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  • Elden, Helen, 1959-, et al. (författare)
  • Demanding and challenging: Men's experiences of living with a pregnant woman with pelvic girdle pain: An interview study
  • 2014
  • Ingår i: Clinical Nursing Studies. - 2324-7940. ; 2:4, s. 17-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Pelvic girdle pain (PGP) is a universally disabling condition affecting approximately 50% of pregnant women. Qualitative research describes how PGP leads to struggle in women’s daily lives, makes them question and doubt their roles and identities as professionals and mothers, and test their (marital) relationships. The purpose of this study was to describe men’s experiences of living with a pregnant woman with PGP. Methods: Participants were men whose pregnant partners participated in a project containing both qualitative and quantitative studies in 2009 to 2011. Interviews were conducted in person (n=18) or by telephone (n=8), lasting approximately 20-50 minutes. Sixteen men were interviewed during their wive’s pregnancies (M age = 30 years), eight men were re-interviewed within 12 months postpartum and two men were interviewed only postpartum (26 interviews). Results: Three major categories emerged: having no knowledge of PGP, a period of emotional and physical strain, and merging. Pregnancy in a woman with PGP caused men to alter focus from themselves to their partners and family. They expressed worry, powerlessness, inadequacy, and a need for support. They had to adapt and cope, both demanding and challenging. However, they stressed that relationships with their older children improved, and that they and their partners had succeeded in becoming a team. Conclusions: The findings indicated a need for greater focus from midwives and other health care providers on the psychological impact of PGP on the man/partner. This is important, not only for men but for their respective women as well, whereby men influence their partner’s health.
  • Elden, Helen, 1959-, et al. (författare)
  • Feeling old in a young body: Women’s experiences of living with severe consequences of an obstetric anal sphincter rupture: An interview study.
  • 2014
  • Ingår i: Clinical Nursing Studies. - 2324-7940 .- 2324-7959. ; 3:1, s. 20-28
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The incidence of obstetric anal sphincter rupture (OASR) is increasing. It may cause anal incontinence and dyspareunia, leading to reduced quality of life and wellbeing. Qualitative studies are lacking. The aim was to describe experiences of living with ongoing severe consequences of an OASR 8 weeks after childbirth. Method: Twenty women with ongoing severe consequences of an OASR 8 weeks after delivery were interviewed using qualitative content analysis. Results: The experience of complications of an OASR is described in the overall theme ”Feeling old in a young body” and four categories: The body as injured; isolation; inability to function sexually, and anxiety for the future. Participants described how the consequences of OASR totally occupied their lives, making them feel old in a young body. They told of repercussions for their physical, psychological, sexual and social lives; how it affected their roles of mothers and partners, making them fear future childbirths. Diet, use of medicines, coal filters in incontinence pads, timing of toilet visits, use of the environment and mobile phones to conceal flatus and/or feces were strategies participants described. Conclusions: This study can contribute to increased understanding of how women can be affected by an OASR, and may enable healthcare personnel and authorities to meet their needs and organize care so that adequate support is available. It would also be beneficial if the women’s physical strategies were integrated into the information provided by health caregivers involved in follow-up. However, more research in this area is warranted.
  • Liljeroos, Maria (författare)
  • Caring needs in patient-partner dyads affected by heart failure An evaluation of the long-term effects of a dyadic psycho-educational intervention
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p><em>Introduction: </em>As medical treatment has improved, patients with heart failure (HF) now live longer and care mostly takes place at home with partners providing the main assistance. Taking care of an ill or disabled individual imposes a well-documented burden on the partner’s healthrelated quality of life. The awareness of partners’ burdensome situation is increasing, but few interventions have targeted the needs of patientpartner dyads with HF. The results have been inconclusive and give no clear guidance on how interventional programmes should be designed to improve both patient and partner outcomes.</p><p><em>Aim: </em>The overall aim of this thesis was to evaluate the effects of a psychoeducational intervention delivered to patient-partner dyads with HF during long-term follow-up, and to explore the dyads’ perceived caring needs.</p><p><em>Methods: </em>The thesis is based on four papers that used both quantitative and qualitative data. Study I and II used a randomized controlled design with a follow-up assessment after 24 months including 155 patientpartner dyads. The control group received care as usual. The intervention group received care as usual, and in addition they participated in the nurse-led psycho-educational intervention. Data was collected using questionnaires before and 24 months after the intervention, in order to determine the long-term effects on patients and partners regarding health related quality of life, perceived control, symptoms of depression and partners’ caregiver burden (I, II). A conceptual health promotion model inspired the intervention. To describe how the model was applied, a qualitative approach analysing nurses’ documentation of the sessions with 71 dyads in the intervention group (III) was used. Study IV has an explorative design. To further explore the dyads’ perceived caring needs, focus groups interviews with 19 patient-partner dyads with heart failure (IV) were performed.</p><p><em>Results: </em>The intervention did not have any significant effect on physical or mental health- related quality of life, depressive symptoms, or perceived control over the heart failure among the dyads (I) or caregiver burden in the partners (II) after 24 months. Furthermore, time to first event did not differ significantly between the dyads in the intervention group and the control group (I, II). As for the partners, both the intervention and control group reported decreased physical health between the baseline assessment and the 24-month follow-up (I). The intervention was composed of three components; 1) cognitive 2) supportive, and 3) behavioural component. The analysis of the nurses’ documentation confirmed the coverage of all the components and the analysis revealed a vide range of caring needs among the dyads (III). The dyads described a need to learn about HF to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital and both the patient and the partner need to be present at the clinic visits. Meeting others who are in the same situation and sharing the burden in nurse-led group sessions was proposed as an opportunity to support each other and others (IV).</p><p><em>Conclusions: </em>Over the 24-month follow-up period, the intervention had a neutral effect on health- related quality of life, depressive symptoms and perceived control over the HF among the dyads, and on partners’ caregiver burden. Considering the fact that partners serve as a critical extension of the formal healthcare system, and that both patients and partners ask for more support, it will become crucial to find new ways to support dyads affected by heart failure. This thesis may be viewed as a first step in trying to understand dyads’ perceived caring needs, and it can serve as a guide in clinical work and when designing new dyadic interventions.</p>
  • Lyckestam, Ida, et al. (författare)
  • Midwives´lived experience of caring during childbirth-A phenomenological study
  • 2014
  • Ingår i: Sexual & Reproductive HealthCare. - 1877-5756. ; 5:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of this study was to obtain a deeper understanding of midwives' lived experience of caring during childbirth in a Swedish context. Methods: Ten midwives were recruited from one university hospital with two separate delivery units in western Sweden. Data were collected by both written narratives and interviews. With an inductive approach using a descriptive phenomenological method, the answers to the question: “Can you describe a situation in which you felt that your caring was of importance for the woman and her partner?” were analysed. Results: A general structure of the phenomenon of caring in midwifery during childbirth, including five key constituents: sharing the responsibility, being intentionally and authentically present, creating an atmosphere of calm serenity in a mutual relationship, possessing the embodied knowledge, and balancing on the borders in transition to parenthood. Conclusions: This study emphasises how the midwives shared the responsibility and their possessed embodied knowledge of childbirth and how new unique knowledge was constructed together with the woman, child and her partner. The study has the potential to increase knowledge and understanding of midwives' lived experience of caring during childbirth and therefore has implications for practice, education, and research.
  • Westgård, Theresa, et al. (författare)
  • Comprehensive geriatric assessment pilot of a randomized control study in a Swedish acute hospital: a feasibility study.
  • 2018
  • Ingår i: Pilot and feasibility studies. - 2055-5784. ; 4
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety. Methods: The CGA pilot took place at a University hospital in Western Sweden, from March to November 2016, with data analyses in March 2017. Participants were frail people aged 75 and older, who required an acute admission to hospital. Participants were recruited and randomized in the emergency room. The intervention group received CGA, a person-centered multidisciplinary team addressing health, participation, and safety. The control group received usual care. The main objective measured the recruitment procedure and retention rates. Secondary objectives were also collected regarding services received on the ward including discharge plan, care plan meeting and hospital risk assessments including risk for falls, nutrition, decubitus ulcers, and activities of daily living status. Result: Participants were recruited from the emergency department, over 32 weeks. Thirty participants were approached and 100% (30/30) were included and randomized, and 100% (30/30) met the inclusion criteria. Sixteen participants were included in the intervention and 14 participants were included in the control. At baseline, 100% (16/16) intervention and 100% (14/14) control completed the data collection. A positive propensity towards the secondary objectives for the intervention was also evidenced, as this group received more care assessments. There was an average difference between the intervention and control in occupational therapy assessment - 0.80 [95% CI 1.06, - 0.57], occupational therapy assistive devices - 0.73 [95% CI 1.00, - 0.47], discharge planning -0.21 [95% CI 0.43, 0.00] and care planning meeting 0.36 [95% CI-1.70, -0.02]. Controlling for documented risk assessments, the intervention had for falls - 0.94 [95% CI 1.08, - 0.08], nutrition - 0.87 [95% CI 1.06, - 0.67], decubitus ulcers - 0.94 [95% CI 1.08, - 0.80], and ADL status - 0.80 [95% CI 1.04, - 0.57]. Conclusion: The CGA pilot was feasible and proof that the intervention increased safety justifies carrying forward to a large-scale study.
  • Jarl, Gustav, et al. (författare)
  • A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics
  • 2018
  • Ingår i: Prosthetics and orthotics international. - Sage Publications. - 0309-3646 .- 1746-1553. ; 42:5, s. 468-475
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>BACKGROUND:</strong> The International Classification of Functioning, Disability and Health is a classification of human functioning and disability and is based on a biopsychosocial model of health. As such, International Classification of Functioning, Disability and Health seems suitable as a basis for constructing models defining the clinical P&amp;O process. The aim was to use International Classification of Functioning, Disability and Health to facilitate development of such a model. Proposed model: A model, the Prosthetic and Orthotic Process (POP) model, is proposed. The Prosthetic and Orthotic Process model is based on the concepts of the International Classification of Functioning, Disability and Health and comprises four steps in a cycle: (1) Assessment, including the medical history and physical examination of the patient. (2) Goals, specified on four levels including those related to participation, activity, body functions and structures and technical requirements of the device. (3) Intervention, in which the appropriate course of action is determined based on the specified goal and evidence-based practice. (4) Evaluation of outcomes, where the outcomes are assessed and compared to the corresponding goals. After the evaluation of goal fulfilment, the first cycle in the process is complete, and a broad evaluation is now made including overriding questions about the patient's satisfaction with the outcomes and the process. This evaluation will determine if the process should be ended or if another cycle in the process should be initiated.</p><p><strong>CONCLUSION:</strong> The Prosthetic and Orthotic Process model can provide a common understanding of the P&amp;O process. Concepts of International Classification of Functioning, Disability and Health have been incorporated into the model to facilitate communication with other rehabilitation professionals and encourage a holistic and patient-centred approach in clinical practice. Clinical relevance The Prosthetic and Orthotic Process model can support the implementation of International Classification of Functioning, Disability and Health in P&amp;O practice, thereby providing a common understanding of the P&amp;O process and a common language to facilitate communication with other rehabilitation professionals.</p>
  • Svensson, I., et al. (författare)
  • Effects of assistive technology for students with reading and writing disabilities
  • 2019
  • Ingår i: Disability and Rehabilitation: Assistive Technology. - 17483115 .- 17483107.
  • Tidskriftsartikel (refereegranskat)abstract
    • Background : Assistive technology has been used to mitigate reading disabilities for almost three decades, and tablets with text-to-speech and speech-to-text apps have been introduced in recent years to scaffold reading and writing. Few scientifically rigorous studies, however, have investigated the benefits of this technology. Purpose : The aim was to explore the effects of assistive technology for students with severe reading disabilities. Method : This study included 149 participants. The intervention group received 24 sessions of assistive technology training, and the control group received treatment as usual. Results : Both the intervention and control groups improved as much in 1 year as the normed population did. However, gains did not differ between the groups directly after the intervention or at 1 year of follow-up. Conclusions : The use of assistive technology seems to have transfer effects on reading ability and to be supportive, especially for students with the most severe difficulties. In addition, it increases motivation for overall schoolwork. Our experience also highlights the obstacles involved in measuring the ability to assimilate and communicate text.Implications for rehabilitations Assistive technology (AT) can be useful for children with reading disabilities to assimilating text as well as boosting their reading. Children with reading disability using AT increased reading performance as much as a norm group, i.e. the students enhanced their reading ability despite no training in traditional reading remediation. Children’s and adolescents’ motivation for schoolwork can be boosted when using AT as a complement for those with reading and writing disabilities.
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