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Sökning: LAR1:lu > Högskolan i Jönköping > (2005-2009)

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  • Ahlström, Gerd, et al. (författare)
  • A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy
  • 2006
  • Ingår i: Clinical Rehabilitation. - 0269-2155. ; 20:2, s. 132-141
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. DESIGN: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. SETTING: Two different counties in Sweden, being either study or control setting. SUBJECTS: The study group comprised 37 adults (21 women, 16 men; mean age 50 years), while the control group comprised 39 people (25 women, 14 men; mean age 46 years). INTERVENTIONS: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. MAIN MEASURES: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. RESULTS: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P= 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P= 0.073) when being compared to the study group. CONCLUSIONS: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial.
  • Ahlström, Gerd (författare)
  • Coping with Neuromuscular disease and the Implications for Interventions
  • 2008
  • Ingår i: The First International Symposium on Psychosocial Aspects of Neuromuscular Disorders. - Bilbao, June 20-21 2008 : University of Deusto, Bilbao. ; s. 1
  • Konferensbidrag (refereegranskat)abstract
    • Coping with Neuromuscular disease and the Implications for InterventionsThe lecture is based on results from three theses and about 25 scientifically articles about the plight of the patient with muscular dystrophy (MD), and the patients’ ways of coping with illness-related problems from a psychosocial perspective. MD is a group of inherited disorders characterised by muscular weakness caused by muscle wasting. Three subgroups are distinguished in our research: one group with different types of proximal MD and the other two groups characterized chiefly by distal weakness. The research was to elucidate how persons with muscular dystrophy experience their everyday life over a ten years period. The research includes four data collections with qualitative and quantitative methods. The data was selected in three different county councils in Sweden.The persons with MD described the change from being independent to being an individual in need of assistive devices and/or personal support to manage activities of every day life. Besides muscular weakness the persons have the strain it means to have a hereditary disease. The deterioration in a decennium was mainly with regard to ambulation. The number of persons walking without assistive devices and working has almost been halved. They experienced periods of sorrow due to losses of independence, control, status and social roles and the loss of one’s identity as a healthy person. The sorrow connecting with repeated losses are in the literature designate as chronic or episodic sorrow. Also, in the lecture the patients’ illness trajectory were described by a model of Sullivan (1994) into four dimensions in order to increase the understanding of what it means to live with muscular dystrophy.The aim of interventions is to support the patient’s appropriate ways of coping as Problem-focused coping/Searching for a solution, Fighting spirit/Struggling, Re-appraising of life values, Maintaining hope, Social comparison, Laughing and joking  and Caring about self.
  • Ahlström, Gerd (författare)
  • Experiences of loss and chronic sorrow in persons with severe chronic illness
  • 2007
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 16:3A, s. 76-83
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. The aims of the present study were to describe losses narrated by persons afflicted with severe chronic physical illness and to identify the concomitant occurrence of chronic sorrow. Background. Reactions connected with repeated losses are referred to in the literature as chronic sorrow, which has recently been described in conjunction with chronic illness. Design. A qualitative study with an abductive approach of analysis, including both inductive and deductive interpretations. Method. The study is based on 30 persons of working age with average disease duration of 18 years. The average age was 51 years. All of the persons had personal assistance for at least three months because of considerable need for help in daily life due to physical disability. Each person was interviewed twice. There was also an independent assessment of the deductive results concerning chronic sorrow. Results. The inductive findings show that all persons had experienced repeated physical, emotional and social losses. Most common were 'Loss of bodily function', 'Loss of relationship', 'Loss of autonomous life' and 'Loss of the life imagined'. 'Loss of identity' included the loss of human worth, dignity and a changed self-image. In addition, the deductive findings suggest that chronic sorrow exists in the study population. Sixteen of 30 participating subjects were assessed by both assessors to be in a state of chronic sorrow and there was an especially high agreement with respect to one criterion of chronic sorrow 'Loss experience, ongoing or single event' (28 of 30 subjects). Conclusions. This study shows that persons with severe chronic illness often experience recurring losses. These experiences are consistent with the phenomenon of chronic sorrow. Relevance to clinical practice. Knowledge of the existence of chronic sorrow in persons with chronic illness will enable nurses to support these persons in a more sensitive and appropriate way.
  • Ahlström, Gerd (författare)
  • Intentional Partnerships—Creating New Partnerships : A national and international model
  • 2008
  • Ingår i: Quality and Safety in Nursing Education : A Clinical Microsystems Approach. - Chicago, USA : The Joint Comission. ; s. 6
  • Konferensbidrag (refereegranskat)abstract
    • Since one of the aims of this meeting is to create a strategy for the participants to connect and share experiences post-conference I will start by giving a very brief account of Jönköping University and the School of Health Sciences, this in order to give you a sense of the school as a possible partner for collaboration. Then I will describe how teachers work to increase knowledge with regard to health care improvement within the nursing program. Thereafter I will talk about a research project and relate this to what we can learn about interprofessional education. The basic values regarding health care improvement described by Paul Batalden and his colleagues are central to our present development. We share the theoretical assumptions concerning the Clinical Microsystem and the view of redesigning health care education in order to produce the best care for the patient and his/her family. So within our organization both teachers and students — like nurses — have two jobs, one of which is to bring about improvement. So we have started the process where the educators need to change their teaching for the sake of better patient outcomes, better system performance, and better professional development. This means communicating not only the existing evidence-based knowledge but also improvement knowledge which involves a substantial shift in our idea of the work of health care — a challenging task that can benefit from the use of a wide variety of tools and methods. A key concern for us in the planning of our different programs is that the improvement of knowledge shall permeate the education and contribute to establishing a professional attitude marked by daily inspiration to produce the best care. The basic education involves four stages. First there is an introduction to concepts and models in health care improvement. This content is in the first semester.  Second the students’ are making a personal improvement in their everyday life. The students apply PDSA-cycle for improvement of an issue, commonly their time-table for studies, time spending for eating breakfast in the morning or eating habits in general. The third stage involves evidence-based nursing and systematic literature reviews and in the fourth stage, the students make health care improvements in collaboration with the staff during a clinical training period. The nurses at the clinic formulate the area of improvement. Then the students work systematically in pairs to collect data and the results are reported to the nurses. The latter stage is a new content in nursing education but we know from occupational therapy that the staff appreciated these works and the results were in most cases used by the staff in their job. The overall aim of the research project “Bridging the gaps” is to generate evidence about the process and outcome of clinical work within the area of quality improvement. The project contributes to an advanced environment for learning and innovation, research and development in the field of health-care management and improvement. There are 14 doctoral students at the research school, who takes part in the research project. Three of them are nurses and doctoral students at the School of Health Sciences. All PhD students have to take two compulsory courses, one is named “Bridging the gaps — a multidisciplinary research field” and the other is named “Interactive Research Methodology”. The Microsystem as a theoretical model is included in the mention research course “Bridging the gaps” and in each doctoral student’s research proposal. The PhD students shall work together with health-care staff by way of an interactive research method. This means that there is an integration of research and practice. The PhD students and the health-care staff are working together throughout the project. The staff is involved at every stage, from designing the improvement work, formulating the research questions to reporting the results. Research with this methodology generates knowledge of great relevance for clinical practice.
  • Ahlström, Gerd (författare)
  • Personal assistance for patients living with a severe neurological disorder.
  • 2006
  • Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 38:3, s. 183-193
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with neurological diseases increasingly are being cared for at home. The purpose of this study was to describe stressful everyday experiences in connection with neurological disorders, to learn how people cope with such experiences, and gain knowledge about coping resources. Twenty-seven persons receiving personal assistance were interviewed twice at home. The 54 interviews were subjected to inductive content analysis. The persons encountered many problems in everyday life and usually handled them by means of acceptance, avoidance, practical problem solving, and reappraisal. Dependence on personal assistance gave rise to a sense of helplessness, but it was also the major coping resource. Nurses can improve home care by giving instruction and guidance to persons working as personal assistants.
  • Alm-Roijer, C, et al. (författare)
  • Knowing your risk factors for coronary heart disease improves adherence to advice on lifestyle changes and medication
  • 2006
  • Ingår i: Journal of Cardiovascular Nursing. - Lippincott Williams & Wilkins. - 1550-5049. ; 21:5, s. 24-31
  • Tidskriftsartikel (refereegranskat)abstract
    • Implementation of guidelines for coronary heart disease prevention is less optimal in clinical practice. The aim of this study was to investigate if specific knowledge (patients' knowledge about their own coronary heart disease risk factors) would correlate to their adherence as measured by self-reported lifestyle changes, reaching defined treatment goals and adhering to treatment with prescribed drugs. The consecutive medical records of 509 men and women younger than 71 years, hospitalized for a cardiac event, were screened. Of these, 392 patients came for an interview and were subjected to a clinical examination. All patients received a questionnaire regarding their specific knowledge of risk factors and their adherence to lifestyle changes, which was completed by 347 patients. In addition, data were collected and analyzed on how their treatment goals were attained in 8 domains and their adherence to drug treatment. There were significant correlations between specific knowledge and self-reported lifestyle changes, the ability to reach treatment goals in all 8 domains, and adherence to prescribed drugs. Patients with coronary heart disease will benefit from increased specific knowledge of risk factors to adhere with lifestyle changes and prescribed medication after a cardiac event.
  • Almborg, Ann-Helene, et al. (författare)
  • Patients' perceptions of their participation in discharge planning after acute stroke
  • 2009
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 18:2, s. 199-209
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. To describe stroke patients' perceptions of their participation in the discharge planning process and identify correlates of perceived participation. Background. Patients have the right to participate in discharge planning, but earlier research has shown that they are often dissatisfied with the information they receive and their involvement in goal-setting during discharge planning. Design. Cross-sectional study. Methods. The sample consisted of 188 persons (mean age 74 years, SD 11·2) with acute stroke who were admitted to a stroke unit at a hospital in southern Sweden during 2003–2005. Data was collected by face-to-face interviews 2–3 weeks after discharge using the 'Patients' Questionnaire on Participation in Discharge Planning'. This instrument measures perceived participation in discharge planning in three subscales: P-Information, P-Medical Treatment, P-Goals and Needs. Results. The percentage of patients who perceived that they had participated in discharge planning was as follows: 72–90% according to P-Information, 29–38% according to P-Medical Treatment and 15–47% according to P-Goals and Needs. Age, education and performance of activities of daily living were significantly related to perceived participation as measured by different subscales. Conclusions. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal-setting. Professionals need to pay more attention to patients in different subgroups to facilitate their participation in discharge planning. Relevance to clinical practice. To facilitate and increase patients' participation in discharge planning, methods should be implemented for goal-setting and identifying patients' needs. Methods that foster patient participation may improve goal-orientated care, services and rehabilitation after discharge.
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