| 1. |
- Blom, Lisbeth, et al.
(författare)
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Vårdprogram minskar postoperativt illamående : en klinisk naturalistisk interventionsstudie
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kraven på hälso- och sjukvårdspersonalens kompetens och insatser ökar. De bör ha ett vetenskapligt förhållningssätt och arbeta utifrån evidensbaserad omvårdnad för att ge en god och säker vård. Vårdpersonalen på en kirurgavdelning upplevde att ett stort antal patienter var illamående postoperativt. Syftet: var att utvärdera effekterna av införandet av ett vårdprogram för postoperativt illamående för patienter som genomgått planerad operation inom mage/tarm. Metod: Studien har haft en kvantitativ, deskriptiv, jämförande pre- och postinterventions design. Metoden som har använts var enkät med strukturerade frågor. Enkäten har använts vid två tillfällen, före (kontrollgrupp) och efter (interventionsgrupp) införandet av vårdprogram för postoperativt illamående. Resultat: Signifikanta skillnader förelåg så tillsvida att interventionsgruppen hade lägre förekomst av postoperativt illamående, kväljningar och kräkningar postoperativt jämfört med kontrollgruppen. Slutsats: Vårdprogram för patienter med mag- och/eller tarmoperation är effektivt för att minska postoperativt illamående. Den här använda metodiken för framtagande, implementering och utvärdering av vårdprogram kan med fördel användas för andra vårdområden. Sannolikt kan vårdprogrammet med fördel användas till andra patienter där postoperativt illamående är en riskfaktor.
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| 2. |
- Blom, Lisbeth, et al.
(författare)
-
Vårdprogram minskar postoperativt illamående : en klinisk naturalistisk interventionsstudie
- 2009
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Kraven på hälso- och sjukvårdspersonalens kompetens och insatser ökar. De bör ha ett vetenskapligt förhållningssätt och arbeta utifrån evidensbaserad omvårdnad för att ge en god och säker vård. Vårdpersonalen på en kirurgavdelning upplevde att ett stort antal patienter var illamående postoperativt. Syftet: var att utvärdera effekterna av införandet av ett vårdprogram för postoperativt illamående för patienter som genomgått planerad operation inom mage/tarm. Metod: Studien har haft en kvantitativ, deskriptiv, jämförande pre- och postinterventions design. Metoden som har använts var enkät med strukturerade frågor. Enkäten har använts vid två tillfällen, före (kontrollgrupp) och efter (interventionsgrupp) införandet av vårdprogram för postoperativt illamående. Resultat: Signifikanta skillnader förelåg så tillsvida att interventionsgruppen hade lägre förekomst av postoperativt illamående, kväljningar och kräkningar postoperativt jämfört med kontrollgruppen. Slutsats: Vårdprogram för patienter med mag- och/eller tarmoperation är effektivt för att minska postoperativt illamående. Den här använda metodiken för framtagande, implementering och utvärdering av vårdprogram kan med fördel användas för andra vårdområden. Sannolikt kan vårdprogrammet med fördel användas till andra patienter där postoperativt illamående är en riskfaktor.
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| 3. |
- Covaci, Adrian, et al.
(författare)
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Urinary BPA measurements in children and mothers from six European member states: Overall results and determinants of exposure.
- 2015
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Ingår i: Environmental Research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 141:Oct 13, s. 77-85
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Tidskriftsartikel (refereegranskat)abstract
- For the first time in Europe, both European-wide and country-specific levels of urinary Bisphenol A (BPA) were obtained through a harmonized protocol for participant recruitment, sampling and quality controlled biomarker analysis in the frame of the twin projects COPHES and DEMOCOPHES. 674 child-mother pairs were recruited through schools or population registers from six European member states (Belgium, Denmark, Luxembourg, Slovenia, Spain and Sweden). Children (5-12y) and mothers donated a urine sample. Information on socio-demographic characteristics, life style, dietary habits, and educational level of the parents was provided by mothers. After exclusion of urine samples with creatinine values below 300mg/L or above 3000mg/L, 653 children and 639 mothers remained for which BPA was measured. The geometric mean (with 95% confidence intervals) and 90th percentile were calculated for BPA separately in children and in mothers and were named "European reference values". After adjustment for confounders (age and creatinine), average exposure values in each country were compared with the mean of the "European reference values" by means of a weighted analysis of variance. Overall geometric means of all countries (95% CI) adjusted for urinary creatinine, age and gender were 2.04 (1.87-2.24) µg/L and 1.88 (1.71-2.07) µg/L for children (n=653) and mothers (n=639), respectively. Multiple regression analysis was used to identify significant environmental, geographical, personal or life style related determinants. Consumption of canned food and social class (represented by the highest educational level of the family) were the most important predictors for the urinary levels of BPA in mothers and children. The individual BPA levels in children were significantly correlated with the levels in their mothers (r=0.265, p<0.001), which may suggest a possible common environmental/dietary factor that influences the biomarker level in each pair. Exposure of the general European population was well below the current health-based guidance values and no participant had BPA values higher than the health-based guidance values.
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| 4. |
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| 6. |
- Jönsson, Anders, 1970-, et al.
(författare)
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Estimating the quality of performance assessments : the case of an “Interactive examination” for teacher competencies
- 2009
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Ingår i: Learning Environments Research. - : Springer. - 1387-1579 .- 1573-1855. ; 12:3, s. 225-241
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Tidskriftsartikel (refereegranskat)abstract
- Professional schools prepare students to become competent professionals. Consequently, there is a need for assessments that can determine the acquisition of the relevant professional competencies. Although using performance assessment to replace traditional paper-and-pencil tests might provide one way to move forward, the use of performance assessments for summative purposes has been shown to be problematic (e.g. marker consistency and construct representation). With the aid of a comprehensive framework of quality criteria for competence assessments, this article considers if one particular existing competence assessment methodology is suitable for summative as well as formative use. It is argued that the comprehensive quality estimation of the examination procedure aids in identifying strengths and weaknesses in the assessment methodology, and that this information can be used to facilitate the inclusion of performance assessment in higher education, both for summative and formative use.
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| 7. |
- Jönsson, Anders, et al.
(författare)
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Estimating the quality of performance assessments : The case of an "interactive examination" for teacher competencies
- 2009
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Ingår i: Learning Environments Research. - : Springer. - 1387-1579 .- 1573-1855. ; 12:3, s. 225-241
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Tidskriftsartikel (refereegranskat)abstract
- Professional schools prepare students to become competent professionals.Consequently, there is a need for assessments that can determine the acquisition of the relevant professional competencies. Although using performance assessment to replace traditional paper-and-pencil tests might provide one way to move forward, the use of performance assessments for summative purposes has been shown to be problematic (e.g. marker consistency and construct representation). With the aid of a comprehensive framework of quality criteria for competence assessments, this article considers if one particular existing competence assessment methodology is suitable for summative as well as formative use. It is argued that the comprehensive quality estimation of the examination procedure aids in identifying strengths and weaknesses in the assessment methodology, and that this information can be used to facilitate the inclusion of performance assessment in higher education, both for summative and formative use.
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| 8. |
- Jönsson, Elias, et al.
(författare)
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Pulmonary fibrosis in relation to genetic loci in an inception cohort of patients with early rheumatoid arthritis from northern Sweden
- 2022
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Ingår i: Rheumatology. - : British Society for Rheumatology. - 1462-0324 .- 1462-0332. ; 61:3, s. 943-952
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Pulmonary manifestations in RA are common comorbidities. Interstitial lung disease (ILD), both idiopathic and in RA, has been associated with several genetic variants. We assessed pulmonary fibrosis (PF) in an inception cohort of RA patients in relation to genetic variants and disease-related factors.METHODS: A total of 1466 early RA patients were consecutively included and followed prospectively from the index date until death or 31 December 2016. Clinical and laboratory data and treatment were continuously registered according to the Swedish Rheumatology Quality Register. DNA was available from 1184 patients and 571 151 genome-wide single-nucleotide polymorphisms (SNPs) were analysed. Thirteen identified genetic variants were extracted. At follow-up, the patients answered a questionnaire regarding disease progression and lung involvement that was validated by reviewing medical records and analysing radiological examinations.RESULTS: The prevalence of PF was 5.6% and the annualized incidence rate was 5.0/1000 (95% CI 3.80, 6.54). Four SNPs were associated with PF in RA: rs35705950 [MUC5B; OR 2.5 (95% CI 1.5, 4.0), adjusted P-value = 0.00016, q-value = 0.0021]; rs111521887 [TOLLIP; OR 1.9 (95% CI 1.3, 2.8), adjusted P-value = 0.0014, q-value = 0.0092]; rs2609255 [FAM13A; OR 1.7 (95% CI 1.1, 2.5), adjusted P-value = 0.013, q-value = 0.055] and rs2736100 [TERT; OR 1.5 (95% CI 1.0, 2.2), adjusted P-value = 0.046, q-value = 0.15]. Older age and RF positivity were associated with increased risk, while MTX treatment was associated with a lower risk of PF.CONCLUSIONS: Development of PF in an inception cohort of RA patients was associated with 4 of 12 ILD risk genes. RA-related factors except for age at diagnosis and RF positivity were of limited importance in PF development.
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| 9. |
- Jönsson, Lisbeth, et al.
(författare)
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A multi-disciplinary education process related to the discharging of children from hospital when the child has been diagnosed with type 1 diabetes - a qualitative study
- 2010
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Worldwide, insulin-dependent type 1 diabetes is one of the most frequently diagnosed long-term endocrine disorders found in children and the incidences of this diseased is still increasing. In Sweden the routines are, according to national guidelines, when the child is diagnosed with type 1 diabetes, the child and its family remains at the hospital for about two weeks. There is limited knowledge about how a diabetes team handles a child and its family from admission to discharge, therefore the purpose of this study was to seek a deeper understanding of how the diabetes team's parent/child education process works, from admission to discharge, among families with a child newly diagnosed with type 1 diabetes. Methods: Qualitative data collection was used. Four focus-group interviews, with a sample of three diabetes teams from different paediatric hospitals in the south western part of Sweden, were conducted and the data recorded on tape and then analysed using qualitative content analysis. Results: The results indicate that achieving a status of self-care on the part of the patient is the goal of the diabetes education programme. Part of the programme is aimed at guiding the child and its parents towards self-help through the means of providing them with knowledge of the disease and its treatment to enable the whole family to understand the need for cooperation in the process. To do this requires an understanding, by the diabetes team, of the individualities of the family in order to gain an overall picture. Conclusion: The results of this study show that the diabetes education programme is specifically designed for each family using the internationally recommended clinical practice guidelines with its specific aims and objectives. Achieving the families' willingness to assist in the self-care of the child care is the goal of the parent education process. To achieve this, the paediatric diabetes specialist nurse and the diabetes specialist paediatrician immediately and deliberately start the process of educating the family using a programme designed to give them the necessary knowledge and skills they will need to manage their child's type 1 diabetes at home.
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| 10. |
- Jönsson, Lisbeth
(författare)
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Children with Type 1 diabetes The initial education process and the impact on children and their parents over the first two years
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate the initial diabetes education process, the impact on children and their parents and parental satisfaction with the care received one and two years subsequent to the child’s diagnosis. In order to seek a deeper understanding for how the diabetes team’s initial education process works from admission to discharge among families with a child newly diagnosed with type 1 diabetes, three diabetes teams from three different paediatric hospitals, two county hospitals and one university hospital were interviewed through focus groups interviews (Paper I). In Paper II, 10 mothers and 8 fathers were individually interviewed to describe their perceptions of the initial diabetes educational process when their child was diagnosed with type 1 diabetes. A qualitative method was used and the interviews were analysed with two different types of content analysis, inductive and deductive. In order to describe and compare the disease impact on parents and children respectively, data were collected focusing parents’ HRQOL one and two years subsequent to the child’s diagnosis (Paper III and IV) and children’s experiences of diabetes-specific HRQOL (Paper III), children’s experiences of diabetes-specific family support (Paper IV) and parents’ satisfaction with the care received (Paper III and IV). The results of the interviews showed that the goal for the diabetes education is to achieve self-care for the child and their parents. The education is aimed to guide the child and parents towards self-help whereby the diabetes team immediately after the child’s diagnosis provides the child and their parents with knowledge and skills about the disease and how to manage the child’s treatment. Furthermore, the diabetes team tries to get an overall picture on each family by focusing on their daily life before the child was diagnosed with type 1 diabetes in order to optimize the new situation for the family. Parents experienced that the educational process was overall satisfactory. However, they wanted the education to be more adapted to each individual family to help them in their everyday life. They described the education process as almost a type of knowledge overload according to a rigid schedule and that there was no time for feeling grief and sadness. Parents felt that it was a difficult task to manage the child’s disease and at the same time continue their normal family life. The results from Paper III and IV showed that both parents’ HRQOL were affected at diagnosis and one and two years subsequent to their child’s diagnosis. The results also showed that mothers were especially emotionally affected during the first two years after the child’s diagnosis and they also had a higher degree of worry than fathers. Both children between 5-7 years and their parents estimated a higher degree of worry after one year than the children between 8-18 years and their respective parents did. After two years there was no relationship between how children experienced parental support and their HbA1c value. Parents were overall satisfied with their child’s healthcare both at diagnosis and one and two years subsequent to the child’s diagnosis. The findings from this thesis can elucidate the understanding of how it is to live with type 1 diabetes from the both the child’s and their parent’s perspective the first years subsequent to the child’s diagnosis. By reflecting on the findings, the diabetes teams may more clearly increase the focus on each family’s individual needs at diagnosis to further develop the education process to be more adapted to the individual family and thereby promote the transition to home. To further elucidate the disease effects on parents, and especially mothers, longitudinal interview studies need to be carried out with both mothers and fathers. Furthermore, it is also important to highlight children's experiences from their perspectives as well as their siblings.
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