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Sökning: WFRF:(Sund Levander Märta)

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  • Hellqvist, Carina, 1976-, et al. (författare)
  • Effects of self-management education for persons with Parkinson's disease and their care partners : A qualitative observational study in clinical care
  • 2020
  • Ingår i: Nursing and Health Sciences. - : John Wiley & Sons. - 1441-0745 .- 1442-2018.
  • Tidskriftsartikel (refereegranskat)abstract
    • Persons with Parkinson's disease and their care partners want support from healthcare to develop the skills to handle everyday life with disease. Earlier findings indicate that participants of the self‐management program Swedish National Parkinson School experience several benefits of the program. The purpose of this qualitative observational study was to explore if participants had implemented the strategies of self‐monitoring included in the program, and use them to communicate health care status and needs in clinical encounters. Data was collected 3–15 months after participation in the program and analysed using constant comparative analysis. Three categories were evident: “Self‐observation in everyday life”, “Self‐care activities to promote health” and “Managing emotional impact of Parkinson's Disease”. Categories were linked together in a core category that highlight the use of self‐management strategies described by participants during clinical encounters. Results confirmed that persons with Parkinson's disease and care partners use the techniques of self‐observation in their everyday lives. Observations of effects in clinical care can be a valuable approach to evaluate the outcomes educational interventions and their benefits for individuals and health care.This article is protected by copyright. All rights reserved.
  • Johansson, Rose-Marie, et al. (författare)
  • Guidelines for preventing urinary retention and bladder damage during hospital care
  • 2013
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 22:3/4, s. 347-355
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives.  To develop evidence-based guidelines for adult patients in order to prevent urinary retention and to minimise bladder damage and urinary tract infection.Background.  Urinary retention causing bladder damage is a well known complication in patients during hospital care. The most common treatment for urinary retention is an indwelling urinary catheter, which causes 80% of hospital-acquired urinary tract infections. Appropriate use of bladder ultrasonography can reduce the rate of bladder damage as well as the need to use an indwelling urinary catheter. It can also lead to a decrease in the rate of urinary tract infections, a lower risk of spread of multiresistant Gram-negative bacteria, and lower hospital costs.Design.  An expert group was established, and a literature review was performed.Methods.  On the basis of literature findings and consensus in the expert group, guidelines for clinical situations were constructed.Results.  The main points of the guidelines are the following: identification of risk factors for urinary retention, managing patients at risk of urinary retention, strategies for patients with urinary retention and patient documentation and information.Conclusion.  Using literature review and consensus technique based on a multiprofessional group of experts, evidence-based guidelines have been developed. Although consensus was reached, there are parts of the guidelines where the knowledge is weak.Relevance to clinical practice.  These guidelines are designed to be easy to use in clinical work and could be an important step towards minimising bladder damage and hospital-acquired urinary tract infections and their serious consequences, such as bacteraemia and the spread of multidrug-resistant bacteria in hospitals.
  • Vackerberg, Nicoline, et al. (författare)
  • What is best for Esther? Building improvement coaching capacity with and for users in health and social Care-A case study
  • 2016
  • Ingår i: Quality Management in Health Care. - : LIPPINCOTT WILLIAMS & WILKINS. - 1063-8628 .- 1550-5154. ; 25:1, s. 53-60
  • Tidskriftsartikel (refereegranskat)abstract
    • While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jonkoping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focusembodied by the senior citizen trainershared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations.
  • Allemann, Hanna, et al. (författare)
  • Nurses' actions in response to nursing assistants' observations of signs and symptoms of infections among nursing home residents
  • 2015
  • Ingår i: Nursing Open. - : Wiley-Blackwell. - 2054-1058. ; 2:3, s. 97-104
  • Tidskriftsartikel (refereegranskat)abstract
    • AimsTo describe what nurses do during episodes of suspected infection in elderly nursing home residents and if these actions are linked to who is initiating an episode and whether the episode is considered an infection or not.DesignProspective descriptive study. Data were collected in 2008–2010.MethodsSummarized and categorized documentation by nursing assistants and nurses was used for summative content analysis.ResultsNurses' actions seem to be related to who initiated the episode and if the episodes are categorized as ‘non-infection’, ‘possible infection’ or ‘infection’. Actions could be ‘observation’, ‘screenings’, ‘engaged in waiting’, ‘follow-ups’, ‘nurse-prescribed actions’, ‘diagnosing’, ‘contacting the physician’, ‘carrying out an action prescribed by the physician’, ‘contacting an ambulance or arranging an emergency visit to the hospital’ and ‘prescribing screening’. As NAs often initiate episodes of suspected infection by observing changed conditions, it seems important to include the NA in the decision-making process as these observations could detect possible early signs and symptoms of infections.
  • Carina, Hellqvist, et al. (författare)
  • A national Swedish self- management program for people with Parkinson’s disease : patients and relatives view
  • 2017
  • Ingår i: Movement Disorders. ; , s. 175-176
  • Konferensbidrag (refereegranskat)abstract
    • Objective: To identify and describe experiences that people with PD and their relatives after participation inthe self-management intervention NPS (National Parkinson School) find valuable for managing daily life.Background: A self-management program called NPS was developed as a collaboration of healthcare providers, researchers and patient organizations. NPS is aiming to provide tools and strategies for people with PD and their relatives to increase ability to manage symptoms and consequences of disease and thereby improving conditions for a good life. Self-monitoring and self-management are central concepts. NPS focuses on life with PD, which via 7 sessions consisting of education/lectures and group discussions are mediated. Home assignments make participants practice the new skills in their own life.Methods: The last session, evaluation of the NPS, was audio recorded in its whole and transcribed verbatim. Data was collected from five separate clinics and analysed both inductively and deductively using Thematic Analysis and by applying the Self-and Family management theory.Results: Through inductive analysis three themes; Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life and Promoting life satisfaction, were identified and described. The themes are capturing the meaning, value and experience of being a participant of NPS. Deductive analysis indicated thatthe Self-and Family management theory was useful and valid for this group of patients and generated a modified framework applicable for patients with PD and their families [figure1].Conclusions: Living with PD affects patients as well as relatives. Meeting others in the same situation gives support and strengthen their self- image. Having the opportunity sharing experiences and practical advices showed that there was a hopeful future to come. Techniques to accept and manage life with PD included seeking information about disease and treatments, self-monitoring in order to adjust to new situations and improve symptoms of disease and having a positive mind-set. Living an active life, participating in enjoyable social, cultural, and physical activities were important to feel happy and satisfied with life. Participation in NPS covered many areas of importance for the ability of self-management in PD. The framework for self-management in chronic disease was found relevant also for the PD population
  • Edberg, Anna-Karin, et al. (författare)
  • Vanliga symtom hos äldre
  • 2017
  • Ingår i: Omvårdnad & äldre. - Lund : Studentlitteratur. - 9789144102795 ; , s. 355-395
  • Bokkapitel (övrigt vetenskapligt)
  • Hellqvist, Carina, et al. (författare)
  • Improving self-management for persons with Parkinson's disease through education focusing on management of daily life : patients' and relatives' experience of the Swedish National Parkinson School.
  • 2018
  • Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 27:19-20, s. 3719-3728
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVE: The two folded aim of this study was firstly to identify and describe experiences valuable for managing daily life after participation in the NPS self-management intervention. The second part was to explore the applicability of the Self- and family management framework by Grey and colleagues for persons with Parkinson's Disease and their relatives.BACKGROUND: The impact of PD is evident on the lives of both patients and relatives. The National Parkinson School (NPS) is a Swedish self-management program designed for patients and relatives, aiming at teaching strategies helpful for the ability of self-management, in order to promote life satisfaction.DESIGN: Qualitative explorative with inductive and deductive analysis.METHODS: Five group discussions with NPS participants were audio-recorded. Verbatim transcriptions were analysed inductively with thematic analysis according to Braun and Clarke, and the findings were then applied deductively to the existing model for patients with chronic disease.RESULTS: Through the first step of inductive analysis three themes capturing the meaning, value and experience of being a participant at the NPS were identified: Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life, and Promoting life satisfaction. The deductive analysis applied the inductive findings to the Self-and family management framework of chronically ill to explore the fit to persons with PD and relatives attending the NPS program.CONCLUSIONS: The NPS program is a promising approach for helping persons with PD and their relatives to achieve better self-management of disease and improved life satisfaction. Further evaluations of program outcomes in clinical practice are warranted.RELEVANCE OF CLINICAL PRACTICE: Self-management programs like the NPS is a promising approach in facilitating a positive mind-set and outlook on life and gain knowledge to understand, adapt and handle chronic disease, such as PD, better. This article is protected by copyright. All rights reserved.
  • Sund Levander, Märta Helena, et al. (författare)
  • Fever or not fever - that's the question : A cohort study of simultaneously measured rectal and ear temperatures in febrile patients with suspected infection
  • 2018
  • Ingår i: Clinical Nursing Studies. - Toronto, Canada : Sciedu Press. - 2324-7940 .- 2324-7959. ; 6:2, s. 47-54
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To study how ear and rectal body temperatures relate to each other over time in febrile patients.Methods: Descriptive cohort study with repeated measurements. The setting was a Unit for Infectious Diseases at a county hospital in Sweden. Patients, ≥ 18 years, admitted for suspected infection and with a rectal or ear temperature of ≥ 37.5°C were invited. 16 females and 24 men, 19 to 94 years were included. Ear and rectal temperature was measured simultaneously every two hours for one day.Results: Mean rectal temperature was higher, compared to both ear sites. Ninety-five percent of the differences between the rectal and ear sites were within 0.6°C to 1.1°C. Changes in rectal temperature were smaller and slower than in ear temperature, especially when patients were given temperature-lowering drugs.Conclusions: Adjustments from one temperature site to another is a risk of diagnostic error affecting clinical decision-making. Ear temperature reacts faster than the rectal site to body temperature changes and antipyretics, and is therefore more reliable in the assessment of the patient’s condition. Traditional paradigm for temperature measurement and assessment needs to be replaced with evidence-based science to improve patient safety.
  • Sund-Levander, Märta, et al. (författare)
  • The Challenge of Infections in Frail Elderly : The Story of Mr. Nilsson
  • 2015
  • Ingår i: Clinical Medical Reviews and Case Reports. - 2378-3656. ; 2:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Signs and symptoms of infection in Nursing Home Residents (NHR) are often atypical with a lack of specific ones, causing a delay in diagnosis and treatment. The complexity of detecting infections in NHR can be explained by difficulties in understanding and interpreting non-specific signs and symptoms and co-existing chronic diseases that blur the clinical picture. The case of Mr. Nilsson illustrates the process from the first signs and symptoms of infection to diagnosis in an elderly person with severe cognitive decline and physical impairment. What we can learn from this case is to reflect on changed behavior from habitual status and/or non-specific symptoms as possible suspected infection, and to consider a rise from individual baseline temperature, so called DiffTemp™, instead of traditional decided cut-off values for fever.
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