| 61. |
- Arvidsson, Barbro, et al.
(författare)
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Nurses' various ways of conceiving their learning process as doctoral students: A phenomenographic study
- 2013
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Ingår i: Nurse Education in Practice. - Kidlington : Elsevier BV. - 1471-5953 .- 1873-5223. ; 13:1, s. 53-57
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to describe variations in how doctoral students conceive their learning process to become researchers in the light of their professional background as nurses. Background: Nursing research is an emerging discipline and the number of nurses who acquire a doctor's degree is increasing. Method: The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Results: Three different description categories emerged: (1) A learning process that provides a synthesis of different parts of the research process aimed at developing preparedness for action within the nursing profession. (2) A learning process where practical problems are integrated with and problematised in relation to scientific theories. (3) A learning process involving the transformation from nurse to researcher. Conclusions: The description categories revealed that the focus was on solving problems that occur in health care and synthesising them by means of research tools. Furthermore, the doctoral students explored different ways of understanding and developing their awareness of the nature of research. Focus was also on the nursing profession and practice and a shift towards the role of a researcher was evident. © 2012 Elsevier Ltd.
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| 62. |
- Arvidsson, Barbro, et al.
(författare)
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Process-oriented group supervision implemented during nursing education : nurses’ conceptions 1 year after their nursing degree
- 2008
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Ingår i: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 16:7, s. 868-875
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS: for Nursing Management Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.
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| 63. |
- Arvidsson, Barbro, et al.
(författare)
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The development of a questionnaire for evaluating process-oriented group supervision during nursing education
- 2008
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Ingår i: Nurse Education in Practice. - Amsterdam : Elsevier. - 1471-5953 .- 1873-5223. ; 8:2, s. 88-93
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Tidskriftsartikel (refereegranskat)abstract
- The benefits of process-oriented group supervision are difficult to evaluate, as the validity and reliability of the existing instruments have been questioned. The aim was to develop and test the psychometric properties of a questionnaire in order to evaluate the effects of process-oriented group supervision on nursing students during their three-year nursing education. A 55-item Process-oriented Group Supervision Questionnaire (PGSQ) with a developmental design was formulated on the basis of a literature review and the expectations of nursing students who participated in a three-year nursing education programme (N = 176). Construct validity and internal consistency reliability were tested at the end of each study year: year 1 (T1), year 2 (T2), and year 3 (T3) by means of exploratory factor analysis and Cronbach’s coefficient. An adequate explorative factor analysis (principal component analysis, varimax rotation) with an Eigenvalue >1.0 and factor loadings >0.40, reduced the questionnaire to 18 items comprising three factors labelled educative, supportive and developmental, which explained 60.2% at T1, 71.8% at T2, and 69.3% at T3 of the total cumulative variance. The corresponding Cronbach’s coefficient figures were 0.89 (T1), 0.94 (T2) and 0.93 (T3). The 18-item PGSQ is considered to be a short and useful tool due to its satisfactory validity and reliability figures.
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| 64. |
- Arvidsson, Susann, 1965-, et al.
(författare)
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Adult survivors’ perceptions of their childhood and the influences of being treated for acute lymphoblastic leukaemia with allogeneic hematopoietic stem cell transplantation as a child : A phenomenographic study
- 2024
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Ingår i: European Journal of Oncology Nursing. - Oxford : Elsevier. - 1462-3889 .- 1532-2122. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adults who had acute lymphoblastic leukaemia (ALL) as children and were treated with allogeneic hematopoietic stem cell transplantation (aHSCT) may have been affected in their lives due to several long-term complications. From a clinical point of view, it is of interest to study how survivors describe their perceptions of their childhood today. The aim was therefore to describe how adults perceived their childhood and the influences of being treated for ALL with aHSCT as a child.Method: Semi-structured telephone interviews were undertaken with 18 adults who had been treated for childhood ALL with aHSCT and were included in a national cohort of childhood ALL survivors, diagnosed between 1985 and 2007 at an age between 0 and 17 years. A phenomenographic analysis was used.Results: Three categories emerged: Feeling different, Feeling security and Feeling guilty. The informants felt that they had been different from other children but had felt security with the healthcare professionals and in care. They felt guilty because both their siblings’ and parents’ lives had been affected, but at the same time many perceived that they and their family members had become closer to one another.Conclusions: The results emphasised that adults who had been treated for childhood ALL with aHSCT were affected both in negative and positive ways during their childhood. This indicates the importance for early psychosocial care interventions directed to children during their treatment, but also the need for person-centred psychological care in long-term outpatient clinics. © 2024 The Authors. Published by Elsevier Ltd.
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| 65. |
- Arvidsson, Susann, 1965-, et al.
(författare)
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Callers' perceptions of their contact with a rheumatology telephone helpline
- 2019
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Ingår i: Musculoskeletal Care. - Oxford : Wiley. - 1478-2189 .- 1557-0681. ; 17:1, s. 105-112
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Tidskriftsartikel (refereegranskat)abstract
- Background Telephone helplines are useful for improving patients' access to healthcare services and reducing the need for frequent face-to-face contact with healthcare professionals. Little is known about how people who phone a helpline perceive the encounter. Objectives The aims of the present study were to describe the variation in how callers perceive their encounter with a rheumatology telephone helpline. Methods The study had a descriptive, qualitative design and used a phenomenographic approach, comprising 27 semi-structured telephone interviews with callers to Rheuma Direct, a rheumatology telephone helpline with specially trained nurses. The callers comprised 22 women and five men, aged 22-89 years (mean 54 years). Results The callers phoned Rheuma Direct when they had problems obtaining answers to questions on the internet or from healthcare professionals. Three descriptive categories emerged: constructive dialogue, specialized competence and applicability. The callers perceived that it was a constructive dialogue when they were able to discuss their concerns with someone, received emotional support, felt reassured and were satisfied with the information provided. They perceived specialized competence when the nurses were experienced and skilful, the advice provided complemented previously received information and when they had more knowledge after the call. The callers perceived that Rheuma Direct had applicability because it was easy to access and they could make different choices before, during and after the telephone call. Conclusions Callers to a rheumatology telephone helpline perceived it as a valuable complement to other sources of information, and felt that it could provide them with the tools to manage their disease better, as well as future contacts with healthcare professionals.
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| 66. |
- Ashfaq, Awais, 1990-, et al.
(författare)
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DEED : DEep Evidential Doctor
- 2023
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Ingår i: Artificial Intelligence. - Amsterdam : Elsevier. - 0004-3702 .- 1872-7921. ; 325
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Tidskriftsartikel (refereegranskat)abstract
- As Deep Neural Networks (DNN) make their way into safety-critical decision processes, it becomes imperative to have robust and reliable uncertainty estimates for their predictions for both in-distribution and out-of-distribution (OOD) examples. This is particularly important in real-life high-risk settings such as healthcare, where OOD examples (e.g., patients with previously unseen or rare labels, i.e., diagnoses) are frequent, and an incorrect clinical decision might put human life in danger, in addition to having severe ethical and financial costs. While evidential uncertainty estimates for deep learning have been studied for multi-class problems, research in multi-label settings remains untapped. In this paper, we propose a DEep Evidential Doctor (DEED), which is a novel deterministic approach to estimate multi-label targets along with uncertainty. We achieve this by placing evidential priors over the original likelihood functions and directly estimating the parameters of the evidential distribution using a novel loss function. Additionally, we build a redundancy layer (particularly for high uncertainty and OOD examples) to minimize the risk associated with erroneous decisions based on dubious predictions. We achieve this by learning the mapping between the evidential space and a continuous semantic label embedding space via a recurrent decoder. Thereby inferring, even in the case of OOD examples, reasonably close predictions to avoid catastrophic consequences. We demonstrate the effectiveness of DEED on a digit classification task based on a modified multi-label MNIST dataset, and further evaluate it on a diagnosis prediction task from a real-life electronic health record dataset. We highlight that in terms of prediction scores, our approach is on par with the existing state-of-the-art having a clear advantage of generating reliable, memory and time-efficient uncertainty estimates with minimal changes to any multi-label DNN classifier. © 2023 The Author(s)
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| 67. |
- Ashfaq, Awais, 1990-, et al.
(författare)
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Readmission prediction using deep learning on electronic health records
- 2019
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Ingår i: Journal of Biomedical Informatics. - Maryland Heights, MO : Elsevier BV. - 1532-0464 .- 1532-0480. ; 97
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Tidskriftsartikel (refereegranskat)abstract
- Unscheduled 30-day readmissions are a hallmark of Congestive Heart Failure (CHF) patients that pose significant health risks and escalate care cost. In order to reduce readmissions and curb the cost of care, it is important to initiate targeted intervention programs for patients at risk of readmission. This requires identifying high-risk patients at the time of discharge from hospital. Here, using real data from over 7500 CHF patients hospitalized between 2012 and 2016 in Sweden, we built and tested a deep learning framework to predict 30-day unscheduled readmission. We present a cost-sensitive formulation of Long Short-Term Memory (LSTM) neural network using expert features and contextual embedding of clinical concepts. This study targets key elements of an Electronic Health Record (EHR) driven prediction model in a single framework: using both expert and machine derived features, incorporating sequential patterns and addressing the class imbalance problem. We evaluate the contribution of each element towards prediction performance (ROC-AUC, F1-measure) and cost-savings. We show that the model with all key elements achieves higher discrimination ability (AUC: 0.77; F1: 0.51; Cost: 22% of maximum possible savings) outperforming the reduced models in at least two evaluation metrics. Additionally, we present a simple financial analysis to estimate annual savings if targeted interventions are offered to high risk patients. © 2019 The Authors
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| 68. |
- Axelsson, Åsa B., et al.
(författare)
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Good and bad experiences of family presence during acute care and resuscitation. What makes the difference?
- 2005
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 4:2, s. 161-169
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Tidskriftsartikel (refereegranskat)abstract
- Background: Family presence (FP) in the resuscitation room is still controversial, and its appropriateness for patient and family has been discussed. We examined both positive and negative experiences in order to establish the reasons for the difference.Aim: The aim of the present literature review was to describe patients', relatives' and staff's opinions and experiences of FP during invasive procedures and resuscitation.Method: 12 original papers, published between January 1995 and February 2003, were reviewed. Most patients and relatives agreed that they had positive experiences of FP. They described how FP enhanced the feeling of support and connectedness within the family. Family members believed that FP helped them in their grieving process. Most staff members without FP experience felt that FP would increase the risk of psychological distress for the family. Those who had participated in an FP programme believed that FP was not only beneficial for the family but also for staff.Conclusion: Family presence during resuscitation and acute care has the potential to enhance the care of the patient and to benefit everyone involved. However, implementation of FP during resuscitation must take account of potential problems.
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| 69. |
- Axelsson, Åsa B., 1955, et al.
(författare)
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How bystanders perceive their cardiopulmonary resuscitation intervention : a qualitative study
- 2000
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Ingår i: Resuscitation. - Amsterdam : Elsevier. - 0300-9572 .- 1873-1570. ; 47:1, s. 71-81
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Tidskriftsartikel (refereegranskat)abstract
- The importance of bystander cardiopulmonary resuscitation (CPR) prior to arrival of the emergency medical service is well documented. In Sweden, CPR is initiated prior to emergency medical services (EMS) arrival in about 30% of cardiac arrests out-of-hospital, a figure which should be improved urgently. To do so, it is of interest to know more about the bystanders' perceptions of their intervention. A qualitative method inspired by the phenomenographic approach was applied to 19 bystanders who had performed CPR. In the analysis, five main categories and 14 subcategories emerged. The main categories were: to have a sense of humanity, to have competence, to feel an obligation, to have courage and to feel exposed. Interviews described how humanity and concern for another human being were the foundation of their intervention. CPR training offers the possibility to give appropriate help in this emergency. If the aim of CPR training was extended beyond teaching the skill of CPR to include preparation of the rescuer for the intervention and his/her reactions, this might increase the number of people able to take action in the cardiac arrest situation.
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| 70. |
- Backman, Ellen, MSc, 1981-, et al.
(författare)
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Gastrostomy tube insertion in children with developmental or acquired disorders : a register-based study
- 2020
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Ingår i: Developmental Medicine & Child Neurology. - Chichester : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 62:10, s. 1191-1197
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe trends in gastrostomy tube insertion in children with developmental or acquired disorders in Sweden and assess their demographic characteristics. Method: Children aged 0 to 18 years with gastrostomy tube insertions recorded between 1998 and 2014 were identified in the Swedish National Patient Register. Associations between disorder type and year of surgery, as well as age at surgery, were analysed using linear regression analyses. The association between disorder type and mortality 2 years from gastrostomy tube insertion was also analysed using logistic regression analysis. Results: The data for 4112 children (2182 males, 1930 females), with a median age of 2 years (interquartile range=1–8y), were analysed. Children who presented with developmental disorders were the largest group (n=3501, 85%). The most common diagnosis in children with developmental disorders was cerebral palsy (n=165, 4%). In children with acquired disorders, acute lymphoblastic leukaemia (n=117, 3%) was the most common diagnosis. Gastrostomy tube insertions increased from 1998 to 2014, with the greatest increase in children with developmental disorders, who were younger than children with acquired disorders when the gastrostomy tube was first inserted. Age at tube insertion decreased in both groups during the study period. Mortality was higher in children with acquired disorders, suggesting that gastrostomy tube insertion should be part of a palliative care approach. Interpretation: Child characteristics differed depending on whether the underlying disorder was developmental or acquired, suggesting a need for clinical health care guidelines related to the specific goals of gastrostomy tube insertion. What this paper adds: Gastrostomy tube insertions increased by 140% from 1998 to 2014 in Sweden. The age of children with developmental disorders decreased by 1 month per year during the study period. Children presenting with developmental disorders were younger than children with acquired disorders when the gastrostomy tube was first inserted. Mortality was higher in children with acquired disorders. © 2020 The Authors. DevelopmentalMedicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press
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