| 1. |
- Swenne, C.L., et al.
(författare)
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Patients' experiences of mediastinitis after coronary artery bypass graft procedure
- 2007
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Ingår i: Scandinavian Cardiovascular Journal. - 1401-7431 .- 1651-2006. - 1401-7431 ; 41:4, s. 255-264
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have focussed on patients' experiences of and suffering due to mediastinitis following Coronary Artery by-pass Graft ( CABG). Mediastinitis creates a complex and invasive experience for the patient with prolonged hospitalisation, and would be expected to be a significant stressor. The aim of the present study was to capture patients' experiences of the medical and nursing care they received for mediastinitis following CABG. Content analysis revealed three themes with regard to how the patients coped with the stress and threats of mediastinitis and its treatment and how they thought it would influence their future life. A first theme centred on physical and psychological discomfort and impact on autonomy. The staff's medical knowledge and the quality of nursing care as well as the patients' understanding of the situation influenced their experience. A second theme was how patients dealt with perceived danger and stress. Coping strategies such as problem solving, information seeking, dissociation, distraction, minimisation and expression of emotion were used to handle the situations. The third theme comprised the patients' belief that the mediastinitis would not affect the outcome of the CABG procedure, even though their confidence in this was influenced by uncertainty about the rehabilitation process.
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| 2. |
- Mårtensson, Gunilla, et al.
(författare)
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Do nurses and cancer patients agree on cancer patients' coping resources, emotional distress and quality of life?
- 2008
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 17:4, s. 350-360
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Tidskriftsartikel (refereegranskat)abstract
- The present study examines differences, associations and agreement in cancer patients' and their nurses' ratings of cancer patients' coping resources, emotional distress and quality of life. The study sample includes 90 individual patient-nurse pairs. The patient and nurse in each pair independently completed the Cancer Behaviour Inventory, the Hospital Anxiety and Depression Scale and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being. The results indicate a distinct pattern in which nurses overestimate patients' emotional distress and underestimate patients' coping resources and quality of life. A nurse who overestimated a patient's emotional distress and underestimated his/her resources for handling the situation was also likely to underestimate the patient's quality of life. Patient-nurse pairs who demonstrated consistent agreement differed from remaining pairs in that they had a larger percentage of nurses with advanced education and previous responsibility for their patients' care and in that they had higher frequencies of patients who had previously received care at the ward > , 5 days. Nurses caring for patients with cancer should be aware of the risk of making systematic misjudgements of patients' status. Increased attention to patients' internal resources may improve nurses' ability to make correct assessments and plan for individualized care.
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| 3. |
- Sjöström, Lars, et al.
(författare)
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Effects of bariatric surgery on mortality in Swedish obese subjects.
- 2007
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Ingår i: The New England journal of medicine. - 1533-4406. ; 357:8, s. 741-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality. In fact, many observational studies suggest that weight reduction is associated with increased mortality. METHODS: The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group). We report on overall mortality during an average of 10.9 years of follow-up. At the time of the analysis (November 1, 2005), vital status was known for all but three subjects (follow-up rate, 99.9%). RESULTS: The average weight change in control subjects was less than +/-2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. There were 129 deaths in the control group and 101 deaths in the surgery group. The unadjusted overall hazard ratio was 0.76 in the surgery group (P=0.04), as compared with the control group, and the hazard ratio adjusted for sex, age, and risk factors was 0.71 (P=0.01). The most common causes of death were myocardial infarction (control group, 25 subjects; surgery group, 13 subjects) and cancer (control group, 47; surgery group, 29). CONCLUSIONS: Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.
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| 4. |
- Arman, Maria, et al.
(författare)
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Indications of change in life perspective among women with breast cancer admitted to complementary care
- 2001
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Ingår i: European Journal of Cancer Care. - OXFORD : BLACKWELL SCIENCE LTD. - 0961-5423 .- 1365-2354. ; 10:3, s. 192-200
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Tidskriftsartikel (refereegranskat)abstract
- In this study, qualitative content analysis was used in order to understand the reported changes of life perspective in interviews with 59 women with breast cancer who were admitted to complementary care. The aim of this research was to study women's perceived consequences as well as perceived causes of breast cancer and to explore aspects of importance to the women. The material was collected in semistructured interviews from women with breast cancer at different stages of the disease. The women received complementary care at an anthroposophic clinic in Sweden. Findings showed that these women's view of their relationships with others grew more valuable. Their self-confidence and experience of strength improved, and they regarded life as being more enriched. A change in their disposition towards becoming more fragile and low-spirited was experienced as a hardship by the women. Am interesting finding was that the patients described the aetiology of the disease from several interacting perspectives, which also affected their ideas of how to achieve wellbeing and health. The findings support the view that changes of both benefit and harm are present in the experience of breast cancer.
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| 5. |
- Arman, M., et al.
(författare)
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Women's Perceptions and Beliefs About the Genesis of Their Breast Cancer
- 2006
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Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 29:2, s. 142-148
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Tidskriftsartikel (refereegranskat)abstract
- A person's belief is seen as a set of assumptions, depending on perceptions, and formed with the influence of experiences and social culture. With the aim of understanding the beliefs about the genesis of their illness, 118 (59 + 59) women with different stages of breast cancer were interviewed. Half of the sample had chosen complementary care in an anthroposophical hospital, and the other half was a matched group. Qualitative content analysis was used. Three themes emerged: (1) belief in a link to life lived (71%), (2) heredity as the sole genesis (4%), and (3) rejection of the question (25%). Under beliefs in a link to life lived, external aspects to the patient's own life (eg, diet and lifestyle) were cited, as well as inner aspects such as psychosocial problems and stress. The findings show that women are well informed about medical facts, although their beliefs reveal a holistic approach. The women's beliefs, where inner psychosocial factors are uppermost, point to a reverse of the causal ranking of medical advisors. The difference between the groups was that the matching sample was more likely to reject the influence of possible causes from life lived. In a caring perspective, women's perceptions of the genesis of their illness are in some cases turned to creative health activities that may increase well-being.
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| 6. |
- Asplund Carlsson, Maj, 1948-, et al.
(författare)
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Bedömnings-, dokumentationspraktiker och pedagogiska identiteter
- 2015
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Ingår i: Educare. - 1653-1868 .- 2004-5190. ; 2015:2, s. 206-233
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Tidskriftsartikel (refereegranskat)abstract
- When competition and an increasing level of marketisation characterises school life, the number of evaluations and the level of control has grown out of proportion. Through comparisons, assessments and ranking systems, also called ‘the terrors of performativity’ according to Ball (2003) commercial agents have gained influence over practices of assessment and documentation within the education system. Increased demands on pupils’ and parents’ participation and a belief that written documentation will lead to better results has caused an extensive use of different web based tools like Unikum. With the point of departure in a collected material of more than a hundred Individual Educations Plans (IEP) where commercial web based tools have been used, we make an analysis with Basil Bernstein’s (1996, 2000) concepts Pedagogic Identity, and Instructional and Regulative discourse in relation to expectations and constructions manifest in the plans. The results show that all four identities are expressed in the plans however, with an emphasis on a neo-liberal identity. We discuss the results in relation to the instructional and regulative discourses. The conclusion is that the tools both shape and determine possible identities and possible discourses in the web based interaction between children, parents and teachers.
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| 7. |
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| 8. |
- Axén, Elin, et al.
(författare)
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Degree of Preservation of Neurovascular Bundles in Radical Prostatectomy and Recurrence of Prostate Cancer
- 2021
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Ingår i: European Urology Open Science. - : Elsevier BV. - 2666-1691 .- 2666-1683. ; 30, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reports on possible benefits for continence with nerve-sparing (NS) radical prostatectomy have expanded the indications beyond preservation of erectile function. It is unclear whether NS surgery affects oncological outcomes. Objective: To determine whether the degree of NS during radical prostatectomy influences oncological outcomes. Design, setting, and participants: Of 4003 patients enrolled in a prospective, controlled trial comparing open and robotic radical prostatectomy during 2008–2011, we evaluated 2401 patients who received robotic radical prostatectomy at seven Swedish centres. Patients were followed for 8 yr. Outcome measurements and statistical analysis: Data for recurrence and positive surgical margin status were assessed using validated patient questionnaires, patient interviews, and clinical record forms before and at 3, 12, and 24 mo and 6 and 8 yr after surgery. Cox and logistic regressions were used to model the effect on recurrence and positive surgical margins (PSM), respectively. Results and limitations: A total of 481 men had PSM and 467 experienced recurrence during follow-up. Median follow-up for men without recurrence was 6.6 yr. There were no statistically significant differences in recurrence rate between degrees of NS. The PSM rate was significantly higher with a higher degree of NS: interfascial NS, odds ratio (OR) 2.32 (95% confidence interval [CI] 1.69–3.16); intrafascial NS, OR 3.23 (95% CI 2.17–4.80). Recurrence rates were higher for patients with pT2 disease and PSM (hazard ratio [HR] 3.32, 95% CI 2.43–4.53) than for patients with pT3 disease without PSM (HR 2.08, 95% CI 1.66–2.62). The lack of central review of pathological specimens is a limitation. Conclusions: A higher degree of NS significantly increased the risk of PSM but did not significantly increase the risk of cancer recurrence. Combined with the known functional benefits of NS surgery, these results underscore the need to identify an individualised balance. Patient summary: In this report we looked at the effect of a nerve-sparing approach during removal of the prostate on cancer outcomes for patients having robot-assisted surgery at seven Swedish hospitals. We found that a high degree of nerve-sparing increased the rate of cancer positivity at the margins of surgical specimens and that positive surgical margins increased the risk of recurrence of prostate cancer. © 2021 The Authors
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| 9. |
- Bergström, Per, 1980, et al.
(författare)
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Testing the potential for improving quality of sediments impacted by mussel farms using bioturbating polychaete worms
- 2017
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Ingår i: Aquaculture Research. - : Hindawi Limited. - 1365-2109 .- 1355-557X. ; 48:1, s. 161-176
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Tidskriftsartikel (refereegranskat)abstract
- Biodeposits from farmed mussels severely influence the biogeochemistry of sediments by increasing the levels of organic matter (OM). Mitigation of such negative impacts is important for the development of sustainable aquaculture operations. As a step towards developing methods for remediation of coastal sediments affected by mussel farming, the effects of the polychaete, Hediste diversicolor was evaluated experimentally. In a series of field- and laboratory experiments we tested hypotheses about the effects of polychaetes on sediment oxygen consumption, nutrient fluxes and sulphide pools under different polychaete densities and sedimentation regimes. The experimental results support the idea that polychaetes can mitigate negative effects on the benthic environment beneath mussel farms. H. diversicolor oxidized the sediment and generally enhanced the oxygen consumption, and thus the decomposition of OM. The accumulation of pore water sulphides were reduced and fluxes of nutrients across the sediment-water interface increased. Additional calculations suggest that the effects of polychaetes were mainly indirect and driven by increased microbial activity due to the borrowing activity of the polychaetes. Trends of increasing decomposition with increasing polychaete density suggest that the decomposition could be further enhanced by higher densities. Overall, we concluded that H. diversicolor is a potentially strong candidate for remediation of mussel farm sediments. The results show that sediments inhabited by H. diversicolor have high assimilative capacity of OM and oxygen conditions are significantly improved following the addition of polychaetes at naturally occurring densities. However, technological developments are needed in order to allow the approach to be used in practice.
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| 10. |
- Bill-Axelson, Anna, et al.
(författare)
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Experiences of randomization : Interviews with patients and clinicians in the SPCG-IV trial
- 2008
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 42:4, s. 358-363
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Recruitment of both patients and clinicians to randomized trials is difficult. Low participation carries the risk of terminating studies early and making them invalid owing to insufficient statistical power. This study investigated patients' and clinicians' experiences of randomization with the aim of facilitating trial participation in the future. Material and methods. This was a qualitative study using content analysis. Patients offered to participate in a randomized trial and randomizing clinicians were interviewed. Five participants, four non-participants and five randomizing clinicians were interviewed, 2-8 years from randomization. Results. Clinicians used strategies in interaction with the patients to facilitate decision making. Patients' attitudes differed and experiences of relatives or friends were often stated as reasons for treatment preferences. Patients described that letting chance decide treatment was a difficult barrier to overcome for randomization. The clinicians used a number of different strategies perceived to make randomization more acceptable to their patients. The clinicians' own motivation for randomizing patients for trials depended on the medical relevance of the study question and the clinicians' major obstacle was to maintain equipoise over time. Regular meetings with the study group helped to maintain equipoise and motivation. Conclusions. To establish a good platform for randomization the clinician needs to know about the patient's treatment preferences and the patient's attitude concerning the role of the clinician to facilitate decision making. The strategies used by the clinicians were perceived as helpful and could be tested in an intervention study.
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