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Sökning: swepub > Malmö högskola > Engelska > Blekinge Tekniska Högskola

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1.
  • Nystedt, Astrid, et al. (författare)
  • Epidural analgesia for pain relief in labour and childbirth - a review with a systematic approach.
  • 2004
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 13:4, s. 455-66
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Clinical ambiguity concerning effects of epidural analgesia for pain relief in labour seems to reflect a need for evidence-based knowledge for midwives. AIMS: This study aimed to review, with a systematic approach, the literature about effects and risks associated with the use of epidural analgesia for pain relief in labour and childbirth. DESIGN: A structured question was formulated and used for deriving search terms, establishing the inclusion of certain criteria and retrieving articles, i.e. what are the effects of epidural analgesia for pain relief in labour and childbirth? References were obtained through searches using MeSH-terms in Medline and Subheadings (SH) in CINAHL (e.g. Obstetrical Analgesia combined either with psychology or adverse effects and together with, Dystocia, Caesarean Section, Infant Newborn and Breastfeeding). The articles were divided into prospective randomized trials (C), non-randomized prospective studies (P) and retrospective studies (R). Scientific quality of the studies was assessed on a three-grade scale: high scientific quality (I), moderate scientific quality (II) or low scientific quality (III). RESULTS: Twenty-four articles were retrieved and systematically assessed. Seven studies were judged as high quality, 15 as moderate quality and two as low quality. The majority of studies appraised in this review failed to obtain or establish a cause and effect relationship. According to the data, it seems clear that the use of epidural analgesia is considered to be an effective method of pain relief during labour and childbirth from the perspective of women giving birth. RELEVANCE TO CLINICAL PRACTICE: Midwives and doctors can recommend this form of pain relief. However, information about possible associations with adverse effects in mothers and infants must be provided to expectant couples.
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2.
  • Andersson, Ewa, et al. (författare)
  • The Experience of Younger Adults Following Myocardial Infarction
  • 2013
  • Ingår i: Qualitative Health Research;6. - Sage. - 1049-7323. ; :6
  • Tidskriftsartikel (refereegranskat)abstract
    • Syftet med denna studie var att belysa meningsupplevelser för personer yngre än 55 år som överlevt sin första hjärtinfarkt. Vi har analyserat 17 intervjuer med fenomenologisk-hermeneutisk metod. Huvudtemat, och det centrala fenomenet var en daglig kamp för att återvinna balansen i livet, vilket inkluderar en existentiell, fysisk och emotionell kamp för att återfå fotfästet i dagligt liv. Efterspelet till denna livshotande händelse involverade en transition/förändringsprocess samtidigt som en ny livsmening skapades. Informanternas berättelser färgades av en energibrist som påverkade deras liv och interagerade med orimliga krav från arbetsgivare och vårdpersonal. Kunskapen från denna studie kan utgöra ett värdefullt tillskott till kvalitetsarbete inom omvårdnad och till utveckling av omvårdnadsinterventioner för hjärtrehabilitering av yngre personer efter hjärtinfarkt.
3.
  • Wann-Hansson, Christine, et al. (författare)
  • Risk factors and prevention among patients with hospital-acquired and pre-existing pressure ulcers in an acute care hospital
  • 2008
  • Ingår i: Journal of Clinical Nursing. - Blackwell Publishing. - 0962-1067. ; 17:13, s. 1718-1727
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. This study aimed to describe and identify risk factors associated with hospital-acquired pressure ulcers among adults in an acute care hospital compared with patients with pre-existing pressure ulcers present on admission. A further aim was to identify the preventive measures performed with both groups respectively. Background. Pressure ulcers occur most often in older and immobile persons with severe acute illness and neurological deficits. However, few studies have addressed risk factors that are associated with hospital-acquired pressure ulcers compared with patients with pre-existing pressure ulcers. Design. A point prevalence study with a cross-sectional survey design was conducted at a Swedish university hospital. Method. Data on 535 patients were recorded using a modified version of the protocol developed and tested by the European Pressure Ulcer Advisory Panel, including the Braden scale for risk assessment. Results. The prevalence of pressure ulcers was 27% (95% confidence interval, 23-31%). Higher age and a total Braden score below 17 were significantly associated with the presence of pressure ulcers. Among individual risk factors higher age, limited activity level and friction and shear while seated or lying down were associated with hospital-acquired pressure ulcers, whereas only higher age and friction and shear were associated with the presence of pressure ulcers in the overall sample. There was an overall sparse use of preventive measures to relieve pressure. Conclusion. The findings of the present study revealed that pressure ulcers and the insufficient use of preventive measure to relieve pressure is still a problem in acute care settings. A continued focus must be placed on staff training in identifying patients at risk for pressure ulcers development. Relevance to clinical practice. Increasing the ability to identify patients who are at risk for pressure ulcer development can assist in preventing unnecessary complications and suffering as well as reduce costs.
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4.
  • Johansson, Maria Eiman, et al. (författare)
  • Nurses' clinical reasoning concerning management of peripheral venous cannulae
  • 2009
  • Ingår i: JOURNAL OF CLINICAL NURSING. - 0962-1067. ; 18:23, s. 3366-3375
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim was to describe nurses' clinical reasoning regarding peripheral venous cannulae management by focusing on the clinical information and circumstances considered during the decision-making process. BACKGROUND: On every shift nurses make several decisions, among others concerning the management of peripheral venous cannulae. Thrombophlebitis is a common complication associated with its use, although more severe complications can arise. There are clinical practice guidelines within the area, but they are not always adhered to. Previous studies have examined decisions related to the management of peripheral venous cannulae, but did not include observations in a naturalistic setting. DESIGN: A qualitative study combining observations and interviews. METHODS: Participant observation facilitated open interviews about the clinical reasoning behind decision-making in observed situations, as well as semi-structured interviews regarding clinical reasoning about the general management of peripheral venous cannulae. Transcribed interview texts were analysed with content analysis. RESULTS: Three main categories describe clinical information and circumstances: the individual patient situation, the nurse's work situation and experience of peripheral venous cannulae management. The overall theme of the interview texts was that the clinical reasoning was a balancing act between minimising patient discomfort and preventing complications from the peripheral venous cannulae. CONCLUSIONS: At all times the patients' well-being was considered, but the ways the nurses approached this differed depending on how they considered clinical information in the individual patient situation, circumstances in their own work situation and their experience of peripheral venous cannulae management. RELEVANCE TO CLINICAL PRACTICE: Knowledge of the clinical information and circumstances considered in naturalistic settings, is valuable when implementing and adjusting clinical practice guidelines to local settings. This knowledge is also useful in nursing education as student nurses' and nurses' ability to balance between preventing complications and avoiding discomfort is important for enhancing patient care.
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6.
  • Woxenius, Johan, 1967-, et al. (författare)
  • Utilising more of the loading space in intermodal line trains – measures and decision support
  • 2013
  • Ingår i: Computers in industry. - 0166-3615. ; 64:2, s. 146-154
  • Tidskriftsartikel (refereegranskat)abstract
    • The focus of this article is to identify, characterise and qualitatively evaluate the existing measures for increasing the utilisation of loading space in intermodal road–rail freight line trains. Normally, these trains operate like intercity passenger trains, because they make short unit load transhipment stops along rail corridors in order to travel comparatively small and short flows. The measures for loading space utilisation include adapting the train’s capacity, changing the departure times, altering the train routes and sending trucks to different terminals as well as replacing rail transport with trucks. Some of the measures require improved information sharing, and executives can strengthen the effect of the measures by adding decision support systems and price incentives to transport buyers.
7.
  • Andersson, Ewa Kazimiera, et al. (författare)
  • Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction.
  • 2013
  • Ingår i: Scandinavian journal of caring sciences. - WILEY-BLACKWELL. - 0283-9318 .- 1471-6712. ; 27:4, s. 864-871
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Suffering a myocardial infarction (MI) is a life-threatening event that impacts not only on the individual concerned but also on the next of kin. However, there seems to be a paucity of naturalistic inquiries that focus specifically on midlife next of kin and their experience of being close to a relative who has suffered an MI. This study aims to elucidate the experience of being a midlife next of kin of a relative who has suffered a myocardial infarction. METHOD: Nine women and four men in midlife participated in the focused interviews, which were conducted and analysed during 2010/2011 using Lindseths and Norbergs' description of the phenomenological hermeneutical method. FINDINGS: Four themes - Solely responsible, Lurking unease, Left out of the picture and Life on hold - formed the basis of the core theme Standing alone when life takes an unexpected turn. The core theme was interpreted as a central phenomenon encompassing the experience of being solely responsible for the well-being of their relative and the family, thus putting their own life on hold. The core theme also reflected the next of kin's experience of being left out of the picture when it came to the relative's care before and after the MI. CONCLUSION: The next of kin's negative feelings of standing alone were further intensified by their experience of being left out of the picture by the healthcare professionals concerning their relative's care. As a cardiac nurse, it would seem essential to have knowledge about the experiences of next of kin in connection with a relative's MI event. Such knowledge can facilitate the planning and organisation of nursing care and at the same time address the next of kin's role in the recovery and rehabilitation process.
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8.
  • Gustafsson, Markus, et al. (författare)
  • Case managers for older persons with multi-morbidity and their everyday work - a focused ethnography
  • 2013
  • Ingår i: BMC Health Services Research. - Biomed Central. - 1472-6963. ; 13, s. 496
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods: The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis. Results: An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions: Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.
9.
  • Hellström, Amanda, et al. (författare)
  • Association between Sleep Disturbances and Leisure Activities in the Elderly:
  • 2014
  • Ingår i: Sleep disorders. - Hindawi Publishing Corporation. - 2090-3545. ; 2014, s. 595208
  • Tidskriftsartikel (refereegranskat)abstract
    • It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (n = 945) aged ≥60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questions and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confounders and gender interactions. After clustering the leisure activities and investigating individual activities, sociointellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of home maintenance. Besides those leisure activities, poor/fair self-rated health (OR 7.50, CI: 4.27-11.81) and being female (OR 4.86, CI: 2.75-8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of a sociointellectual nature, especially among women, to promote sleep.
10.
  • Kao-Walter, Sharon, et al. (författare)
  • A Finite Element Analysis of a Crack Penetrating or Deflecting Into an Interface in a Thin Laminate
  • 2006
  • Ingår i: Key Engineering Materials. - Trans Tech Publications. ; 312, s. 173-178
  • Tidskriftsartikel (refereegranskat)abstract
    • The crack tip driving force of a crack growing from a pre-crack that is perpendicular to and terminating at an interface between two materials is investigated using a linear fracture mechanics theory. The analysis is performed both for a crack penetrating the interface, growing straight ahead, and for a crack deflecting into the interface. The results from finite element calculations are compared with asymptotic solutions for infinitesimally small crack extensions. The solution is found to be accurate even for fairly large amounts of crack growth. Further, by comparing the crack tip driving force of the deflected crack with that of the penetrating crack, it is shown how to control the path of the crack by choosing the adhesion of the interface relative to the material toughness.
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