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1.
  • Henricsson, Maria, et al. (författare)
  • The outcome of tactile touch on oxytocin in intensive care patients: a randomised controlled trial
  • 2008
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 17:19, s. 2624-2633
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim.  To explore the effects of five-day tactile touch intervention on oxytocin in intensive care patients. The hypotheses were that tactile touch increases the levels of oxytocin after intervention and over a six-day period.Background.  Research on both humans and animals shows a correlation between touch and increased levels of oxytocin which inspired us to measure the levels of oxytocin in arterial blood to obtain information about the physiological effect of tactile touch.Design.  Randomised controlled trial.Method.  Forty-four patients from two general intensive care units, were randomly assigned to either tactile touch (n = 21) or standard treatment – an hour of rest (n = 23). Arterial blood was drawn for measurement of oxytocin, before and after both treatments.Results.  No significant mean changes in oxytocin levels were found from day 1 to day 6 in the intervention group (mean −3·0 pM, SD 16·8). In the control group, there was a significant (p = 0·01) decrease in oxytocin levels from day 1 to day 6, mean 26·4 pM (SD 74·1). There were no significant differences in changes between day 1 and day 6 when comparing the intervention group and control group, mean 23·4 pM (95% CI −20·2–67·0).Conclusion.  Our hypothesis that tactile touch increases the levels of oxytocin in patients at intensive care units was not confirmed. An interesting observation was the decrease levels of oxytocin over the six-day period in the control group, which was not observed in the intervention group.Relevance to clinical practice.  Tactile touch seemed to reduce the activity of the sympathetic nervous system. Further and larger studies are needed in intensive care units to confirm/evaluate tactile touch as a complementary caring act for critically ill patients.
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2.
  • Yang, Zhe, et al. (författare)
  • An Investigation of the Business Model in the Karlskrona Municipal Wireless Network in Sweden
  • 2008
  • Konferensbidrag (refereegranskat)abstract
    • In this paper, an investigation on an emerging operational "business model" for the municipal wireless network in the city of Karlskrona in Sweden is explored. We inquire into the association between of different actors involved in the business model implemented by Karlskrona municipality in our selected case study, and identify a number of key considerations in the business model and wireless city services for municipality when it is initializing and deploying the municipal wireless network as a business driven and public-utility driven service.
3.
  • Helldin, Lars, et al. (författare)
  • Experience of quality of life and attitude to care and treatment in patients with schizophrenia: Role of cross-sectional remission
  • 2008
  • Ingår i: International Journal of Psychiatry in Clinical Practice. - 1365-1501. ; 12:2, s. 97
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectiveThe concept of cross-sectional remission was investigated in a sample of patients with schizophrenia. A total of 243 patients were tested for quality of life, burden and handicap, insight and satisfaction with the care provided in an epidemiological study. The question addressed was if remission is of importance for outcome.MethodsCross-sectional remission was defined by applying the symptom criteria of remission, where none of eight selected PANSS items should exceed 3 points. Out of 243 patients, 38% were in met cross-sectional remission. Quality of life was assessed with the MOS SF-36 and the Rosser Index. The Patients' understanding of their illness was assessed based on symptoms and disorder insight. Finally, attitudes to care and, health service were assessed by the UKU/Consumer Satisfaction Questionnaire and the Drug Attitude Inventory.ResultsPatients who were in cross-sectional remission reported higher quality of life and reduced burden related to the disorder, a greater level of insight into their symptoms and the illness, and a more positive attitude to treatment, including drugs.ConclusionThis study implies that remission, here expressed in terms of cross-sectional remission, is of importance for patients' well-being. Patients who had no interference from symptoms in their daily functioning found their life better, had a superior insight and were more positive to treatment.
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4.
  • Henricson, Maria (författare)
  • Tactile touch in intensive care
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Aim: The overall aim of this thesis was to acquire knowledge about whether tactile touch as a complementary method can (i) promote comfort and (ii) reduce stress reactions during care in an intensive care unit (ICU) Method: In Paper I, five nurses with a touch therapist training were interviewed about their experiences of preparation before giving tactile touch in an ICU. To analyse the meaning of preparation as a phenomenon, Giorgi’s descriptive phenomenological approach was used. In Paper II and III a randomised controlled trial was set up to investigate the effects of a five-day tactile touch intervention on patients’ oxytocin levels in arterial blood (II), on patients’ blood pressure, heart rate and blood glucose level, and on patients’ levels of anxiety, sedation and alertness (III). Forty-four patients were randomised to either an intervention group (n = 21) or a control group (n = 23). Data were analysed with non-parametric statistics. In Paper IV, six patients who had received the tactile touch intervention were interviewed to illuminate the experience of receiving tactile touch during intensive care. To gain a deeper understanding of the phenomenon and to illuminate the meaning, Ricoeur’s phenomenological hermeneutical method, developed by Lindseth and Norberg, was used. Findings: The nurses need four constituents (inner balance, unconditional respect for the patients’ integrity, a relationship with the patient characterized by reciprocal trust and a supportive environment) to be prepared and go through the transition from nurse to touch therapist (I). In the intervention study, no significant differences were shown for oxytocin levels between intervention and control group over time or within each day (II). There were significantly lower levels of anxiety for patients in the intervention group. There were no significant differences between the intervention and control groups for blood pressure, heart rate, the use of drugs, levels of sedation or blood glucose levels (III). The significance of receiving tactile touch during intensive care was described as the creation of an imagined room along with the touch therapist. In this imagined room, the patients enjoyed tactile touch and gained hope for the future (IV). Conclusion: Nurses needed internal and external balance to be prepared for providing tactile touch. Patients did not notice the surroundings as much as the nurses did. Patients enjoyed the tactile touch and experienced comfort. The impact on stress parameters were limited, except for levels of anxiety which declined significantly. The results gave some evidence for the benefit of tactile touch given to patients in intensive care.
5.
  • Boström, Anne-Marie, et al. (författare)
  • Barriers to research utilization and research use among registered nurses working in the care of older people. Does the BARRIERS Scale discriminate between research users and non-research uses on perception of barriers?
  • 2008
  • Ingår i: Implementation Science. - 1748-5908. ; 3:24
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundOne strategy to enhance research use and change current practice is to identify barriers and then implement tailored interventions to reduce these barriers. In nursing, the BARRIERS scale has been frequently used to identify nurses' perceptions of barriers to research utilization. However, this scale has not been applied to care of older people, and only one study has investigated how identified barriers link to research utilization. Therefore, the purpose of this study was twofold: to describe RNs' perceptions of barriers to and facilitators of research utilization and to examine the validity of the BARRIERS scale in relation to research use.MethodsA cross-sectional survey design was used and registered nurses (RNs) working in the care of older people participated (response rate 67%, n = 140/210). Two questionnaires, the BARRIERS scale and the Research Utilization Questionnaire (RUQ), were used. Data were analyzed using descriptive and bivariate inferential statistics.ResultsCharacteristics of the organization and the presentation of research findings were rated as the most prominent barriers. The three items most frequently reported as barriers were: the nurse is isolated from knowledgeable colleagues with whom to discuss the research (89%); the facilities are inadequate for implementation (88%); and, the relevant literature is not compiled in one place (81%). Surveyed RNs suggested more support from unit managers and better availability of user-friendly reports in Swedish to enhance research use.The RNs reported a modest use of research. A weak but significant correlation was found between the Research Use index in RUQ and the Presentation subscale in the BARRIERS scale (r = -0.289, p < 0.01), suggesting that the RNs reporting more research use were less likely to perceive presentation of research as a barrier. Dividing the sample into research users (n = 29) and non-research users (n = 105), the research users rated significantly lower on the subscales Presentation, Nurse and Research in the BARRIERS scale.ConclusionThe BARRIERS scale revealed differences in the perception of barriers between research users and non-research users. Thus, methodologically the scale appears useful in identifying some types of barriers to research utilization but not organizational barriers. The identified barriers, however, are general and wide-ranging, making it difficult to design useful specific interventions.
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6.
  • Kajermo, Kerstin, et al. (författare)
  • Predictors of nurses' perceptions of barriers to research utilization
  • 2008
  • Ingår i: Journal of Nursing Management. - 0966-0429. ; 16:3, s. 305-314
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To identify predictors of nurses' self-reported barriers to using research findings in clinical practice. Background Several studies have shown that nurses perceive barriers to research utilization but to our knowledge predictors of nurses perceptions of barriers to research utilization have not been identified before. Methods Three questionnaires were answered by 833 nurses: the Barriers Scale, the Quality Work Competence questionnaire and a questionnaire including questions on professional issues. Results Dissatisfaction with support from immediate superiors for participating in research and/or development projects, having no academic degree and unclear and unrealistic workplace goals were identified as factors increasing the risk of perceiving barriers to the use of research findings in clinical practice. Conclusions The results imply that head nurses, nursing managers and other health care leaders should create strategies for supporting nurses' professional development and possibilities to implement research findings in clinical practice. Implications for nursing management To support research utilization and evidence-based care health care leaders, head nurses and nurse managers should create clear and realistic goals for the work place including demands on evidence-based care. It is also important for head nurses and nurse managers to create strategies for supporting nurses' professional development and possibilities to implement research findings in clinical practice.
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7.
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8.
  • Almasri, Abdullah, et al. (författare)
  • Clustering using Wavelet Transformation
  • 2008
  • Ingår i: Handbook of research on cluster theory. - Cheltenham : Edward Elgar. - 978-1-84542-516-6 - 9781845425166 ; s. 169-186
  • Bokkapitel (populärvet., debatt m.m.)
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9.
  • Andersson, Henrik, et al. (författare)
  • Cognitive ability and scale bias in the contingent valuation method : An analysis of willingness to pay to reduce mortality risk
  • 2008
  • Ingår i: Environmental and Resource Economics. - 0924-6460. ; 39:4, s. 481-495
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigates whether or not the scale bias found in contingent valuation (CVM) studies on mortality risk reductions is a result of cognitive constraints among respondents. Scale bias refers to insensitivity and non-near-proportionality of the respondents’ willingness to pay (WTP) to the size of the risk reduction. Two hundred Swedish students participated in an experiment in which their cognitive ability was tested before they took part in a CVM-study asking them about their WTP to reduce bus-mortality risk. The results imply that WTP answers from respondents with a higher cognitive ability are less flawed by scale bias
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10.
  • Athlin, Elsy, 1945-, et al. (författare)
  • Grupphandledning i klinisk sjuksköterskeutbildning
  • 2008
  • Rapport (övrigt vetenskapligt)abstract
    • I ett samarbetsprojekt finansierat av UNISKA deltog 2 högskolor från Norge, Högskolan Dalarna och Karlstads universitet. Syftet var att stötta kliniska handledare till studenter inom sjuksköterske-program. Sammanlagt 49 sjuksköterskor deltog i grupphandlednng under ett år. Rapporten beskriver och utvärderar projektet.
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