| 1. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 2. |
- Rylander, Lars, et al.
(författare)
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Very high correlations between fresh weight and lipid-adjusted PCB-153 serum concentrations: Irrespective of fasting status, age, body mass index, gender, or exposure distributions.
- 2012
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Ingår i: Chemosphere. - : Elsevier BV. - 1879-1298 .- 0045-6535. ; 88:7, s. 828-831
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIM: Persistent organochlorine pollutants (POPs) have in epidemiological studies been associated with health hazards. The exposure window might be crucial and it is, accordingly, important to analyze exposure concentrations in samples collected at the window of interest. This makes the use of stored blood samples extremely interesting. However, small blood volumes from stored samples in biobanks means that the researchers in epidemiological studies most often have to select a limited number of biomarkers representing the POP exposure and abstain from analyses of lipid concentrations. This raises the question of the necessity of lipid adjustment. The aim of the present study was to evaluate the correlation between fresh weight and lipid adjusted concentrations. METHODS: We included data from studies were we have used the PCB congener 2,2',4,4',5,5'-hexachlorobiphenyl (PCB-153) as a biomarker for POP exposure and where fresh weight as well as lipid adjusted PCB-153 concentrations are known (n=1628). The variety of the cohort members in the different studies gave us the possibility to better understand how well these measures correlate. RESULTS: When all individuals were included in the analyses a correlation coefficient of 0.95 between fresh weight and lipid adjusted serum concentrations was obtained. Restricting the analyses to specific subgroups (based on gender, fasting status, age and BMI) gave correlation coefficients between 0.85 and 0.97. CONCLUSIONS: This study does strongly support the use of samples from biobanks in epidemiological studies for analyzing PCBs, at least regarding PCB-153, even though it is not possible to lipid adjust the results.
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| 3. |
- Björkdahl, Anna, et al.
(författare)
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Barriers and enablers to the implementation of Safewards and the alignment to the i-PARIHS framework : A qualitative systematic review
- 2024
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Ingår i: International Journal of Mental Health Nursing. - Richmond, VIC : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 33:1, s. 18-36
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Forskningsöversikt (refereegranskat)abstract
- Inpatient mental healthcare settings should offer safe environments for patients to heal and recover and for staff to provide high-quality treatment and care. However, aggressive patient behaviour, unengaged staff approaches, and the use of restrictive practices are frequently reported. The Safewards model includes ten interventions that aim to prevent conflict and containment. The model has shown promising results but at the same time often presents challenges to successful implementation strategies. The aim of this study was to review qualitative knowledge on staff experiences of barriers and enablers to the implementation of Safewards, from the perspective of implementation science and the i-PARIHS framework. A search of the Web of Science, ASSIA, Cochrane Library, SCOPUS, Medline, Embase, PsycINFO, and CINAHL databases resulted in 10 articles. A deductive framework analysis approach was used to identify barriers and enablers and the alignment to the i-PARIHS. Data most represented by the i-PARIHS were related to the following: local-level formal and informal leadership support, innovation degree of fit with existing practice and values, and recipients' values and beliefs. This indicates that if a ward or organization wants to implement Safewards and direct limited resources to only a few implementation determinants, these three may be worth considering. Data representing levels of external health system and organizational contexts were rare. In contrast, data relating to local (ward)-level contexts was highly represented which may reflect Safewards's focus on quality improvement strategies on a local rather than organizational level.
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| 4. |
- Björkdahl, Anna, et al.
(författare)
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Changes in the occurrences of coercive interventions and staff injuries on a psychiatric intensive care unit.
- 2007
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Ingår i: Archives of Psychiatric Nursing. - : Elsevier BV. - 0883-9417 .- 1532-8228. ; 21:5, s. 270-7
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to compare the occurrences of coercive interventions and violence-related staff injuries before and after a 2-year violence prevention intervention on a psychiatric intensive care unit. The intervention aimed to improve nursing care by addressing patient violence from multiple perspectives. During the study, the unit was reorganized toward a higher concentration of severely disturbed patients. The results showed an increased proportion of coercive interventions without a corresponding increase in staff injuries. Use of coercive interventions is discussed in relation to a safe environment for both patients and staff.
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| 5. |
- Björkdahl, Ann, 1959, et al.
(författare)
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Effect of very early supported discharge versus usual care on activi-ties of daily living ability after mild stroke: a randomized controlled trial.
- 2023
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Ingår i: Journal of rehabilitation medicine. - 1651-2081. ; 55
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Tidskriftsartikel (refereegranskat)abstract
- To examine the ability to perform basic and instrumental activities of daily life after very early supported discharge vs usual discharge and referral routine during the first year after mild stroke.A secondary analysis of data from the Gothenburg Very Early Supported Discharge randomized controlled trial. Patients: A total of 104 patients (56% men; mean (standard deviation) age 75 (11) years) who had experienced a first stroke classified as mild.The primary outcome was the Activities of Daily Living Taxonomy score. Stroke Impact Scale (activities of daily living, and mobility) scores was a secondary measure. Patients were randomized to either very early supported discharge with 4 weeks of home rehabilitation provided by a multidisciplinary stroke team, or a control group discharged according to usual routine (referral to primary care when needed). Assessments were performed at discharge, 4 weeks post-discharge, and 3 and 12 months post-stroke.Instrumental activities of the Activities of Daily Living Taxonomy scores (the lower the better) in the very early supported discharge and control groups were median 4 and 6 (p=0.039) at 4 weeks post-discharge and 3 and 4.5 (p=0.013 at 3 months post-stroke, respectively. Stroke Impact Scale (Mobility) median scores (the higher the better) in the very early supported discharge and control groups at 3 months were 97 and 86 (p=0.040), respectively. There were no group differences in the 2 outcomes at 12 months post-stroke.Compared with usual discharge routine, team-based rehabilitation during the first month at home is beneficial for instrumental activity in the subacute phase, in patients with mild stroke. One year post-stroke both groups show equal results.
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| 6. |
- Björkdahl, Anna, et al.
(författare)
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Sensory rooms in psychiatric inpatient care : Staff experiences.
- 2016
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Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 25:5, s. 472-479
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Tidskriftsartikel (refereegranskat)abstract
- There is an increased interest in exploring the use of sensory rooms in psychiatric inpatient care. Sensory rooms can provide stimulation via sight, smell, hearing, touch and taste in a demand-free environment that is controlled by the patient. The rooms may reduce patients' distress and agitation, as well as rates of seclusion and restraint. Successful implementation of sensory rooms is influenced by the attitudes and approach of staff. This paper presents a study of the experiences of 126 staff members who worked with sensory rooms in a Swedish inpatient psychiatry setting. A cross-sectional descriptive survey design was used. Data were collected by a web based self-report 12-item questionnaire that included both open- and closed-ended questions. Our findings strengthen the results of previous research in this area in many ways. Content analyses revealed three main categories: hopes and concerns, focusing on patients' self-care, and the room as a sanctuary. Although staff initially described both negative and positive expectations of sensory rooms, after working with the rooms, there was a strong emphasis on more positive experiences, such as letting go of control and observing an increase in patients' self-confidence, emotional self-care and well-being. Our findings support the important principals of person-centred nursing and recovery-oriented mental health and the ability of staff to implement these principles by working with sensory rooms.
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| 7. |
- Björkdahl, Anna
(författare)
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Violence prevention and management in acute psychiatric care : aspects of nursing practice
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The general aim of this thesis was to explore and evaluate different aspects of nursing practice in relation to prediction, prevention and management of patient violence in acute psychiatric care. The specific aims were: to evaluate the short-term predictive capacity of the violence risk assessment instrument Brøset Violence Checklist (BVC) when used by nurses in a psychiatric intensive care unit (study I), to compare the occurrences of coercive interventions and violence-related staff injuries before and after a two-year nursing development and violence prevention intervention (study II), to describe aspects of the caring approaches used by nurses in acute psychiatric intensive care units (study III) and finally (in study IV) to test the hypothesis that staff training according to the ‘Bergen model’ has a significant positive influence on the violence prevention and management climate in psychiatric inpatient wards, as perceived by patients and staff. Methods: Both quantitative and qualitative methods were used. In study I, data from the BVC and the Staff Observation Aggression Scale were retrospectively collected from a psychiatric intensive care unit (PICU) and analysed in an extended Cox proportional hazards model. In study II, register-based rates of coercive interventions and violence-related staff injuries were retrospectively collected from the same unit as in study I, and subsequently analysed through Chi-square tests. In study III, qualitative data were collected from 19 individual interviews with nurses working on four PICUs in different parts of Sweden. The data analysis was guided by the interpretive description approach. In study IV, a 13 item questionnaire was developed (called the E13). Each item was related to the violence prevention and management climate on inpatient units. The E13 was distributed to patients and staff on 41 psychiatric wards before the staff had been trained according to the Bergen model and subsequently to patients and staff on 19 wards where the staff had been trained. Data analysis included factor analysis, Fisher’s exact test, Cronbach’s alpha and Mann-Whitney U-test. Findings: A positive scoring by the nurses on any of the six BVC items resulted in a six-fold increase in the risk for short-term severe violence on the PICU. A negative scoring on all items correctly predicted no risk for severe violence in 99% of all assessments (study I). In study II, an increase in the total rate of coercive interventions was found on the PICU one year after the intervention, while the rate of violence related staff injury remained unchanged. However, during the study period, an unplanned re-organisation of the PICU, including a substantial reduction of beds, meant that the PICU from then on could only admit the most acutely ill patients. In study III, interviews with nurses working on four different PICUs revealed two caring approaches which were metaphorically named the bulldozer and the ballet dancer. The bulldozer approach functioned as a shield of power that protected the ward from chaos, but at the same time involved the risk for engaging in uncaring actions. The ballet dancer approach functioned as a means of initiating relationships with patients and appeared strongly related to caring actions. In study IV, four items of the E13 questionnaire were rated significantly more positive by staff on trained wards. These four items concerned good rules on the ward, the ability of staff to stay calm when approaching aggressive patients, the staff’s interest in understanding why a patient is acting aggressively and the ability of staff to approach aggressive patients at an early stage. One item was rated significantly more positive by patients on trained wards which was the item relating to the interest of staff in understanding why a patient is aggressive. No item was rated more negatively on trained wards. Conclusions: Violence prevention and management in nursing practice involves a caring approach in all levels of prevention; in the everyday care as well as in coercive situations. It involves protection of the dignity of the patient and the nurse-patient relationship. The BVC has a good predictive capacity but should primarily be used to initiate early preventive interventions. In evaluation studies of violence prevention and management interventions, a mixed methods design should be considered, including the perspective of patients.
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| 8. |
- Danielsson, Anna, 1957, et al.
(författare)
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Self-perceived mobility in the first year after mild stroke – a comparison between Very Early Supported Discharge and ordinary discharge routine
- 2022
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Ingår i: 12th World Congress for Neurorehabilitation, Wien, 14-17 dec 2022.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: People with mild stroke mostly present with good basic but may experience difficulties with complex ADL activities. Knowledge about effects of common rehabilitation interventions after mild stroke is scarce. Objective: To investigate perceived mobility after Very Early Supported Discharge (VESD) compared to standard discharge. Methods: At an inpatient stroke unit 140 participants (39% women) were included day 2 post stroke. Inclusion criteria: stroke according to WHO criteria, age >18 years, living ≤30 min from the hospital, NIHSS score 0-16, Barthel Index score 50-100 and Montreal Cognitive Assessment <26 if BI=100. Exclusion criteria: life expectancy <1 year, non-communicating in Swedish prior stroke. Patients were randomised to VESD delivered at home by occupational therapist, physiotherapist and nurse from the stroke unit, for 4 weeks or to a control group discharged according to standard routine. VESD was focused on individual goals in personal care, transfers, household and leisure activities. The control group received standard rehabilitation as needed. The Mobility domain (0-100) of the Stroke Impact Scale (SIS) was administered 5 days after onset, 3 and 12 months after discharge. Results: Participants’ mean age was 74 (SD 11) year and NIHSS score median 2 (min-max 0-11). Mean (SD) SIS Mobility was 71.2 (22,7) and 73.6 (23.6) at baseline, in the VESD and control groups respectively. At the 3-month follow up SIS mobility score was significantly higher in the VESD group, 89.6 (15.0) compared to the controls’ 80.9 (21.3), p 0.027. There was no group difference at 12 months after discharge with 85.0 (18.1) and 86.6 (16.8), respectively. We conclude that stroke specialised team rehabilitation at home in the subacute phase may be beneficial for both basic and more demanding mobility situations in the first months, in people with mild stroke.
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| 9. |
- Hedlund Lindberg, Mathilde, et al.
(författare)
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The experiences of patients in using sensory rooms in psychiatric inpatient care
- 2019
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 28:4, s. 930-939
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Tidskriftsartikel (refereegranskat)abstract
- The use of sensory rooms and similar sensory approaches in psychiatric inpatient settings is becoming increasingly common. In sensory rooms, patients can choose different sensory stimulating items that may help regulate distress and enhance well-being. Outcomes are often measured as effects on patients' self-rated distress and rates of seclusion and restraint. The subjective experiences of patients using sensory rooms have been less explored. This paper presents a qualitative study of the experiences of 28 patients who chose to use sensory rooms on seven different types of psychiatric inpatient wards. Data were collected by individual patient interviews and by texts written by patients. A qualitative content analysis resulted in four categories: emotional calm, bodily calm, empowerment, and unexpected effects. A majority of the participants described several positive experiences, such as enhanced well-being, reduced anxiety, increased self-management, and enhanced self-esteem. Our findings align with previous research that has shown similar positive patient experiences, and support the use of sensory rooms as part of person-centred care.
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| 10. |
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