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1.
  • Arenhall, Eva, et al. (författare)
  • The female partners' experiences of intimate relationship after a first myocardial infarction
  • 2011
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 20:11/12, s. 1677-1684
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. This study aimed to explore and describe women’s experience of intimate relationships in connection to and after their partner’s first myocardial infarction (MI).Background. Support from partners is important for recovery, but little is known about partners’ experience of intimate relationships after MI.Design. The study used an explorative, qualitative design.Methods. The first author interviewed 20 women having a partner who had suffered a first MI during the preceding year. Qualitative content analysis was used to analyse the data.Findings. Three themes emerged: ‘limited life space’, ‘sense of life lost’ and ‘another dimension of life’. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: ‘uncertainty of life’, ‘certain of relationship’ and ‘share life more’.Conclusions. The partners’ MI had an impact on the interviewees’ intimate relationships; they suffered a major loss and missed their ‘former’ partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners’ lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space.Relevance to clinical practice. Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following MI.
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2.
  • Arenhall, Eva, et al. (författare)
  • The male partners' experiences of the intimate relationships after a first myocardial infarction
  • 2011
  • Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151. ; 10, s. 108-114
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.Aim: This study aimed to explore and describe the experience of men’s intimate relationships in connection to and after their female partner’s first MI.Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis.Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.Conclusions: After their spouse’s MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders.
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3.
  • Brannstrom, Margareta, et al. (författare)
  • Sexual Knowledge in Patients With a Myocardial Infarction and Their Partners
  • 2014
  • Ingår i: Journal of Cardiovascular Nursing. - Lippincott, Williams andamp; Wilkins. - 0889-4655. ; 29:4, s. 332-339
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Sexual health and sexual activity are important elements of an individuals well-being. For couples, this topic is often affected after a myocardial infarction (MI). It has become increasingly clear that, after an MI, patients are insufficiently educated on how to resume normal sexual activity. However, sufficient data on the general knowledge that patients and partners have about sexual activity and MI are lacking. Objective: The aims of this study were to explore and compare patients and partners sexual knowledge 1 month after a first MI and 1 year after the event and to compare whether the individual knowledge had changed over time. A second aim was to investigate whether patients and their partners report receiving information about sexual health and sexual activity from healthcare professionals during the first year after the event and how this information was perceived. Subjects and Methods: This descriptive, comparative survey study enrolled participants from 13 Swedish hospitals in 2007-2009. A total of 115 patients with a first MI and their partners answered the Sex After MI Knowledge Test questionnaire 1 month after the MI and 1 year after the event. Correct responses generated a maximum score of 75. Results: Only 41% of patients and 31% of partners stated that they had received information on sex and relationships at the 1 year follow-up. The patients scored 51 +/- 10 on the Sex After MI Knowledge Test at inclusion into the study, compared with the 52 +/- 10 score for the partners. At the 1-year follow-up, the patients knowledge had significantly increased to a score of 55 +/- 7, but the partners knowledge did not significantly change (53 +/- 10). Conclusions: First MI patients and their partners reported receiving limited information about sexual issues during the cardiac rehabilitation and had limited knowledge about sexual health and sexual activity.
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4.
  • Eriksson, Anders, et al. (författare)
  • Skeletal muscle morphology in power-lifters with and without anabolic steroids
  • 2005
  • Ingår i: Histochemistry and Cell Biology. - 0948-6143. ; 124:2, s. 167-175
  • Tidskriftsartikel (refereegranskat)abstract
    • The morphological appearance of the vastus lateralis (VL) muscle from high-level power-lifters on long-term anabolic steroid supplementation (PAS) and power-lifters never taking anabolic steroids (P) was compared. The effects of long- and short-term supplementation were compared. Enzyme-immunohistochemical investigations were performed to assess muscle fiber type composition, fiber area, number of myonuclei per fiber, internal myonuclei, myonuclear domains and proportion of satellite cells. The PAS group had larger type I, IIA, IIAB and IIC fiber areas (p<0.05). The number of myonuclei/fiber and the proportion of central nuclei were significantly higher in the PAS group (p<0.05). Similar results were seen in the trapezius muscle (T) but additionally, in T the proportion of fibers expressing developmental myosin isoforms was higher in the PAS group compared to the P group. Further, in VL, the PAS group had significantly larger nuclear domains in fibers containing > or = 5 myonuclei. The results of AS on VL morphology in this study were similar to previously reported short-term effects of AS on VL. The initial effects from AS appear to be maintained for several years.
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5.
  • Ernesäter, Annica, et al. (författare)
  • Incident reporting within nurse-led national telephone triage in Sweden: : reported errors reveal a pattern that needs to be broken
  • 2010
  • Ingår i: Journal of Telemedicine and Telecare. - 1357-633X. ; 16:5, s. 243-247
  • Tidskriftsartikel (refereegranskat)abstract
    • We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data were collected during 2007 from all county councils that participated in the SHD and were analysed using content analysis. Incident reports were then compared concerning differences in reported categories and who reported the errors. The 426 incident reports included 452 errors. Of the analysed incident reports, 41% concerned accessibility problems, 25% incorrect assessment, 15% routines/guidelines, 13% technical problems and 6% information and communication. The most frequent outgoing incident reports (i.e. sent from SHD to other health-care providers) concerned accessibility problems and the most frequently incoming reports (i.e. sent to SHD from other health-care providers) concerned incorrect assessment. There was a significant difference (P <  0.001) between outgoing and incoming reports regarding the main category. Telenurses have limited possibilities for referring the caller to their primary health-care provider or specialist, which may cause them to over-triage or under-triage the callers' need for care. This over-triage or under-triage may in turn cause other health-care providers to report incorrect assessment to SHD. The implications for practice are that poor accessibility is a matter that should be addressed and that the reasons for incorrect assessment should be explored.
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6.
  • Ernesäter, Annica, et al. (författare)
  • Malpractice claims regarding calls to Swedish telephone advice nursing : what went wrong and why?
  • 2012
  • Ingår i: Journal of Telemedicine and Telecare. - 1357-633X. ; 18:7, s. 379-383
  • Tidskriftsartikel (refereegranskat)abstract
    • We analysed the characteristics of all malpractice claims arising out of telephone calls to Swedish Healthcare Direct (SHD) during 2003–2010 (n = 33). The National Board of Health and Welfare's (NBHW) investigations describing the causes of the malpractice claims and the healthcare providers' reported measures were analysed using Qualitative Content Analysis. The original telephone calls themselves, which had been recorded, were analysed using the Roter Interaction Analysis System (RIAS). Among the 33 cases, 13 patients died and 12 were admitted to intensive care. Failure to listen to the caller (n = 12) was the most common reason for malpractice claims, and work-group discussion (n = 13) was the most common measure taken to prevent future re-occurrence. Male patients (n = 19) were in the majority, and females (n = 24) were the most common callers. The most common symptoms were abdominal (n = 11) and chest pain (n = 6). Telenurses followed up on caller understanding in six calls, and mainly used closed-ended questions. Despite the severity of these malpractice claims, the measures taken mainly addressed active failure, rather than the latent conditions. Third-party communication should be regarded as a risk. When callers make repeated contacts, telenurses need to re-evaluate their need for care.
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7.
  • Flackman, Birgitta, et al. (författare)
  • Struggling to adapt : caring for older persons while under threat of organizational change and termination notice
  • 2009
  • Ingår i: Nursing Inquiry. - 1320-7881. ; 16:1, s. 82-91
  • Tidskriftsartikel (refereegranskat)abstract
    • FLACKMAN B, HANSEBO G and KIHLGREN A. Nursing Inquiry 2009; 16: 82-91 Struggling to adapt: caring for older persons while under threat of organizational change and termination notice Organizational changes are common in elder care today. Such changes affect caregivers, who are essential to providing good quality care. The aim of the present study was to illuminate caregivers' experiences of working in elder care while under threat of organizational change and termination notice. Qualitative content analysis was used to examine interview data from 11 caregivers. Interviews were conducted at three occasions during a two-year period. The findings show a transition in their experiences from 'having a professional identity and self-confidence', to 'being a professional in a threatening situation caused by someone else' and to 'struggling to adapt to a changed working environment as a person and a professional'. The caregivers experienced a loss of pride and satisfaction. Previous literature indicates that this may have consequences for the quality of care and that employees may be at risk of negative health effects. However, the caregivers continued to struggle, doing their best to complete their duties. The study has implications for high-level decision-makers, managers and caregivers in similar work-life situations in that it deals with factors that facilitate or impede similar transitions.
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8.
  • Flygare, Erik, et al. (författare)
  • Lessons From a Concurrent Evaluation of Eight Antibullying Programs Used in Sweden
  • 2013
  • Ingår i: American Journal of Evaluation. - 1098-2140. ; 34:2, s. 170-189
  • Tidskriftsartikel (refereegranskat)abstract
    • Sweden has a low prevalence of bullying and Swedish schools are legally obliged to have anti-bullying policies. Many commercial programs are available. A mixed methods, quasi-experimental, concurrent evaluation of 8 programs, chosen from a pool of 21 widely used anti-bullying programs, was planned. Preliminary data, based on 835 stakeholder interviews, both individual and group, revealed extensive program-contamination in "treatment" schools (n = 31), and extensive program use in nominally designated control/comparison schools (n = 8). An evolved evaluation strategy focused on arrays of program components, use of which was assessed through detailed qualitative data gathered from principals, teaching and non-teaching staff, anti-bullying teams, and pupils. Bullying victimization, Grades 4-9, in 39 schools, was assessed by questionnaire, administered in three waves. Response rates were 76.1% (with N = 10,919) at the first wave, 74.3% (of 10,660) at the second wave, and 70.6% (of 10,523) at the final wave. Longitudinal aggregate and individual outcomes (3,487 pupils answered all three questionnaires) were assessed. Prevalence of victimization was 8.1% at first wave and (7.4% at last). Based on individual data, persistent victimization (bullied at both waves) was estimated at 1.5% with 4.7% experiencing a worsening situation (not bullied at the first wave but bullied at last) and 4.8% with an improved situation. Hierarchical cluster analysis was used to designate intervention types (shared arrays of strong, weak, or absent component use) and schools with similar approaches. A quasi-experimental, longitudinal design with individual data and an aggregate cross-sectional follow-up indicated differences in effective, ineffective, and iatrogenic components, component clusters (intervention types), and successful schools.
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9.
  • Flygare, Erik, et al. (författare)
  • Utvärdering av metoder mot mobbning
  • 2011
  • Rapport (övrigt vetenskapligt)abstract
    • Denna utvärdering ger besked om insatser och arbetssätt som effektivt förebygger och åtgärdar mobbning. Utvärderingen är unik genom att den omfattar stora mängder data, både kvalitativa och kvantitativa från 39 skolor, att enskilda individers utsatthet följs upp vid tre tillfällen och att den omfattar flera program samtidigt.Resultaten visar bland annat att olika insatser har olika effekt för pojkar och flickor samt olika effekt beroende på om mobbningen är social eller fysisk. Den visar också att ingen enskild insats har dramatiskt positiva effekter. För att en skola ska lyckas förebygga och åtgärda mobbning krävs ett systematiskt arbete och en kombination av insatser. Åtta namngivna program som används mot mobbning har ingått i utvärderingen: Farstametoden, Friends, Lions Quest, Olweusprogrammet, SET - Social och emotionell träning, Skolkomet, Skolmedling samt Stegvis. I utvärderingens fristående metodfördjupning Utvärdering av metoder mot mobbning. Metodappendix och bilagor till rapport 353, (endast publicerad som pdf ) redovisar forskarna utförligt utvärderingens design och redogör för tillvägagångssättet vid datainsamling och analys.
10.
  • Fläckman, Birgitta, et al. (författare)
  • Despite shattered expectations a willingness to care for elders remains with education and clinical supervision
  • 2007
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 21:3, s. 379-389
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim was to describe nursing home (NH) caregivers' work experiences while receiving education and clinical supervision for 2 years. Working in elder care seems to be losing its attraction especially with organizational changes, cutbacks and changes in work place conditions. Clinical supervision has been reported to increase job satisfaction and creativity. Semi-structured interviews from caregivers working at an NH in Sweden were conducted, at the start and again at 12 and 24 months. At about 12 months the caregivers were informed of planned cutbacks. Content analysis was the method used to analyse the interviews from seven caregivers who participated throughout the entire period. Findings show that the value of a caring milieu was one category generated by the subcategories: experiences related to work activities and changes, and experiences related to relationships. The value of knowledge was the other category that was influenced by the experiences related to the different backgrounds and the experiences related to increased knowledge gained from the support through education and clinical supervision. The categories contained positive as well as negative influences on care. The initial focus on practical duties associated with the opening of the NH shifted towards caregiver activities with the elders they spoke warmly about. After 2 years the caregivers' willingness to care continued despite their disappointment in the worsened working conditions. The main theme that resulted was: Despite shattered expectations a willingness to care for elders remained. Continued education and clinical supervision seems to be one factor behind the retained willingness. These findings demonstrate that support and caregiver involvement in educational programmes are important during times of change and when disappointments arise in the workplace.
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