| 1. |
- Enskär, Ida, et al.
(författare)
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Barriers in the School-Based Pan-Gender HPV Vaccination Program in Sweden : Healthcare Providers' Perspective
- 2023
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Ingår i: Vaccines. - : MDPI. - 2076-393X. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Human papillomavirus (HPV) vaccines effectively prevent, and can even eliminate, HPV-related cancers. Currently, vaccination rates are suboptimal in the national Swedish school-based vaccination program. School nurses play a key role in all aspects of the vaccination process. Therefore, this study aims to explore school nurses' perceived HPV vaccination challenges.Methods: Seven focus group interviews were conducted with school nurses (n = 35) working in nine socio-demographically diverse municipalities in mid-Sweden. Data were analyzed using qualitative content analysis.Results: Participants described difficulties in encountering and handling the diversity of reasons for vaccine hesitancy. Parents known to be skeptical of vaccines in general were seen as most difficult to reach. Uncertainty was expressed concerning the extent of professional responsibility for vaccine promotion. The informants expressed a lack of guidelines for vaccine promotion and described challenges in supporting the child's own wishes. Creating a safe space for the individual child was seen as crucial. Other problems described were the challenges of overcoming children's fear of needles, supporting unvaccinated children, and being confronted with the remaining gender inequities of the pan-gender vaccination program.Conclusions: Our results suggest that school nurses, especially those new to their profession, may benefit from training and guidance22 material on how to address vaccine hesitancy.
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| 2. |
- Enskär, Ida, et al.
(författare)
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School children's perceptions about being offered the HPV vaccination : A focus group study
- 2024
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227.
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Tidskriftsartikel (refereegranskat)abstract
- AimThere is limited knowledge about the perceptions of HPV vaccination in middle-school children. This qualitative study aimed to explore their views.MethodsWe conducted focus group interviews with children, 10–11 years of age, who had been offered HPV vaccination through the school health services in mid-north Sweden in spring of 2023. Data were analysed with qualitative content analysis.ResultsThis study included six focus group interviews with 49 children (boys n = 29; girls n = 20), mean of 11 years of age. Participating children expressed the need to feel safe to be of utmost importance and the means to do so was to be prepared and informed by someone the child trusted. The school nurse was perceived as the expert, best suited to provide factual information, support and motivation, both to children and their parents.ConclusionWe confirm that healthcare providers' recommendations are crucial for HPV vaccine acceptance also from the child's perspective. Improved information about HPV vaccination to children is necessary. Children's right to participate on their own terms is not fulfilled today. Vaccine promotion, both to children and parents, should be actively managed by the school nurse.
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| 3. |
- Gard, Helena, et al.
(författare)
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Exploring young people's experiences of race, gender and socioeconomic status in relation to everyday challenges : A focus group study
- 2024
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Ingår i: Children & society. - : John Wiley & Sons. - 0951-0605 .- 1099-0860. ; 38:1, s. 228-244
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Tidskriftsartikel (refereegranskat)abstract
- Reports indicate a decrease in youth mental health in Sweden but at the same time research suggests that what is interpreted as mental ill-health could be considered everyday challenges by young people themselves. The distribution of mental health and illness among young people is uneven based on inequities related to factors such as race, gender and socioeconomic status. Sweden in particular is a country with large socioeconomic inequities in youth mental health and in school results, compared to other European countries. The aim of this study was to explore young people's experiences of the role of race, gender and socioeconomic status in relation to everyday challenges. Sixty-five young people aged 13–15 years old were recruited by student health services and participated in focus group discussions at schools in the southernmost part of Sweden. Data were analysed by secondary analysis with deductive qualitative content analysis using Ecosocial theory of disease distribution as theoretical framework. The analysis resulted in one main theme; Navigating inequities to gain and keep social status, with three underlying themes; Guided by social norms, Negative impact in everyday life and Importance of family influence. Participants were aware and critical of norms and expectations related to race, gender and socioeconomic status. Experiences of prejudice and unfairness was both own lived experiences by the participants as well as observed through friends and classmates. Young people spontaneously identify everyday challenges related to race, gender and socioeconomic status, even when not asked directly about these issues. Conforming to sexist, racist and classist, expectations is a way to lose and gain status in a school setting. Many of the inequities discussed related to socioeconomic status and the direct consequences of having or not having money. Young people's everyday experience of inequities is important to consider in youth mental health promotion aiming to tackle health inequities. Further research is needed on those experiences and how this affects mental health.
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| 4. |
- Gard, Helena, et al.
(författare)
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Exploring young people's experiences of race, gender and socioeconomic status in relation to everyday challenges : A focus group study
- 2024
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Ingår i: Children & society. - : John Wiley & Sons. - 0951-0605 .- 1099-0860. ; 38:1, s. 228-244
-
Tidskriftsartikel (refereegranskat)abstract
- Reports indicate a decrease in youth mental health in Sweden but at the same time research suggests that what is interpreted as mental ill-health could be considered everyday challenges by young people themselves. The distribution of mental health and illness among young people is uneven based on inequities related to factors such as race, gender and socioeconomic status. Sweden in particular is a country with large socioeconomic inequities in youth mental health and in school results, compared to other European countries. The aim of this study was to explore young people's experiences of the role of race, gender and socioeconomic status in relation to everyday challenges. Sixty-five young people aged 13-15 years old were recruited by student health services and participated in focus group discussions at schools in the southernmost part of Sweden. Data were analysed by secondary analysis with deductive qualitative content analysis using Ecosocial theory of disease distribution as theoretical framework. The analysis resulted in one main theme; Navigating inequities to gain and keep social status, with three underlying themes; Guided by social norms, Negative impact in everyday life and Importance of family influence. Participants were aware and critical of norms and expectations related to race, gender and socioeconomic status. Experiences of prejudice and unfairness was both own lived experiences by the participants as well as observed through friends and classmates. Young people spontaneously identify everyday challenges related to race, gender and socioeconomic status, even when not asked directly about these issues. Conforming to sexist, racist and classist, expectations is a way to lose and gain status in a school setting. Many of the inequities discussed related to socioeconomic status and the direct consequences of having or not having money. Young people's everyday experience of inequities is important to consider in youth mental health promotion aiming to tackle health inequities. Further research is needed on those experiences and how this affects mental health.
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| 5. |
- Johansen, Kine
(författare)
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Towards an evidence-based assessment of early motor performance in the child health services : Psychometric properties and clinical utility of the Structured Observation of Motor Performance in Infants
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Swedish child health services (CHS) have a unique position in that they reach almost all children 0-6 years of age. The child health nurse has the main responsibility for developmental surveillance. Twelve scheduled visits with the nurse during the child’s first year of life make this an ideal setting to systematically identify infants with motor problems, ranging from asymmetric head positioning that may lead to plagiocephaly to more severe forms such as cerebral palsy (CP). However, the CHS lack evidence-based methods to assess motor development.The Structured Observation of Motor Performance in Infants (SOMP-I) assesses motor performance in two domains, i.e. level of motor development and quality of motor performance. SOMP-I is quick, non-invasive, requires minimal handling, and is suitable for a busy clinical setting when applied by physiotherapists. Given the importance of early detection, the increased likelihood of detecting motor problems when using evidence-based assessment methods and the key role of nurses within the CHS, the overall aim of this thesis was investigate the psychometric properties and clinical utility of SOMP-I when used by child health nurses. Furthermore, we aimed to establish the ability of SOMP-I to detect CP.Our results show that child health nurses can reliably assess the level of motor development in infants using SOMP-I. More variability was found when they assessed the infants’ quality of motor performance. Although the nurses expressed concern about introducing a more time-consuming assessment in an already tight schedule, they were able to integrate the SOMP-I assessment in routine care. The nurses reported that barriers to using SOMP-I were mostly logistic and practical in nature, and they pointed out the necessity of education and practice in order to become proficient assessors. Using SOMP-I appears to have supported the nurses in the decision-making process regarding motor performance in routine care. SOMP-I detected CP during the first months of life in neonatal intensive care recipients.To our knowledge, these studies are the first to evaluate child health nurses’ assessment of early motor performance using an evidence-based assessment method in routine care. The results are promising, but further research is warranted.
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| 6. |
- Petersson, Christina, et al.
(författare)
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Children's experiences about a structured assessment of health-related quality of life during a patient encounter
- 2016
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Ingår i: Child Care Health and Development. - : Wiley. - 0305-1862 .- 1365-2214. ; 42:3, s. 424-432
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIt has been stated that care for children with chronic health conditions tends to focus on condition-specific issues rather than how these children experience their health and everyday life functioning.AimThe aim of this study was to explore children's experiences about a structured assessment of health-related quality of life applied during a patient encounter.MethodsPrior to the start of the study, a clinical intervention based on the questionnaire DISABKIDS Chronic Generic Measure (DCGM-37) was performed. A qualitative explorative design was chosen, and 25 children between 10–17 years of age were interviewed after the consultation at four different paediatric outpatient clinics. Data were analysed according to qualitative content analysis.ResultsThe results were twofold: children experienced that the assessment was providing them with insights about their health, which motivated them to make lifestyle changes. When outcomes were discussed and requested, the children felt encouraged.ConclusionsThe use of an assessment of health-related quality of life may promote insights about health and encourage children with chronic health conditions to discuss their outcomes with healthcare professionals.
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| 7. |
- Petersson, Christina, et al.
(författare)
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Impact of type 1 diabetes on health-related quality of life among 8–18-year-old children
- 2016
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Ingår i: Comprehensive Child and Adolescent Nursing. - : Taylor & Francis. - 2469-4207 .- 2469-4193. ; 39:4, s. 245-255
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Tidskriftsartikel (refereegranskat)abstract
- Measuring the health-related quality of life (HRQOL) is one way to understand an individual’s perspective on health, and, more specifically, how type 1 diabetes (T1D) affects a child’s everyday life. Early detection of poor HRQOL is considered a crucial factor for identifying children who are at risk of psychosocial problems. The aim of this study was to describe the differences in the HRQOL of children with T1D according to age, gender, and metabolic control (HbA1c). Cross-sectional data were collected from children with T1D using the DISABKIDS Chronic Generic Measure-37 (DCGM-37) and the diabetes specific module (DM-10). Non-parametric tests were used to investigate differences. There were differences between girls and boys, and girls reported lower HRQOL than boys (HRQOL total score: mean 74 and 67 respectively; p = .005). Adolescents described more worries and fears about the future compared with younger children. Children with poor metabolic control reported a lower HRQOL than those with better metabolic control (HRQOL total score:mean 68 and 76 respectively; p = .006), but the social dimensions were not affected. The findings of the present study elucidate the importance for paediatric nurses to explore potential problems in children with T1D and use this knowledge in clinical practice. Assessment of the HRQOL can provide the patient’s perspective on the quality of diabetes care. The HRQOL is correlated with HbA1c, gender, and age, and the HRQOL as well as HbA1c levels should be regularly assessed to establish a comprehensive care for children with T1D.
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| 8. |
- Petersson, Christina, et al.
(författare)
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To promote child involvement – healthcare professionals' use of a health-related quality of life assessment tool during paediatric encounters
- 2017
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Ingår i: European Journal for Person Centered Healthcare. - : University of Buckingham Press. - 2052-5648 .- 2052-5656. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children and healthcare professionals should be provided with easy-to-use tools which could lead to actionable results.Objectives: There is increasing interest in the use of patient reported outcomes to aid management of individual care; therefore, the use of health-related qualityof life (HRQOL) assessments during consultations need to be studied. The aim of this study was to explore how healthcare professionals use a HRQOL assessment tool during paediatric encounters.Design: A descriptive, explorative design with a qualitative approach based on video recordings was chosen.Methods: Twenty-one video recordings, from nine different healthcare professionals’ consultations where an assessment tool of HRQOL were used were analysed by content analysis.Results: The healthcare professionals were using different strategies and when they combined these strategies three approaches emerged. The instructing approach was characterized by healthcare professionals giving a summary of the results, leading to children becoming passive bystanders in the encounter. Based on an inviting approach, the children’s perceptions of their situation were requested while the items were explored. This resulted in involving the children in the conversations. In the engaging approach, an open dialogue and a common interpretation were sought to guide further care which was interpreted as children becoming actively involved.Conclusions: The child’s involvement could be facilitated depending on which approach is being used. When an inviting and engaging approach is used, actions in a non-linear set of interactions is co-produced with the child.Relevance to practice: The use of an HRQOL assessment tool change the management during consultations and could promote child involvement dependent on which approach the healthcare professionals are using.
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| 9. |
- Petersson, Christina
(författare)
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Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments.Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system.Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings.Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations.Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.
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| 10. |
- Valan, Lotha
(författare)
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Föräldrars användning av Internet för rådgivning avseende sina friska barns hälsa och utveckling och dess inverkan på Barnhälsovårdens konsultativa arbete : En studie i Svensk Barnhälsovård
- 2020
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Att bli förälder är en livsomvälvande händelse som kan vara både glädjande och skrämmande. Som förälder ansvarar man för en annan människa där man i vissa fall behöver ny information, kunskap och råd för att leva upp till de nya kraven som en förändrad familjesituation kräver. Förmågan att tillgodogöra sig information, kunskap och råd kan relateras till begreppet hälsolitteracitet som berör hur personer förstår och tillgodogör sig hälsorelaterad information. Den svenska barnhälsovårdens mål är att främja barns hälsa och utveckling och förebygga ohälsa hos barn, samt stödja föräldrar i föräldrarollen. Barnhälsovårdens sjuksköterskor följer barnets hälsa och utveckling till dess att barnet fyller fem år och är en viktig del i stöttningen av föräldrarna. De flesta av dagens föräldrar är födda i den digitala generationen och Internet är en naturlig källa till information och ökad kunskap. Föräldrarnas hälsolitteracitet kan inverka på hur internetinformationen påverkar dem och deras agerande för att möta barnens behov. I nuläget är litet känt om hur informationsöverflödet från digitala källor som Internet används av föräldrar och i interaktionen med barnhälsovården. Denna licentiatavhandlings syfte är att generera ökad kunskap om hur föräldrar använder Internet för hälsorelaterad information relaterat till deras 0–6 åriga friska barn och hur detta kan påverka dem själva samt om och i så fall, hur detta inverkar på barnavårdssjuksköterskans konsultativa arbete. I licentiatavhandlingen ingår två delstudier: Delstudie I genomfördes som en kvalitativ intervjustudie med sjuksköterskor (n=20) verksamma inom Barnhälsovården. Syftet var att beskriva deras erfarenheter och uppfattningar om föräldrars internetanvändning. I resultatet framkom tre kategorier som belyste syftet: Det framkom att ”Internet underlättar vård samt tillgång och tillgänglighet av vård och vårdinformation”, vidare att ” Internet gör yrkesutövande mer komplext” samt till sist uttrycktes det ”Ett behov av förändrad yrkesroll för barnhälsovårdssjuksköterskan”. I delstudie II genomfördes en enkätundersökning med föräldrar (n=687) som hade barn inskrivna på barnhälsovården inom en region i norra Sverige. Syftet var att beskriva föräldrars internetanvändning för råd eller information relaterat till hälsa och barns utveckling för deras friska barn samt hur informationen användes i kontakten med Barnhälsovården. Nästan alla föräldrar (n=686), uppfattade att Internet är en bra informationskälla för råd och information om barns hälsa och utveckling, men de uttryckte osäkerhet inför mängden av information samt kring den egna förmågan att söka, sortera och värdera funnen information. I resultatet sågs också att många föräldrar 81,7% (n = 561) önskade ha stöd och vägledning av sin barnhälsovårdssjuksköterska avseende internetinformation och webbsidor. Licentiatavhandlingens resultat visar att föräldrar har ett behov av stöd och att barnhälsovårdens sjuksköterskor genom den uppbyggda relationen dem emellan både kan vägleda och ge råd för att stödja föräldrar. Genom att stödja föräldrar på detta sätt kan barnhälsovården bidra till att öka föräldrars hälsolitteracitet och därmed även deras hälsokompetens. Barnhälsovårdens medarbetare behöver kompetensutveckling och verktyg för att kunna stödja föräldrar mot större hälsolitteracitet och därigenom även en högre hälsokompetens. Det ses som viktigt att utveckla fler kvalitetssäkrade digitala verktyg som komplement till dagens Barnhälsovård baserad på personliga möten. Verktygen skulle kunna bestå i att stötta föräldrar till att söka och värdera information från evidensbaserade källor, samt att införliva chatt och videokonferensmöjligheter mellan föräldrar och barnhälsovårdssjuksköterskorna också inom offentlig sjukvård.
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| 11. |
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| 12. |
- Björklund, Ann-Christin, et al.
(författare)
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Using ICF to Describe Problems With Functioning in Everyday Life for Children Who Completed Treatment for Brain Tumor : An Analysis Based on Professionals' Documentation
- 2021
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Ingår i: Frontiers in Rehabilitation Sciences. - : Frontiers Media S.A.. - 2673-6861. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children treated for brain tumors often experience persistent problems affecting their activity performance and participation in everyday life, especially in school. Linking these problems to the International Classification of Functioning, Disability and Health (ICF) classification system can be described as affecting body function, activity performance, and/or participation. Services involved in the everyday life of the child have different focus and goals when meeting the child in context, which advantage the use of ICF to overcome this impediment to follow-up and provide comprehensive support for children who have completed treatment for a brain tumor.Aim: The aim of the study was to use the ICF classification system to describe how professionals in healthcare, habilitation, and school document problems with everyday life functioning at body, activity, and participation levels for children who completed treatment for a brain tumor.Materials and Methods: A retrospective review of records from healthcare, habilitation, and school concerning nine children completed treatment for brain tumor was implemented. Identified problems in everyday life were linked to ICF codes. Descriptive statistics of ICF-linked code frequency supplemented by network visualization diagrams viewing the co-occurrence between codes within the body, activity participation, and environmental components were performed.Results: Most documented problems were found in healthcare records, whereas the documentation in habilitation and school was sparse. The frequently occurring codes, independent of record source, were linked to the body function component, and ICF-linked problems in habilitation and school were salient in the activity and participation component. To gain a holistic picture of relations between ICF codes and problems, network visualization diagrams were used to illustrate clusters of problems.Conclusion: Code prevalence likely reflects where healthcare professionals and educators focus their attention when meeting the needs of children treated for a brain tumor in context. To maximize the comprehensive view of functioning and participation of children in everyday life, the full range of difficulties regarding body impairments, activity limitations, and participation restrictions must be identified and linked to each other in patterns of co-occurrence, which the ICF facilitate. However, ICF provides no guidance on how to identify networks of problems within the body, activity, and participation. Identifying such networks is important for building comprehensive interventions for children.
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| 13. |
- Björkman, Berit, et al.
(författare)
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Are radiographers prepared to meet children with special needs, when seen for an examination?
- 2017
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455. ; 58:1 Suppl., s. 16-16
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Anxiety is often experienced by children undergoing health care procedures, and children with autism spectrum disorders (ADS) experience more anxiety than typically developed children. A prerequisite for obtaining an optimum procedure is firstly based on the health care provider’s knowledge about children with ASD, but may also depend on the use of guidelines. Two previous national surveys showed, that none radiology or paediatric departments and a minority of anaesthesiology departments throughout Sweden use specific guidelines when seeing children with ASD. Following, the purpose was to develop guidelines to use when caring for and preparing children with ASD in those settings.Methods: A modified Delphi method was used, including19 experts identified from the two afore mentioned surveys. The questions considered in the process, proceeded from previous research and the results from the surveys. The experts’ responses regarding the importance of each item, were analysed and scrutinized between each round.Results: The Delphi process resulted in guidelines consisting of 15 items and a checklist with 16 aspects. The items cover the areas: planning and involving parents, features in the environment, use of time, communication, thehealth care professionals. The checklist covers the child’spattern of communication, anxiety, sensory stimuli, special interests and likes/dislikes.Conclusions: To obtain an optimum caring encounter when a child with ASD is seen in the preoperative and radiology setting, a meticulous planning is important and the environment should be adjusted for the needs of the child. To accomplish this, guidelines need to be in place and be followed.
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| 14. |
- Björkman, Berit
(författare)
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Children in the Radiology Department : a study of anxiety, pain, distress and verbal interaction
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation focuses on children’s experiences of going through an acute radiographic examination due to a suspected fracture. The findings from interviews with children aged 3-15 years showed anxiety, pain and distress to be a concern in conjunction with an examination (Paper I). These initial findings entailed empirical studies being undertaken in order to further study children’s pain and distress in conjunction with an examination (Paper II) as well as children’s anxiety, pain and distress related to the perception of care in the periradiographic process (Paper III). Finally, the verbal interaction between the child and radiographer during the examination was studied (Paper IV).The research was conducted through qualitative, quantitative and mixed method studies. The data collection methods comprised interviews (Paper I), children’s self-reports (Papers II and III), drawings (Paper III), questionnaire (Paper III) and video recordings (Papers I, II and IV). Altogether, 142 children (3-15 years) and 20 female radiographers participated in the studies.Children aged 5-15 years were observed and they completed selfreports on pain and distress. The children were also provided with an opportunity to express their perceptions of the peri-radiographic process and to make a drawing that was analysed with regard to their level of anxiety. Finally, the verbal interaction between the child and radiographer during the examination was analysed.Qualitative content analysis was used to analyse the interviews and the written comments in the questionnaire (Papers I and III). The Child Drawing: Hospital Manual (CD:H) was used when analysing the children’s drawings (Paper III), and the Roter Interaction Analysis System (RIAS) was used when analysing the verbal interaction derived from the video recordings (Paper IV). Non-parametric statistics were applied when analysing the quantitative data (Papers II, III and IV). The findings showed that children aged 5-15 years reported pain on the Coloured Analogue Scale (CAS) and distress on the Facial Affective Scale (FAS) above levels at which treatment or further intervention is recommended. These findings corresponded to the observed pain behaviour measured on the Face, Legs, Activity, Cry and Consolability Scale (FLACC) and anxiety expressed through drawings (CD:H). The children’s perception of the care being provided in the peri-radiographic process, was not related to the experience of anxiety, pain and distress however. The children were confident in the radiographers, who they perceived to be skilled in the task and sensitive to their needs. These findings are supported by the analysis of the verbal interaction (RIAS), which showed that the radiographer adjusted the communication when balancing the task-focused and socio-emotional interaction according to the child’s age.The findings point to the conclusion that children going through an acute radiographic examination should be assessed regarding the anxiety, pain and distress they experience. This is a prerequisite for the radiographer to provide care according to the child’s ability and preferences when interacting with children in the peri-radiographic process.
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| 15. |
- Björkman, Berit, et al.
(författare)
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Children's and parents' perceptions of care during the peri-radiographic process when the child is seen for a suspected fracture
- 2016
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Ingår i: Radiography. - : Elsevier BV. - 1078-8174 .- 1532-2831. ; 22:1, s. 71-76
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Tidskriftsartikel (refereegranskat)abstract
- Background Visiting a Radiology department may elicit both positive and negative feelings for children and parents alike. This study investigated children's and parents' perceptions of care during the peri-radiographic process and whether these perceptions correlated with the child's perceptions of pain and distress. Methods This study utilized a quantitative descriptive design. Its data was collected in five Radiology departments, two where examinations are performed exclusively on children and three that treat both children and adults. Data collection contained questionnaires from children (n = 110) and their parent (n = 110) as well as children's self-reports of pain and distress. Results The findings illustrated that the children and their parent were satisfied with the care provided throughout the peri-radiographic process, unrelated to the child's self-reported levels of pain and distress or examination setting (i.e. children's department or general department). The highest scores of satisfaction were ascribed to “the radiographer's kindness and ability to help in a sufficient way,” whereas “available time to ask questions and to meet the child's emotional needs” received the lowest scores. Conclusions Parents and children alike perceived the radiographers as skilled and sensitive throughout the examination, while radiographers' time allocated to interacting with the child was not perceived be sufficiently covered.
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| 16. |
- Björkman, Berit, et al.
(författare)
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Children's Anxiety, Pain, and Distress Related to the Perception of Care While Undergoing an Acute Radiographic Examination
- 2014
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Ingår i: Journal of Radiology Nursing. - : Elsevier BV. - 1546-0843. ; 33:2, s. 69-78
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Tidskriftsartikel (refereegranskat)abstract
- Visiting the hospital is likely a frightening experience for a child, and going through a radiographic examination has been reported as both distressing and painful. More knowledge from the children's perspective is needed on this subject, however, and thus, the aim of this study was to investigate children's anxiety, pain, and distress in conjunction with an acute radiographic procedure and whether these factors can be related to the perception of care. A mixed method design was used to analyze data from 110 participants between 5 and 15 years of age, who were examined in a Swedish radiology department. The quantitative findings showed anxiety, pain, and distress to be a concern during a radiographic examination. Significant correlations were obtained between anxiety and pain as well as between anxiety and distress. In addition, also the qualitative findings showed pain and the waiting time to be concerns. Regardless of the quantitative findings, however, children of all ages were satisfied with the care performed in the periradiographic process, perceiving the examination as supportive and geared to their needs. Robust assessment of anxiety, pain, and distress is imperative when interacting with children in acute examination situations to avoid both negative short-term and long-term consequences.
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| 17. |
- Björkman, Berit, et al.
(författare)
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Children's experience of going through an acute radiographic examination
- 2012
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Ingår i: Radiography. - : Elsevier. - 1078-8174 .- 1532-2831. ; 18:2, s. 84-89
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Tidskriftsartikel (refereegranskat)abstract
- Children’s experience of radiographic examinations remains largely unexplored, although most radiographers examine children on a daily basis. In order to provide the high quality care that meets the needs of patients it was considered important to undertake research focused upon the patients’ experience of radiographic practice.The aim of the study was to investigate children’s experiences undergoing a radiographic examination for a suspected fracture.Inclusion criteria were Swedish-speaking children between 3 and 15 years of age who were submitted for a radiographic examination with an acute condition of the upper or lower extremity. Patients were informed of the study and together with the escorting parent or relative asked for consent to participate.During the examination the child was videotaped and immediately after, the child was interviewed in a nearby facility. The interview contained open-ended questions and was conducted while watching the videotape together with the child and their parent or relative and the researcher.Qualitative content analysis was used in analyzing the collected data. The analysis resulted in two categories - “feeling uncomfortable” and “feeling confident”. The subcategories contained in these categories were “pain in relation to injury and examination”, “the waiting time is strenuous”, “worries for the future and consequences of the injury”, “confidence in parental presence”, “confidence in radiographic staff and examination procedure”, and finally “recognition entails familiarity”.The results revealed that for the younger children, the experience of undergoing an acute radiographic examination was associated with pain and anxiety, but for the older children, the anxiety was more connected to whether the injury had caused a fracture and any anticipated future consequences or complications.
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| 18. |
- Björkman, Berit, et al.
(författare)
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Children’s pain and distress while undergoing an acute radiographic examination
- 2012
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Ingår i: Radiography. - Elsevier : Elsevier BV. - 1078-8174 .- 1532-2831. ; 18:3, s. 191-196
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Tidskriftsartikel (refereegranskat)abstract
- Pain has been highlighted as a main concern for children in conjunction with an acute radiographic examination. The aim of this study was to further investigate children’s pain and distress while undergoing an acute radiographic examination.The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acute radiographic examination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’s pain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children.Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographic examination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.
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| 19. |
- Björkman, Berit, et al.
(författare)
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Peri-radiographic guidelines for children with autism spectrum disorder : a nationwide survey in Sweden
- 2017
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Ingår i: Child Care Health and Development. - : Wiley-Blackwell. - 0305-1862 .- 1365-2214. ; 43:1, s. 31-36
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process.METHOD: A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics.RESULTS: In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD.CONCLUSION: It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.
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| 20. |
- Björkman, Berit, et al.
(författare)
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Will it Hurt? Verbal Interaction between Child and Radiographer during Radiographic Examination
- 2013
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963. ; 28:6, s. e10-e18
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the nature of verbal interactions between child, parent and radiographer and theextent to which it varied as a function of the child's age. The participants were 20 female radiographersand 32 children (3–15 years) examined for acute injuries. The verbal interactions during theexamination were video recorded and analyzed using the Roter Interaction Analysis System (RIAS).Results indicated that 80% of the verbal interaction was accounted for by the radiographer, 17% by thechild and 3% by the parent. The distribution of utterances varied with regard to children's age.
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| 21. |
- Carlson, Elisabeth, et al.
(författare)
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Students´ Experiences of Participation in a Research Team : Evaluation of a Research-based Teaching Activity in HigherEducation
- 2022
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Ingår i: International Journal for the Scholarship of Teaching & Learning. - : Faculty Center at Georgia Southern University. - 1931-4744. ; 16:3
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Tidskriftsartikel (refereegranskat)abstract
- AbstractIn Sweden as well as internationally the teaching and research nexus has been described as the defining charac-teristics of higher education promoting generic skills such as information analysis and critical reflection. Vertically Integrated Projects has been proposed as one educational strategy where research and teaching are linked by in-viting students to take active part in actual research projects. The strategy is well aligned to Scholarship of teaching and learning enabling the transition from a teacher-centred accepted knowledge to a student-centred perspective where students are invited as producers of knowledge. The aim of the current study was to explore students’ experiences of participation in a research-based learning activity with academia and industrial partners, designed as a qualitative explorative study using focus group interviews. Findings describe not only factors students find motivating for learning, but also their experience of being part of professional life with its benefits and challenges.
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| 22. |
- Darcy, Laura, 1967-, et al.
(författare)
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Following Young Children's Health and Functioning in Everyday Life Through Their Cancer Trajectory
- 2016
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Ingår i: Journal of Pediatric Oncology Nursing. - Thousand Oaks, CA : Sage Publications. - 1043-4542 .- 1532-8457. ; 33:3, s. 173-189
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Tidskriftsartikel (refereegranskat)abstract
- Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children's health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children's trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.
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| 23. |
- Darcy, Laura, et al.
(författare)
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Health and functioning in the everyday lives of young children with cancer : documenting with the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY)
- 2014
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Ingår i: Child Care Health and Development. - : Wiley-Blackwell Publishing Ltd.. - 0305-1862 .- 1365-2214.
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Tidskriftsartikel (refereegranskat)abstract
- Background Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY). Aims The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. Method Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. Results A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence. Conclusions The ICF-CY can be used to document the nature and range of characteristics and consequences of cancer experienced by children. The identified comprehensive code set could be helpful to health care professionals, parents and teachers in assessing and supporting young children’s health and everyday life through the cancer trajectory. The comprehensive code set could be developed as a clinical assessment tool for those caring for young children with cancer. The universal language of the ICF-CY means that the utility of a clinical assessment tool based on identified codes can have wide reaching effects for the care of young children with cancer.
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| 24. |
- Darcy, Laura, et al.
(författare)
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ICF applications in health care for children with cancer in Sweden
- 2017
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Ingår i: An emerging approach for education and care. - London : Routledge. - 9781315519685 - 9781138698178 ; , s. 178-186
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Bokkapitel (refereegranskat)abstract
- The International Classification of Functioning, Disability and Health (ICF) and its version for children and youth, the ICF-CY, can contribute to the present knowledge on the lives of young children with cancer, with an international and interdisciplinary language. In this context, the term health can be seen as a multidimensional concept in which both illness and non-illness/well-being are dimensions that can be present at the same time, rather than two opposite concepts. Health is the result of a continuous process rather than something that one individual has; it is a resource for everyday life rather than the objective of living (WHO, 1986). The ICF was developed to classify different dimensions on individuals’ health as a unified standardised common language and framework, to be used across disciplines (WHO, 2007). It acknowledges that health and illness are complex concepts and promotes a biopsychosocial model of health, in which the context is as important as the individual and his/her needs. The view of health as functioning in everyday life can be operationalised using the ICF model of body structure, body function, activities and participation and environmental factors (Rosenbaum & Gorter, 2012).
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| 25. |
- Darcy, Laura, 1967-, et al.
(författare)
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It’s not just about making them talk : Some thoughts and experiences on interviewing children in research
- 2016
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Ingår i: Nordic Conference on Nursing Research 2016.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- It’s not just about making them talk - thoughts and experiences on interviewing children in researchHistorically, children’s views have not been valued in medical care. In research, children have been seen as a vulnerable group, difficult to access and unable to tell their story. Many proxy studies have been performed where health care staff and parents have given their views about what they think the child experiences. However,it is difficult to draw valid conclusions about the child´s experience using proxy valuations. Children have the right and the ability to contribute unique information about their own experiences. These views are valuable in providing evidence based care.The aim of this paper is to share experiences and thoughts gained from interviewing children with cancer aged 3-13 years of age.Young children (from 3 years of age) have sufficient mental ability, cognition and concepts to describe experiences– just not in the same way as adults. They are able to articulate their experiences, providing the interview context feels safe, questions and props are developmentally appropriate and the interviewer follows the child’s leads. Special considerations need to be taken such as how to best inform them about the study, ethical issues, where and when to undertake the interview, how long the interview should be, how to make the child talk in the interview and which elucidating devices/props can be used during the interview as facilitators. Parental contributions to child interviews can be useful as long as focus is kept on the child’s experiences. Interviewing over several time points gives new insights.
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