| 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. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Health-promoting factors in higher education for a sustainable working life : protocol for a multicenter longitudinal study
- 2020
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.
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| 3. |
- Barimani, Mia, et al.
(författare)
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Professional support and emergency visits during the first 2 weeks postpartum
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 28:1, s. 57-65
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the study was to assess mothers' perceived satisfaction with professional support during the first 2 weeks after childbirth and the extent to which mothers seek emergency care during the same period. Design: A cross-sectional study was conducted of all mothers (n = 546) in Stockholm County, Sweden, who gave birth to a live baby during the same week in 2009. Ethical issues: The study was approved by the regional Research and Ethics Committee at the Karolinska Insititutet, Sweden. Methods: The mothers responded to a study-specific questionnaire on perceived satisfaction with professional support and the sense of coherence scale, which measures coping strategies. The mothers also provided information about their socio-demographic background, obstetric and infant data, and visits to hospital emergency departments. Descriptive and logistic regression analyses were performed. Results: Fifty-three percent of the mothers rated the support received as sufficient or more than sufficient, 29.7% as neither sufficient nor insufficient and 17.7% as insufficient or completely insufficient. The results indicate a lack of continuity in postpartum care. As many as 17% of the mothers in the study population visited hospital emergency departments during the first 2 weeks after childbirth, as a result of problems related to delivery, breastfeeding or infant health. A higher frequency of such emergency visits was associated with poor perception of professional support, low sense of coherence and delivery complications. Conclusions: Relative to otherwise comparable mothers, mothers who experience complications with delivery are less satisfied with professional support and turn more frequently to hospital emergency departments for support. © 2013 Nordic College of Caring Science. Published by Blackwell Publishing Ltd.
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| 4. |
- Barimani, M., et al.
(författare)
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Support and continuity during the first 2weeks postpartum
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:3, s. 409-417
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo investigate mothers' perceived satisfaction with support from antenatal care (AC), postpartum care (PC) and child health care (CHC), respectively, during the first two weeks after childbirth. Ethical issuesThe study was approved by the Regional Research and Ethics Committee at the Karolinska Insititutet, Sweden. MethodsData were collected using a study-specific questionnaire that focused on mothers' satisfaction with support from AC, PC and CHC during the first 2weeks after childbirth. All mothers in Stockholm County (n=546) who gave birth to a live infant during a 1-week period in 2009 were invited to participate. Descriptive and logistic regression analyses and a content analysis were performed. ResultsA large discrepancy was found between levels of satisfaction with AC, PC and CHC. Mothers were satisfied with the support from CHC healthcare nurses, but missed follow-up contact from AC and PC midwives. Nearly 40% of all mothers commented on insufficient support including that continuity in the chain of care was lacking and support for mothers' physical and emotional health was insufficient. Delivery at <37weeks of gestation was associated with reduced satisfaction with both AC and CHC, but not with PC. Mothers who made emergency visits during the first two weeks were more likely to be dissatisfied with support from PC. ConclusionAll links in the chain of care are important for the support of mothers during the first 2weeks after childbirth, but continuity needs to be improved to raise the quality of care for mothers.
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| 5. |
- Lindberg, A., et al.
(författare)
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Experiences of complementary and alternative medicine in patients with inflammatory bowel disease - a qualitative study
- 2014
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Ingår i: Bmc Complementary and Alternative Medicine. - : Springer Science and Business Media LLC. - 1472-6882. ; 14:407
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of Complementary and Alternative Medicine (CAM) in Inflammatory Bowel Disease (IBD) is increasing. Although CAM often improves patients' well-being, it can also lead to side-effects and interactions with conventional medications. Research on patients with IBD in Sweden who have experiences of CAM is sparse. More studies are needed to enhance awareness of and improve communication about CAM. The aim of this study was to describe experiences of CAM in the healthcare context reported by patients with IBD. Methods: Fifteen patients with IBD, eight with Crohn's disease (CD) and seven with ulcerative colitis (UC), were recruited. Semi-structured qualitative interviews were conducted and qualitative content analysis was performed. Results: The analysis revealed the theme Knowledge and communication lead to participation in the area of CAM based on three categories; CAM use, Communication and Self-care. Patients with IBD wanted to be asked about CAM to be able to start a dialogue, as some perceived being treated in a disparaging manner and not taken seriously when raising the subject. Healthcare professionals (HCPs) need to be aware of this in order to meet and understand patient needs. Patients with IBD found it easier to communicate about CAM with the IBD nurses than physicians and dietary changes was one important CAM treatment. Conclusions: The finding that it was easier to discuss CAM with nurses than physicians emphasizes the important role of the IBD nurse in communication and monitoring patients' CAM use. Patients wanted to be asked about CAM to be able to start a dialogue, as some perceived not taken seriously when raising the subject. Furthermore, HCPs need to understand that many patients with IBD regard dietary changes as an important part of CAM treatment. Further research in these areas is needed.
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| 6. |
- Lindberg, Annelie, et al.
(författare)
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Inflammatory bowel disease professionals' attitudes to and experiences of complementary and alternative medicine
- 2013
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Ingår i: BMC Complementary and Alternative Medicine. - : Springer Science and Business Media LLC. - 1472-6882. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Complementary and alternative medicine (CAM) use in patients with IBD is on the increase. Patients report they use CAM when their condition is unresponsive to conventional medication or when they suffer from side-effects, negative stress and disease-related concerns. CAM use may improve patients’ well-being but it can also lead to side-effects and interactions with conventional medications. Research on attitudes to and experiences of CAM among healthcare professionals working with IBD patients is not well studied. Studies in this area could lead to enhanced awareness of and improved communication about CAM between care staff and IBD patients. The aim of this study was to explore IBD professionals’ attitudes to and experience of CAM. Methods Sixteen physicians and nurses, 26–70 years old, who had worked with IBD patients for 1–42 years, were recruited. Semi-structured qualitative interviews were conducted. Qualitative content analysis was performed. Results Participants stated patients used CAM to improve their well-being generally and there conditions specifically. Participants had a positive attitude towards CAM and respected their patients’ decision to use it, but reported a lack of CAM knowledge. They required education about CAM to be able to meet patients’ needs and provide adequate information. The result of this study indicates that there is a need for CAM education to be implemented in nursing and medical school. Conclusions All participants had experience of IBD patients who had used CAM in an attempt to achieve improvement and well-being. Attitudes to CAM were mainly positive, although a problematic aspect was lack of knowledge and evidence in relation to CAM. Implementing CAM education in nursing and medical school will allow healthcare professionals to gain an understanding of therapies widely used by patients with IBD. In clinical practice, using a standard questionnaire regarding CAM use allow healthcare professionals to better understand their patients’ wishes and current CAM use.
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| 7. |
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| 8. |
- Mikkelsen, Andrea, et al.
(författare)
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Monitoring the impact of cow's milk allergy on children and their families with the FLIP questionnaire - a six-month follow-up study
- 2015
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 26:5, s. 409-415
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMany children with cow's milk allergy (CMA) develop tolerance, but, challenges in daily life may remain. Using the Food hypersensitivity famiLy ImPact questionnaire (FLIP), we sought to monitor changes in the impact of CMA over time. MethodsFamilies of children with CMA, who participated in the validation of the FLIP, were re-approached 6months later for follow-up. Change in reported difficulties was assessed by paired sample t-test and mixed models, stratifying by outgrown vs. persistent CMA. ResultsImpact on families with children who had outgrown CMA (n=20) decreased in the FLIP's total score (p=0.0001) and in two subscales; Health and Emotions (p=0.0001) and Everyday Life (p=0.0001). In contrast, no significant improvements were registered in nutritional concerns. Impact on the group with persistent CMA (n=57) was unchanged at follow-up except for more impact on Everyday Life (p=0.001). In the final analysis comparing longitudinal changes in the groups, the strongest differences were observed for the subscales Health & Emotions and Everyday Life; for the Nutrition subscale, the between-group changes also differed, but to lesser extent. ConclusionsWe have documented the varying impact of CMA on parents and children over time. Families who were still affected continued to experience impact in daily life. Despite development of tolerance, families who were no longer affected revealed continuing nutritional concerns. Follow-ups should be offered even after outgrown CMA to encourage progression to unrestricted diet, to prevent eating disorders and to promote healthy growth.
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| 9. |
- Mikkelsen, Andrea, et al.
(författare)
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The Food hypersensitivity famiLy ImPact (FLIP) questionnaire - development and first results
- 2013
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Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157. ; 24:6, s. 574-581
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Tidskriftsartikel (refereegranskat)abstract
- Background: Elimination of the offending food(s) is the usual treatment when a child suffers from food hypersensitivity. This treatment can impair everyday life in families with affected children. Instruments to assess these impairments generated from families attending primary care and in comparison to families with children without food hypersensitivity are scarce. The aim of this study is to develop and test a method to assess food hypersensitivity's impact on everyday life on affected families. Methods: The Food hypersensitivity famiLy ImPact (FLIP) questionnaire was developed and validated on parents of children (0.5-7 years) with cow's milk protein hypersensitivity, exclusively or in combination with other food hypersensitivity, together with the Swedish Parental Stress Questionnaire (SPSQ) and in comparison to parents with children without food hypersensitivity. Results: The validation of FLIP on 94 families indicated excellent internal consistency (Cronbach a 0.9) and good reproducibility (ICC 0.71). The FLIP showed moderate correlation with the SPSQ (r = 0.48) and proved capable of discriminating families by disease burden. Affected families experienced higher stress on their daily lives (p = 0.02) and higher impact on nutrition concerns (p < 0.0001) compared to families with children without food hypersensitivity. Conclusions: The FLIP is a reliable, valid and sensitive instrument and could be valuable both clinically and in research. The results confirm recommendations of the need for continuous and updated dietary treatment and support for the families with young children with food hypersensitivity.
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| 10. |
- Milton, Jenny, 1974, et al.
(författare)
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Healthcare professionals' perceptions of interprofessional teamwork in the emergency department: a critical incident study
- 2022
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 30:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Interprofessional teams contribute to patient safety during clinical care. However, little is known about how interprofessional teams manage and cope with critical incidents in the emergency department (ED). Therefore, the study aimed to describe healthcare professionals (HCPs) perceptions of critical incidents linked to the enablers of and barriers to interprofessional teamwork in a high-risk setting, the ED. Methods Individual interviews with HCPs regarding events at the ED were held during the period of May 2019-January 2020. The Critical Incident Technique approach was used to guide the interviews and the qualitative analysis. Data were analyzed inductively using qualitative content analysis. Results Interview participants (n = 28) included 7 physicians (25%), 12 registered nurses (43%), 7 nurse assistants (25%) and 2 administrators (7%). Overall, 108 critical incidents were described. Eight categories that described functional and dysfunctional experiences within interprofessional teamwork were identified: salience of reflection; professional experience makes a difference; demanding physical and psychosocial work environment; balancing communication demands; lacking management support, structure, and planning; tensions between professional role and responsibility; different views on interprofessional teamwork; and confidence in interprofessional team members. Conclusion Findings of this study indicate that poor ED-specific communication and limited professional experience are essential factors in handling critical incidents related to interprofessional teamwork. An important aspect of critical incident management is the ergonomics of the physical work environment and how it enables interprofessional teamwork. This study emphasizes the factors enabling interprofessional teamwork to manage critical incidents in the complex working environment of the ED.
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| 11. |
- Milton, Jenny, 1974, et al.
(författare)
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Interprofessional teamwork before and after organizational change in a tertiary emergency department: An observational study
- 2023
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Ingår i: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 37:2, s. 300-311
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Tidskriftsartikel (refereegranskat)abstract
- In healthcare settings, suboptimal interprofessional teamwork and communication contribute to unsafe care and avoidable harm. Interprofessional teamwork is essential in high-risk clinical areas such as the emergency department (ED). The aims of this study were to describe interprofessional teamwork in a hospital ED and to evaluate factors influencing interprofessional communication before and after implementation of a department-wide multifaceted intervention. Structured observations were undertaken during 2015/16 and 2019. Differences in interprofessional communication practices, teamwork, and sources of interruptions were compared before and after the intervention. The following domains were surveilled: (a) healthcare professionals (HCPs) communication initiatives, (b) HCPs' contribution to patient assessment, (c) interprofessional communication processes, and (d) team interruptions. The intervention included strategies to enable use of communication tools, changes to team structures, changes in work environment, ethical principles, and establishment of a code of professional conduct during interprofessional communication. Team interruptions significantly decreased post-intervention, and our findings suggest that organizational changes affect domains of teamwork. Statistically significant differences were observed in the initiated communication pre-intervention and contribution to patient assessment significantly increased post-intervention. Multifaceted organizational interventions can positively affect interprofessional team communication and work-flow in the ED, thus patient safety and quality of care can be improved.
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| 12. |
- Milton, Jenny, 1974, et al.
(författare)
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Patients' perspectives on care, communication, and teamwork in the emergency department
- 2023
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X. ; 66
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Tidskriftsartikel (refereegranskat)abstract
- Background: The work of healthcare professionals (HCPs) in the emergency department (ED) involves effective communication and efficient teamwork, which may be perceived differently by patients and HCPs. Therefore, it is important to explore patient perspectives of information exchange and clinical assessment.Aim: To evaluate experiences of care, communication, and teamwork from ED patients' perspectives. Methods: Semi-structured interviews were conducted with 17 patients who were assessed in a Swedish ED during Spring 2021. Thematic analysis was used.Results: Participants' experiences reflected the complex environment of the ED. Findings emphasize the impor-tance of information exchange in relation to a caring approach. Three themes emerged: the need for a caring approach by HCPs towards patients'; the need for dialogue between patient and HCPs; and the need for infor-mation on ED environment constraints.Conclusions: Patients felt comforted when they experienced a caring empathic approach from the HCPs. For example, patients valued an individual holistic approach rather than feeling that they were being objectified by their medical conditions. This was important in coping with the anxiety caused by a stressful ED environment. There is a critical need for effective exchange of information between patients and HCPs.
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| 13. |
- Milton, Jenny, 1974, et al.
(författare)
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Safety attitudes and working climate after organizational change in a major emergency department in Sweden
- 2020
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X. ; 53
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors Background: Medically complex patients present challenges to the health care system, particularly in the emergency department (ED) setting. Specifically, teamwork is thought to affect staff safety climate, which in turn impacts patient safety. Aim: This study aimed to evaluate the effect of organizational changes to interprofessional team assessment processes on staff perception of teamwork and safety attitudes in the ED. Methods: This prospective observational study used cross-sectional design and measured ED staff perception of patient safety related domains at two time-points (before and after an organizational intervention), using the Safety Attitude Questionnaire. Results: Statistically significant changes were seen among the overall sample (n = 112 at time point one and n = 121 at time point two) for the safety climate, working conditions, and stress recognition domains. Nurses and doctors showed different baseline attitudes and different responses to the intervention between the two time points. Conclusion: The results reflect improved positive attitudes overall though there were differences in responses between the nursing and medical professions. The findings highlight opportunities to improve attitudes among ED team members through defined organizational change and learning from one another. Organizational change can affect staff perceptions of the safety climate and interprofessional teamwork, which may improve the ED working environment.
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| 14. |
- Nordahl Amorøe, Torben, et al.
(författare)
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How theories of complexity and resilience affect interprofessional simulation-based education: a qualitative analysis of facilitators' perspectives
- 2023
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Ingår i: BMC Medical Education. - 1472-6920. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundQuality of care and patient safety rely on the ability of interprofessional teams to collaborate effectively. This can be trained through interprofessional simulation-based education (IPSE). Patient safety also relies on the ability to adapt to the complexity of such situations, an ability termed resilience. Since these needs are not explicitly addressed in IPSE, the aim of this study was to explore how central concepts from complexity-theory and resilience affect IPSE, from facilitators' perspective, when applied in debriefings.MethodsA set of central concepts in complexity-theory and resilience were introduced to facilitators on an IPSE course for nursing and medical students. In five iterations of focus groups interviews the facilitators discussed their application of these concepts by reviewing video recordings of their own debriefings. Video recordings of the interviews were subjected to coding and thematic analysis.ResultsThree themes were identified. The first, Concepts of complexity and resilience are relevant for IPSE, points to the applicability of these concepts and to the fact that students often need to deviate from prescribed guidelines/algorithms in order to solve cases. The second theme, Exploring complexity, shows how uncertainty could be used as a cue to explore complexity. Further, that individual performance needs to account for the context of actions and how this may lead to certain outcomes. Moreover, it was suggested that several ways to approach a challenge can contribute to important insight in the conditions for teamwork. The third theme, Unpacking how solutions are achieved, turns to needs for handling the aforementioned complexity. It illustrates the importance of addressing self-criticism by highlighting how students were often able to overcome challenges and find solutions. Finally, this theme highlights how pre-defined guidelines and algorithms still work as important resources to help students in transforming perceived messiness into clarity.ConclusionsThis study suggests that IPSE provides the possibility to explore complexity and highlight resilience so that such capability can be trained and improved. Further studies are needed to develop more concrete ways of using IPSE to account for complexity and developing resilience capacity and to evaluate to what extent IPSE can provide such an effect.
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| 15. |
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| 16. |
- Oxelmark, Lena, et al.
(författare)
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Group-based intervention program in inflammatory bowel disease patients : effects on quality of life
- 2007
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press (OUP). - 1078-0998 .- 1536-4844. ; 13:2, s. 182-90
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD) have great impact on patients' health-related quality of life (HRQOL). The aim of this study was to develop an integrated medical and psychological/ psychosocial group-based intervention program for IBD patients and to evaluate if such a program could influence the patients' HRQOL and coping abilities.METHODS: IBD patients in remission or with low disease activity were randomized to intervention or control groups. The intervention comprised nine weekly sessions, alternating lectures, and group therapy sessions. The Inflammatory Bowel Disease Questionnaire (IBDQ) and the Sense of Coherence scale (SOC) were used to measure HRQOL and coping ability at 0, 6, and 12 months. The intervention was evaluated by a visual analog scale (VAS) and written comments by a content analysis.RESULTS: In all, 24 patients were included in the intervention group and 20 in the control group. The mean IBDQ score showed no statistically significant differences before (173.9) or after the intervention at month 6 (175.7) or at month 12 (171.8), or when comparing intervention and controls at month 12. Similarly, there were no statistically significant differences in mean SOC before or after intervention or when comparing groups. The VAS and the content analysis showed that the intervention was well appreciated by the patients.CONCLUSIONS: The group-based intervention program was feasible and highly appreciated. There were no statistically significant differences in average IBDQ or SOC over time or in comparison with controls, although a significant increase was seen in patients with short disease duration.
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| 17. |
- Oxelmark, Lena, et al.
(författare)
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Patients prefer clinical handover at the bedside; Nurses do not: Evidence from a Discrete Choice Experiment
- 2020
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489. ; 105:May
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Tidskriftsartikel (refereegranskat)abstract
- Background Shift-to-shift bedside handover is advocated as a patient-centred approach, yet its enactment is challenging. Objectives To describe and compare the preferences of both patients and nurses in the implementation of bedside handover in a Swedish University Hospital. Design A discrete choice experiment (DCE) survey. Settings University setting, four medical wards in two hospitals. Participants Adult medical patients (n=218) and registered nurses (n=101) Methods The survey was administered by an electronic tablet-assisted face-to-face survey. Respondents made repeated choices between two hypothetical bedside handover alternatives and a third alternative of ‘handover away from the bedside’. Handover alternatives were described according to six attributes: invitation to participate, number of nurses present at the handover, family member, carer or trusted friend (of the patient) allowed to be present, level of (patient) involvement, what information related to your (patient) care is discussed. Choice data were analysed using a mixed logit model. Results A total of 1308 (patients) and 909 (nurses) choice observations were included in the preference models. Patients showed a strong preference for handover at the bedside compared to nurses. Nurses generally preferred handover away from the bedside. Patients perceived their level of involvement in handover as highly important, being able to speak, hear what was said being the most important characteristic, closely followed by being invited to participate and asked questions as well as being heard. Nurses considered patients being invited to participate most important, followed by level of involvement. Different options for handing over sensitive information were not perceived of importance by patients or nurses. There was substantial variation at the individual level across both patients and nurses for where and how handover is delivered. Conclusions In this study, patients strongly preferred handover at the bedside, while the nurses considered patients to be invited to participate to be the most important preference but generally preferred handover to take place away from the bedside, all else equal. When implementing bedside handover in a Swedish context this must be considered, although participation is a prerequisite for bedside handover. Differences between patients and nurses’ preferences could jeopardize future introduction of bedside handover in Swedish health care, and might explain why bedside handover is still not very common in hospital wards.
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| 18. |
- Oxelmark, Lena
(författare)
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Quality of life in inflammatory bowel diseases : aspects on interventions and unconventional treatments
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) of unknown aetiology and characterized by periods of remission and exacerbation. Disabling bowel symptoms, untoward effects of treatments and interventions, the risk of developing colorectal cancer in longstanding UC, ignorance of the disease, disappointment in conventional medicine, all these features may influence the patient s health related quality of life (HRQOL) in various ways. The aims of this study were to assess the attitudes to and the use of complementary and alternative medicine (CAM) among patients with IBD, and to evaluate interventions such as a group based educational programme, colonoscopic surveillance, treatment with leukocyte apheresis and its effect on HRQOL, functional health status, general state of health as well as anxiety and coping ability in patients with IBD. Two hundred and eighty-nine IBD patients in four different countries answered a self-administered questionnaire concerning the use of and attitudes to CAM. Fifty-one percent used some form of alternative therapy. The usage was higher in North America than in Europe. The six most commonly used therapies were: exercise (28%), prayer (18%), counselling (13%), massage (11%), chiropractic (11%) and relaxation (10%). Only 7% used acupuncture or homeopathy and 5% used herbal medicine. Forty-one patients with longstanding, extensive/total UC in remission undergoing colonoscopic colorectal cancer (CRC) surveillance were compared with two groups of UC patients not undergoing surveillance. Four self-administered questionnaires were used: Sickness Impact Profile (SIP), Health Index (HI), State Trait Anxiety Inventory (STAI) and Sense of Coherence (SOC). No significant differences between the groups studied were found using any of the questionnaires nor before or after the colonoscopy. Thirty-four UC patients underwent weekly one hour apheresis sessions with a selective leukocyte adsorptive device for five consecutive weeks. HRQOL was measured by the Inflammatory Bowel Disease Questionnaire (IBDQ) before, at week 3, and after treatment. The mean IBDQ increased from 138 (range 97-208) at start to 154 (95-214) at week 3 (p=0.001) and 163 (117-216) after treatment (p=0.0006). When analysed separately, the IBDQ bowel, systemic and emotional dimensions improved significantly during the study. Forty-four IBD patients in remission or with low disease activity were randomized to a group-based medical and psychological/psychosocial intervention or to a control group. The intervention comprised nine weekly sessions with lectures and psychological/psychosocial group treatment. HRQOL was measured by the IBDQ and coping by the SOC before, at 6 and 12 months. The control patients received conventional medical and psychosocial treatment. No significant change was observed for IBDQ before (173.9) and after the intervention at month 6 (175.7), or at month 12 (171.8) or when comparing intervention (171.8) and controls (173.7) at month 12. Similarly, no significant differences in SOC scores were observed. However, the mean values from a visual analogue scale (VAS) and the results from a content analysis showed a positive trend. There is an increased interest in CAM among IBD patients, and this may reflect the patients disappointment of conventional medicine. Complicated and invasive interventions such as colonoscopic surveillance (for detecting CRC), and selective leukocyte apheresis do not seem to impair HRQOL in UC patients. A group based medical and psychological/psychosocial intervention was highly appreciated in IBD patients, but no effect on HRQOL could be demonstrated by using standard HRQOL or coping measurements.
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| 19. |
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| 20. |
- Oxelmark, Lena, et al.
(författare)
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Registered Nurses' experiences of patient participation in hospital care: Supporting and hindering factors patient participation in care
- 2018
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 32:2, s. 612-621
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 Nordic College of Caring Science. Background: Promoting patient participation in care is an international priority identified by the World Health Organization and various national bodies around the world and an important aspect of person-centred care. Aim: The aim of this study was to describe Registered Nurses' experiences with patient participation in nursing care including their barriers and facilitators for participation. Method: The study setting was a University Hospital in Sweden. Interviews were conducted with twenty Registered Nurses working at medical wards in 2013. Thematic data analysis was used to analyse the transcribed interview data. Results: Twenty nurses from four wards in two hospitals were included. Five themes emerged from the analysis including listening to the patient, engaging the patient, relinquishing some responsibility, sharing power and partnering with patients. The core theme 'partnering with patients' was enacted when nurses listened to and engaged patients and when they relinquished responsibility and shared power with patients. In addition, hindering and facilitating factors to participation were identified, such as patients wanted to take on a passive role, lack of teamwork which participants understood would enhance interprofessional understanding and improve patient safety. Patient participation was hindered by medical jargon during the ward round, there was a risk of staff talking over patients' heads but sometimes inevitable having conversations at the patient's bedside. However, nurses preferred important decisions to be made away from bedside. Conclusions: It all came down to partnering with the patient and participants described how they made an effort to respect the patients' view and accept patient as a part of the care team. Identified hindering factors for participation were lack of teamwork, patients' taking on passive roles and communication during ward rounds having conversations at the patient's bedside. Nurses wished for a change but lacked strategies on how. Nurses preferred important decisions to be made away from bedside.
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| 21. |
- Oxelmark, Lena, et al.
(författare)
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Students' understanding of teamwork and professional roles after interprofessional simulation: a qualitative analysis
- 2017
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Ingår i: Advances in Simulation. - : Springer Science and Business Media LLC. - 2059-0628. ; 2:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study explores how interprofessional simulation-based education (IPSE) can contribute to a change in students’ understanding of teamwork and professional roles. A series of 1-day training sessions was arranged involving undergraduate nursing and medical students. Scenarios were designed for practicing teamwork principles and interprofessional communication skills by endorsing active participation by all team members. Methods: Four focus groups occurred 2–4 weeks after the training. Thematic analysis of the transcribed focus groups was applied, guided by questions on what changes in students’ understanding of teamwork and professional roles were identified and how such changes had been achieved. Results: The first question, aiming to identify changes in students’ understanding of teamwork, resulted in three categories: realizing and embracing teamwork fundamentals, reconsidering professional roles, and achieving increased confidence. The second question, regarding how participation in IPSE could support the transformation of students’ understanding of teamwork and of professional roles, embraced another three categories: feeling confident in the learning environment, embodying experiences, and obtaining an outside perspective. Conclusions: This study showed the potential of IPSE to transform students’ understanding of others’ professional roles and responsibilities. Students displayed extensive knowledge on fundamental teamwork principles and what these meant in the midst of participating in the scenarios. A critical prerequisite for the development of these new insights was to feel confident in the learning environment. The significance of how the environment was set up calls for further research on the design of IPSE in influencing role understanding and communicative skills in significant ways.
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| 22. |
- Oxelmark, Lena, et al.
(författare)
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Use of complementary and alternative medicine in Swedish patients with inflammatory bowel disease : a controlled study.
- 2016
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Ingår i: European Journal of Gastroenterology and Hepathology. - London : Lippincott Williams & Wilkins. - 0954-691X .- 1473-5687. ; 28:11, s. 1320-1328
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is an increasing interest in complementary and alternative medicine (CAM) in patients with chronic diseases, including those with inflammatory bowel disease (IBD). Patients may turn to CAM when conventional therapies are inadequate or associated with side effects for symptomatic relief or to regain control over their disease. The objectives were to explore CAM use and perceived effects in IBD patients in comparison with a control group.METHODS: A cross-sectional, multicenter, controlled study was carried out. IBD patients were invited from 12 IBD clinics in Sweden. Controls were selected randomly from a residence registry. A study-specific questionnaire was used for data collection.RESULTS: Overall, 48.3% of patients with IBD had used some kind of CAM during the past year compared with 53.5% in controls (P=0.025, adjusted for age, sex, geographic residence, and diet). The most frequently used CAM among IBD patients was massage (21.3%), versus controls (31.4%) (adjusted P=0.0003). The second most used CAM was natural products, 18.7% in IBD patients versus 22.3% of the controls (unadjusted P=0.018). In all, 83.1% of the patients experienced positive effects from CAM and 14.4% experienced negative effects.CONCLUSION: Overall, 48.3% of Swedish IBD patients used some kind of CAM and controls used CAM significantly more. Natural products were used by one-fifth of the patients and even more by controls. This is notable from a patient safety perspective considering the possible risks of interactions with conventional medication. In all, 40% of the patients reported adverse events from conventional medicine. Patients experienced predominantly positive effects from CAM, and so did controls.
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| 23. |
- Oxelmark, Lena, et al.
(författare)
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Use of complementary and alternative medicine in Swedish patients with inflammatory bowel disease: a controlled study
- 2016
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Ingår i: European Journal of Gastroenterology & Hepatology. - : Ovid Technologies (Wolters Kluwer Health). - 0954-691X. ; 28:11, s. 1320-1328
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThere is an increasing interest in complementary and alternative medicine (CAM) in patients with chronic diseases, including those with inflammatory bowel disease (IBD). Patients may turn to CAM when conventional therapies are inadequate or associated with side effects for symptomatic relief or to regain control over their disease. The objectives were to explore CAM use and perceived effects in IBD patients in comparison with a control group.MethodsA cross-sectional, multicenter, controlled study was carried out. IBD patients were invited from 12 IBD clinics in Sweden. Controls were selected randomly from a residence registry. A study-specific questionnaire was used for data collection.ResultsOverall, 48.3% of patients with IBD had used some kind of CAM during the past year compared with 53.5% in controls (P=0.025, adjusted for age, sex, geographic residence, and diet). The most frequently used CAM among IBD patients was massage (21.3%), versus controls (31.4%) (adjusted P=0.0003). The second most used CAM was natural products, 18.7% in IBD patients versus 22.3% of the controls (unadjusted P=0.018). In all, 83.1% of the patients experienced positive effects from CAM and 14.4% experienced negative effects.ConclusionOverall, 48.3% of Swedish IBD patients used some kind of CAM and controls used CAM significantly more. Natural products were used by one-fifth of the patients and even more by controls. This is notable from a patient safety perspective considering the possible risks of interactions with conventional medication. In all, 40% of the patients reported adverse events from conventional medicine. Patients experienced predominantly positive effects from CAM, and so did controls.
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| 24. |
- Ringdal, Mona, 1955, et al.
(författare)
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Patient preferences for participation in patient care and safety activities in hospitals
- 2017
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Ingår i: Bmc Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Active patient participation is a patient safety priority for health care. Yet, patients and their preferences are less understood. The aim of the study was to explore hospitalised patients' preferences on participation in their care and safety activities in Sweden. Methods: Exploratory qualitative study. Data were collected over a four-month period in 2013 and 2014. Semi-structured interviews were conducted with 20 patients who were admitted to one of four medical wards at a university hospital in Sweden. Data were analysed using thematic analysis. Results: Nine men and eleven women, whose median age was 72 years (range 22-89), were included in the study. Five themes emerged with the thematic analysis: endorsing participation; understanding enables participation; enacting patient safety by participation; impediments to participation; and the significance of participation. This study demonstrated that patients wanted to be active participants in their care and safety activities by having a voice and being a part of the decision-making process, sharing information and possessing knowledge about their conditions. These factors were all enablers for patient participation. However, a number of barriers hampered participation, such as power imbalances, lack of patient acuity and patient uncertainty. Patients' participation in care and patient safety activities seemed to determine whether patients were feeling safe or ignored. Conclusion: This study contributes to the existing literature with fundamental evidence of patients' willingness to participate in care and safety activities. Promoting patient participation begins by understanding the patients' unique preferences and needs for care, establishing a good relationship and paying attention to each patient's ability to participate despite their illness.
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