| 1. |
- Kihlgren, Annica, 1957-, et al.
(author)
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A Decision support system (DSS) for municipal nurses encountering health deterioration among older people
- 2016
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In: BMC Nursing. - London, United Kingdom : BioMed Central. - 1472-6955. ; 15
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Journal article (peer-reviewed)abstract
- Backgrund: This study is part of a larger project called ViSam and includes testing of a decision support system developed and adapted for older people on the basis of M (R) ETTS (Rapid Emergency Triage and Treatment System). The system is designed to allow municipal nurses to determine the optimal level of care for older people whose health has deteriorated. This new system will allow more structured assessment, the patient should receive optimal care and improved data transmission to the next caregiver.Methods: This study has an explanatory approach, commencing with quantitative data collection phase followed by qualitative data arising from focus group discussions over the RNs professional experience using the Decision Support system. Focus group discussions were performed to complement the quantitative data to get a more holistic view of the decision support system.Results: Using elements of the decision support system (vital parameters for saturation, pain and affected general health) together with the nurses' decision showed that 94 % of the older persons referred to hospital were ultimately hospitalized. Nurses felt that they worked more systematically, communicated more effectively with others and felt more professional when using the decision support system.Conclusions: The results of this study showed that, with the help of a decision support system, the correct patients are sent to the Emergency Department from municipal home care. Unnecessary referrals of older patients that might lead to poorer health, decreased well-being and confusion can thus be avoided. Using the decision support system means that healthcare co-workers (nurses, ambulance/emergency department/district doctor/SOS alarm) begin to communicate more optimally. There is increased understanding leading to the risk of misinterpretation being reduced and the relationship between healthcare co-workers is improved. However, the decision support system requires more extensive testing in order to enhance the evidence base relating to the vital parameters among older people and the use of the decision support system.
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| 2. |
- Rasoal, Dara, 1980-, et al.
(author)
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Clinical Ethics Support for Healthcare Personnel : An Integrative Literature Review
- 2017
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In: HEC Forum. - Dordrecht, Netherlands : Springer. - 0956-2737 .- 1572-8498. ; 29:4, s. 313-346
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Research review (peer-reviewed)abstract
- This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different coun-tries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a ‘‘bot-tom-up’’ perspective might give healthcare personnel opportunities to think and reflect more than a ‘‘top-down’’ perspective. A ‘‘bottom-up’’ approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a ‘‘top-down’’ approach risks removing such moral responsibility.
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| 3. |
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| 4. |
- Andrews-Chavez, Johanna, et al.
(author)
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Identifying households with low immunisation completion in Bangladesh
- 2012
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In: Health. - Irvine, USA : Scientific Research Publishing. - 1949-4998 .- 1949-5005. ; 4:11, s. 1088-1097
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Journal article (peer-reviewed)abstract
- The objective of this study was to investigate if the mothers’ demographics and household characteristics—including type of use of cooking fuel, energy and toilet facilities—have any implication for complete immunisation rates among their children. A cross-sectional data analysis of a nationally representative sample of 4925 women with at least one child was performed. Chisquared tests and multivariate logistic regression analyses were used. Immunisation coverage was positively associated with the mother’s education and with household characteristics such as toilet facility, electricity and involvement in a microfinance group. These findings indicate the need for further advocacy for increased knowledge on the importance of vaccination and affordable public immunisation programs focusing on higher risk households such as those with pit facilities, lack of electricity and no participation in a microfinance group. Such households warrant further attention and can be targeted for immunisation coverage.
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| 5. |
- Biswas, Animesh, 1978-, et al.
(author)
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Maternal complications in a geographically challenging and hard to reach district of Bangladesh : a qualitative study
- 2016
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In: F1000 Research. - London, United Kingdom : Faculty of 1000 Ltd.. - 2046-1402. ; 5
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Journal article (peer-reviewed)abstract
- Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community.Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed.Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications. There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment.Conclusions: The rural community lacks adequate knowledge on maternal complications. Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.
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| 6. |
- Dalal, Koustuv, 1969-, et al.
(author)
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Economics of global burden of road traffic injuries and their relationship with health system variables
- 2013
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In: International Journal of Preventive Medicine. - : Wolters Kluwer. - 2008-7802 .- 2008-8213. ; 4:12, s. 1442-1450
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Journal article (peer-reviewed)abstract
- BACKGROUND: To estimate the economic loss due to road traffic injuries (RTIs) of the World Health Organization (WHO) member countries and to explore the relationship between the economic loss and relevant health system factors.METHODS: Data from the World Bank and the WHO were applied to set up the databases. Disability-adjusted life year (DALY) and gross domestic product per capita were used to estimate the economic loss relating to RTIs. Regression analysis was used. Data were analyzed by IBM SPSS Statistics, Versions 20.0.RESULTS: In 2005, the total economic loss of RTIs was estimated to be 167,752.4 million United States Dollars. High income countries (HIC) showed the greatest economic losses. The majority (96%) of the top 25 countries with the greatest DALY losses are low and middle income countries while 48% of the top 25 countries with the highest economic losses are HIC. The linear regression model indicates an inverse relationship between nurse density in the health system and economic loss due to RTI.CONCLUSIONS: RTIs cause enormous death and DALYs loss in low-middle income countries and enormous economic loss in HIC. More road traffic prevention programs should be promoted in these areas to reduce both incidence and economic burden of RTIs.
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| 7. |
- Dalal, Koustuv, 1969-, et al.
(author)
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Knowledge and attitudes towards childhood injury prevention : a study of parents in Shanghai, China
- 2012
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In: HealthMed. - Sarajevo, Bosnia & Herzegovina : DRUNPP. - 1840-2291 .- 1986-8103. ; 6:11, s. 3783-3789
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Journal article (peer-reviewed)abstract
- Childhood injuries are a major problem worldwide. The study explored the parents' knowledge and attitudes towards childhood injury prevention in relation to theirsocioeconomic status. The study also tried to compare parents' perceptions of cause and place of child injury with actual cause and place of injury. This was a cross sectional study of 986 randomly selected parents whose children (3-6 years old) were enrolled at selected kindergartens in a 'Safe Community' in Shanghai, China. Chi-square tests and bar diagrams were used. Almost all parents (97%) thought that injury was a serious problem for their children. Around half of the parents thought that child injuries could be prevented while almost one-third (29%) of parents indicated that there were risk factors in the living environment of their children. Parental perceptions of cause of injuries and place of injuries significantly differed from that of the reality. Parents identified the most common barriers of childhood injury prevention: lack of parental attention (41.6%), environment (35.6%) and children's risky behavior (22.7%). The difference between parental opinions and reality illustrated that parents had incorrect knowledge of childhood injuries, which might lead to incorrect foci of prevention programs.Before tackling environmental modifications to prevent child injuries, policy makers should focus on rectifying parents' incorrect perceptions and on modifying their attitudes as key players. It is important to first raise awareness about childhood injury prevention among the parents for appropriate intervention strategies.
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| 8. |
- Dalal, Koustuv, 1969-, et al.
(author)
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The magnitude of injury problems among child labourers in a rural community of Bangladesh : findings from an injury surveillance system
- 2016
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In: International Health. - Oxford, United Kingdom : Oxford University Press. - 1876-3405 .- 1876-3413. ; 8:1, s. 73-76
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Journal article (peer-reviewed)abstract
- Background: Child labour is an important topic in contemporary society. In this study we have tried to explore the magnitude of injury problems among child labourers in Bangladesh using an injury surveillance system.Methods: An injury surveillance system (ISS) was performed under the Prevention of Child Injuries through Social intervention and Education (PRECISE) project in Bangladesh during 2006–2010 in three sub-districts covering a population of more than 700 000. We used the ISS for assessing child labour. Appropriate epidemiological methods were considered in the study.Results: Considering the reported main occupation of the children, 30% of children from the surveillance households were identified as child labourers. More than two thirds of child labourers were educated to primary or secondary level. The majority of boys worked as unskilled labourers and girls were employed in domestic work. The incidence of injury and deaths among child labourers was estimated as 24 per 100 000 children years. More than 19 injury related illnesses of moderate to severe intensity were found among 1000 child labourers in a year. Fractures, sprains, dislocations, cuts/wounds, animal bites, abrasions or lacerations, burns, head injuries and internal organ injuries are most common among child labourers.Conclusions:Working children are at risk of injury, death and illness in Bangladesh. Child labourers are now even more clearly tied to quantified morbidity and mortality.
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| 9. |
- Falk-Brynhildsen, Karin, 1959-, et al.
(author)
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Swedish translation, cultural adaptation and psychometric evaluation of the pressure ulcer knowledge assessment tool for use in the operating room
- 2023
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In: International Wound Journal. - : John Wiley & Sons. - 1742-4801 .- 1742-481X. ; 20:5, s. 1534-1543
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Journal article (peer-reviewed)abstract
- The aim of this study was to psychometrically evaluate the Swedish operating room version of PUKAT 2.0. In total, 284 Swedish operating room nurses completed the survey of whom 50 completed the retest. The item difficulty P-value of 14 items ranged between 0.38 and 0.96 (median 0.65). Three items were found to be too easy (0.90-0.96). The D-value of 14 items ranged between 0.00 and 0.42 (median 0.46). Three items had a D-value lower than 0.20 (0.11-0.16) and eight items scored higher than 0.40 (0.45-0.61). The quality of the response alternatives (a-value) ranged between 0.00 and 0.42. This showed that nurses with a master's degree had a higher knowledge than nurses with a professional degree (respectively 9.4/14 versus 8.6/14; t = -2.4, df = 199, P = 0.02). The ICC was 0.65 (95% CI 0.45-0.78). The ICCs for the domains varied from 0.12 (95% CI = -0.16-0.39) to 0.59 (95% CI = 0.38-0.75). Results indicated that 11 of the original items contributed to the overall validity. However, the low participation in the test-retest made the reliability of the instrument low. An extended evaluation with a larger sample should be considered in order to confirm aspects of the psychometric properties of this instrument.
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| 10. |
- Falk-Brynhildsen, Karin, 1959-, et al.
(author)
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The Swedish version of the attitude towards pressure ulcer prevention instrument for use in an operating room context (APUP-OR) : A nationwide psychometric evaluation
- 2022
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In: JOURNAL OF TISSUE VIABILITY. - : Elsevier. - 0965-206X .- 1876-4746. ; 31:1, s. 46-51
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Journal article (peer-reviewed)abstract
- Introduction: To assess operating room (OR) nurses' attitudes towards pressure ulcer prevention, the Attitude towards Pressure Ulcer Prevention (APuP) instrument was developed. Aim: The aim of this study was to psychometrically evaluate the Attitude towards Pressure Ulcer Prevention (APuP) instrument in a Swedish OR context. Materials and methods: A psychometric evaluation study was conducted, using a convenience sample, between February and August 2020. Validity (content, construct, discriminatory power) and reliability (stability and internal consistency) were evaluated. Results: The first survey (test) was completed by 284 Swedish OR nurses, of whom n = 50 (17.6%) completed the second survey (retest). A Principal Component Analysis was conducted for the 13-item instrument. The KMO value for this model was 0.62. Bartlett's test for sphericity was statistically significant (p 0.001). Five factors were identified which accounted for 56% of the variance in responses related to attitudes toward pressure ulcer prevention. The Cronbach's a for the instrument "attitude towards Pressure Ulcer Prevention" was 0.66. The intraclass correlation coefficient was 0.49 (95% CI = 0.25-0.67). Conclusion: This Swedish version of the APuP- OR is the first step in the development of an instrument to measure OR nurses' attitudes towards PU prevention in a Swedish OR context. The reliability of the instrument was low and the validity moderate. A larger sample and the revision or addition of items related to the context of the operating room should be considered in order to confirm aspects of the psychometric properties.
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