| 1. |
- Hellgren, Mikko, 1972-, et al.
(författare)
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Hypertension management in primary health care : a survey in eight regions of Sweden
- 2023
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 41:3, s. 343-350
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore hypertension management in primary healthcare (PHC).Design: Structured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021.Setting: Seventy-six PHCCs in eight regions of Sweden.Main outcome measures: Staffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up.Results: The management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in & GE;96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300-11300) patients.Conclusions: The management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension.
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| 2. |
- Höök+, Angelica, 1972, et al.
(författare)
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Content validity of the electronic faces thermometer scale for pain in children: is a picture worth more than a thousand words?
- 2024
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Ingår i: Frontiers in pain research (Lausanne, Switzerland). - : Frontiers Media S.A.. - 2673-561X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Early recognition of pain in children is crucial, and their self-report is the primary source of information. However, communication about pain in healthcare settings can be challenging. For non-verbal communication regarding different symptoms, children prefer digital tools. The electronic Faces Thermometer Scale (eFTS) utilizes a universal design with colors, face emojis, and numbers on an 11-point scale (0-10) for pain assessment. The aim of this study was to establish content validity of the eFTS for pain assessments in children.A mixed methods design was used. The study took place at a university hospital in eastern Sweden, involving 102 children aged 8-17 years who visited outpatient clinics. Participants were presented with 17 pictures representing varying pain levels and asked to assess hypothetical pain using the eFTS. A think-aloud approach was employed, prompting children to verbalize their thoughts about assessments and the eFTS. Quantitative data were analyzed using descriptive and comparative statistics, together with a qualitative approach for analysis of think-aloud conversations.A total of 1,734 assessments of hypothetical pain using the eFTS were conducted. The eFTS differentiated between no pain (level 0-1) and pain (level 2-10). However, no clear agreement was found in the differentiation between hypothetical pain intensity levels (level 2-10). The analysis revealed that children utilized the entire scale, ranging from no pain to high pain, incorporating numbers, colors, and face emojis in their assessments.The variability in assessments was influenced by prior experiences, which had an impact on the statistical outcome in our study. However, employing the think-aloud method enhances our understanding of how children utilize the scale and perceive its design, including the incorporation of emotion-laden anchors. Children express a preference for using the eFTS to assess their pain during hospital visits.
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| 3. |
- Nilsson, Stefan, 1972, et al.
(författare)
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School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety.
- 2009
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Ingår i: Paediatric anaesthesia. - : Wiley. - 1460-9592 .- 1155-5645. ; 19:12, s. 1184-90
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. BACKGROUND: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure) in children after minor surgery. METHODS: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. RESULTS: Data were recorded from 80 children aged 7-16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' CONCLUSIONS: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.
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| 4. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
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Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 40:18, s. 2152-2162
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Forskningsöversikt (refereegranskat)abstract
- © 2017 Informa UK Limited, trading as Taylor & Francis Group Background: Children with cerebral palsy (CP) face particular challenges, e.g. daily pain that threaten their participation in school activities. This study focuses on how teachers, personal assistants, and clinicians in two countries with different cultural prerequisites, Sweden and South Africa, manage the pain of children in school settings. Method: Participants’ statements collected in focus groups were analysed using a directed qualitative content analysis framed by a Frequency of attendance-Intensity of involvement model, which was modified into a Knowing-Doing model. Results: Findings indicated that pain management focused more on children’s attendance in the classroom than on their involvement, and a difference between countries in terms of action-versus-reaction approaches. Swedish participants reported action strategies to prevent pain whereas South African participants primarily discussed interventions when observing a child in pain. Conclusion: Differences might be due to school- and healthcare systems. To provide effective support when children with CP are in pain in school settings, an action-and-reaction approach would be optimal and the use of alternative and augmentative communication strategies would help to communicate children’s pain. As prevention of pain is desired, structured surveillance and treatment programs are recommended along with trustful collaboration with parents and access to “hands-on” pain management when needed.Implications for rehabilitation• When providing support, hands-on interventions should be supplemented by structured preventive programs and routines for parent collaboration (action-and-reaction approach).• When regulating support, Sweden and South Africa can learn from each other;○ In Sweden, the implementation of a prevention program has been successful.○ In South Africa, the possibilities giving support directly when pain in children is observed have been beneficial.
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| 7. |
- Benjaminsson, Merja Vantaa, et al.
(författare)
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Using Picture and Text Schedules to Inform Children: Effects on Distress and Pain during Needle-Related Procedures in Nitrous Oxide Sedation
- 2015
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Ingår i: Pain Research & Treatment. - : Hindawi Limited. - 2090-1542 .- 2090-1550. ; 2015:2015
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Tidskriftsartikel (refereegranskat)abstract
- During hospital visits, children often undergo examinations and treatments that may involve an experience of pain and distress that is also connected to the staff’s treatment. The United Nation’s Convention on the Rights of Persons with Disability advocates the use of Universal Design. One way of implementing this idea within paediatric nursing is to increase the use of pictorial supports, and the few studies that have been published show promising results. The aim of this study was to do a comparison between two groups of children in regard to the pre- and postconditions of implementing an intervention including staff instruction and the use of pictorial support. The support consisted of a visual schedule with pictures and text, used both preparatory to and during the hospital visit. One hundred children aged 5–15 (50 children during the preinterventional data collection and 50 children postinterventionally) reported pain intensity and distress during needle-related procedures in nitrous oxide sedation. The results showed that the intervention had a positive effect in significantly lowering the level of preprocedural distress. The results showed that the pain intensity was also lowered however not reaching statistical significance. This confirms other positive research results on the use of visual supports within paediatric care, a topic that has to be further studied.
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| 8. |
- Bergström, Gunnar, et al.
(författare)
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Direct burial of district heating pipe bends – A limited casing pipe temperature ap-proach
- 2003
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Ingår i: Euroheat & Power - English Edition.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The direct burial of district heating pipe bends, i.e., without the use of expansionabsorbing elements, has reportedly frequently been done withoutany observed pipe-line damage. This in spite of current design principles,predicting so large stresses on a directly buried L bend that the techniqueshould be avoided. A reason for the lack of correspondence between practicalexperience and design theory is the difficulties in formulating relevantcriteria for tolerable stresses and deformations in the pipe. Conservative designlimits are traditionally used, particularly regarding allowable stresses inthe PUR foam.An alternative method for design with respect to the PUR foam may bedeveloped based on the idea that the deformation of the PUR foam, and thusalso the displacement of the steel pipe relative to the casing pipe, must belimited only to avoid overheating of the polyethylene. The factors influencingthe deformation of the PUR foam is mainly a question of the temperatureinduced steel pipe displacement versus the stiffness and strength of thebackfill material. When the loading properties of the PUR foam and thebackfill material are known, the relationship between the steel pipe displacementand the PUR foam deformation is defined. Thus also a relation betweena specified thermal motion of the steel pipe and the resulting maximumtemperature on the casing pipe is established. This makes it possible touse the maximum casing pipe temperature as a design value.The conclusion using this approach is that the laying of bends directly inthe ground should be possible with normal backfill materials and compactionconditions. Certain care must be taken, though, when bends are laid invery stiff and strong backfill, where high reaction pressures may develop. Ingeneral, the risk for pipeline damage is minimised if directly buried bendsare laid in only moderately compacted backfill.
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| 9. |
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| 10. |
- Bergström, Gunnar, et al.
(författare)
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Durability testing for 100 year lifetime for buried non-pressure plastic pipes
- 2006
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Ingår i: Plastics Pipes XIII.
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Konferensbidrag (refereegranskat)abstract
- For plastics pipes used for underground drainage and sewerage there is at present no internationally accepted method for the evaluation of durability. This makes it difficult to make an objective assessment for both new materials and new pipe designs entering the market. This paper presents a possible future structure of such a durability evaluation for nonpressure pipes. Based on an experimental study of pipes made from a filled and an unfilled PP material and one made from an HDPE material different damage mechanisms and changes in pipe characteristics were observed when the pipes were exposed to long-term deflection and long term (one-year) ageing at +95 °C. A CAED methodology is also described which was used to investigate the distribution and time dependence of pipe stresses.
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