| 1. |
- Ahlqvist, Margary, et al.
(författare)
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A new reliable tool (PVC assess) for assessment of peripheral venous catheters
- 2010
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 16:6, s. 1108-1115
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Tidskriftsartikel (refereegranskat)abstract
- Rationale and aims To evaluate the extensive use of peripheral venous catheters (PVCs), including catheter-related complications, a reliable tool for PVC assessment is needed. The aim of this study was to develop such a tool to evaluate PVCs in relation to management, documentation and signs and symptoms of thrombophlebitis (TH), as well as to determine its inter-rater and test-retest reliability. Method The tool development included confirmation of content and face validity. Two groups of registered nurses used the new tool (PVC assess) to assess PVC management and signs of TH independently. Group A (n = 3) assessed 26 items in 67 PVCs bedside (inter-rater reliability). Group B (n = 3) assessed photographs (67 PVCs, 21 items) of the same PVCs as those in Group A with a 4-week interval (test-retest reliability). Proportion of agreement P(A) and Cohen's kappa were calculated to evaluate inter-rater and test-retest reliability. Results Among nurses assessing PVCs at bedside, the P(A) was good to excellent (0.80-1) in 96% of the items in PVC assess. In 80% of the items kappa was substantial to almost perfect (0.61-1). TH sign erythema fell into the fair range (kappa = 0.40). In test-retest reliability analysis the P(A) was within the good and excellent range (0.80-1.0) and kappa varied from moderate to almost perfect (0.41-1.0) in 95% of the items. One item 'outer dressing is clean' was in fair range (0.21-0.40). Conclusions The PVC assess instrument shows satisfactory inter-rater and test-retest reliability. Reliability tests on reviewing documentation remain to be performed.
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| 2. |
- Ahlqvist, Margary, et al.
(författare)
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Handling of peripheral intravenous cannulae : effects of evidence-based clinical guidelines.
- 2006
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:11, s. 1354-61
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study aimed at evaluating the outcome of implemented evidence-based clinical guidelines by means of surveying the frequency of thrombophlebitis, nurses' care, handling and documentation of peripheral intravenous cannulae. BACKGROUND: Peripheral intravenous cannulae are frequently used for vascular access and, thereby, the patients will be exposed to local and systemic infectious complications. Evidence-based knowledge of how to prevent these complications and how to care for patients with peripheral intravenous cannula is therefore of great importance. Deficient care, handling and documentation of peripheral intravenous cannulae have previously been reported. DESIGN: A cross-sectional survey was conducted by a group of nurses at three wards at a university hospital before and after the implementation of the evidence-based guidelines. METHOD: A structured observation protocol was used to review the frequency of thrombophlebitis, the nurses' care, handling and the documentation of peripheral intravenous cannulae in the patient's record. RESULTS: A total of 107 and 99 cannulae respectively were observed before and after the implementation of the guidelines. The frequency of peripheral intravenous cannulae without signs of thrombophlebitis increased by 21% (P < 0.01) and the use of cannula size 0.8 mm increased by 22% (P < 0.001). Nurses' documentation of peripheral intravenous cannula improved significantly (P < 0.001). CONCLUSION: We conclude that implementation of the guidelines resulted in significant improvements by means of decreased frequency of signs of thrombophlebitis, increased application of smaller cannula size (0.8 mm), as well as of the nurses' documentation in the patient's record. RELEVANCE TO CLINICAL PRACTICE: Further efforts to ameliorate care and handling of peripheral intravenous cannulae are needed. This can be done by means of increasing nurses' knowledge and recurrent quality reviews. Well-informed patients can also be more involved in the care than is common today.
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| 3. |
- Ahlqvist, Margary, et al.
(författare)
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Satisfactory reliability among nursing students using the instrument PVC ASSESS to evaluate management of peripheral venous catheters
- 2014
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Ingår i: Journal of Vascular Access. - : SAGE Publications. - 1129-7298 .- 1724-6032. ; 15:2, s. 128-134
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Nursing students should be given opportunities to participate in clinical audits during their education. However, audit tools are seldom tested for reliability among nursing students. The aim of this study was to present reliability among nursing students using the instrument PVC assess to assess management of peripheral venous catheters (PVCs) and PVC-related signs of thrombophlebitis. Methods: PVC assess was used to assess 67 inserted PVCs in 60 patients at ten wards at a university hospital. One group of nursing students (n= 4) assessed PVCs at the bedside (inter-rater reliability) and photographs of these PVCs were taken. Another group of students (n= 3) assessed the PVCs in the photographs after 4 weeks (test-retest reliability). To determine reliability, proportion of agreement [P(A)] and Cohen's kappa coefficient (k) were calculated. Results: For bedside assessment of PVCs, P(A) ranged from good to excellent (0.80-1.0) in 55% of the 26 PVC assess items that were tested. P(A) was poor (< 0.70) for two items: "adherence of inner dressing to the skin" and " PVC location." In 81% of the items, k was between moderate and almost perfect: moderate (n= 5), substantial (n= 3), almost perfect (n= 5). For edema at insertion site and two items on PVC dressing, k was fair (0.21-0.40). Regarding test-retest reliability, P(A) varied between good and excellent (0.81-1) in 85%-95% of the items, and the k ranged between moderate and almost perfect (0.41-1) in 90%-95%. Conclusions: PVC assess demonstrated satisfactory reliability among nursing students. However, students need training in how to use the instrument before assessing PVCs.
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| 4. |
- Alavian-Ghavanini, Ali, et al.
(författare)
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Prenatal Bisphenol A Exposure is Linked to Epigenetic Changes in Glutamate Receptor Subunit Gene Grin2b in Female Rats and Humans
- 2018
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Bisphenol A (BPA) exposure has been linked to neurodevelopmental disorders and to effects on epigenetic regulation, such as DNA methylation, at genes involved in brain function. High doses of BPA have been shown to change expression and regulation of one such gene, Grin2b, in mice. Yet, if such changes occur at relevant doses in animals and humans has not been addressed. We investigated if low-dose developmental BPA exposure affects DNA methylation and expression of Grin2b in brains of adult rats. Furthermore, we assessed associations between prenatal BPA exposure and Grin2b methylation in 7-year old children. We found that Grin2b mRNA expression was increased and DNA methylation decreased in female, but not in male rats. In humans, prenatal BPA exposure was associated with increased methylation levels in girls. Additionally, Iow APGAR scores, a predictor for increased risk for neurodevelopmental diseases, were associated with higher Grin2b methylation levels in girls. Thus, we could link developmental BPA exposure and Iow APGAR scores to changes in the epigenetic regulation of Grin2b, a gene important for neuronal function, in a sexual dimorphic fashion. Discrepancies in exact locations and directions of the DNA methylation change might reflect differences between species, analysed tissues, exposure level and/or timing.
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| 5. |
- Almquist B., Ylva, et al.
(författare)
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Associations between social support and depressive symptoms : social causation or social selection-or both?
- 2017
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 27:1, s. 84-89
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Numerous studies have demonstrated an association between social support and health, almost regardless of how social support and health have been conceptualised or measured. Even so, the issue of causality has not yet been sufficiently addressed. This issue is particularly challenging for mental health problems such as depressive symptoms. The aim of the present study is to longitudinally assess structural and functional aspects of social support in relation to depressive symptoms in men and women, through a series of competing causal models that, in contrast to many other statistical methods, allow for bi-directional effects.METHODS: Questionnaire data from the Northern Swedish Cohort (n = 1001) were utilised for the years 1995 (age 30) and 2007 (age 42). Associations were analysed by means of gender-specific structural equation modelling, with structural and functional support modelled separately.RESULTS: Both structural and functional support were associated with depressive symptoms at ages 30 and 42, for men and women alike. A higher level of support, particularly functional support, was associated with a decrease in depressive symptoms over time among men. Among women, there were bi-directional effects of social support and depressive symptoms over time.CONCLUSION: Concerning social support and health, the social causation hypothesis seems relevant for men whereas, for women, the associations appear to be more complex. We conclude that preventive and health promoting work may need to consider that the presence of depressive symptoms in itself impedes on women's capability to increase their levels of social support.
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| 6. |
- Anclair, Malin, et al.
(författare)
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Parental fears following their child's brain tumor diagnosis and treatment.
- 2009
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Ingår i: Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses. - : SAGE Publications. - 1043-4542 .- 1532-8457. ; 26:2, s. 68-74
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study is to portray the illness-related threats experienced by parents of children after the diagnosis of central nervous system (CNS) tumor. Parents were asked to rate the extent to which they experienced a set of specific fears related to their child's brain tumor and its treatment. Outcomes for parents of CNS tumor patients (n = 82) were compared with those of reference parents of patients treated for acute lymphoblastic leukemia (n = 208). The fears about an illness recurrence and the late effects of treatment were most prominent among parents of CNS tumor patients. For 7 out of 11 kinds of fear, parents of CNS tumor patients expressed a stronger fear than the reference group. More than a quarter of the parents of children treated for CNS tumors feared a complete decline of the child. Parents of CNS tumor patients experience relatively heightened cancer related fears in several domains. The fear of devastating consequences felt by one fourth of parents signals the need of individualized psychological support and information at diagnosis and follow-up to facilitate parental coping with the posttreatment situation.
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| 7. |
- Andersen, R. D., et al.
(författare)
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The Complexities of Nurses’ Pain Assessment in Hospitalized Preverbal Children
- 2019
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Ingår i: Pain Management Nursing. - : Elsevier. - 1524-9042 .- 1532-8635. ; 20:4, s. 337-344
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Tidskriftsartikel (refereegranskat)abstract
- Background: Preverbal children are at increased risk for underassessment of pain. Pain is a social transaction involving the child in pain and the nurse assessor. However, our understanding of the nurse's part in this transaction is limited. Aims: The aim of this study was to explore nurses’ assessment of pain in hospitalized preverbal children based on self-selected clinical examples. Design: Qualitative, descriptive design. Settings: Five different hospital units in Canada and Norway. All units had an observational pain scale for preverbal children available for use. Participants/Subjects: Nurses (N = 22) with ≥1 year experience caring for preverbal children. Methods: Individual, semistructured interviews. Data were analyzed using inductive thematic analysis. Results: Nurses' assessment of pain in hospitalized preverbal children emerged as a nonlinear complex process incorporating different actions and reflections in response to the child's situation and expression of distress. Information from parents was routinely included in the assessment, although further parental involvement varied considerably. Although each assessment was personalized to the individual child, the nurse used previous experiences to interpret observations of and information from the child and the parents. Few nurses described using structured pain scales, but when used, these scales were included as only one aspect of their overall assessment. Conclusions: Nurses preferred pain assessment based on clinical judgment and tailored to the individual child. Implementation strategies that aim to integrate structured pain scales with clinical judgment to assess pain may be more likely to succed. Further examination of this approach is warranted.
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| 8. |
- Andersson, Gerhard, et al.
(författare)
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Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
- 2012
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:9, s. 544-550
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Tidskriftsartikel (refereegranskat)abstract
- Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.
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