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

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  • 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.
  • Nilsson, Helena, et al. (författare)
  • Tooth loss and cognitive functions among older adults
  • 2014
  • Ingår i: Acta Odontologica Scandinavica. - 0001-6357. ; 72:8, s. 639-644
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate the association between the number of teeth and cognitive functions adjusted for age and education level in a cohort of older adults living in Sweden.Materials and methods: The study employed a cross-sectional design in which 1147 individuals between 60-96 years underwent a clinical oral examination. The cognitive functions were assessed using Mini-Mental State Examination (MMSE) and Clock-test. The level of education was obtained from a questionnaire. Data were subjected to Chi-square tests and multivariate logistic regression analyses were employed, grouping the different variables into pre-determined categories.Results: The co-variables age and education were significantly associated with the number of teeth (p < 0.05). The multivariate logistic regression analysis revealed that the association between the number of teeth and the cognitive functions persisted even after adjusting for age and level of education.Conclusions: The findings suggest that the presence of teeth may be of importance for cognitive abilities in older adults.
  • Andersson, Ewa, 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.
  • Andersson, Ewa, et al. (författare)
  • The Experience of Younger Adults Following Myocardial Infarction.
  • 2013
  • Ingår i: Qualitative health research. - 1049-7323. ; :Mars,20
  • 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.
  • Bjarnason, Elizabeth, et al. (författare)
  • Challenges and Practices in Aligning Requirements with Verification and Validation:
  • 2014
  • Ingår i: Empirical Software Engineering. - Springer. - 1382-3256. ; 19:6, s. 1809-1855
  • Tidskriftsartikel (refereegranskat)abstract
    • Weak alignment of requirements engineering (RE) with verification and validation (VV) may lead to problems in delivering the required products in time with the right quality. For example, weak communication of requirements changes to testers may result in lack of verification of new requirements and incorrect verification of old invalid requirements, leading to software quality problems, wasted effort and delays. However, despite the serious implications of weak alignment research and practice both tend to focus on one or the other of RE or VV rather than on the alignment of the two. We have performed a multi-unit case study to gain insight into issues around aligning RE and VV by interviewing 30 practitioners from 6 software developing companies, involving 10 researchers in a flexible research process for case studies. The results describe current industry challenges and practices in aligning RE with VV, ranging from quality of the individual RE and VV activities, through tracing and tools, to change control and sharing a common understanding at strategy, goal and design level. The study identified that human aspects are central, i.e. cooperation and communication, and that requirements engineering practices are a critical basis for alignment. Further, the size of an organisation and its motivation for applying alignment practices, e.g. external enforcement of traceability, are variation factors that play a key role in achieving alignment. Our results provide a strategic roadmap for practitioners improvement work to address alignment challenges. Furthermore, the study provides a foundation for continued research to improve the alignment of RE with VV.
  • 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.
  • 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.
  • 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.
  • 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.
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