| 1. |
- Andreae, Christina, 1969-, et al.
(författare)
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Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure
- 2018
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Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 33:2, s. E15-E20
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Tidskriftsartikel (refereegranskat)abstract
- Background: Decreased appetite and depressive symptoms are clinical problems in patients with heart failure. Both may result in impaired health status. Objective: The aims of this study were to investigate the association between appetite and health status in patients with heart failure and to explore whether depressive symptoms moderate this association. Methods: In this cross-sectional study, patients with heart failure (n = 186; mean age, 71 years), New York Heart Association class II to IV, participated. Data on appetite (Council of Nutrition Appetite Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and health status (EQ-5D 3-level scale [EQ-5D-3L] descriptive system, EQ-5D-3L index, and EQ Visual Analog Scale) were collected by self-rating questionnaires. Pearson correlation was used to investigate the association between appetite and health status. Multiple regression was performed to examine whether depressive symptoms moderate the association between appetite and health status. Results: There was a significant association between appetite and health status for EQ-5D-3L descriptive system, mobility (P < .001), pain/discomfort (P < .001), and anxiety/depression (P < .001). This association was also shown in EQ-5D-3L index (P < .001) and EQ Visual Analog Scale (P < .001). Simple slope analysis showed that the association between appetite and health status was only significant for patients without depressive symptoms (B = 0.32, t = 4.66, P < .001). Conclusions: Higher level of appetite was associated with better health status. In moderation analysis, the association was presented for patients without depressive symptoms. Decreased appetite is an important sign of poor health status. To improve health status, health professionals should have greater attention on appetite, as well on signs of depressive symptoms.
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| 2. |
- Andreae, Christina, 1969-, et al.
(författare)
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Prevalence and associated factors for decreased appetite among patients with stable heart failure
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:11-12, s. 1703-1712
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo explore the prevalence of decreased appetite and factors associated with appetite among patients with stable heart failure.BackgroundDecreased appetite is an important factor for the development of undernutrition among patients with heart failure, but there are knowledge gaps about prevalence and the factors related to appetite in this patient group.DesignObservational, cross-sectional study.MethodsA total of 186 patients with mild to severe heart failure were consecutively recruited from three heart failure outpatient clinics. Data were obtained from medical records (heart failure diagnosis, comorbidity and medical treatment) and self-rated questionnaires (demographics, appetite, self-perceived health, symptoms of depression and sleep). Blood samples were taken to determine myocardial stress and nutrition status. Heart failure symptoms and cognitive function were assessed by clinical examinations. The Council on Nutrition Appetite Questionnaire was used to assess self-reported appetite. Bivariate correlations and multivariate linear regression analyses were conducted to explore factors associated with appetite.ResultsSeventy-one patients (38%) experienced a loss of appetite with a significant risk of developing weight loss. The final multiple regression model showed that age, symptoms of depression, insomnia, cognitive function and pharmacological treatment were associated with appetite, explaining 27% of the total variance.ConclusionIn this cross-sectional study, a large share of patients with heart failure was affected by decreased appetite, associated with demographic, psychosocial and medical factors. Relevance to clinical practiceLoss of appetite is a prevalent problem among patients with heart failure that may lead to undernutrition. Health care professionals should routinely assess appetite and discuss patients' experiences of appetite, nutrition intake and body weight and give appropriate nutritional advice with respect to individual needs.
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| 3. |
- Andreae, Christina, 1969-, et al.
(författare)
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The relationship between physical activity and appetite in patients with heart failure : A prospective observational study
- 2019
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 18:5, s. 410-417
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Physical activity and appetite are important components for maintaining health. Yet, the association between physical activity and appetite in heart failure (HF) populations is not completely understood. The aim of the present study was to investigate the relationship between physical activity, functional capacity, and appetite in patients with HF. Methods: This was a prospective observational study. In total, 186 patients diagnosed with HF, New York Heart Association (NYHA) class II-IV (mean age 70.7, 30% female), were included. Physical activity was measured using a multi-sensor actigraph for seven days and with a self-reported numeric rating scale. Physical capacity was measured by the six-minute walk test. Appetite was measured using the Council on Nutrition Appetite Questionnaire. Data were collected at inclusion and after 18 months. A series of linear regression analyses, adjusted for age, NYHA class, and B-type natriuretic peptide were conducted. Results: At baseline, higher levels of physical activity and functional capacity were significantly associated with a higher level of appetite in the unadjusted models. In the adjusted models, number of steps (p = 0.019) and the six-minute walk test (p = 0.007) remained significant. At the 18-month follow-up, all physical activity variables and functional capacity were significantly associated with appetite in the unadjusted regression models. In the adjusted models, number of steps (p = 0.001) and metabolic equivalent daily averages (p = 0.040) remained significant. Conclusion: A higher level of physical activity measured by number of steps/day was associated with better self-reported appetite, both at baseline and the 18-month follow-up. Further research is needed to establish causality and explore the intertwined relationship between activity and appetite in patients with HF.
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| 4. |
- Bratt, Anna S., 1969-, et al.
(författare)
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An internet-based compassion course for healthcare professionals : Rationale and protocol for a randomised controlled trial
- 2022
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 28
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe stress is one of the most common causes of sick leave in Sweden. Previous research has shown that compassion interventions for healthcare professionals can decrease work-related stress through the introduction of self-care, self-awareness, and emotion regulation abilities when experiencing difficult situations. Internet-based stress management interventions have hitherto shown promising results in reducing stress. However, further research is needed to examine the effectiveness of internet-based compassion interventions for healthcare professionals. Objective: In the present study protocol, a randomised controlled trial is described, aiming to examine the effects of an internet-based compassion course for healthcare professionals on work-related stress and stress of conscience. Method: Healthcare professionals will be offered an internet-based stress management course of five modules across a period of five weeks. The design is a randomised controlled study consisting of three groups enrolled in one of the following: a compassion course (n = 120), a cognitive behavioural stress management course (n = 120), or placed on a waitlist followed by either the compassion course or the cognitive behavioural stress management course (n = 36). We hypothesise that the internet-based compassion course would reduce the participants' stress of conscience to a greater degree compared to the other two groups. The secondary hypothesis is that the compassion course would increase the participants' professional quality of life (i.e., higher job satisfaction and lower empathy fatigue) and self-compassion. In addition, the internet-based compassion course is expected to reduce the participants' work-related stress and sick leave rates to the same degree (non-inferiority) as the cognitive behavioural stress management course and to a higher degree when compared to the waitlist condition. The primary outcome measure is the Stress of Conscience Questionnaire (SCQ) and the secondary outcome measures are the Professional Quality of Life Scale (PROQOL), the Work-related Stress Copenhagen Psychosocial Questionnaire (COPSOQ), and the Self-compassion Scale (SCS). Assessments will be performed at baseline, four weekly assessments during treatment, post-treatment (5 weeks), and follow-ups at 10 weeks, 15 weeks, and 6 months. The repeated measures data will be analysed using a generalised estimating equation for repeated measurements to examine whether changes over time differ between the groups and whether the improvements persist over time. Discussion: The clinical trial is expected to provide novel data on the effects of compassion interventions and add to the existing knowledge of internet-based interventions for stress management in healthcare professionals.
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| 5. |
- Bremer, Anders, Docent, 1957-, et al.
(författare)
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Ethical conflicts in patient relationships : experiences of ambulance nursing students
- 2020
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:4, s. 946-959
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Tidskriftsartikel (refereegranskat)abstract
- Background: Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts.Aim: To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies.Research design: An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses.Participants: The 69 participants attended a 1-year educational programme for ambulance nurses at a Swedish university.Ethical consideration: The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study.Findings: The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care.Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation.Conclusion: The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability.
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| 6. |
- Brommesson, Douglas, 1976-, et al.
(författare)
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“Teach more, but do not expect any applause” : Are Women Doubly Discriminated Against in Universities’ Recruitment Processes?
- 2022
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Ingår i: Journal of Academic Ethics. - : Springer Science and Business Media LLC. - 1570-1727 .- 1572-8544. ; 20:3, s. 437-450
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Tidskriftsartikel (refereegranskat)abstract
- Studies repeatedly find that women and men experience life in academia differently. Importantly, the typical female academic portfolio contains less research but more teaching and administrative duties. The typical male portfolio, on the other hand, contains more research but less teaching and administration. Since previous research has suggested that research is a more valued assignment than teaching in academia, we hypothesise that men will be ranked higher in the peer-evaluations that precede hirings to tenured positions in Swedish academia. We analyze 861 peer review assessments of applicants in 111 recruitment processes in Economics, Political Science, and Sociology at the six largest Swedish universities. Our findings confirm that the premises established in previous research are valid in Sweden too: Women have relatively stronger teaching merits and men relatively stronger research merits, and also that, on balance, research is rewarded more when applicants are ranked by reviewers. Accordingly, male applicants are ranked higher compared to female applicants.
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| 7. |
- Carnesten, Hillewi, et al.
(författare)
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Caring approach for patients with chest pain : Swedish registered nurses’ lived experiences in Emergency Medical Services
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Encountering patients with chest pain is common for Registered Nurses (RNs) in Emergency Medical Services (EMS) who are responsible for the patient’s medical and nursing care . From a lifeworld perspective, bodily illness is related to existential suffering, requiring knowledge to asses the situation from a holistic perspective . The aim of this study is to describe the caring approach when RNs encounter patients with chest pain.Methods: A phenomenological methodology to capture RNs’ lived experiences was chosen. Seven qualitative in-depth interviews were conducted at three ambulance stations in Sweden.Results: The essence of the caring approach while encountering patients with chest pain comprises two constituents; “trust based on confidence and competence” and “the collegial striving towards the best possible care”. Trust is two-parted; trust in oneself, and striving towards gaining the patient’s trust . Competence and experience when combined, develop into confidence especially in stressful situations. The caring approach is nurtured in a well-functioning collegial team.Conclusions: This study contributes to understanding the caring approach based on the specific patient’s lifeworld in holistic EMS care. By trusting oneself, the patient, and one’s colleague, RNs in EMS shift focus from medical-orientated care to a holistic lifeworld caring approach. More research is needed on trust as a phenomenon in EMS, both from caregivers’ and patients’ perspectives.
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| 8. |
- Erlingsson, Gissur Ó, 1974-, et al.
(författare)
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How Coerced Municipal Amalgamations Thwart the Values of Local Self-Government
- 2021
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Ingår i: Urban Affairs Review. - : Sage Publications. - 1078-0874 .- 1552-8332. ; 57:5, s. 1226-1251
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Tidskriftsartikel (refereegranskat)abstract
- Arguments invoking increased functional efficiency have had a profound impact on local government reforms in advanced democracies during the past 60 years. Consequently, most mature democracies have implemented municipal amalgamation reforms, often through top-down coercion. In this article, we demonstrate how far central governments have been willing to go, in terms of coercion, by providing an in-depth historical account of Swedish municipal amalgamations between 1952 and 1974. Debates on amalgamation reforms have typically revolved around pros and cons of mergers. But very few discussions have addressed the more fundamental moral problem of enforcing amalgamations through coercion. Often, large-scale mergers are carried through against the expressed will of municipalities who wish to remain self-governing. In this article, we present a normative defense of strong local self-government, based partly on values of individual autonomy, and partly on group-based human rights, and we show how coerced amalgamations are at odds with these values.
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| 9. |
- Erlingsson, Gissur, 1974-, et al.
(författare)
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Understanding Large-Scale Institutional Change : Social Conflicts and the Politics of Swedish Municipal Amalgamations 1952-1974
- 2015
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Ingår i: Scandinavian Journal of History. - London : Taylor & Francis. - 0346-8755 .- 1502-7716. ; 40:2, s. 195-214
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Tidskriftsartikel (refereegranskat)abstract
- A remarkable reform in modern Swedish political history was the transformation of the local government structure between 1952 and 1974. In a mere 22 years, the number of municipalities was reduced from 2,498 to 277. This study aims to answer how such large-scale reforms could come about politically, particularly since much of the literature on institutions and political reform asserts that carrying out large-scale political change should be a difficult task. Two opposing stories of institutional change are presented: evolutionary accounts, which see the amalgamations as rational adaptations to changing circumstances, are contrasted with a social conflict perspective, which explains amalgamations in terms of their distributional consequences. By investigating the processes leading up to this vast restructuring of Swedish local political geography, we demonstrate that an understanding of these reforms as rational adaptations to changing circumstances, made on the basis of consensus among leading political actors, is not accurate. The reforms were not as uncontroversial and non-conflictual as they often have been portrayed. Our results weaken the evolutionary approach to institutional change, whilst supporting the social conflict perspective.
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| 10. |
- Frank, Catharina, 1961-, et al.
(författare)
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Healthcare professionals’ perceptions of their work with patients of working age with heart failure
- 2018
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Ingår i: Nordic journal of nursing research. - : SAGE Publications Ltd. - 2057-1585 .- 2057-1593. ; 38:3, s. 160-166
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about healthcare professionals’ perspectives on rehabilitation in relation to heart failure. Still, collaboration between different professionals can impact patients. The purpose of this study was to describe healthcare professionals’ perceptions of their work with patients of working age with heart failure. The sample population consisted of six nurses, one physiotherapist and one cardiologist. One individual interview and two focus-group interviews were conducted. The interviews were analyzed using qualitative content analysis. Three descriptive categories were constructed: ‘the impact of heart failure on patients’ life situations’, ‘heart failure service’, and ‘patients’ process of returning to work’. To support patients, healthcare professionals need to find ways to combine patients’ personal needs with protocol-driven care. © The Author(s) 2017.
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