| 1. |
- Khalaf, Atika, et al.
(författare)
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Caring for undernourished patients in an orthopaedic setting
- 2009
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 16:1, s. 5-18
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Tidskriftsartikel (refereegranskat)abstract
- This study elucidates the nursing of undernourished patients as experienced by eight registered clinical nurses and five nursing assistants by using content analysis. The participants' narratives describe the inner perspective of caring for undernourished patients, known in Sweden as `the thin ones'. Categories identified were: frustration in nursing, joy in nursing and that undernourishment is taboo. The taboo was narrated as feelings of guilt and shame. Frustration in nursing could be seen as feeling stressed, exposed, lonely, powerless, helpless, and being torn between demands and needs. Joy in nursing was experienced when creating a trusting relationship, promoting pleasure in the meal situation and working with respect for each individual's life-style and context of life. Understanding staff members' views is important when implementing guidelines as well as in the teaching situation in order to identify where staff stand with regard to knowledge and attitudes.
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| 2. |
- Argento, Daniela, et al.
(författare)
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Integrating sustainability in higher education : a Swedish case
- 2020
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Ingår i: International Journal of Sustainability in Higher Education. - : Emerald Group Publishing Limited. - 1467-6370 .- 1758-6739. ; 21:6, s. 1131-1150
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – This paper aims to unveil how sustainability is integrated into the courses/programmes ofhigher education institutions. The research question addressed is: how do academics representing differentdisciplines cooperate and engage in the work of integrating sustainability into their teaching programmes.Design/methodology/approach – This paper draws upon the notions of practise variation andinstitutional work from institutional theory and empirically focusses on the case of Kristianstad University(Sweden). This case is based on an autoethnographic approach and illustrates the experiences shared by sixcolleagues, representing different disciplines, engaged in implementing sustainability in their courses/programmes.Findings – The findings highlight how academics representing different disciplines, with specific traditionsand characteristics, face the sustainability challenge. Despite being bound by similar sustainable developmentgoals, differences across disciplines need to be acknowledged and used as an asset if trans-disciplinarity is theultimate goal.Research limitations/implications – Although the intrinsic motivation of individuals to work withsustainability might be a strong driver, the implementation of sustainability within courses/programmes andacross disciplines requires joint efforts and collective institutional work.Practical implications – By highlighting how academics engage in the work of integratingsustainability, this study emphasizes that managers of higher education institutions need to account for thetime and additional resources needed to ensure that academics effectively cope with sustainability. Intrinsicmotivation may not last if organizational structures and leadership are not supportive on a practical level andin the long run.
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| 3. |
- Brogårdh, Christina, et al.
(författare)
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Psychometric properties of the Walking Impact Scale (Walk-12) in persons with late effects of polio
- 2021
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Ingår i: PM&R. - : Wiley-Blackwell. - 1934-1482 .- 1934-1563. ; 13:3, s. 297-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many persons with late effects of polio (LEoP) perceive walking limitations in everyday life. A common rating scale to assess walking limitations is the Walking Impact Scale (Walk-12). However, there is limited knowledge about its psychometric properties.OBJECTIVE: To investigate the psychometric properties of Walk-12 in persons with LEoP.DESIGN: Rasch model analysis of cross-sectional data.SETTING: University Hospital.PARTICIPANTS: A total of 325 persons with LEoP (175 women; mean age 70 ± 10 yr).MAIN OUTCOME MEASUREMENT: The Walk-12, comprising 12 items with five response categories ranging from 1 (not at all) to 5 (extremely).METHODS: Data of Walk-12 were collected by a postal survey. The Rasch model analysis was used to analyze unidimensionality of the scale, local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed.RESULTS: The analysis revealed that Walk-12 was multidimensional and suffered from some local dependency. Targeting was compromised among persons with less and worse walking limitations. Hierarchically, the most difficult item to perform was "running" and the easiest was "walking indoors with support". There was a minor DIF for gender in one item ("support when walking outdoors"). Reliability was high (PSI = 0.94). Disordered response category thresholds were found for three items; when merging the middle response categories for these items model fit slightly improved and unidimensionality was achieved.CONCLUSION: The Walk-12, in its current version, does not fully meet the rigorous psychometric Rasch measurement standards in persons with LEoP. Further development of the scale is warranted, including merging response categories and complementing Walk-12 with objective measures of gait in order to improve targeting. As these limitations can be considered minor, the current version of Walk-12 can still be useful for research and clinical practice. This article is protected by copyright. All rights reserved.
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| 4. |
- Hagell, Peter, et al.
(författare)
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Measurement properties of the SF-12 Health Survey in Parkinson's disease
- 2011
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Ingår i: Journal of Parkinson's Disease. - : IOS Press. - 1877-7171 .- 1877-718X. ; 1:2, s. 185-196
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Tidskriftsartikel (refereegranskat)abstract
- The 12-item Short-Form Health Survey (SF-12) is an abbreviated version of the SF-36, one of the most widely used patient-reported health outcome rating scales. Similar to the SF-36, it yields summary scores of physical and mental health (PCS and MCS, respectively). However, SF-36 derived PCS and MCS scores have not been found valid in neurological disorders such as Parkinson's disease (PD). Here we used modern psychometric methodology (Rasch analysis) to test the SF-12 in PD, and explored the appropriateness of a total SF-12 score representing overall health. SF-12 data from 150 non-demented people with PD (56% men; mean age/PD-duration, 70/5 years) were analyzed regarding Rasch model fit for the PCS, MCS, as well as for the full SF-12. Data showed some signs of misfit to the Rasch model for all three scales (overall item-trait interaction, P ≥ 0.003; reliability, ≥ 0.85). For example, all scales exhibited signs of dependency between item responses, and the PCS measured with relatively low precision. Model fit (but not measurement precision) was improved following deletion of one PCS and one MCS item (overall item-trait interaction, P ≥ 0.387; reliability, ≥ 0.82). These observations suggest that the SF-12 can be used as a coarse health survey tool in PD and that a total SF-12 may be useful as a measure of overall health. However, its appropriateness as an outcome measure can be questioned and it is somewhat unclear exactly what the derived scores represent. As such, the SF-12 should probably be considered an assessment tool (or index) rather than a measurement instrument.
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| 5. |
- Jakobsson, Ulf, et al.
(författare)
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Construct validity of the SF-12 in three different samples
- 2012
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell. - 1356-1294 .- 1365-2753. ; 18:3, s. 560-566
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives Studies have challenged the validity and underlying measurement model of the physical and mental component summary scores of the 36-item Short-Form Health Survey in, for example the elderly and people with neurological disorders. However, it is unclear to what extent these observations translate to physical and mental component summary scores derived from the 12-item short form (SF-12) of the 36-item Short-Form Health Survey. This study evaluated the construct validity of the SF-12 in elderly people and people with Parkinson's disease (PD) and stroke.Methods SF-12 data from a general elderly (aged 75+) population (n = 4278), people with PD (n = 159) and stroke survivors (n = 89) were analysed regarding data quality, reliability (coefficient alpha) and internal construct validity. The latter was assessed through item-total correlations, exploratory and confirmatory factor analyses.Results Completeness of data was high (93–98.8%) and reliability was acceptable (0.78–0.85). Item-total correlations argued against the suggested items-to-summary scores structure in all three samples. Exploratory factor analyses failed to support a two-dimensional item structure among elderly and stroke survivors, and cross-loadings of items were seen in all three samples. Confirmatory factor analyses showed lack of fit between empirical data and the proposed items-to-summary measures structure in all samples.Conclusions These observations challenge the validity and interpretability of SF-12 scores among the elderly, people with PD and stroke survivors. The standard orthogonally weighted SF-12 scoring algorithm is cautioned against. Instead, when the assumed two-dimensional structure is supported in the data, oblique scoring algorithms appear preferable. Failure to consider basic scoring assumptions may yield misleading results.
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| 6. |
- Jakobsson, Ulf, et al.
(författare)
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Exploring determinants for quality of life among older people in pain and in need of help for daily living
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:3a, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. The aim of the study was to investigate the quality of life and related factors among older people who are in pain and in need of help to manage daily living. Background. To intervene against the low quality of life in nursing care knowledge about factors affecting it is needed and this is especially important for vulnerable people such as those who suffer from pain and who are in need of help to manage daily living. Methods. Five hundred and twenty-six people, aged 75–102 years participated in this study. Results. Those in pain reported a significantly higher degree of all complaints and lower quality of life in all measures compared with those not in pain. Overall quality of life was associated with mobility problems, sleeping problems and depressed mood, while health-related quality of life was associated with living in special accommodations, walking problems, mobility problems and fatigue. Conclusions. Those in need of help to manage daily living and in pain seem to be at higher risk of lowered quality of life than those not in pain and the lower quality of life among those in pain is probably caused by the complex of complaints rather than pain per se. Relevance to clinical practice. Daily nursing care should identify and treat the complex of complaints related to pain as well as pain itself, to improve everyday life and quality of life for older people in pain.
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| 7. |
- Jakobsson, Ulf, et al.
(författare)
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Statistical methods for assessing agreement for ordinal data
- 2005
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 19:4, s. 427-431
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Tidskriftsartikel (refereegranskat)abstract
- Evaluation of various methods in clinical practice is often based on interpretations by two or more observers. Such data need to be analysed with correct statistics, or the results and conclusions may be misleading. In this study, the use of measures of agreement for ordinal data in five international nursing journals is reviewed and various methods for measuring agreement are presented and discussed. Analyses of agreement did not seem to be very common in nursing research, but a great variation was found regarding the choice of method for analysing agreement. Both acceptable and unacceptable methods were found in the articles reviewed. When choosing among various methods for agreement the weighted κ-coefficient is probably the most useful for ordinal data, but several issues of concern arise and need to be taken into consideration when using these types of analyses.
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| 8. |
- Lindskov, Susanne, et al.
(författare)
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A controlled trial of an educational programme for people with Parkinson's disease
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:11C, s. 368-376
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVE: To evaluate patient-reported health outcomes of a multidisciplinary group educational programme for people with Parkinson's disease (PD), delivered as part of routine clinical practice. BACKGROUND: Studies suggest that educational programmes for people with PD have potential to improve patients' perceived health and well-being. However, controlled trials of multidisciplinary group educational programmes are lacking. DESIGN: Naturalistic non-randomized controlled trial. METHODS: Following ethical approval and informed consent, 48 people with PD (58% men; mean age, 69.3) received the intervention and 48 (52% men; mean age, 72) were allocated to a delayed intervention control group. The intervention was a six-week (two hours per week) multidisciplinary group educational programme. Patient-reported health outcomes were assessed by the 12-item short-form health survey (SF-12) at baseline and one month postintervention. RESULTS: Changes in SF-12 scores at follow-up did not differ between the groups and there were no within-group differences over time. Daily dopaminergic medication increased in the control group but not in the intervention group. CONCLUSIONS: Slightly, but significantly, increased drug requirement in the control group may in part have masked deterioration in perceived health. However, failure to demonstrate improved patient-reported health may relate to the intervention design, response shift (i.e. change in how people perceive their health), and/or quality and choice of outcome measures. Further studies that take these aspects into consideration are needed to determine the potential for patient education interventions in PD. RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals need to document the effects of patient educational programmes and to be aware of the importance of intervention design and challenges associated with evaluating programme outcomes. Otherwise, there is a risk that benefits cannot be demonstrated and that decision makers will not invest resources in interventions that actually are beneficial for chronically ill people.
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| 9. |
- Stenzelius, Karin, et al.
(författare)
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Bowel function among people 75+ reporting faecal incontinence in relation to help seeking, dependency and quality of life
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:3, s. 458-468
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The aim was to compare faecal incontinence and related bowel symptoms among men and women and being dependent or not (aged >or=75 years) and furthermore to identify which bowel symptoms predicted help seeking, dependency and low quality of life (QoL). BACKGROUND: Faecal incontinence (FI) in old age is a common condition and influences daily life to a great extent, although few actually seek medical help. METHODS: A total of 248 people with reported difficulties controlling faeces answered a postal questionnaire or were interviewed with questions about FI-related bowel symptoms. A factor analysis resulted in four areas of bowel symptoms and was used in logistic regression with help seeking, dependency and low QoL as dependent variables. RESULTS: Of all the subjects, 56.4% had leakage, 54.7% did not reach the toilet in time, 55.6% had incomplete emptying, 27.9% had hard stool, 36.8% bother from moisture from the anus, 32.2% could not withstand urgency for five minutes and 17% had red skin or wounds in the genital region. Women and those dependent were most affected. Totally 40.8% had sought help and 30.1% used protective aids. Leakage, discomfort, consistency and contractibility symptoms were the categories of bowel symptoms related to FI. Discomfort predicted help seeking (OR 3.0), dependency (OR 1.5) and physical QoL (OR 1.7). Leakage predicted help seeking (OR 1.9) but not dependency and QoL. CONCLUSIONS: Overall bowel function was disturbed among those with FI and unmet needs seem problematic especially for women and those needing help in Activities of Daily Living (ADL). Encouragement to seek and get medical help and to use protective aids may improve the very low quality of life in this group. RELEVANCE TO CLINICAL PRACTICE: Older people with FI should be asked about, assessed for and examined for overall bowel function to get adequate treatment and be encouraged to use protection.
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| 10. |
- Westergren, Albert, 1967-, et al.
(författare)
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Conceptual relationships between the ICF and experiences of mealtimes and related tasks among persons with Parkinson’s disease
- 2016
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Ingår i: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 36:4, s. 201-208
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate experiences of mealtimes and related tasks among people with Parkinson’s disease (PD) and to link these conceptually to the International Classification of Functioning, Disability and Health (ICF). Data were collected by use of semi-structured interviews of 19 people with PD. Inductive content analysis resulted in five categories: 1) Managing mealtime preparations and related tasks, 2) Compromised physical control, 3) Difficulties enjoying meals, 4) Difficulties eating together with others, and 5) Strategies to maintain conventional norms and independence. Deductive content analysis linked the categories to the ICF categories: body functions (mental, sensory, neuromusculoskeletal and movement-related functions); activities (self-determination and chores); participation (interpersonal interactions and relationships); and environmental factors (conventional norms, attitudes of friends and strangers). Emotional and involuntary movement functions were represented in all five inductively derived categories. Eating difficulties may have negative consequences on participation and the emotional wellbeing of people with Parkinson’s disease.
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