| 1. |
- Almborg, Ann-Helene, et al.
(författare)
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Discharged after stroke - important factors for health-related quality of life
- 2010
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 19:15-16, s. 2196-2206
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Tidskriftsartikel (refereegranskat)abstract
- Aims. This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke. Background. HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge. Design. Cross-sectional study. Methods. The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL. Results. Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL. Conclusions. Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests. Relevance to clinical practice. These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.
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| 2. |
- Janlöv, Ann-Christin, et al.
(författare)
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An improvement program as a way to intensify inter-professional collaboration in the community for people with mental disabilities : a follow-up
- 2016
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 37:12, s. 885-893
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to follow up inter-professional experiences of improvement work one year after a completed CII improvement program aiming at improve health care and social services for people with mental disabilities living in ordinary housing. This study was performed with a qualitative descriptive approach which employed six focus group interviews followed by a thematic analysis. The results revealed four themes; Self-awareness and insights; Behavior and actions in daily practice; Organizational cultures and subcultures; and Organizational practices, using Ken Wilbers' integral theory of four quadrants of realities as a holistic frame in the discussion.
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| 3. |
- Almborg, Ann-Helene, et al.
(författare)
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Discharge planning of stroke patients : the relatives' perceptions of participation
- 2009
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. - 0962-1067 ; 18:6, s. 857-865
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Tidskriftsartikel (refereegranskat)abstract
- To describe relatives' perceived participation in discharge planning for patients with stroke and identify correlates to perceived participation. Stroke affects both patients and their relatives and previous research shows that relatives were often dissatisfied with their perceived involvement in discharge planning and the information they get. Prospective cross-sectional study. The study comprised 152 consecutively enrolled relatives (mean age = 60.8 years) of acute stroke patients admitted to a stroke unit in southern Sweden during 2003-2005. Data were collected through interviews 2-3 weeks after discharge using 'Relative's Questionnaire about Participation in Discharge planning'. This instrument measures perceived participation in three subscales: R-Information-Illness, R-Information-Care/support, and R-Goals and Needs. The Overall Rating of Relative's Perceived Participation in Discharge Planning was measured by a visual analogue scale (VAS) (1-10 score). Among the relatives, 56-68% reported positively according to R-Information-Illness, but 46-53% perceived that they did not receive any information about care/medication/rehabilitation/support. About 80% perceived no participation at all in goals and needs. The mean value of the VAS was 3.89 (SD 3.40) score. Regression analyses revealed that longer stay at hospital, patients with higher education, and relatives of female patients and female relatives were associated with relatives' perceptions of higher participation in discharge planning. Relatives perceived that they needed more information and knowledge about stroke and care/medication/rehabilitation/support. They also needed to be more involved in goal-setting and in identifying patient needs. Professionals should take into consideration these associated variables to improve relatives' perceived participation. Clinicians should give more attention to the altered situation of stroke patients' relatives when planning for continuing care and when setting postdischarge goals for the patients. The professionals need to develop strategies to involve relatives in sharing information, goal-setting and needs assessment in discharge planning.
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| 4. |
- Bala, Sidona-Valentina, et al.
(författare)
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The experience of care at nurse-led rheumatology clinics
- 2012
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Ingår i: Musculoskeletal Care. - : Wiley. - 1478-2189 .- 1557-0681. ; 10:4, s. 202-211
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics. Methods Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis. Results Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety. Conclusion The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.
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| 5. |
- Bertills, Karin, et al.
(författare)
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Measuring self-efficacy, aptitude to participate and functioning in students with and without impairments
- 2018
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Ingår i: European Journal of Special Needs Education. - : Taylor & Francis. - 0885-6257 .- 1469-591X. ; 33:4, s. 572-583
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Tidskriftsartikel (refereegranskat)abstract
- Including vulnerable groups of students such as students with learning disabilities in mainstream school research, require ethical considerations and questionnaire adaptation. These students are often excluded, due to low understanding or methodologies generating inadequate data. Students with disability need be studied as a separate group and provided accessible questionnaires. This pilot study aims at developing and evaluating student self-reported measures, rating aspects of student experiences of school-based Physical Education (PE). Instrument design, reliability and validity were examined in Swedish secondary school students (n = 47) including students, aged 13, with intellectual disability (n = 5) and without impairment and test–retested on 28 of these students. Psychometric results from the small pilot-study sample were confirmed in analyses based on replies from the first wave of data collection in the main study (n = 450). Results show adequate internal consistency, factor structure and relations between measures. In conclusion, reliability and validity were satisfactory in scales to measure self-efficacy in general, in PE, and aptitude to participate. Adapting proxy ratings for functioning into self-reports indicated problems. Adequacy of adjustments made were confirmed and a dichotomous scale for typical/atypical function is suggested for further analyses.
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| 6. |
- Björklund, Margereth, 1950-, et al.
(författare)
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Health promoting contacts as encountered by individuals with head and neck cancer
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - 1752-9816 .- 1752-9824. ; 1:3, s. 261-268
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer. Background. Head and neck cancer has a profound and chronic impact on the individual's everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual's health. Design. A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed. Findings. Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one's illness story; having a working relationship with health professionals and receiving individualised, tailored care. Conclusions. Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient's lifeworld in relation to health, illness and suffering and focusing on the individual's personal strengths and health resources. Relevance to clinical practice. The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.
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| 7. |
- Björklund, Margereth, 1950-, et al.
(författare)
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Health promotion and empowerment from the perspective of individuals living with head and neck cancer
- 2008
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Ingår i: European Journal of Oncology Nursing. - 1462-3889 .- 1532-2122. ; 12:1, s. 26-34
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to shed light on health promotion from the perspective of individuals living with head and neck cancer. Eight informants were interviewed and latent content analysis was used. Individuals living with head and neck cancer experienced many problems that had a negative impact on their health. One overarching main theme was demonstrated; the ability to regain control and empower oneself. Three themes emerged: (1) Being enabled by dialogue with one's inner self, including three sub-themes: transformed and improved self-esteem, recognising and embracing existentiality, and increased self-determination. (2) Being enabled by means of contact with a social network, including two sub-themes: emotional support and practical support. (3) Being enabled by means of contact with and a passion for the environment, including two sub-themes: nature, hobbies and activities. Empowerment, the goal of health promotion, was understood as an ongoing process, and the ability to promote health varied and was dependent on internal and external enabling of acting and doing. The interpretation of this ongoing process demonstrates interplay assisted by a dialogue with one's inner self, contact with a social network and a passion for the environment. Altogether, these findings may inspire nurses and other health care professionals to support the individual's empowerment process and pose non-pathology-oriented questions such as "what improves your health?" or "what makes you feel good?"
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| 8. |
- Björklund, Margereth, 1950-, et al.
(författare)
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Living with head and neck cancer : a profile of captivity
- 2010
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - 1752-9816 .- 1752-9824. ; 2:1, s. 22-31
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To illuminate what it means to live with head and neck cancer.Background. Patients could experience head and neck cancer as more emotionally traumatic than other cancers because of visible disfigurement and its life-threatening impact on vital functions. This long-term illness often leads to lifestyle changes such as to physical function, work and everyday tasks, interpersonal relationships and social functioning.Design. This study used a qualitative and explorative longitudinal and prospective design with semi-structured interviews and open-ended questions. Twenty-one interviews were conducted with six participants with newly diagnosed or newly recurrent head and neck cancer. The analysis was descriptive and interpretive.Findings. The participants were living 'in captivity' in the sense that their symptoms were constant reminders of the disease. Our findings also revealed existential loneliness and spiritual growth, as interpreted within six themes: altered sense of affiliation; hostage of health care; locked up in a broken body, but with a free spirit; confined in a rogue body, forced dependency on others, and caught up in a permanent illness trajectory.Conclusions. Living with head and neck cancer involves emotional and existential vulnerability. The participants and their next of kin experienced insufficient support from health services and inadequate coordination between phases of their lengthy illness trajectory. These findings call for changes in oncological rehabilitation and management. Patient care must take a holistic view of everyone involved, centring on the individual and the promotion of health. A care coordinator could navigate between the individual patient needs and appropriate health services, hopefully with results that lessen the individual's emotional and existential confinement.
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| 9. |
- Einberg, Eva-Lena, et al.
(författare)
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'Through my eyes' : health-promoting factors described by photographs taken by children with experience of cancer treatment
- 2016
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Ingår i: Child: care, health and development. - 0305-1862 .- 1365-2214. ; 42:1, s. 76-86
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Health promotion for children with cancer should be based on the children's own needs and desires. Because there is a lack of knowledge in this area, the aim of this study was to explore what promotes health from the perspective of children with experience of cancer treatment.METHODS:Fifteen children between 8 and 12 years of age participated in focus groups with three children in each group. The children were given a camera and instructions to photograph subjects that promote their health. Focus group discussions were based on the photographs and the children's own description of those photographs. The analysis of focus group discussions and photographs was conducted using inductive content analysis.RESULTS:According to the children, health-promoting factors are defined as meaningful relationships, recreational activities and a trustful environment. Meaningful relationships include togetherness within the family, affection for pets and friendship with peers. Recreational activities include engagement in play and leisure, withdrawal for relaxation and feeling enjoyment. Trustful environment includes confidence in significant others and feeling safe.CONCLUSIONS:Knowledge from this study can contribute to health promotion interventions and quality improvements in the health care of children with experience of cancer treatment. Children's experiences with what promotes health in their everyday lives provide a better understanding of the type of support children prefer when promoting their own health.
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| 10. |
- Elgán, Carina, 1962-, et al.
(författare)
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Bone mineral density in relation to body mass index among young women : a prospective cohort study
- 2006
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 43:6, s. 663-672
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To identify important predictors among lifestyle behaviours and physiological factors of bone mineral density (BMD) in relation to body mass index (BMI) among young women over a 2-year period. DESIGN, SAMPLE AND MEASUREMENTS: Data were collected in 1999 and 2001. Healthy young women (n=152) completed a questionnaire. BMD measurements were performed by DEXA in the calcaneus. The women were subdivided into three categories according to baseline BMI. RESULTS: Baseline bodyweight explained 25% of the variability in BMD at follow-up in the BMI<19 category, and high physical activity seemed to hinder BMD development. In the BMI>24 category, a difference in time spent outdoors during winter between baseline and follow-up was the single most important factor for BMD levels. Overweight women with periods of amenorrhoea had lower BMD than overweight women without such periods. CONCLUSIONS: Predictors and lifestyle behaviours associated with BMD are likely to be based on women of normal weight. BMI should be considered when advising on physical activity, since high physical activity seems to impair BMD development among underweight young women, possibly due to energy imbalance. Among overweight women, sleep satisfaction is the greatest predictor associated with BMD change and may indicate better bone formation conditions. Energy balance and sleep quality may be prerequisites of bone health and should be considered in prevention.
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