| 1. |
- Andersson, Thomas, et al.
(författare)
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Effects of chewing gum against postoperative ileus after pancreaticoduodenectomy - a randomized controlled trial.
- 2015
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Ingår i: BMC research notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Postoperative ileus is common after surgery. One non-pharmacological intervention that has shown promising results in reducing the duration of postoperative ileus is chewing gum after surgery. However, this has not been investigated in upper gastrointestinal surgery such as pancreatic surgery. Hence the aim of this study was to investigate the effects of chewing gum treatment on patients undergoing pancreaticoduodenectomy ad modum whipple due to pancreatic or periampullary cancer.
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| 2. |
- Andersson, Thomas, et al.
(författare)
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Health is belonging: Lived experiences during recovery after pancreaticoduodenectomy.
- 2012
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Ingår i: ISRN nursing. - : Hindawi Limited. - 2090-5483 .- 2090-5491. ; :Article ID 602323
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the lived experience of the symptoms, health, and illness reported by patients recovering after pancreaticoduodenectomy ad modum Whipple due to pancreatic or periampullary cancer. Thirteen patients with pancreatic or periampullary cancer who underwent pancreaticoduodenectomy ad modum Whipple between 2006 and 2008 were interviewed during postoperative recovery. Data were analysed using the phenomenological-hermeneutic method. The structural analysis of patient experiences revealed that recovery after pancreaticoduodenectomy was described as recapturing everyday life, being healthy, and looking to the future. Participants experienced symptoms but did not dwell on them, instead they stated that their general health was good. They strived to regain their former precancer selves and be a part of as well as contribute to the social context. Overall, the participants’ view of the future was positive, and improvement in their health generated further confidence and encouragement. This study suggests that persons recovering from pancreaticoduodenectomy ad modum Whipple due to a pancreatic or periampullary tumour experience health despite postoperative symptoms. They manage their symptoms by means of different strategies and express a positive view of the future. Nurses working with such patients should adopt a person-centred approach focusing on patient perspectives, participation, and possibilities.
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| 3. |
- Andersson, Thomas K., et al.
(författare)
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Perceptions of Experiences of Recovery After Pancreaticoduodenectomy-A Phenomenographic Interview Study
- 2022
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Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 45:3, s. 172-180
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Tidskriftsartikel (refereegranskat)abstract
- Background Pancreatic surgery in the context of enhanced recovery has mainly been evaluated using clinical variables. However, there is limited knowledge about patients' perceptions of recovery in this context. Hence, the aim of this study was to explore patients' perceptions of recovery after pancreatic surgery within an enhanced recovery program. Objective To explore the variations in patients' perceptions, a qualitatively designed study was undertaken. Methods Data in this phenomenographic study consisted of interviews with 19 patients at 4 to 6 weeks after surgery. Results Recovery after pancreatic surgery was classified into 5 categories, based on patients' perceptions: to be as before, affected by symptoms, physical activity, understanding the process, and facilitated by other people. Conclusion The study focused on various areas of recovery, which took place between the in-hospital and after-discharge phases. Physical experiences were found to disturb recovery, in contrast to social and emotional experiences, which facilitated recovery. Variations in perceptions of recovery suggest that care may need to be more individualized, both in the preoperative and the postoperative phase. Working with realistic expectations and early patient education might better prepare patients to continue working on their own recovery after discharge from the hospital. Implications for Practice Major cancer surgery needs to be perceived as a personal journey for the patient, even in enhanced recovery program care. Preoperative education is good, but adding continuous and individually adopted education during recovery is better. Knowledge about both hindering and facilitating factors for recovery is important for the healthcare personal.
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| 4. |
- Avander, Karin, et al.
(författare)
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Trauma Nurses Experience of Workplace Violence and Threats: Short- and Long-Term Consequences in a Swedish Setting
- 2016
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Ingår i: JOURNAL OF TRAUMA NURSING. - : LIPPINCOTT WILLIAMS & WILKINS. - 1078-7496. ; 23:2, s. 51-57
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Tidskriftsartikel (refereegranskat)abstract
- Violence in health care is increasing globally and Sweden is no exception. Still, this topic is sparsely studied in the Swedish trauma care setting. This focus group study examined nurses experience of violence and threats, and their consequences. The content analysis revealed two main categories, threatening situations and consequences, which led to a change in priorities in nursing care in order to avoid a potential violent situation. Furthermore, negative stress among the staff and greater vigilance and unwillingness to be near the patient resulted in altered communication and, in the end, a decreased quality of nursing care.
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| 5. |
- Bergström, Annika, et al.
(författare)
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Comfort Theory in Practice-Nurse Anesthetists' Comfort Measures and Interventions in a Preoperative Context
- 2018
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 33:2, s. 162-171
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The Comfort Theory proposes a systematic work approach to respond to patients' holistic needs. The usefulness of the Comfort Theory in the perioperative setting should be investigated. The aim of this study was to describe and analyze the nurse anesthetist's comfort measures in the preoperative context on the basis of the Comfort Theory. Design: Qualitative observational study. Methods: Semi-structured, clinical observation data collection in the preoperative context and deductive thematic analysis. Findings: The nurse anesthetist's comfort measures in the preoperative phase in the operating room department aim to ensure the patient's needs of relief, ease and transcendence in the physical, psycho-spiritual, environmental and socio-cultural contexts. Conclusion: The application of the Comfort Theory to daily work in the preoperative phase is of value for the nurse anesthetist in becoming more aware of the individual holistic needs of the patient and in this way adapting and initiating comfort measures and interventions.
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| 6. |
- Bjerså, Kristofer, et al.
(författare)
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Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study.
- 2015
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Ingår i: Pain management nursing : official journal of the American Society of Pain Management Nurses. - : Elsevier BV. - 1532-8635 .- 1524-9042. ; 16:6, s. 944-950
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Tidskriftsartikel (refereegranskat)abstract
- The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. The effects on pain at rest, following short walk, and after deep breath were assessed by visual analog scale (VAS) grading. Number of patients assessed was lower than calculated because of change in clinical routine. Pain scores overall were low. A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p<.05). This controlled pilot study indicate benefits of TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery.
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| 7. |
- Bjerså, Kristofer
(författare)
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Att få veta – en enkätstudie om intensivvårdssjuksköterskors behov av att följa upp utskrivna patienter
- 2007
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Ingår i: D-uppsats, Student essay..
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduktion Att arbeta på intensivvårdsavdelning är utmanande med höga krav på intensivvårdssjuksköterskans vård. För att få djupare förståelse och kunskap för sitt arbete och för patientens och den närståendes situation krävs samordning kring patientens varande efter utskrivning från intensivvårdsavdelningen. Syfte Syftet med studien var att undersöka intensivvårdssjuksköterskans behov av att följa upp utskrivna patienter från intensivvårdsavdelningen med fokus på varför behovet uppstår, hur uppföljningen ser ut, hur ofta den sker och om det finns hinder, och fördelar respektive nackdelar med uppföljning. Metod Med en enkät tillfrågades 154 intensivvårdssjuksköterskor på tre intensivvårdsavdelningar om sina uppfattningar kring behovet att följa upp utskrivna patienter. Av dessa besvarade 90 enkäten. Resultat Majoriteten av intensivvårdssjuksköterskorna hade ett behov av att följa upp utskrivna patienter. De vanligaste orsakerna var empati för patienten, att rätt omvårdnads- och medicinska åtgärder utförts och för att öka kunskapen. Uppföljning skedde mer sällan än då behovet uppstod. Hinder var framför allt tidsbrist och sekretesslagen. Nackdelar med att inte följa upp var uteblivet tillfälle till kvalitetssäkring. Diskussion Den empatiska anledningen till att behovet att följa upp uppstod kan ses utifrån Travelbees interaktionsteori. Organisatoriska hinder för uppföljning kan leda till bristande motivation och uteblivet tillfälle till lärande och förståelse. Uppföljning skulle kunna organiseras genom införandet av liaision nurse. Ytterligare forskning behövs för att se om behovet att följa upp patienten finns generellt hos sjuksköterskan och vilka effekter uppföljning kan innebära.
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| 8. |
- Bjerså, Kristofer
(författare)
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Complementary and Alternative Therapies in Surgical Care
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- International and national use of complementary and alternative medicine (CAM) is high in the general population and among patients. The level of knowledge about CAM among health care professions is low, but an interest in receiving education about this field has been observed. Concerning surgical care, previous studies indicate a wide range of CAM use among patients, but the level of knowledge among health care professions is poorly investigated, both internationally and in Sweden. Concerning CAM therapies in the management of signs and symptoms in surgical care, transcutaneous electric nerve stimulation (TENS) was used with a variety of effectiveness and osteopathic medicine was found to be poorly investigated in this context. The overall objective of this thesis was to investigate CAM in the surgical context with a focus on health care professions’ perceptions and understanding and the usefulness of therapy in symptom management in clinical settings. Both inductive (paper I; semi structured interviews, n=16) and deductive (paper II; questionnaire, n=737) methods were used to investigate perceptions and understanding of CAM among Swedish health care professions in surgical care. TENS as a pain relieving complement during the transition from epidural analgesia (EDA) to general analgesia after major abdominal surgery was investigated in a randomized controlled trial design (paper III; n=20). Osteopathic intervention in management of chronic signs and symptoms after thoracotomy was investigated with a single-subject research design (paper IV; n=8). The results reveal that surgical health care professions understand and perceive CAM as a wide range of therapies, remedies and systems. Their self valued level of knowledge was low, both concerning CAM and CAM research, but a desire was found to gain knowledge about CAM. A majority of the participants would consider learning a CAM therapy. Dialog about and referral to CAM occurred, but to a limited extent. Concerning therapy usability, TENS was not found to significantly relieve pain, promote recovery or reduce consumption of analgesics. In addition, comments from nurses and patients indicated that TENS treatment obstructed postoperative care. A significant improvement was observed in the osteopathic intervention in stiffness and benefits for pain, but not in breathing. The comprehensive conclusion of the thesis is that Swedish health care professions recognise the concept of CAM and some of its therapies, but their knowledge is in general low. Concerning therapy usability and the effectiveness of CAM in surgical care, the context is essential; TENS after major abdominal surgery in EDA elimination is questionable as concerns pain and its clinical application, while osteopathy may be beneficial in the management of chronic signs and symptoms after thoracotomy.
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| 9. |
- Bjerså, Kristofer, et al.
(författare)
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High frequency TENS as a complement for pain relief in postoperative transition from epidural to general analgesia after pancreatic resection
- 2014
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Ingår i: Complementary Therapies in Clinical Practice. - : Elsevier. - 1744-3881 .- 1873-6947. ; 20:1, s. 5-10
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study investigated the effect of high frequency transcutaneous electric nerve stimulation (TENS) as a pain relieving complementary therapy at the transition from epidural (EDA) to general analgesia after pancreatic surgery by horizontal, abdominal incision. Method: Fifty-five consecutive patients undergoing pancreatic resection were enrolled in the study and randomly assigned to active or sham TENS treatment. Twenty subjects were included in the analysis. Pain, quality of recovery and additional analgesia consumption were measured during the 24hof transition from EDA to general analgesia. Results: Additional analgesic consumption and pain estimations at 24hafter EDA termination differed between the two groups, but was not statistically significant. Conclusion: This study did not find support to reject use of high frequency TENS as complement during transition from EDA to general analgesia after major abdominal surgery with horizontal incision.
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| 10. |
- Bjerså, Kristofer, et al.
(författare)
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Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals.
- 2012
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Ingår i: BMC complementary and alternative medicine. - : Springer Science and Business Media LLC. - 1472-6882. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method: A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result: A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were positive to learning such therapy. Communication about CAM between patients and the health care professions was found to be rare. Conclusion: There is a lack of knowledge about CAM and research about it among registered health care professions in Swedish surgical care. However, in contrast to previous studies the results revealed that the majority perceived it as important to gain knowledge in this field.
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