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1.
  • Ängeby, Karin, et al. (creator_code:aut_t)
  • Prevalence of Prolonged Latent Phase and Labor Outcome : Review of Birth Records in a Swedish Population
  • 2018
  • record:In_t: Journal of midwifery & women's health. - Hoboken : John Wiley & Sons. - 1526-9523 .- 1542-2011. ; 63:1, s. 33-44
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase.METHODS:A descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013-2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables.A prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26).Based on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.
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2.
  • Ängeby, Karin, et al. (creator_code:aut_t)
  • Primiparous women's preferences for care during a prolonged latent phase of labour
  • 2015
  • record:In_t: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 6:3, s. 145-150
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Objective: To investigate primiparous women's preferences for care during a prolonged latent phase of labour. Methods: A qualitative study based on focus groups and individual interviews and analysed with inductive content analysis.Results: Sixteen primiparous women with a prolonged latent phase of labour >18 hours were interviewed in five focus groups (n = 11) or individually (n = 5). One main category emerged “Beyond normality – a need of individual adapted guidance in order to understand and manage an extended latent phase of labour” which covers the women's preferences during the prolonged latent phase. Five categories were generated from the data: “A welcoming manner and not being rejected”, “Individually adapted care”, “Important information which prepares for reality and coping”, “Participation and need for feedback” and “Staying nearby the labour ward or being admitted for midwifery support”. Women with a prolonged latent phase of labour sought to use their own resources, but their needs for professional support increased as time passed. A welcoming attitude from an available midwife during the latent phase created a feeling of security, and personally adapted care was perceived positively. Conclusions:  Women with a prolonged latent phase of labour preferred woman-centred care. Midwives play an important role in supporting these women. Women's need for midwifery-support increases as the time spent in latent phase increases.
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3.
  • Nilsson, Jan, 1963-, et al. (creator_code:aut_t)
  • Nursing in a globalized world : Nursing students with international study experience report higher competence at graduation
  • 2014
  • record:In_t: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; :4, s. 848-858
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas; “Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were; living alone, not having children or other commitments, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.
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4.
  • Andersson, Maria, 1969-, et al. (creator_code:aut_t)
  • Older people's perceptions of the quality of oral care in short-term care units : A cross-sectional study
  • 2018
  • record:In_t: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 13:2, s. 1-14
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Background: There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. Aim: To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. Methods: A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. Results: The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. Conclusions: Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. Implications for practice: Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC. © 2018 John Wiley & Sons Ltd.
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5.
  • Bååth, Carina, 1959-, et al. (creator_code:aut_t)
  • Interrater reliability using Modified Norton Scale, Pressure Ulcer Card, Short Form- Mini Nutritional Assessment by registered and enrolled nurses in clinical practice
  • 2008
  • record:In_t: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:5, s. 618-626
  • swepub:Mat_article_t (swepub:level_scientificother_t)abstract
    • Aim.  Examine the interrater reliability between and among registered and enrolled nurses using Modified Norton Scale, Pressure Ulcer Card and Short Form-Mini Nutritional Assessment. Background.  In Sweden, registered nurses and enrolled nurses usually co-operate in patient care. National guidelines emphasize that reliable and valid assessment tools should be used. Interrater reliability for regular use of assessment tools is seldom studied. Design cross-sectional.  Registered nurses and enrolled nurses made 228 assessments of patients’ skin, risk for pressure ulcer and malnutrition, in patients with hip fracture and patients who had suffered a stroke. Results.  The interrater reliability of the Modified Norton Score total score was very good among registered nurses, good among enrolled nurses and between both groups. There was good, moderate and fair agreement on the subscales. Interrater reliability of Short Form Mini-Nutritional Assesment screening score was very good between both groups, good among registered nurses and moderate among enrolled nurses. There was good and moderate agreement on the items. There was good, moderate and fair agreement between and among registered nurses and enrolled nurses when using the Pressure Ulcer Card. Conclusion.  The Modified Norton Scale and Short Form Mini-Nutritional Assessment were reasonably understandable and easy to utilize in clinical care. Therefore, it seems possible for nurses to accomplish assessment using these tools. The agreement level was low for most skin sites except sacrum when nurses assessed patients’ skin with the Pressure Ulcer Card. Relevance to clinical practice.  The utilize of reliable and valid assessment tools is important in clinical practice. The tools could be used as an aid to the clinical judgement and therefore identify patients at risk for pressure ulcers and malnutrition. Pressure ulcer grading is a difficult skill that requires training and time to develop.
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6.
  • Bååth, Carina, 1959-, et al. (creator_code:aut_t)
  • Registered nurses and enrolled nurses assessment of postoperative pain and risk for malnutrition and pressure ulcers in patients with hip fracture
  • 2010
  • record:In_t: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier BV. - 1878-1241 .- 1878-1292. ; 14:1, s. 30-39
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The aim of the study was to describe and compare registered (RNs’) and enrolled nurses’ (ENs’) assessments of postoperative pain, risk for malnutrition and pressure ulcers in patients with hip fracture. Furthermore, the aim was to describe and compare their perceptions of using assessment tools. Thirty-four (34) RNs and forty-three (43) ENs, working on orthopaedic wards in Sweden, took part in the study. The assessments were carried out on 82 patients with hip fracture. The assessment tools included the numerical rating scale (NRS), short-form nutritional assessment tool (MNA-SF), modified Norton scale (MNS) and pressure ulcer card. Many patients were assessed to be in postoperative pain and at possible risk for malnutrition. Around 50% were assessed as being at risk for pressure ulcer formation (PU). There is a difference between RNs and ENs assessments of patients’ postoperative pain, risk for malnutrition and PU. ENs assessed to a greater degree that patients were in intense pain currently. RNs assessed to a greater degree that patients had been in intense pain in the past 24 h. Single items on the tools showed differences. However, there was no statistically difference for MNA-SF screening score and MNS total score. ENs found it easier to assess postoperative pain with the NRS compared to RNs.
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7.
  • From, Ingrid, 1953-, et al. (creator_code:aut_t)
  • Formal caregivers' perceptions of quality of care for older people : predicting factors
  • 2015
  • record:In_t: BMC Research Notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 8:623
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • BackgroundDespite the growing number of studies concerning quality of care for older people, there is a lack of studies depicting factors associated with good quality of care from the formal caregivers’ perspective. The aim was to describe formal caregivers’ perceptions of quality of care for older people in the community and explore factors associated with these perceptions. In total, 70 nursing assistants, 163 enrolled nurses and 198 registered nurses from 14 communities in central Sweden participated in the study. They filled out the following questionnaires: a modified version of Quality from the Patient’s Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items regarding education and competence, Health Index and Sense of coherence questionnaire. The overall response rate was 57 % (n = 431).ResultsIn the perceived reality of quality of care respondents assessed the highest mean value in the dimension medical-technical competence and physical technical conditions and lower values in the dimensions; identity-oriented approach, socio-cultural atmosphere and in the context specific dimension. The caregivers estimated their competence and health rather high, had lower average values in sense of coherence and organizational climate and low values in stress of conscience.ConclusionsThe PR of quality of care were estimated higher among NA/ENs compared to RNs. Occupation, organizational climate and stress of conscience were factors associated with quality of care that explained 42 % of the variance. Competence, general health and sense of coherence were not significantly associated to quality of care. The mentioned factors explaining quality of care might be intertwined and showed that formal caregivers’ working conditions are of great importance for quality of care.
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8.
  • Larsson, Gerry, et al. (creator_code:aut_t)
  • Changes over time in the importance patients ascribe to different aspects of care : On the need to improve person-centeredness
  • 2012
  • record:In_t: The International Journal of Person Centered Medicine. - United Kingdom : The University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 2:3, s. 482-490
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Rational and aim: Knowledge of which aspects of care are more important to patients is crucial for health providers. The aim of the work presented here was to explore changes over time in patients’ preferences in hospital and in out-patient settings.Method: Cross-sectional data were collected among patients at a number of Swedish hospital wards and out-patient clinics in 2003, 2004, 2005 and 2008 (N = 46,525). Data for men and women were analysed separately. The main outcome measure consisted of replies to the questionnaire “Quality from the Patient’s Perspective” (QPP) (numerous references).Results: (1) Subjective importance (preference) ratings increased throughout the time period studied, (2) in-patients gave higher ratings than out-patients and (3) women gave higher ratings than men, particularly in out-patient settings.Conclusion: The increase over time in ratings of the importance ascribed to different aspects of care may reflect a general trend towards strengthened consciousness among citizens as consumers of care and is an important index for improving the person-centeredness of clinical services.
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