| 1. |
- Ahlstrand, Inger, et al.
(författare)
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Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study
- 2022
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
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| 2. |
- Berglund, Mia, et al.
(författare)
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Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.
- 2016
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Ingår i: Journal of Gerontology & Geriatric Research. - : OMICS Publishing Group. - 2167-7182.
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Tidskriftsartikel (refereegranskat)abstract
- Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home. Aim: The aim of this study was to describe the older adults' experiences of the intervention Reflective STRENGTH-Giving Dialogue. Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention. Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life. Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.
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| 3. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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An educational intervention to improve communication skills in home care – a feasibility study
- 2022
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Konferensbidrag (refereegranskat)abstract
- An educational intervention to improve communication skills in home care – a feasibility studyBackgroundAn educational intervention focused on person-centred communication with older persons in home care was developed. Twenty-three nursing assistants (NAs) from two home care units were offered the intervention. This feasibility study was conducted to capture benefits and pit falls with study processes before large scale interventions, such as acceptability and appropriateness of evaluation methods.AimTo explore the feasibility of proposed methods for evaluating a novel educational intervention on person-centered communication for NAs in home care.MethodFeasibility study with pre- and post-assessments, including evaluation of data collection procedures, completion rates, and missing data for two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction. Descriptive and statistical analysis was conducted. ResultsThe results showed a completion rate of 83% and 61% in pre- and post-assessment respectively, and a low proportion of missing data. The questionnaires were feasible and acceptable for NAs to complete and understand. Stress due to staff shortages and high workload negatively affected NAs’ participation in data collection. Overall, NAs rated their communication skills as high with a tendency towards higher communication self-efficacy after the intervention, however, this difference was not statistically significant. Job satisfaction remained unchanged pre- and post-intervention.ConclusionLow follow-up rates suggest that the data collection procedures need refinement. Although the outcomes are preliminary at this point, they indicate a ceiling effect in NAs’ self-efficacy ratings. The ceiling effect limits possibilities for improvement and suggests that studies with a larger sample is needed.Implications for caring in a changing worldIn a changing world, where a rapid aging population challenges home care services, there is a need for innovative interventions that support and strengthen health care professionals’ communication skills, aiming at improving older persons’ well-being This study contributes with knowledge to the complexity of developing and evaluating complex interventions on communication in home care.
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| 4. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:3, s. 1375-1382
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.DesignA feasibility study with pre- and post-assessments.MethodsFeasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.ResultsThe questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.
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| 5. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Walk a fine line between meaningfulness or discomfort : the complexity of emotional communication
- 2022
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Konferensbidrag (refereegranskat)abstract
- Background: The home care of older persons includes inter-personal interactions and communication needed to care for and respond to diverse needs of older people. Previous research has focused on emotional expressions of older persons and responses by nursing staff. Research on the meaning of the interaction in these sequences is sparse. Therefore, the aim of this study was to illuminate the meaning attached to sequences of emotional communication and the interaction during these sequences between older persons and nursing assistants during home care visits.Methods: A descriptive observational design was used. The data consisted of 44 audio recordings of real-life conversations between older persons and nursing assistants during home care visits. A hermeneutic phenomenological analysis was conducted.Findings: Preliminary results indicate sequences of emotional communication being a window of opportunities. The interaction that followed were linked to dual and sometimes incongruent meanings. Expressions being actively blocked or ignored could cause an increase of unpleasant emotions or distract away from negative feelings. Simultaneously, such conversations could both ease or add to the complexity of the interaction and communication. Conversations elaborating on the older persons’ emotions seemed to instill trust and create meaningfulness, at the same time as these situations contained unpleasant moments with sad or angry feelings. The risk for discomfort in these sequences could threaten the trust in the relationship.Discussion: Conversations on older persons worries can be complex: the findings point to a fine line between meaningfulness and distress in these sequences. Unpleasant emotions call for attention and caution, these may need to be noticed at the same time as they cannot be forced out.
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| 6. |
- Hedén, Lena, 1971-
(författare)
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Distressing Symptoms in Children with Cancer in General; During Needle Procedures in Particular
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aims of this thesis were to investigate the effect of distraction, midazolam and morphine on fear, distress, and pain during needle procedures, and to longitudinally describe parents’ perceptions of their children’s symptom burden during and after cancer treatment.The design in Study I-III was that of a randomized controlled trial (RCT) conducted in a medical setting; Studies II-III were placebo controlled. Study IV has a longitudinal design, and data were collected at three times during treatment and three times after the end of successful treatment. Participants in Study I were children aged 1 to 7 (n=28), in Study II children aged 1 to 19 (n=50), in Study III children aged 1 to 19 (n=50), and in Study IV parents (n=160) of children aged 1 to 19.Blowing soap bubbles or having a heated pillow reduces children’s fear and distress in connection with needle procedures. Low-dose oral midazolam 0.3mg/kg body weight is effective in reducing fear and distress, especially in younger children. Interestingly, oral morphine at a dose of 0.25mg/kg body weight does not reduce fear, distress or pain.These studies have evaluated interventions that may be of help for the most frightened children during needle procedures. We suggest that the first-line intervention against procedural fear, distress, and/or pain should be standard care (i.e. EMLA) in addition to distraction interventions when needed, and only when this is insufficient to add pharmacological interventions.According to parents, feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms in their children, whereas less hair than usual is the most prevalent symptom during treatment. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout treatment. The child’s symptom burden, as reported by parents, decreases over time. Information about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during and after cancer treatment.
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| 7. |
- Hedén, Lena, 1971-, et al.
(författare)
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The relationship between fear and pain levels during needle procedures in children from the parents' perspective.
- 2016
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 20:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The primary objective was to determine the levels of and potential relationships between procedure-related fear and pain in children. Secondary objectives were to determine if there are associations between the child's age and sex, diagnostic group, time since diagnosis, time since last needle insertion, cortisol levels and the parent's fear level in relation to fear and pain.METHODS: The child's level of pain and fear was reported by parents on 0-100 mm visual analogue scales (VAS). One hundred and fifty-one children were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port. All children were subjected to one needle insertion following topical anaesthesia (EMLA) application. The effect of the child's age and sex, diagnostic group, time since diagnosis, time since last needle insertion, cortisol change levels and the parent's fear level, on fear and pain levels was investigated with multiple regression analysis.RESULTS: The needle-related fear level (VAS mean 28 mm) was higher than the needle-related pain level (VAS mean 17 mm) when topical anaesthesia is used according to parents' reports (n = 151, p < 0.001). With fear as the dependent variable, age and pain were significantly associated and explained 33% of the variance, and with pain as the dependent variable, fear, parents' fear and change in cortisol level were significantly associated and explained 38% of the variance.CONCLUSIONS: According to parents, children experienced more fear than pain during needle insertion when topical anaesthesia is used. Therefore, in addition to pain management, an extended focus on fear-reducing interventions is suggested for needle procedures.
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| 8. |
- Höglander, Jessica, et al.
(författare)
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Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol
- 2023
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826
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| 9. |
- Kleye, Ida, 1984-
(författare)
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Barncentrerad vård vid nålprocedurer : Betydelsen av att möta barns rädsla och smärta
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Children report needle procedures as the worst source of fear and pain during hospital care and treatment. How children communicate their fear and pain varies, which can be challenging for nurses to understand and meet. Nurses need to be able to recognize and acknowledge children’s emotions for needle procedures to be child centered. Aim: To explore the effects of a child centered intervention on fear and pain during needle procedures. Methods: Four studies combining qualitative and quantitative approaches, with boys and girls aged 4 – 12 years old undergoing a needle procedure, were conducted. Study I explored child-identified strategies used to manage fear and pain in hospital, with data collected through semi-structured interviews. Data through observations from video recordings were used in Study II to explore children’s expressions of emotional cues and concerns, and nurses’ response to these expressions. To examine whether children experience less fear and pain when receiving standard care with the addition of the intervention iCC compared with the experience of standard care only, self-reported fear and pain before and immediately after a needle procedure were conducted in study III. To further evaluate the effect of the intervention, time required for the procedure, heart rate, success rate for the procedure, behavioral observations, and patient preference to undergo the needle procedure in the same way again, were collected. Study IV evaluated child-nurse emotional communication when using a child centered intervention versus a control group. Data collection consisted of video-observations. Main results: The opportunity to choose strategy themselves was particularly supportive to children. Unpleasant emotions were commonly expressed through non-verbal communication, but seldom acknowledged by nurses. Less fear and pain were observed in the intervention group and less time required performing the needle procedure. Most children using iCC intervention were positive to the possibility of undergoing a needle procedure in the same way again in the future. Nurses using the intervention acknowledged the child’s expressed unpleasant emotions to a greater extent. Conclusion: Approaching children as active and competent actors during needle procedures contributes positively to nurses’ involvement, to the time a needle procedure takes, and to children’s experiences and emotional state.
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| 10. |
- Kleye, Ida
(författare)
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Barncentrerad vård vid nålprocedurer : Betydelsen av att möta barns rädsla och smärta
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Children report needle procedures as the worst source of fear and pain during hospital care and treatment. How children communicate their fear and pain varies, which can be challenging for nurses to understand and meet. Nurses need to be able to recognize and acknowledge children’s emotions for needle procedures to be child centered. Aim: To explore the effects of a child centered intervention on fear and pain during needle procedures. Methods: Four studies combining qualitative and quantitative approaches, with boys and girls aged 4 – 12 years old undergoing a needle procedure, were conducted. Study I explored child-identified strategies used to manage fear and pain in hospital, with data collected through semi-structured interviews. Data through observations from video recordings were used in Study II to explore children’s expressions of emotional cues and concerns, and nurses’ response to these expressions. To examine whether children experience less fear and pain when receiving standard care with the addition of the intervention iCC compared with the experience of standard care only, self-reported fear and pain before and immediately after a needle procedure were conducted in study III. To further evaluate the effect of the intervention, time required for the procedure, heart rate, success rate for the procedure, behavioral observations, and patient preference to undergo the needle procedure in the same way again, were collected. Study IV evaluated child-nurse emotional communication when using a child centered intervention versus a control group. Data collection consisted of video-observations. Main results: The opportunity to choose strategy themselves was particularly supportive to children. Unpleasant emotions were commonly expressed through non-verbal communication, but seldom acknowledged by nurses. Less fear and pain were observed in the intervention group and less time required performing the needle procedure. Most children using iCC intervention were positive to the possibility of undergoing a needle procedure in the same way again in the future. Nurses using the intervention acknowledged the child’s expressed unpleasant emotions to a greater extent. Conclusion: Approaching children as active and competent actors during needle procedures contributes positively to nurses’ involvement, to the time a needle procedure takes, and to children’s experiences and emotional state.
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| 11. |
- Kleye, Ida, 1984-, et al.
(författare)
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Positive effects of a child‐centered intervention on children's fear and pain during needle procedures
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : Wiley. - 2637-3807 .- 2637-3807. ; 5:1, s. 23-30
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Tidskriftsartikel (refereegranskat)abstract
- To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure.
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| 12. |
- Sundler, Annelie Johansson, 1973-, et al.
(författare)
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The patient’s first point of contact (PINPOINT) – protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses
- 2023
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Ingår i: BMC Primary Care. - : BioMed Central Ltd. - 2731-4553. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: A major challenge for primary care is to set priorities and balance demands with available resources. The registered nurses in this study are practice nurses working in primary care offices, playing a large role in initial assessments. The overall objective of this research is to investigate practices of communication and decision-making during nurses’ initial assessment of patients’ health problems in primary care, examine working mechanisms in good practices and develop feasible solutions. Methods: Project PINPOINT aims for a prospective multicenter study using various methods for data collection and analysis. A purposive sample of 150 patient‒nurse consultations, including 30 nurses and 150 patients, will be recruited at primary care centers in three different geographic areas of southwest Sweden. The study will report on outcomes of communication practices in relation to patient-reported expectations and experiences, communication processes and patient involvement, assessment and decision-making, related priorities and value conflicts with data from patient questionnaires, audio-recorded real-time communication, and reflective interviews with nurses. Discussion: This research will contribute to the knowledge needed for the guidance of first-line decision-making processes to best meet patient and public health needs. This knowledge is necessary for the development of assessments and decisions to be better aligned to patients and to set priorities. Insights from this research can empower patients and service providers and help understand and enhance feasible person-centered communication strategies tailored to patients’ level of health literacy. More specifically, this research will contribute to knowledge that can strengthen nurses’ communication, assessments, and clinical decision-making in primary care. In the long term, this will contribute to how the competencies of practice nurses and other professionals are organized and carried out to make the best use of the resources within primary care. Trial registration: ClinicalTrials.gov Identifier: NCT06067672.
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| 13. |
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| 14. |
- Östman, Malin, et al.
(författare)
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The patient's first point of contact in primary care – registered nurses' communication and initial assessment
- 2023
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Konferensbidrag (refereegranskat)abstract
- Overall information:This is a postdoc project that includes three work packages (WP). The purpose of this research is to investigate key principles and conflicts of goals in registered nurses’ (RNs) initial assessments and nurse-patient communication related to the priority of patients’ needs and care provision in primary care. This abstract focuses on the first WP.Background:Primary care is central to the Swedish healthcare system, for “good quality, local health care”, with focus on accessibility and continuity. In primary care, RNs are usually the patient's first point of contact and those who carry out initial assessments and priorities. The RNs communication and interaction with the patient is important for the initial exploration and understanding about patient’s health concerns, and RNs assessment includes data gathering, the interpretation of these data and decision-making on what action needs to be taken. Communication strategies used can optimize RNs assessment and clinical reasoning. However, assessments and priorities are complex, as health problems and illness severity must be weighed against accessibility and available resources. There is a lack of research on RNs communication strategies used to address individual patients’ need in their initial contact with primary care.Aim:To explore nurse-patient communication during initial assessments and RNs’ priorities with focus on expressed needs and concerns.Methods:The first WP is based on observational data, subjects for the project are RNs and patients from primary care units in Region Västra Götaland, Sweden. Data will be gathered on real time nursepatient communication using audio recordings with ten RNs doing five recordings each. A purposeful sampling will be made to collect data related to patients with a first point of contact with different disease conditions and illness complexities. The processing and analysis of data collected on audio recordings will be coded with the Verona Coding Definitions on Emotional Sequences (VR-CoDES). The data will allow for both statistical and qualitative analysis.Expected findings:This study can contribute to more knowledge about RNs communication strategies in relation to RNs’ assessment in patient’s first point of contact in primary care, but also whether gender differences or other inequalities exist.Timeplan:The first WP will start in Spring 2023 and by the end of the year, reporting and dissemination of findings is expected to be possibleRequest for feedback:We have planned to code the data with VR-CoDES. Other methods or approaches that may be suitable?
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