| 1. |
- Andersson, Henrik, 1968-, et al.
(författare)
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The early chain of care in bacteraemia patients: Early suspicion, treatment and survival in prehospital emergency care
- 2018
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Ingår i: American Journal of Emergency Medicine. - : Elsevier BV. - 0735-6757 .- 1532-8171. ; 36:12, s. 2211-2218
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28 days after admission to hospital. Furthermore, the long-term outcome was assessed. Methods: This study has a quantitative design based on data from Emergency Medical Services (EMS) and hospital records. Results: In all, 961 patients were included in the study. Of these patients, 13.5% died during the first 28 days. The EMS was more frequently used by non-survivors. Among patients who used the EMS, the suspicion of sepsis already on scene was more frequent in survivors. Similarly, EMS personnel noted the ESS code "fever, infection" more frequently for survivors upon arriving on scene. The delay time from call to the EMS and admission to hospital until start of antibiotics was similar in survivors and non-survivors. The five-year mortality rate was 50.8%. Five-year mortality was 62.6% among those who used the EMS and 29.5% among those who did not (p < 0.0001). Conclusion: This study shows that among patients with bacteraemia who used the EMS, an early suspicion of sepsis or fever/infection was associated with improved early survival whereas the delay time from call to the EMS and admission to hospital until start of treatment with antibiotics was not. 50.8% of all patients were dead after five years. (C) 2018 Elsevier Inc. All rights reserved.
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| 2. |
- Axelsson, Christer, et al.
(författare)
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The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting
- 2016
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Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 31:3, s. 272-277
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about the early phase of severe infection. This report describes the early chain of care in bacteraemia as follows: (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start of intravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter.All patients in the Municipality of Gothenburg (Sweden) with a positive blood culture, when assessed at the Laboratory of Bacteriology in the Municipality of Gothenburg, from February 1 through April 30, 2012 took part in the survey.In all, 696 patients fulfilled the inclusion criteria. Their mean age was 76 years and 52% were men. Of all patients, 308 (44%) had been in contact with the EMS and/or the emergency department (ED). Of these 308 patients, 232 (75%) were transported by the EMS and 188 (61%) had “true pathogens” in blood cultures. Patients who were transported by the EMS were older, included more men, and suffered from more severe symptoms and signs.The EMS nurse suspected sepsis in only six percent of the cases. These patients had a delay from arrival at hospital until the start of antibiotics of one hour and 19 minutes versus three hours and 21 minutes among the remaining patients (P =.0006). The corresponding figures for cases with “true pathogens” were one hour and 19 minutes versus three hours and 15 minutes (P =.009).Among patients with bacteraemia, 75% used the EMS, and these patients were older, included more men, and suffered from more severe symptoms and signs. The EMS nurse suspected sepsis in six percent of cases. Regardless of whether or not patients with true pathogens were isolated, a suspicion of sepsis by the EMS clinician at the scene was associated with a shorter delay to the start of antibiotic treatment.
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| 3. |
- Darcy, Laura, 1967-, et al.
(författare)
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Following Young Children's Health and Functioning in Everyday Life Through Their Cancer Trajectory
- 2016
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Ingår i: Journal of Pediatric Oncology Nursing. - Thousand Oaks, CA : Sage Publications. - 1043-4542 .- 1532-8457. ; 33:3, s. 173-189
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Tidskriftsartikel (refereegranskat)abstract
- Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children's health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children's trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.
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| 4. |
- Darcy, Laura, et al.
(författare)
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The process of striving for an ordinary, everyday life, in young children living with cancer, at six months and one year post diagnosis
- 2014
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Ingår i: European Journal of Oncology Nursing. - Amsterdam : Elsevier. - 1462-3889 .- 1532-2122. ; 18:6, s. 605-612
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Health care focus is shifting from solely looking at surviving cancer to elements of attention relating to living with it on a daily basis.The young child's experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of young children as expressed by the child and parents at six months and one year post diagnosis.METHODS: Interviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from two time points, six months and one year post diagnosis, was carried out.RESULTS: The process of living with cancer at six months and at one year post diagnosis revealed the child's striving for an ordinary, everyday life. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described.CONCLUSION: Nurses have a major role to play in the process of striving for a new normal in the world post-diagnosis, and provide essential roles by giving the young child information, making them participatory in their care and encouraging access to both parents and peers. Understanding this role and addressing these issues regularly can assist the young child in the transition to living with cancer. Longitudinal studies with young children are vital in capturing their experiences through the cancer trajectory and necessary to ensure quality care.
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| 5. |
- Enskär, Karin, et al.
(författare)
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A Swedish perspective on nursing and psychosocial research in paediatric oncology : A literature review
- 2015
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Ingår i: European Journal of Oncology Nursing. - Amsterdam : Elsevier. - 1462-3889 .- 1532-2122. ; 19:3, s. 310-317
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: A dramatic improvement in outcomes of survival rates of childhood cancer has been seen. Caring science research is central in providing skills and knowledge to the health care sector, but few overviews of the content of published research have been carried out. The aim of this review was to investigate the content and methodology of published studies in paediatric oncology relevant to caring science, and also to compare possible differences in content and method of the published studies from the nursing and psychosocial perspectives. Method: A systematic literature review was performed of 137 published articles on paediatric oncology relevant to caring science in Sweden. Results: The results show that most of the studies were descriptive or comparative ones with a quantitative design. Most of them focused on parents (43%) or children (28%). Most of the studies investigated wellbeing (88%), using questionnaires (54%) or interviews (38%). Several different measurement instruments had been used. While the results were often clearly presented, the clinical implications were more diffuse. The most acknowledged research fund was the Swedish Childhood Foundation (75%). Conclusions: To reflect the children' perspectives in paediatric oncology require that future researchers take on the challenge of including children (even young ones) in research. The use of a limited number of agreed measurement instruments is desirable. The biggest challenge for the future is to make a shift from explorative to intervention studies. There is an urgent need to transform research results into clinical practice. (C) 2014 Elsevier Ltd. All rights reserved.
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| 6. |
- Enskär, Karin, et al.
(författare)
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An analytic review of clinical implications from nursing and psychosocial research within Swedish pediatric oncology
- 2015
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Ingår i: Journal of Pediatric Nursing. - Amsterdam : Elsevier. - 0882-5963 .- 1532-8449. ; 30:4, s. 550-559
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this manuscript is to analyze researchers' suggestions for clinical implications of their findings as stated in recent published articles on nursing and psychosocial research within the setting of Swedish pediatric oncology. Identified categories included staff awareness of the effects of child illness on families; systems for care improvement; provision of quality of care, education and support; and empowerment of children and families. In order to be able to realize these clinical suggestions, expanded research is needed as well as continued education and support for staff.
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| 7. |
- Johannesson, Krister, 1970-
(författare)
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I främsta rummet : planerandet av en högskolebiblioteksbyggnad med studenters arbete i fokus
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of the thesis is to investigate planning processes for academic library buildings and the outcomes of such processes. This is accomplished through a case study utilising discourse analysis. The main question is: How is a vision of an academic library implemented in and through a building? The case study is retrospective and focused on the building of a new library at Kalmar University, Sweden, at the end of the 1990s. During this period, technological and educational developments and general societal change transformed the context of library planning and made way for renegotiations of the librarian profession. A critical realist approach characterises the study of visions, processes and the analysis of the various functions of the building. Results reveal the proactive nature of the activities of the library director in Kalmar. Early in the process he formulated a vision in which he presents the library as an information resource, a meeting place between different user groups and a workplace intended to promote learning and knowledge. From a professional point of view, the vision implied a dehierarchisation of relations both within the library staff and between library staff and visitors. The vision was based on an interpretation of Swedish national educational policy, and architecturally manifested by an ambition to reduce the physical and psychological boundaries between library staff and visitors. The early formulation of the vision together with the clients’ use of architectural expertise facilitated the choice of architects. However during the process a need arose to anchor the decision in the library field. Efforts were made to address library expertise and to collect user comments from a broader academic field. Discourses concerning the university library as a workplace and a meeting place were especially evident in the strategies of the leading agents. The discourses uncovered in the study correspond to more general discourses which became prominent in society and higher education during the period in question. The library itself has met growing appreciation by users both from within and outside the university. The proactive leadership demonstrated by the library director in Kalmar was based on hegemony rather than coercion. This corresponds to contemporary tendencies. Hegemonic consent may persist even after changes in leadership. In Kalmar however, architectural solutions with insufficient support from the library staff have been reconstructed after changes in leadership. Future research on architectural planning processes may pay further attention to different discursive resources, social fields and the positions within them.
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| 8. |
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| 9. |
- Johansson, Annelie, et al.
(författare)
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Living with experiences following a myocardial infarction
- 2003
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier. - 1474-5151 .- 1873-1953. ; 2:3, s. 229-336
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Tidskriftsartikel (refereegranskat)abstract
- Coronary heart disease is a major cause of sudden death and morbidity in the developed world, as well as a cause of great suffering. Research within this area has primarily focused symptoms, risk factors and treatment. The aim of this paper was to explore women's experiences following a myocardial infarction (MI). Eight women were interviewed; the interviews were audiotaped and transcribed into text and analysed using a phenomenological approach. To explore the meaning that is experienced in the lived world of the patient a method of reflective lifeworld research, based upon phenomenological epistemology has been used. The results indicate that the body is vital for the women in their lifeworlds. After a MI the patient's natural and unreflective relationship with the body and the lived world is interrupted. Uncertainty about life and death as well as the body is experienced as a suffering in the women's lifeworlds. In relation to this, the women's existence is characterised by an uncertainty and a loss of context. It is through reconciliation with their bodies and their illnesses that the women can achieve a sense of well-being and harmony in life. In that process the women can re-establish a natural relationship with their bodies and lifeworlds.
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| 10. |
- Johansson Sundler, Annelie, et al.
(författare)
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The Meaning of Close Relationships and Sexuality : Women's Well-Being Following a Myocardial Infarction
- 2009
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 19:3, s. 375-387
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Tidskriftsartikel (refereegranskat)abstract
- Relationships and sexuality following heart attack (MI) have been studied; nevertheless, little is known about the meaning of social support and relationships to health and well-being after an MI. To our knowledge, no qualitative studies have further investigated the phenomenon. In this study we explore the meaning of close relationships and sexuality to women's health and well-being following MI. Ten women were interviewed using a reflective lifeworld approach and phenomenological epistemology. The meaning of women's close relationships following an MI appears to be closely intertwined with their long-term health process; both health processes and the relationships are affected. Suffering after an MI can be compared to taking a fall in that close relationships can become a safety net. Close relationships and sexuality are integrated into their lived bodies, and in that way have profound influence in their lifeworld experiences. Not all close relationships are intimate; however, all close and meaningful relationships can provide power and strength to the women's health processes. At the same time, these relationships also appear to drain energy and cause suffering.
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