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- Stålnacke, Britt-Marie, 1955-, et al.
(författare)
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Long-Term Follow-Up of Disability, Cognitive, and Emotional Impairments after Severe Traumatic Brain Injury
- 2019
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Ingår i: Behavioural Neurology. - : Hindawi Publishing Corporation. - 0953-4180 .- 1875-8584. ; 2019
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3 months to up to 7 years post trauma. Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the Hospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) at 3 months, 1 year, and 7 years after the injury. Results. The scores on both GOSE and BNIS improved significantly from 3 months (GOSE mean: 4.4 +/- 2.3, BNIS mean: 31.5 +/- 7.0) to 1 year (GOSE mean: 5.5 +/- 2.7, p=0.003, BNIS mean: 33.2 +/- 6.3, p=0.04), but no significant improvement was found from 1 year to 7 years (GOSE mean: 4.7 +/- 2.8, p=0.13, BNIS mean: 33.5 +/- 3.9, p=0.424) after the injury. The BNIS subscale "speech/language" at 1 year was significantly associated with favourable outcomes on the GOSE at 7 years (OR=2.115, CI: 1.004-4.456, p=0.049). Conclusions. These findings indicate that disability and cognition seem to improve over time after s-TBI and appear to be relatively stable from 1 year to 7 years. Since cognitive function on some of the BNIS subscales was associated with outcome on the GOSE, these results indicate that both screening and follow-up of cognitive function could be of importance for the rehabilitation of persons with s-TBI.
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- Sundin, Karin, et al.
(författare)
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Responses after participating in Family Health Conversations in families with a family member who has suffered a stroke : A mixed methods research study
- 2016
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 4:4, s. 46-57
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Tidskriftsartikel (refereegranskat)abstract
- Background: It has been proposed that support for families in which a family member has suffered a stroke should involve the whole family system. Aim: The aim was to evaluate the responses of Family Health Conversation (FamHC) in families with a member under the age of 65 who has been diagnosed with stroke. Methods: In this mixed methods research study, families were included in an intervention group and in a control group. For both groups pre- and post-intervention quantitative data was collected and for the intervention group, qualitative data was collected post-intervention. Underlying theoretical propositions and the two data sets were then integrated. Results: Family health measured as “the general atmosphere of the interaction of the family” had improved in the intervention group when compared to the control group. The intervention families, moreover, described how they had become more cooperative, their communication had improved, they had become more confident with their situation and also when planning for the future when comparing to before the FamHC. Conclusions: Based on the empirical results supporting the theoretical proposition underlying FamHC, we conclude that it works as intended, and the evidence for the theoretical proposition is thereby strengthened. This paper contributes to the scientific evidence concerning FamHC. With the available evidence, RNs are suggested to consider changing practice so as to work in a more family-centred way to support families living with ill-health. Implementing FamHC can be one way of undertaking such supportive work.
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- Sundin, Karin, et al.
(författare)
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What Couples Choose to Focus on During Nurse-led Family Health Conversations When Suffering Stroke
- 2015
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Ingår i: International journal for human caring. - : Springer Publishing Company. - 1091-5710 .- 2578-2304.
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate which topics 2 couples, ages younger than 65 years old, where 1 partner has suffered a stroke, choose to focus on when participating in nurse-led family health conversations. Six conversations were audiotaped, transcribed, and analyzed by qualitative content analysis. Three categories emerged illustrating that the couples choose to talk about how they were affected on a personal and family level and, moreover, the importance of support within and outside the family. The altered way of living involved distressed feelings, gratitude, and hopes. This study highlights the importance of nurses viewing the family as a unit.
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- Östlund, Ulrika, et al.
(författare)
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A Family Systems Nursing Approach for Families Following a Stroke : Family Health Conversations
- 2016
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Ingår i: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 22:2, s. 148-171
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Tidskriftsartikel (refereegranskat)abstract
- Stroke in midlife is a life altering, challenging experience for the whole family thereby necessitating a family approach to intervention. The aim of this study was to describe the experiences of 17 family members living in Sweden, including seven adult stroke patients (six males; one female) under the age of 65 who participated in a series of three nurse-led family conversations that were offered in each family's home. These Family Health Conversations (FamHC) were guided by the conceptual lens of Family System Nursing. Individual, semi-structured, evaluative interviews conducted with each participant one month after the FamHC were analyzed by qualitative content analysis. The FamHC were described by family members as a unique conversation that they had not previously experienced in health care contexts. Family members described possibilities for relational sharing and meaningful conversations as well as changes in family functioning that support the suitability of FamHC for family stroke care.
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- Östlund, Ulrika, et al.
(författare)
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Nurses' fidelity to theory-based core components when implementing Family Health Conversations - a qualitative inquiry
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:3, s. 582-590
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: A family systems nursing intervention, Family Health Conversation, has been developed in Sweden by adapting the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model. The intervention has several theoretical assumptions, and one way translate the theory into practice is to identify core components. This may produce higher levels of fidelity to the intervention. Besides information about how to implement an intervention in accordance to how it was developed, evaluating whether it was actually implemented as intended is important. Accordingly, we describe the nurses' fidelity to the identified core components of Family Health Conversation. Intervention and research methods: Six nurses, working in alternating pairs, conducted Family Health Conversations with seven families in which a family member younger than 65 had suffered a stroke. The intervention contained a series of three-1-hour conversations held at 2-3 week intervals. The nurses followed a conversation structure based on 12 core components identified from theoretical assumptions. The transcripts of the 21 conversations were analysed using manifest qualitative content analysis with a deductive approach. Results and conclusion: The 'core components' seemed to be useful even if nurses' fidelity varied among the core components. Some components were followed relatively well, but others were not. This indicates that the process for achieving fidelity to the intervention can be improved, and that it is necessary for nurses to continually learn theory and to practise family systems nursing. We suggest this can be accomplished through reflections, role play and training on the core components. Furthermore, as in this study, joint reflections on how the core components have been implemented can lead to deeper understanding and knowledge of how Family Health Conversation can be delivered as intended. © 2015 Nordic College of Caring Science.
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- Ahlm, Kristin, et al.
(författare)
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Suicidal drowning deaths in northern Sweden 1992-2009 : the role of mental disorder and intoxication
- 2015
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Ingår i: Journal of Forensic and Legal Medicine. - : Elsevier. - 1752-928X .- 1878-7487. ; 34, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- Suicides by drowning have received limited attention by researchers. A recent finding that almost onethird of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.
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| 9. |
- Aléx, Jonas, 1975-
(författare)
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Cold exposure and thermal comfort among patients in prehospital emergency care : innovation research in nursing
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundPatients’ cold exposure is a neglected problem in prehospital emergency care. Cold stress increases pain and anxiety and contributes to fear and an overall sense of dissatisfaction. When left untreated, cold stress disturbs vital body functions until ultimately reaches hypothermia.AimThe overall aim was to investigate patients’ experiences of thermal comfort and reactions to cold exposure in prehospital emergency care and to evaluate the effects of an intervention using active warming from underneath.MethodStudy I:Persons (n=20) injured in a cold environment in the north of Sweden were interviewed. Active heat was given to 13 of them.Study II:In wintertime, 62 patients were observed during prehospital emergency care. The field study was based on observations, questions about thermal discomfort, vital signs, and temperature measurements.Study III:Healthy young persons (n=23) participated in two trials each. Data were collected inside and outside a cold chamber. In one trial, the participants were lying on a regular ambulance stretcher and in a second trial on a stretcher supplied with a heated mattress. Outcomes were the Cold Discomfort Scale (CDS), back, finger, and core body temperature, four statements from the State-TraitAnxiety-Inventory (STAI), vital signs, and short notes about their experiences of the two stretchers.Study IV:A quantitative intervention study was conducted in prehospital emergency care in the north of Sweden. The patients (n=30) in the intervention group were transported in an ambulance supplemented with a heated mattress on the stretcher, whereas only a regular stretcher was used in the ambulance for the patients (n=30) in the control group. Outcomes were the CDS, finger, core body, and air temperature, and questions about cold experiences.ResultsStudy I:Patients suffered more because of the cold than from the pain of their injuries. The patients were in a desperate need of heat.Study II:Patients are exposed to cold stress due to cold environments. There was a significant decrease from the first measurement in finger temperature of patients who were indoors when the ambulance arrived, compared to the measurement taken in the ambulance. In the patient compartment of the ambulance, 85% of the patients had a finger temperature below the comfort zone and almost half of them experienced the patient compartment in the ambulance to be cold. The regular mattress surface temperature at the ambulance ranged from -22.3 to 8.4 ºC.Study III:A statistical increase of the participants’ back temperature was found between those lying on the heated mattress compared to those lying on the regular mattress. The heated mattress was experienced as warm, comfortable, providing security, and easy to relax on.Study IV:Thermal comfort increased for the patients in the intervention group and decreased in the control group. A significant higher proportion of the participants rated the stretcher as cold to lie on in the control group compared to the intervention group.ConclusionThe ambulance milieu is too cold to provide thermal comfort. Heat supply from underneath increased comfort and might prevent cold stress and hypothermia
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| 10. |
- Aléx, Jonas, et al.
(författare)
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Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study
- 2015
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Ingår i: International Journal of Circumpolar Health. - : Informa UK Limited. - 1239-9736 .- 2242-3982. ; 74
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care.METHODS: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures.RESULTS: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001). At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes.CONCLUSIONS: The use of active heat from underneath increases the patients' thermal comfort and may prevent the negative consequences of cold stress.
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