| 1. |
- Dannapfel, Petra, et al.
(författare)
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A Qualitative Study of Individual and Organizational Learning through Physiotherapists’ Participation in a Research Project
- 2014
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Ingår i: International Journal of Clinical Medicine. - : OMICS. - 2158-284X .- 2158-2882. ; 5:9, s. 514-524
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Tidskriftsartikel (refereegranskat)abstract
- The need for evidence-based practice has been recognized by physiotherapy organizations over the past decades. Earlier studies have documented facilitators and barriers that affect the use and implementation of evidence-based practice. Less is known about what kind of interventions might be useful to implement evidence-based practice. This study explores what physiotherapists learn through participation in a research project relevant to their professional development towards achieving a more evidence-based physiotherapy practice. To what extent this learning was transferred to colleagues for organizational learning is also examined. This study was set in Sweden, where health care is publicly funded. Patients do not need a referral from a physician to consult a physiotherapist. Eleven interviews were conducted with physiotherapists who had participated in a randomized, controlled, multicenter, physiotherapy intervention investigating neck-specific exercise for patients with whiplash disorder. Gadamer’s hermeneutics was used to analyze the data. The physiotherapists described a range of learning experiences from their project participation, including instrumental learning (the concrete application of knowledge to achieve changes in practice) and conceptual learning (changes in knowledge, understanding or attitudes). The research project enabled the physiotherapists to develop new treatment techniques for broader application and extend their competence in techniques already known (instrumental learning). The physiotherapists believed that project participation enhanced their overall competence as physiotherapists, increased their job motivation and strengthened their self-confidence and self-efficacy (conceptual learning). Physiotherapists’ participation in the research project yielded many individual learning experiences, fostered positive attitudes to research and was conducive to achieving a more research-informed physiotherapy practice. Participation was associated with a deeper understanding of the challenges involved in conducting research. The transfer from indi-
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| 2. |
- Jansson, Caroline, et al.
(författare)
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Application of “Swanson’s middle range caring theory” in Sweden after miscarriage
- 2011
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing. - 2158-284X .- 2158-2882. ; 2:2, s. 102-109
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to apply Swanson’s Middle Range Caring Theory to the follow-up visit with a midwife for Swedish women who have suffered early miscarriage or received care for late missed miscarriage in pregnancy week 18 - 20. Methods: Twenty-five tape recorded interviews with women four weeks after their early miscarriages and thirteen tape recorded semi-structured interviews with midwives and nurses who had the experience of caring for women who have been diagnosed with a missed miscarriage during a routine ultrasound scan. The interviews were transcribed verbatim and interpreted deductively from the text using the theory. Results : Each woman described her personal experience of miscarriage in the relative terms of a human experience. The midwives and nurses described their experiences with women who received care for missed miscarriage. The interviews included information about the treatment provided by the caregivers during the period afterward of the diagnosis. The caregiver attitude was formed from Swanson’s caring categories: “Maintaining belief”, “knowing”, “being with”, “doing for”, “enabling”. Conclusions: Swanson’s Middle Range Caring Theory as applied to the caregiver includes being emotionally present, giving support with respect for the woman’s dignity, being competent, meeting each woman’s own individual needs. Given the proper care after a miscarriage every woman has the power within herself to improve their wellbeing.
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| 3. |
- Johansson, Ann-Marie, et al.
(författare)
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How the health care nurse supports and enhances the child’s attachment to their parents
- 2011
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 2:4, s. 418-428
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to provide insight into how the Child Healthcare Clinic (BVC) nurse supports and encourages the child’s bonding to their parents during the regularly scheduled checkups at the healthcare clinics. Method: The study was done using a qualitative approach. The data was collected from the interviews of four focus groups which were comprised of a total of eighteen BVC nurses who work solely for the BVC. The resulting data was analyzed using qualitative content analysis. Results: The following theme emerged from the research material: Em-power the parents in order to enable the child to have a healthy connection to the parents. This is accomplished by the BVC nurse building and creating a trusting relationship with the parents and providing support for them in their new roles as parents. The BVC nurses must have comprehensive knowledge about the needs and development of children and they need to have exceptional communication skills as well. It is also mandatory that the BVC nurse have access to cooperation and support from their colleagues and the support of other related professions. Conclusion: Providing support to parents during the bonding period of their infant children is a most important function for BVC nurses be-cause there is much to be determined about children’s development and future possibilities during this formative period.
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| 4. |
- Lindblad, Pär, et al.
(författare)
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A Chest Compression Quality Evaluation Using Mechanical Chest Compressions under Different Working Situations in the Ambulance
- 2015
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 6, s. 530-537
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to analyze the quality of chest compressions in different working situations pertaining to ambulance crews using either standard chest compressions (S-CC) or LUCAS mechanical chest compressions (L-CC) in a manikin setting. Participants and Methods: Cardiopulmonary resuscitation (CPR) was performed using a compression to ventilation ratio of 30:2 with both S-CC and L-CC. Quality parameters were collected using a modified manikin enabling impedance measurements. The evaluation was performed in two manikin scenarios: Scenario 1 evaluated ten minutes of CPR on the ground and Scenario 2 assessed six minutes of CPR in different settings relevant to work in the ambulance. Quality parameters compared were: time to apply LUCAS, hands-off fraction, number of correct chest compressions and the rate of compressions. Results: In Scenario 1 the hands-off fraction was higher when S-CC was performed (S-CC group 29% vs. L-CC 16%, P = 0.003). We found a higher number of chest compressions (S-CC = 913 vs. L-CC = 831, P = 0.0049) and a higher rate of chest compressions (S-CC = 118 vs. L-CC = 99, P < 0.0001) in the S-CC group. In Scenario 2 we noted a higher hands-off fraction for S-CC (39% vs. L-CC = 19%, P = 0.003), but a higher number of compressions given during S-CC ((n = 504) vs. L-CC (n = 396) P = 0.0002). Conclusion: Mechanical chest compression with the LUCAS 2TM device enables ambulance personnel to provide high quality chest compression even while transporting the patient.
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| 5. |
- Lindblad, Pär, et al.
(författare)
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Quality of Chest Compressions Differs over Time between Advanced and Basic Life Support
- 2015
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 6:12, s. 944-953
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: According to guideline recommendations, chest compressions (CC) during cardiopulmonary resuscitation (CPR) should be performed at a rate of 100 - 120 per minute, with a CC fraction (CCF) of ≥80%. The aim of this work is to explore whether CC quality differs between advanced life support (ALS) and basic life support (BLS) performed by two rescuers. Method: Cardiopulmonary resuscitation was performed by two ambulance personnel in ten ALS and ten BLS manikin scenarios. Data from these scenarios were then compared with data on ten ALS cases from the clinical setting, all with non-shockable rhythms. Data from the first two 5-minute periods of CC were evaluated from impedance data (LIFEPAK 12 defibrillator monitors) using a modified Laerdal Skillmaster manikin. Quality parameters compared were: number of CC pauses (CCPs), total time of CC (%), number of CC given and CC rate/min. Results: During the first 5 minutes, the BLS manikin scenarios had the highest number of CCPs, 15 (14 - 16), compared with the ALS manikin scenario, 14 (13 - 15), and the clinical ALS cases, 12 (10 - 15). The BLS scenario also had the highest CCFs, 81% (77% - 85%), and number of CC, 450 (435 - 495), compared with the ALS manikin scenario, 75% (64% - 81%) and 400 (365 - 444) respectively, and the clinical ALS cases, 63% (50% - 74%) and 408 (306 - 489). The median rate of CC/min in the BLS scenario was 115 (110 - 120) compared with the ALS manikin scenario, 110 (106 - 115), and the clinical ALS cases, 130 (118 - 146). During the second 5-minute period, the BLS scenario had the highest number of CCPs, 16 (15 - 17), compared with 15 (14 - 16) for the ALS manikin scenario and 11 (11 - 12) for the clinical ALS cases. The CCF in the BLS setting was 79% (75% - 83%), and the number of CC 455 (430 - 480), compared with the ALS manikin scenario, 79% (74% - 84%) and 435 (395 - 480) respectively, and the clinical ALS cases, 71% (57% - 77%) and 388 (321 - 469) respectively. The median CC rate was 118 (113 - 124) for BLS, 111 (105 - 120) for ALS manikins and 123 (103 - 128) CC/min for clinical ALS cases. Conclusion: None of the groups being studied could deliver CC at a rate of 100 - 120 CC/min or a CCF of ≥80% over the whole 10-minute period in any of the resuscitation scenarios analyzed. However, BLS had the best compliance with CC quality recommendations according to the 2010 guidelines.
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| 6. |
- Robins Wahlin, Tarja-Brita, et al.
(författare)
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Episodic Learning and Memory in Prodromal Huntington’s Disease : The Role of Multimodal Encoding and Selective Reminding
- 2015
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 6:11, s. 876-886
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated episodic memory in prodromal HD. Three groups were compared (N=70): mutation carriers with less than 12.5 years to disease onset (n=16), mutation carriers with 12.5 or more years to disease onset (n=16), and noncarriers (n=38). Episodic memory was assessed using the Fuld Object Memory Evaluation, which includes multimodal presentation and selective reminding, and the Claeson-Dahl Learning Test which includes verbal repeated presentation and recall trials. Both carrier groups demonstrated deficient episodic memory compared to noncarriers. The results suggest deficient episodic memory in prodromal HD, and that inconsistent retrieval contributes to these deficits. Multimodal presentation attenuates the deficits.
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| 7. |
- Rönnbäck, Elisabeth, et al.
(författare)
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Number of Daily Doses Does Not Affect Compliance with Flucloxacillin Prescriptions
- 2013
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 4:9, s. 384-387
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To achieve optimal effect with beta-lactam antibiotics, regimens with frequent dosages have been found nec- essary. However, if compliance is negatively influenced by more frequent dosages, this might hamper the effect of the treatments. Therefore, we have studied whether the numbers of daily dosages influence the compliance with prescribed flucloxacillin regimens.Design:A prospective interview study of patients with different dosing regimens of flucloxacil- lin.Setting:In the study, 200 patients with different dosing regimens of flucloxacillin underwent structured telephone interviews in order to reveal their compliance with the medication. Of these, 13 were prescribed twice-daily doses, 163 three times daily and 24 patients four times daily regimens.Results:There were no statistically significant differences between missed doses and prescribed numbers of daily doses. There was, however, a significant difference in the num- ber of daily doses and experiences associated with the medication.Conclusions:This study shows that patients comply well with regimens of up to four daily doses of flucloxacillin, despite experiencing increasing difficulties with regimens of more frequent dosages.
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| 8. |
- Sundström, Torbjörn, et al.
(författare)
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Influences of age and length of education on rCBF-SPECT in healthy elderly : diagnostic implications for dementia
- 2011
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Ingår i: Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2077-0383 .- 2158-284X .- 2158-2882. ; 2:2, s. 143-157
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few previous studies have described other than age- and gender related changes in regional cerebral blood flow (rCBF) in healthy elderly. What is the influence of other common clinically relevant variables such as ache, education, MMSE, and smoking history?Purpose: To study rCBF in Swedish healthy elderly by single-photon emission computed tomography (SPECT) and evaluate the influence on rCBF of age, gender, education, MMSE, ache, and smoking with a focus on education in relation to the ‘cognitive reserve’.Methods: Healthy subjects (n = 45, 50 -75 y), sampled from a large longitudinal aging study took part in an extensive examination of health and memory, including cognitive testing and socio-economic survey. After injection of 99 mTc-hexamethylpropylene amine oxime (HMPAO) followed by SPECT the rCBF-SPECT images were analyzed using statistical parametric mapping (SPM).Results: Age-related decreases in uptake were seen in interhemispheric and interlobar regions. There was a positive rCBF correlation with education in the inferior frontal lobe and a higher uptake in the left temporal lobe in an age-gender-matched high education subgroup.Conclusion: The localization of the age related findings except for the medial temporal lobe differs markedly from typical dementia related findings. A reduction close to interhemispheric or interlobar space should always be related to chronological age. Education seems to have an influence on basal brain function at a resting-state condition. Knowledge of normal rCBF variations for variables such as age and education should be considered when making clinical diagnosis. The findings could be interpreted as further support for the theory of cognitive reserve.
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| 9. |
- Suserud, Björn-Ove, et al.
(författare)
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Do the right patients use the Ambulance Service in South-Eastern Finland
- 2011
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Ingår i: International Journal of Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 2:5, s. 544-549
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several Emergency Medical Systems use a criteria-based prioritization system for ambulance response. The emergency medical priority dispatching of ambulances was introduced in the 1980s. In a system of this kind, the operators at the medical emergency dispatch centers have to assess the patients’ symptoms and the need for ambulance response. The prioritization of the ambulance response is based on the seriousness of the patient’s symptoms, his/her current condition and, in the case of trauma, the trauma mechanism. The priority system is supposed to optimize the use of the ambulance service and to match and meet the patients’ needs with an adequate response from the ambulances. The aim of this study was to describe the dispatching and utilization of the ambulance service in a part of Finland. Results: There was a substantial divergence between the initial priority assigned and the patients’ medical status at the scene. The ambulance staff confirmed the need for ambulance transport for 65% of all the patients who were assigned an ambulance by the dispatch center. Conclusions: Using a criteria-based dispatch protocol, the dispatch operator works with a wider safety margin in the priority assessments for ambulance response than was actually confirmed by the ambulance personnel at the scene. In this sample, there may be some overuse of the ambulance service. According to the assessments made by the ambulance staff, 35% of the patients did not require ambulance transport. The emergency system has to accept and work with safety margins. At the same time, there must be a balance between a safety margin and a waste of limited resources.
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| 10. |
- Wallerstedt, Sven, 1944, et al.
(författare)
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Educational Value of Doctor Trainee Employments (“Student Doctor”) —A Questionnaire Study
- 2015
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Ingår i: International Journal Clinical Medicine. - : Scientific Research Publishing, Inc.. - 2158-284X .- 2158-2882. ; 6:7, s. 469-474
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, medical students can work as employed doctor trainees under supervision during medical school breaks. The aim of the present study was to evaluate the educational value of such employments, as well as to compare university and non-university positions. Method: A questionnaire was administered to all employed doctor trainees at Sahlgrenska University Hospital, Gothenburg, in 2003-2004 (n = 67) plus all students in last term medical school 2005 who had had such a position inside or outside this university hospital (n = 43). The questionnaire included questions on trainee position/s, as well as statements regarding the educational value. Result: 75 unique individuals returned a filled-in questionnaire (response rate: 78%). The respondents experienced the positions as valuable concerning gain in professional confidence (mean ± standard deviation: 3.9 ± 1.1; 1 = total disagreement to 5 = total agreement) and independence (3.9 ± 1.1), subsequent learning in medical school (4.3 ± 0.9), and future professional work (4.2 ± 1.0). The gain in professional confidence and independence was greater for those who had worked in a non-university hospital (n = 17) than in a university hospital (n = 29): 4.4 ± 0.6 vs. 3.6 ± 3.6, P = 0.011; 4.3 ± 0.7 vs. 3.6 ± 1.1, P = 0.038. Conclusion: Employment as a doctor trainee seems to facilitate subsequent learning in medical school and enhance professional progress; the latter is particularly prominent in non-university hospitals.
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