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  • Sjöblom, I., et al. (författare)
  • Creating a Safe Haven-Women's Experiences of the Midwife's Professional Skills During Planned Home Birth in Four Nordic Countries
  • 2014
  • Ingår i: Birth. - 0730-7659. ; 41:1, s. 100-107
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The midwife assisting a birth has a considerable influence on the woman's experience of the birth. The aim of this study was to investigate the experience of the midwife's professional skills among women in Norway, Denmark, Iceland, and Sweden who chose a planned home birth. Design and Setting: All known home birth midwives were asked to inform the mothers about the project and invite them to complete a questionnaire about different aspects of their home birth experience. Method: The women were asked to assess 10 different aspects of the midwives' professional skills on a 4-graded scale below the main question: What was your experience of the midwife who assisted the labor? Furthermore, the mothers' experiences with the attending midwives were identified in the free text birth stories. The chosen method was a mixed method design. Findings: The home birth midwives' professional skills were generally high scored. No statistically significant differences were found with respect to the assessment of the midwife. The content analyses yielded one overarching theme: The competence and presence of the midwife creates a safe haven, and three categories, midwife's safe hand, midwife's caring approach, and midwife's peaceful presence. Conclusion: Women choosing a home birth in the four Nordic countries experienced that their midwives were highly skilled and they found the presence of the midwives valuable in helping them to feel safe and confident during birth. Despite differences in organization and guidelines for home births, the women's experience of the midwife's professional skills did not differ between the four countries. © 2014, Wiley Periodicals, Inc.
  • Hammar, Henrik, et al. (författare)
  • The kilometer tax and Swedish industry-effects on sectors and regions
  • 2011
  • Ingår i: Applied Economics. - London : Chapman and Hall. - 0003-6846. ; 43:22, s. 2907-2917
  • Tidskriftsartikel (refereegranskat)abstract
    • An introduction of a kilometer tax for heavy goods vehicles can be constrained by the risk of that higher production costs than competitors in other countries will negatively affect regions and industries of policy concern. We estimate factor demand elasticities in the Swedish manufacturing industry using firm level data for the 1990 to 2001 period on input prices and quantities. The results show that the introduction of a kilometer tax for heavy goods vehicles decreases transport demand and increases labour demand. The effects are less pronounced in terms of changes in output, though some industries (e.g. wood, pulp and paper) can be expected to be affected more than others due to their dependence on road freight transport. The regional dimension regarding the consequences of a kilometer tax seems to be small or even nonexisting.
  • Lagerqvist, Bo, et al. (författare)
  • Outcomes 1 year after thrombus aspiration for myocardial infarction.
  • 2014
  • Ingår i: New England Journal of Medicine. - Massachusetts Medical Society. - 0028-4793. ; 371:12, s. 1111-1120
  • Tidskriftsartikel (refereegranskat)abstract
    • Routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) has not been proved to reduce short-term mortality. We evaluated clinical outcomes at 1 year after thrombus aspiration.
  • Allvin, Renée, et al. (författare)
  • Confident but not theoretically grounded experienced simulation educators perceptions of their own professional development
  • 2017
  • Ingår i: Advances in Medical Education and Practice. - Dove Medical Press. - 1179-7258. ; 8, s. 99-108
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature.Objectives: To explore changes in experienced simulation educators’ perceptions of their own teaching skills, practices, and understanding of teaching over time.Methods: A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis.Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor’s pedagogical development.Conclusion: Experienced simulation educators’ pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.
  • Arenhall, Eva, et al. (författare)
  • The female partners' experiences of intimate relationship after a first myocardial infarction
  • 2011
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 20:11/12, s. 1677-1684
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. This study aimed to explore and describe women’s experience of intimate relationships in connection to and after their partner’s first myocardial infarction (MI).Background. Support from partners is important for recovery, but little is known about partners’ experience of intimate relationships after MI.Design. The study used an explorative, qualitative design.Methods. The first author interviewed 20 women having a partner who had suffered a first MI during the preceding year. Qualitative content analysis was used to analyse the data.Findings. Three themes emerged: ‘limited life space’, ‘sense of life lost’ and ‘another dimension of life’. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: ‘uncertainty of life’, ‘certain of relationship’ and ‘share life more’.Conclusions. The partners’ MI had an impact on the interviewees’ intimate relationships; they suffered a major loss and missed their ‘former’ partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners’ lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space.Relevance to clinical practice. Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following MI.
  • Arenhall, Eva, et al. (författare)
  • The male partners' experiences of the intimate relationships after a first myocardial infarction
  • 2011
  • Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151. ; 10:2, s. 108-114
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis. Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
  • Craftman, Åsa, et al. (författare)
  • Older people's experience of utilisation and administration of medicines in a health- and social care context.
  • 2015
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 29:4, s. 760-768
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.DESIGN: A qualitative descriptive study.METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.
  • Djarv, T., et al. (författare)
  • Traumatic cardiac arrest in Sweden 1990-2016 - a population-based national cohort study.
  • 2018
  • Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - 1757-7241. ; 26:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA).METHODS: A cohort study based on data from the nationwide, prospective population-based Swedish Registry for Cardiopulmonary Resuscitation (SRCR), a medical cardiac arrest registry, between 1990 and 2016. The definition of a TCA in the SRCR is a patient who is unresponsive with apnoea where cardiopulmonary resuscitation and/or defibrillation have been initiated and in whom the Emergency Medical Services (EMS, mainly a nurse-based system) reported trauma as the aetiology. Outcome was overall 30-day survival. Descriptive statistics as well as multivariable logistic regression models were used.RESULTS: In all, between 1990 and 2016, 1774 (2.4%) cases had a TCA and 72,547 had a medical CA. Overall 30-day survival gradually increased over the years, and was 3.7% for TCAs compared to 8.2% following a medical CA (p < 0.01). Among TCAs, factors associated with a higher 30-day survival were bystander witnessed and having a shockable initial rhythm (adjusted OR 2.67, 95% C.I. 1.15-6.22 and OR 8.94 95% C.I. 4.27-18.69, respectively).DISCUSSION: Association in registry-based studies do not imply causality but TCA had short time intervals in the chain of survival as well as high rates of bystander-CPR.CONCLUSION: In a medical CA registry like ours, prevalence of TCAs is low and survival is poor. Registries like ours might not capture the true incidence. However, many individuals do survive and resuscitation in TCAs should not be seen futile.
  • Dragano, Nico, et al. (författare)
  • Effort-Reward Imbalance at Work and Incident Coronary Heart Disease A Multicohort Study of 90,164 Individuals
  • 2017
  • Ingår i: Epidemiology. - 1044-3983. ; 28:4, s. 619-626
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease.Methods: This multicohort study (the "IPD-Work" consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis.Results: At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00-1.35) was observed for effort-reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain.Conclusions: Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.
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