were out of labour marketas compared to those employed. Furthermore, people who were out of work had a higher risk of anxiety and depression. The odds were slightly higher for anxiety than for depression.

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