| 1. |
- Hedberg, Hans, et al.
(author)
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Effects of an advanced first aid course or real-time video communication with ambulance personnel on layperson first response for building-site severe injury events : a simulation study
- 2024
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In: BMC Emergency Medicine. - : BioMed Central (BMC). - 1471-227X. ; 24:1
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Journal article (peer-reviewed)abstract
- Background: The risk of high-energy trauma injuries on construction sites is relatively high. A delayed response time could affect outcomes after severe injury. This study assessed if an advanced first aid course for first aid response for laypersons (employees or apprentices) in the construction industry or real-time video communication and support with ambulance personnel, or neither, together with access to an advanced medical kit, would have an effect on immediate layperson vital responses in a severe injury scenario.Method: This was a controlled simulation study. Employees or apprentices at a construction site were recruited and randomly allocated into a group with video support or not, and advanced first aid course or not, and where one group had both. The primary outcomes were correct behavior to recognize and manage an occluded airway and correct behavior to stop life-threatening bleeding from a lower extremity injury. Secondary outcomes included head-to-toe assessment performed, placement of a pelvic sling, and application of remote vital signs monitors.Results: Ninety participants were included in 10 groups of 3 for each of 4 exposures. One group was tested first as a baseline group, and then later after having done the training course. Live video support was effective in controlling bleeding. A first aid course given beforehand did not seem to be as effective on controlling bleeding. Video support and the first aid course previously given improved the ability of bystanders to manage the airway, the combination of the two being no better than each of the interventions taken in isolation. Course exposure and video support together were not superior to the course by itself or video by itself, except regarding placing the biosensors on the injured after video support. Secondary results showed an association between video support and completing a head-to-toe assessment. Both interventions were associated with applying a pelvic sling.Conclusion: These findings show that laypersons, here construction industry employees, can be supported to achieve good performance as first responders in a major injury scenario. Prior training, but especially live video support without prior training, improves layperson performance in this setting.
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| 2. |
- Gyllencreutz, Lina, et al.
(author)
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Chemical incident preparedness among emergency medical service personnel
- 2024
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In: International Journal of Paramedicine. - : National EMS Management Association. - 2831-6967. ; :5, s. 103-117
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Journal article (peer-reviewed)abstract
- Background: Hazardous chemicals are essential for modern society but the use and transportation of them bears the risk of major incidents. Past incidents have revealed the importance of preparation and training of emergency medical service (EMS) personnel when responding to these incidents. However, studies have shown the level of preparedness to be insufficient. There is a lack of knowledge as to how EMS personnel perceive their preparedness and response when facing chemical incidents.Aim: The aim of this study was to qualitative investigate working procedures regarding chemical incidents among a cohort of EMS personnel.Method: Seventeen ambulance nurses from rural and urban areas were individually interviewed using four different realistic scenarios (vignettes). The transcribed text from the interviews was analyzed using qualitative content analysis.Result: The results were derived into two categories with underlying sub-categories: a struggle to organize the onsite work situation (insufficient managerial support, limited resources, trust in rescue services, difficult decision making, stressful responsibilities); and decontamination—a demanding and risky situation (risk management, work in protective gear, aggravating circumstances). Participants often lack real life experience in facing a chemical incident and training that improves preparedness and the ability to respond adequately.Conclusion: Chemical incidents pose many challenges for EMS personnel, but with proper training efforts many of these challenges could be solved. This study has shown the need for more accessible chemical incident training targeting EMS personnel: especially focusing on risk assessment; managerial support; resource management; equipment; and decontamination, including stress management and decision-making. Research in the area of chemical incidents is sparse and there remains much to understand concerning work procedures during chemical incidents.
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| 3. |
- Gyllencreutz, Lina, et al.
(author)
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Preparedness for chemical, radiologic and nuclear incidents among a sample of emergency physicians' and general practitioners' : a qualitative study
- 2023
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In: International Journal of Emergency Services. - : Emerald Group Publishing Limited. - 2047-0894 .- 2047-0908. ; 12:2, s. 161-170
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Journal article (peer-reviewed)abstract
- Purpose: This study describes preparedness of emergency physicians and general practitioners following chemical, radiological and nuclear incidents.Design/methodology/approach: Five emergency physicians and six general practitioners were interviewed individually, and data was analysed using qualitative content analysis.Findings: The study results showed that physicians' preparedness for chemical, radiological and nuclear incidents is linked to one main category: to be an expert and to seek expertise and two categories: preparations before receiving CRN patients, and physical examination and treatment of CRN patients with subcategories.Research limitations/implications: The results have implications for further research on the complexity of generalist vs specialist competence and knowledge when responding to chemical, radiological and nuclear incidents.Originality/value: This study provides insights regarding chemical, radiological and nuclear preparedness among physicians at emergency departments and primary healthcare centres.
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| 4. |
- Hedberg, Pia, 1972-, et al.
(author)
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Depression in relation to purpose in life among a very old population : a five-year follow-up study
- 2010
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In: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 14:6, s. 757-763
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Journal article (peer-reviewed)abstract
- Objectives: To investigate the relationship between purpose in life and depression and, in a five-year follow-up investigate whether purpose in life, adjusted for different background characteristics, can prevent very old men and women from developing depression. Methods: A cross-sectional study included 189 participants (120 women and 69 men) 85–103 years of age living in a county in northern Sweden. Those who had not been diagnosed as depressed at baseline were included in the five-year follow-up study (n=78). Depression was assessed using the Geriatric Depression Scale-15, the Organic Brain Syndrome scale, the Montgomery–Åsberg Depression Rating Scale, and Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Purpose in life was assessed with the Purpose in Life (PIL) scale. Results: In the cross-sectional study, 40 participants out of 189 (21.2%) were depressed, and those with depression had significantly lower PIL scores (mean score 107 vs. 99, p=0.014). In the follow-up study, 78 persons were available for the assessment of depression. Of those, 21 (26.9%) were diagnosed as depressed and their mean PIL score at baseline was 106 (SD=17.4) versus 108 (SD=16.0, p=0.750) among those not depressed. Using multivariate logistic regression analysis controlling for possible confounders, we found no association between purpose in life and the risk of developing depression after five years (OR=1.0, 95% CI 0.97–1.03). Conclusions: The results show a significant inverse relationship between purpose in life and depression in the cross-sectional study; however, a high PIL score does not seem to serve very old people as a protection against the risk of developing depression.
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| 5. |
- Hedberg, Pia, 1972-, et al.
(author)
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Experiences of purpose in life when becoming and being a very old woman
- 2009
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In: Journal of Women & Aging. - : Informa UK Limited. - 0895-2841 .- 1540-7322. ; 21:2, s. 125-137
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Journal article (peer-reviewed)abstract
- The aim of the study was to illuminate how very old women describe their experiences of purpose in life (PIL) in narratives about becoming and being very old. The participants comprised 30 women selected from 120 women who had answered the PIL test and had been interviewed about their experiences of being very old. The interviews were analyzed with qualitative content analysis, which revealed four themes: having a positive view of life, living in relation to God, having meaningful activities, and simply existing. Our findings show that very old women experience purpose in life both in their daily activities and in their contact with a spiritual world. It seems to be facilitated by a positive view of life. Although the results were dominated by a positive view of life, some of the participants saw their lives in terms of simply existing, and did not experience purpose in life.
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| 6. |
- Hedberg, Pia, 1972-, et al.
(author)
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Identification of a Very High Cuff Pressure byManual Palpation of the External Cuff Balloonon an Endotracheal Tube
- 2015
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In: Journal of american association of nurse anesthtists. - 0094-6354. ; 83:3, s. 179-182
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Journal article (peer-reviewed)abstract
- The most common complication due to intubation isa high cuff pressure. A high cuff pressure can causepostanesthetic tracheal mucosal injuries in patientsundergoing surgery. The aim of this cross-sectionalstudy was to describe whether anesthetic nurses andanesthesiologists identified a very high cuff pressureby manual palpation of the external cuff balloon onan endotracheal tube. An airway device was intubatedwith an endotracheal tube cuffed to 95 cm H2O. Eachparticipant palpated the external cuff balloon and thenfilled out a questionnaire, including estimation of thecuff pressure and user frequency of the cuff pressuremanometer. The results showed that 89.1% estimatedthat the cuff pressure was high. Among the participantswho rated the cuff pressure as high, 44.8% ratedthe pressure as quite high and 60.6% rated the pressureas very high. There was no significant relationshipbetween profession and skill in identifying a veryhigh cuff pressure (P = .843) or between work experienceand skill in terms of identifying a very high cuffpressure (P = .816). These findings indicate that 10%of patients are at risk of tracheal erosion because of ahigh cuff pressure.
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| 7. |
- Hedberg, Pia, 1972-, et al.
(author)
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Purpose in life among men and women aged 85 years and older
- 2010
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In: The International Journal of Aging & Human Development. - 0091-4150 .- 1541-3535. ; 70:3, s. 213-229
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate purpose in life in relation to psychological well-being, social relations, and physical and psychological symptoms among very old women (n = 120) and men (n = 69). Their purpose in life was evaluated using the Purpose in Life (PIL) scale. Women scored lower on this PIL scale than men (102 vs.108 p = .0.013). Regression analysis was used to estimate influencing factors on the PIL score. Determinants for purpose in life did not differ between the men and women, except for musculoskeletal symptoms. Attitude toward own aging had the strongest relation to PIL scores for both men and women; to have family to talk to was also important, as were musculoskeletal symptoms, for women. Our study indicates that the very old people studied were feeling indecisive about their purpose in life and that feelings are linked with poorer psychological health. For this reason, the purpose in life must be discussed and taken into consideration in the care of the elderly.
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| 8. |
- Hedberg, Pia, 1972-
(author)
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Purpose in life among very old people
- 2010
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Doctoral thesis (other academic/artistic)abstract
- The aim of this thesis is to explore purpose in life among very old people. The proportion of elderly is increasing in Sweden, especially among the group of very old aged over 85 years. Ageing has been associated from some perspectives with health, wisdom, maturity, and inner strength. Ageing can also, however, lead to reduced physical function, cognitive impairments, and loss of purpose in life. A loss of purpose in life can lead to mental health problems such as depression. This thesis is part of the Umeå 85 + study/GERDA begun in 2000. Half of all 85-year-olds, all 90-year-olds, and all those 95 years of age or older living in the municipality of Umeå were invited to the larger study, which was expanded in 2002 to include five rural municipalities in Västerbotten County with the same inclusion criteria. The Umeå 85 + study/GERDA is a collaborative project between several departments at Umeå University.Selection criteria for participants in the thesis were the ability to answer Likert-type questionnaires and the ability to participate in interviews. A follow-up study was conducted in Umeå in 2005 and in Västerbotten County in 2007. Paper I is a cross-sectional study with 189 participants (120 women and 69 men) who had responded to several questionnaires including the Purpose in Life test (PIL). In the results women scored significantly lower on the PIL test than men; attitudes towards one’s own aging were associated with purpose in life for both men and women; and musculoskeletal disorders were associated with lower purpose in life in women. Paper II includes the 189 participants from study I. In results at baseline the 40 who were diagnosed with depression had significantly lower purpose in life, and women were diagnosed with depression more often than men (32/120 women and 8/69 men). The 40 participants with a diagnosis of depression were excluded five years later, when 78 of 149 participants were available for the follow-up, 21 of whom (26.9%) had developed depression. There was no difference in the mean scores on the PIL test between those who had developed depression and those who had not. Purpose in life does not seem to protect very old people from developing depression.Paper III includes 51 people who responded to the PIL test on two occasions five years apart, and its results show that purpose in life decreased after five years. There was no difference in mean PIL scores at baseline between those with a diagnosis of depression and those without depression, but purpose in life declined significantly over the five years in those with diagnosed depression. In study IV, to gain a deeper understanding of purpose in life, content analysis was conducted on interviews from 30 women. To obtain 5 variety and breadth in the stories we selected 10 women with low estimated purpose in life, 10 women with undecided estimated purpose, and 10 women with high estimated purpose in life. The results show that despite the fact that women estimated their purpose in life lower than men, their stories were positive. The women experienced purpose in their daily life where social relations was important and on a spiritual level. However, there were also expressions of experiencing life as simply existing. In Study V we included 23 men who had responded to a question about purpose in life. Their answers were subjected to content analysis and the results show that for men work is an important part of purpose in life. All men except one had a positive outlook on life, and the men found purpose in life most strongly in memories of when they were younger.Lack of purpose in life can result in mental disorders like depression. Stereotypes of older people can affect their views of their own ageing, which in turn can weaken their purpose in life. To prevent mental illness it is important to experience purpose in life throughout life. Society at large and the health care system must consider purpose in life integral to mental health and work to combat ageist stereotypes to support purpose in life through the entire lifespan.
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| 9. |
- Hedberg, Pia, 1972-, et al.
(author)
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Purpose in life over a five-year period : a longitudinal study in a very old population
- 2011
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In: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 23:5, s. 806-813
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Journal article (peer-reviewed)abstract
- Background: Few studies have specifically examined purpose in life among very old people, and we know of none that has used a prospective approach. The aim of this study was to examine changes in pupose in life over five years in very old men and women and to investigate whether depressed mood, malnutrition, inactivity in daily life, or cognitive impairment increased the risk for developing low purpose in life.Methods: The study includes data from 51 participants (42 women and 9 men) living in Northern Sweden who completed the Purpose in Life Test once at baseline and again five years later.Results: Purpose in life decreased over five years and the decrease was significantly associated with being a woman (p<0.001) and having depressed mood (p=0.009) or depression (p=0.002) at baseline. There were no differences in baseline PIL scores between depressed and not depressed, but those who had depression had significantly decreased PIL scores after five years (p=0.001).Conclusion: A strong purpose in life does not seem to prevent very old people from developing depression, and being depressed at baseline and living with depression over five years is associated with a loss of purpose in life.
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| 10. |
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