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1.
  • Westerbotn, Margareta, et al. (författare)
  • How do older people experience their management of medicines?
  • 2008
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:5A, s. 106-15
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective. BACKGROUND: Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes. METHODS: This qualitative study involved audiotaped interviews with 25 very old persons. Inclusion criteria: aged >or=85 years, mini-mental state examination >or=24, living at home, taking medicines regularly. Data collected May-June 2005, analysed using content analysis. DESIGN: Descriptive study. RESULTS: Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up. CONCLUSION: Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes. RELEVANCE TO CLINICAL PRACTICE: Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health-care resource use.
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2.
  • Hallström, Inger (författare)
  • Editorial
  • 2000
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 9:4, s. 471-472
  • Tidskriftsartikel (refereegranskat)
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3.
  • Hallström, Inger, et al. (författare)
  • Response
  • 2005
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 14:3, s. 409-410
  • Tidskriftsartikel (refereegranskat)
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4.
  • Kristensson Hallström, Inger (författare)
  • Editorial
  • 2000
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 9:4, s. 471-472
  • Tidskriftsartikel (refereegranskat)
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5.
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6.
  • Gebru, Kerstin, et al. (författare)
  • Nursing and medical documentation on patients´cultural background
  • 2007
  • Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 16:11, s. 2056-2065
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. To investigate if, and to what extent, nursing and medical documentation in patients records include entries on cultural background. Background. Health care professionals in Sweden may have difficulties in providing satisfactory care, due to lack of knowledge about immigrants´background. According to Swedish law the information needed to garantee safe care must be specified in the patients´records. It is therefore, important to investigate what information nurses and physicians document on patients´cultural background. Design and methods. In this descriptive study, archival data concerning older and terminally ill patients were analysed retrospectively. The sample consisted of records from 121 patients 65 years or more at the time of the death, who were born abroad and died during the year 1999. Content analysis was used to interrogate data collected from patients records, which related to the patient´s cultural background. Entries (sentences or proportion of sentences) were identified, coded and categorized using Leininger´s Sunrise Model. Results. From the patient records, entries could be related to all factors in the upper part of the Sunrise Model. Some factors were found in all records, and all factors, except technological factors, could be traced across the patients´records. Information concerning folk/lay care could not be found. Conclusion. The results from this study indicate that nurses´and physicians´documentation in patient records included all factors in the Sunrise Model except technological. The overall impression is that the documentation is partly atomistic and insufficient as cultural assessment. Relevance to clinical practice. Even if the health care personnel want to reduce the amount of documentation produced, this study highlighted the importance of documentation on cultural factors. To save time the nursing documentation coukd be based on the Sunrise Model and structured according to the VIPS model.
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7.
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8.
  • Almborg, Ann-Helene, et al. (författare)
  • Patients' perceptions of their participation in discharge planning after acute stroke
  • 2009
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 18:2, s. 199-209
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. To describe stroke patients' perceptions of their participation in the discharge planning process and identify correlates of perceived participation. Background. Patients have the right to participate in discharge planning, but earlier research has shown that they are often dissatisfied with the information they receive and their involvement in goal-setting during discharge planning. Design. Cross-sectional study. Methods. The sample consisted of 188 persons (mean age 74 years, SD 11·2) with acute stroke who were admitted to a stroke unit at a hospital in southern Sweden during 2003–2005. Data was collected by face-to-face interviews 2–3 weeks after discharge using the 'Patients' Questionnaire on Participation in Discharge Planning'. This instrument measures perceived participation in discharge planning in three subscales: P-Information, P-Medical Treatment, P-Goals and Needs. Results. The percentage of patients who perceived that they had participated in discharge planning was as follows: 72–90% according to P-Information, 29–38% according to P-Medical Treatment and 15–47% according to P-Goals and Needs. Age, education and performance of activities of daily living were significantly related to perceived participation as measured by different subscales. Conclusions. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal-setting. Professionals need to pay more attention to patients in different subgroups to facilitate their participation in discharge planning. Relevance to clinical practice. To facilitate and increase patients' participation in discharge planning, methods should be implemented for goal-setting and identifying patients' needs. Methods that foster patient participation may improve goal-orientated care, services and rehabilitation after discharge.
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9.
  • Almborg, Ann-Helene, et al. (författare)
  • Patients' perceptions of their participation in discharge planning after acute stroke
  • 2009
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 18:2, s. 199-209
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. To describe stroke patients' perceptions of their participation in the discharge planning process and identify correlates of perceived participation. Background. Patients have the right to participate in discharge planning, but earlier research has shown that they are often dissatisfied with the information they receive and their involvement in goal-setting during discharge planning. Design. Cross-sectional study. Methods. The sample consisted of 188 persons (mean age 74 years, SD 11·2) with acute stroke who were admitted to a stroke unit at a hospital in southern Sweden during 2003–2005. Data was collected by face-to-face interviews 2–3 weeks after discharge using the 'Patients' Questionnaire on Participation in Discharge Planning'. This instrument measures perceived participation in discharge planning in three subscales: P-Information, P-Medical Treatment, P-Goals and Needs. Results. The percentage of patients who perceived that they had participated in discharge planning was asfollows: 72–90% according to P-Information, 29–38% according to P-Medical Treatment and 15–47% according to P-Goals and Needs. Age, education and performance of activities of daily living were significantly related to perceived participation as measured by different subscales. Conclusions. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal-setting. Professionals need to pay more attention to patients in different subgroups to facilitate their participation in discharge planning. Relevance to clinical practice. To facilitate and increase patients' participation in discharge planning, methods should be implemented for goal-setting and identifying patients' needs. Methods that foster patient participation may improve goal-orientated care, services and rehabilitation after discharge.
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10.
  • Andersson, P, et al. (författare)
  • Testing an oral assessment guide during chemotherapy treatment in a Swedish care setting: a pilot study
  • 1999
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 8:2, s. 150-158
  • Tidskriftsartikel (refereegranskat)abstract
    • Oral complications are common in patients with haematological malignancies who undergo chemotherapy treatment. A pilot study including 16 haematological patients was carried out to evaluate the oral status using an Oral Assessment Guide (OAG) and to test the reliability of the OAG. The oral assessments were made daily by registered nurses at a Department of Internal Medicine in Sweden. Once a week a dental hygienist made the oral assessments independent of the registered nurses in order to provide data for calculations of inter-rater reliability. All patients had varying degrees of alterations in the oral cavity, especially in the mucous membranes, teeth/dentures and gums. The inter-rater agreement between the nurses and the dental hygienist was good for saliva and swallow, and moderate for voice and gums. Assessments to detect alterations in the oral cavity afford the opportunity for early and individualized interventions and may decrease the risk of oral infections. It is necessary to train the nurses to ensure high levels of reliability in the oral assessments. The OAG seems to be a reliable and clinical useful tool for assessing the oral cavity status and determining changes.
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11.
  • Andrén, Signe, et al. (författare)
  • The relationship between caregiver burden, caregivers' perceived health and their sense of coherence in caring for elders with dementia.
  • 2008
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 17:6, s. 790-799
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. The aim of this study is to examine associations between caregiver burden, perceived health and sense of coherence in family caregivers to persons with dementia living at home. Background. Most of the studies on family caregivers have focused on burden and morbidity. However, the caregiver's sense of coherence and perceived health have not been studied earlier in relation to caregiver burden. Design. A cross-sectional investigation design was used. Methods. Older persons, 2238 subjects, with any form of social services, were invited to an assessment of cognitive capacity. Those who had cognitive decline (255) were invited for a medical examination and 130 persons were diagnosed as having dementia. The family caregivers to persons with dementia answered a questionnaire including a caregiver burden scale, the Nottingham health profile scale, sense of coherence scale and the Euroqol instrument. Results. The family caregivers experienced moderate burden, and strong associations were noted between burden, especially isolation, disappointment and emotional involvement with perceived health and sense of coherence, adjusted for age and relationship. Caregivers with lower burden reported significantly better perceived health and higher mean score of sense of coherence than caregivers with higher burden. Conclusions. Assessment of status of family caregivers of persons with dementia living at home seems to be gaining considerable importance. The caregiver burden scale and the sense of coherence scale seem to be highly useful for identifying carers at risk of stress, pattern of burden and coping strategies. Relevance to clinical practice. Nurses can help family caregivers to identify their negative experiences about caregiving and can help them reflect upon their coping strategies to find balance in their situation. Risk groups of caregivers may be identified, especially those with low perceived health and sense of coherence, for early interventions to reduce burden.
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12.
  • Blomqvist, Kerstin, et al. (författare)
  • Pain in older adults living in sheltered accommodation--agreement between assessments by older adults and staff
  • 1999
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 8:2, s. 159-169
  • Tidskriftsartikel (refereegranskat)abstract
    • This study aimed to investigate the presence of pain, pain duration, localization(s), intensity, type and pharmacological treatment among older adults living in sheltered accommodation or receiving rehabilitation, as well as the agreement between pain assessments performed by staff and the older adults. Twenty-nine randomly selected older adults (65+ years) and the staff who looked after them participated in a structured interview based on standardized measures for pain assessment and physical, intellectual and communicative functions. Pain was found to be common, with a majority of participants experiencing it every day or all of the time. Nine out of 22 of the older adults in pain had no pain relief drugs at all. Agreement between assessments by the older adults and the staff was no higher than moderate and in general pain levels were underestimated. The findings indicate that older adults were at risk of undetected and untreated pain and the risk was even higher for those with speech difficulties. The provision of good nursing care for older adults in sheltered accommodation requires systematic routines for frequent pain assessments.
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13.
  • Borg, Christel, et al. (författare)
  • Life satisfaction among older people (65+) with reduced self-care capacity : the relationship to social, health and financial aspects.
  • 2006
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 15:5, s. 607-18
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: This study aimed at investigating life satisfaction and its relation to living conditions, overall health, self-care capacity, feeling lonely, physical activities and financial resources among people (65+) with reduced self-care capacity. BACKGROUND: Knowledge about factors related to low life satisfaction among older people with reduced self-care capacity is sparse, although this is important in health care and nursing so that the care is adapted to their needs and perspective. Previous research has mainly focused on isolated aspects such as pain in relation to life satisfaction among older people in general and less among so those with reduced self-care capacity in general. DESIGN AND METHOD: A subsample of 522 persons was selected from a randomly selected cross-sectional survey using a modified form of the Older Americans' Resources Schedule and Life Satisfaction Index Z. RESULTS: The mean age in the total sample was 77.9; women (79.5) were significantly older than men (77.0). Low life satisfaction was found among women, as well as those living in special accommodations. Life Satisfaction Index Z was 15.3 (SD 5.6) in the total sample. Gender and living conditions did not explain life satisfaction whilst poor overall self-reported health and poor financial resources in relation to needs had the strongest explanatory value. Also of significant importance were loneliness, the degree of reduced self-care capacity and feeling worried. CONCLUSION: Life satisfaction in older people with reduced self-care capacity is determined by several factors, with social, physical, mental and financial aspects probably interacting with each other; especially feeling lonely, degree of self-care capacity, poor overall health, feeling worried and poor financial resources in relation to needs. These factors need to be considered in the care of these people to preserve or improve their life satisfaction. RELEVANCE TO CLINICAL PRACTICE: Nursing interventions in terms of preventive home visits, rehabilitation, health education directed towards physical, psychological, social and economic aspects of importance may help to preserve or improve life satisfaction for those with reduced self-care capacity.
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14.
  • Borg, Christel, et al. (författare)
  • Life satisfaction among older people (65+) with reduced self-care capacity: the relationship to social, health and financial aspects
  • 2006
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 15:5, s. 607-618
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. This study aimed at investigating life satisfaction and its relation to living conditions, overall health, self-care capacity, feeling lonely, physical activities and financial resources among people (65+) with reduced self-care capacity. Background. Knowledge about factors related to low life satisfaction among older people with reduced self-care capacity is sparse, although this is important in health care and nursing so that the care is adapted to their needs and perspective. Previous research has mainly focused on isolated aspects such as pain in relation to life satisfaction among older people in general and less among so those with reduced self-care capacity in general. Design and method. A subsample of 522 persons was selected from a randomly selected cross-sectional survey using a modified form of the Older Americans' Resources Schedule and Life Satisfaction Index Z. Results. The mean age in the total sample was 77.9; women (79.5) were significantly older than men (77.0). Low life satisfaction was found among women, as well as those living in special accommodations. Life Satisfaction Index Z was 15.3 (SD 5.6) in the total sample. Gender and living conditions did not explain life satisfaction whilst poor overall self-reported health and poor financial resources in relation to needs had the strongest explanatory value. Also of significant importance were loneliness, the degree of reduced self-care capacity and feeling worried. Conclusion. Life satisfaction in older people with reduced self-care capacity is determined by several factors, with social, physical, mental and financial aspects probably interacting with each other; especially feeling lonely, degree of self-care capacity, poor overall health, feeling worried and poor financial resources in relation to needs. These factors need to be considered in the care of these people to preserve or improve their life satisfaction. Relevance to clinical practice. Nursing interventions in terms of preventive home visits, rehabilitation, health education directed towards physical, psychological, social and economic aspects of importance may help to preserve or improve life satisfaction for those with reduced self-care capacity.
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15.
  • Boström, Barbro, et al. (författare)
  • A comparison of pain and health-related quality of life between two groups of cancer patients with differing average levels of pain
  • 2003
  • Ingår i: Journal of Clinical Nursing. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 12:5, s. 726-735
  • Tidskriftsartikel (refereegranskat)abstract
    • A study was performed to describe and compare pain and Health-Related Quality of Life (HRQOL) in two groups of cancer patients in palliative care as well as to describe the correlation between pain and HRQOL. ○ Forty-seven patients with mild average pain [Visual Analogue Scale (VAS) < 3] and 28 patients with moderate to severe average pain (VAS > 3) were included. Medical Outcomes Study Short Form (SF-36) was used to evaluate HRQOL, pain intensity levels were measured with the VAS on Pain-O-Meter. ○ Compared to patients with mild pain, patients with moderate to severe pain had statistically significant, higher pain intensity for the items 'pain at time of interview', 'worst pain in the past 24 hours' and 'pain interrupting sleep.' They also had the lowest scores of the SF-36 dimensions: physical functioning, role-physical, and bodily pain. Patients with moderate to severe pain had statistically significant, fewer months of survival. There were statistically significant positive correlations between pain items and negative correlation between pain and SF-36 dimensions. ○ The conclusion is that pain has a negative impact on HRQOL, especially on physical health and that pain increases towards the final stages of life. Even if patients have to endure symptoms such as fatigue and anxiety during their short survival time, dealing with pain is an unnecessary burden, which can be prevented.
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16.
  • Bramhagen, Ann-Cathrine, et al. (författare)
  • Factors influencing iron nutrition among one-year-old healthy children in Sweden
  • 2011
  • Ingår i: Journal of Clinical Nursing. - : Blackwell Munksgaard. - 0962-1067 .- 1365-2702. ; 20:13-14, s. 1887-1894
  • Tidskriftsartikel (refereegranskat)abstract
    • Syfte och mål. Att beskriva möjliga sociala, nutritionella och biologiska faktorer som påverkar järnintag och järnstatus bland friska ett-åriga barn i södra Sverige. Bakgrund. Järnbrist är en av de viktigaste nutritionella bristtillstånden och ökar risken för försenad mental och motorisk utveckling. Barn utgör en riskgrupp relaterat till snabb tillväxt, vilken kräver ett relativt högt järnbehov. Design. En prospektiv studie. Metod. Slumpmässigt valda ett-åriga barn (n=90) och deras föräldrar deltog. Föräldrarna besvarade ett frågeformulär med sociodemografiska data samt barnets hälsa och nutrition under det första året. Barnets totala matintag och blodprover (hemoglobin, röda blodkroppars medelcellsvolum, S-ferritin och transferrin receptorer) samlades in. Resultat. Tjugosju procent av barnen hade ett järnintag som var under de Nordiska rekommendationerna på 8 mg/dag (NNR 2004). Välling och järnberikad gröt bidrog till 64 % av barnets totala järnintag. Partiell bröstmjölksuppfödning och låg utbildning bland mödrarna correlerade negativt med järnintag från tilläggskosten. Totalt, 10.3 % (n=9) av barnen hade tömda järnförråd (S-ferritin <12 ug/l) och 2.3 % (n=2) hade järnbrist med eller utan anemi (Hb<100g/l). Konklusion. Ett-åriga barn i Sverige kan utveckla järnbrist men information om järnrik föda kan förbättra järnstatus. Relevans till kliniskt arbete. Kunskap kring vilka faktorer som kan påverka barns järnintag och järnstatus kan förbättre de råd och den utbildning kring mat från barnhälsovården för att förebygga eller upptäcka järnbrist.
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17.
  • Bramhagen, Ann-Cathrine, et al. (författare)
  • Mothers' experiences of feeding situations : an interview study.
  • 2006
  • Ingår i: Journal of Clinical Nursing. - : Blackwell Munksgaard. - 0962-1067 .- 1365-2702. ; 15:1, s. 29-34
  • Tidskriftsartikel (refereegranskat)abstract
    • SYFTE: Syftet med studien var att beskriva föräldrars upplevelser av matsituationerna och kontakten med sjuksköterskan inom barnhälsovården (BHV). BAKGRUNDEN: Några av de viktigaste uppgifterna för sjuksköterskan inom BHV är att följa tillväxten, identifiera uppfödningsproblem och att ge råd om kost och uppfödningsrutiner. METOD: Arton mödrar med varierande ålder, utbildning etnicitet och antal barn och rekryterades från olika barnavårdscentraler blev intervjuade. Berättelserna skrevs ut ordagrant och analyserades med innehållsanalys på manifest och latent nivå. RESULTAT: Alla mödrar beskrev att kost och uppfödning var väsentliga delar i deras liv vilka krävde en hel del tid och engagemang. Två huvudkategorier avseende mödrars förhållningssätt kunde identifieras - ett flexibel förhållningssätt ett kontrollerande förhållningssätt. Mödrar som uttryckte ett flexibelt förhållningssätt var mer öppna för sina barns signaler och svarade på dem för att skapa en god kommunikation. Mödrar som uttryckte ett behov av kontroll skapade regler och rutiner kring matsituationerna. Mödrar med ett kontrollerande förhållningssätt uttryckte att de fick otillräckligt stöd från sjuksköterskan inom BHV. KONKLUSION AND KLINISKA IMPLIKATION: Denna studie visade att några mödrar beskrev otillräckligt stöd från sjuksköterskan inom BHV. Kunskap kring mödrars upplevelser av matsituationerna och deras olika förhållningssätt gentemot sitt barn i samband med måltider kan öka kunskapen hos sjuksköterskorna inom BHV och bidra till ökad förståelse och adekvat stöd till mödrar som upplever uppfödningsproblematik.
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18.
  • Bramhagen, Ann-Cathrine, et al. (författare)
  • Response
  • 2008
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 17:5, s. 697-698
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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19.
  • Bäck-Pettersson, Siv, 1946, et al. (författare)
  • Nurses´Experiences of participation in a research and development programme
  • 2013
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 22:7-8, s. 1103-1111
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. To describe clinical nurses’ experience of participating in a Research and Development (R&D) programme and its influence on their research interest and ability to conduct and apply nursing research. Background. To stimulate nurses’ research interest and to overcome barriers for building research capacity in nursing, there is a need for sustainable research programmes. A two-year programme was designed for nurses, to take part in both an academic education for master and research seminars and workshops to conduct a research project from idea to publication. Design. A qualitative approach using using focus group interviews. Methods. Registered nurses (n = 12) with a bachelor’s degree in nursing, participated. Data were collected in focus group interviews, after one year and when the programme ended. Content analysis was used to analyse the data. Results. The findings consist of two themes: being a traveller in the world of nursing research, which included three categories, and experiencing professional growth as a result of nursing research training, in both cases focusing on the experience of students involved in a cohesive programme which included four categories: discovering new dimensions of clinical nursing practice; selected and confirmed; supported by professional others; development of professional self-concept. Conclusions. To support early career researchers, there is a need for strong leadership, an organisational and supportive infrastructure underpinning research capability building in nurses. In this context, research strategies, programmes and collaboration between leaders of academia and clinical institutions appear to be essential. Relevance to clinical practice. The R&D programme illustrates an effective way of stimulating nurses’ lifelong learning by building the capacity to conduct and apply nursing research in clinical practice. The structure of the programme can be used as a model in other contexts.
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20.
  • Carlsson, Anna, et al. (författare)
  • Burn injures in small children, a population-based study in Sweden
  • 2006
  • Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing Ldt. - 0962-1067 .- 1365-2702. ; 15:15, s. 129-134
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe characteristics in burn injuries in children (zero to six years old), consulting primary care and hospital-based care in Malmö, Sweden. Burn-injured children consulting the University Hospital or the 21 Health Centres, during year 1998 and year 2002, were included. Background. Epidemiological studies of burns in children have mostly been hospital-based and the cases that never reached the hospital have been excluded. Design. The study had a retroperspective design with data collected from medical records. Methods. Chi-squared test was used to analyse differences in nominal data and cross tables were used to analyse the proportions between the characteristics of the injuries and sex, age and nationality. Results. The burn-injured children were 148 and 80% of those were scalds, caused by hot liquid (71%) or hot food (29%). The greatest number was boys between one and two years old. Children to foreign born parents were more frequently affected and the extent of the injuries often larger. Almost all the accidents (96%) occurred in home environment, while a family member was next to the child. The Health Centres received more often children affected on hand/arm and by causes like hot food than the University Hospital. Conclusions. Our data demonstrate the importance of developing a programme for the prevention of paediatric scalds with education of family members to be aware of the danger. With present study the knowledge about the occurrence of injuries in scald accidents in children has become deeper. This knowledge may contribute to more individual adept child accident prevention programme, to use in the child health care.
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21.
  • Cronfalk, Berit, et al. (författare)
  • Inner power, physical strength and existential well-being in daily life: relatives' experiences of receiving soft tissue massage in palliative home care
  • 2009
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 18:15, s. 2225-2233
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim and objectives. This article explores relatives' experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home. Background. In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support. Design. Qualitative design Method. Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open-ended semi-structured tape-recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis. Results. Soft tissue massage gave the relatives' feelings of 'being cared for', 'body vitality' and 'peace of mind'. For a while, they put worries of daily life aside as they just experienced 'being'. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was 'inner power, physical strength and existential well-being in their daily lives'. Conclusion. All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care. Relevance to clinical practice. In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.
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22.
  • Drevenhorn, Eva, et al. (författare)
  • Blood pressure measurement--an observational study of 21 public health nurses
  • 2001
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 10:2, s. 189-194
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to observe how public health nurses perform blood pressure measurement. Structured observations were made of 21 randomly selected public health nurses while they performed three blood pressure measurements. The public health nurses used an overall correct method for blood pressure measurement. Five nurses out of 21 used the Tri-cuff but the soft cuff was most frequently used. When choosing the breadth of the cuff, 10 nurses decided by eye and not by the marks on the cuff. To ensure a completely correct method additional information is needed by nurses.
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23.
  • Drevenhorn, Eva, 1954, et al. (författare)
  • Outcomes following a programme for lifestyle changes with people with hypertension.
  • 2007
  • Ingår i: Journal of clinical nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:7B, s. 144-51
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The purpose of the study was to explore the effects of using a structured nursing intervention programme in hypertension care. BACKGROUND: Counselling on lifestyle changes to address hypertension helps patients reduce risk factors such as smoking, high alcohol consumption, overweight, dyslipidemia, negative stress and physical inactivity. DESIGN: The study was performed as a pre-test-post-test study. METHODS: All 177 patients diagnosed with hypertension visiting a health centre in Southern Sweden were invited to be counselled by a public health nurse about hypertension, cardiovascular risk factors and non-pharmacological treatment with 15 months follow up. RESULTS: One hundred patients participated in the study. Systolic blood pressure decreased overall (p < 0.01), three patients with high alcohol consumption were identified, two smokers stopped smoking, two new diabetics were discovered, physical activity increased (p = 0.035) and one-third of the patients changed their medication. CONCLUSION: The level of exercise increased and a reduction in systolic blood pressure and in women's weight were the most obvious results of this intervention study. The study elucidates the challenge of executing health behaviour changes. RELEVANCE TO CLINICAL PRACTICE: Counselling following a hypertension programme gives hypertensive patients a chance to execute lifestyle changes and have their medication adjusted to achieve goals for blood pressure control. Further prospective studies in this area, with well-defined intervention approaches and several years of follow up, are necessary.
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24.
  • Forsberg, Karl Anton, 1955-, et al. (författare)
  • Influence of a life style intervention among persons with a psychiatric disability : a cluster randomised controlled trial on symptoms, quality of life and sense of coherence
  • 2010
  • Ingår i: Journal of Clinical Nursing. - Malden : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 19:11-12, s. 1519-1528
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives: The aim of this study was to investigate how a life style intervention programme influences psychiatric and psychosocial factors among persons with psychiatric disabilities. Background: Persons with psychiatric disabilities often suffer from a simultaneous physical health problem, where circulatory disorder, hyperlipideamia, digestive disease, diabetes mellitus and obesity are prevalent. Studies have also shown a relationship between physical activity and mental health. But few randomised controlled trails have been aimed specifically at life style interventions and their effect on psychiatric health and quality of life among persons with psychiatric disabilities.Design: a cluster randomised controlled trail.Methods: Forty one persons with a DSM- ІV diagnosis in eight supported housing facilities and two housing support programmes and their carers were on cluster level randomly assigned to a 12 month health intervention programme in the form of study circles with diet sessions and physical activities or a control programme. The changes in the mean of quality of life, level of functioning, psychiatric symptoms and sense of coherence was investigated and its relationship to physical health and attendance.Results: A significant increase in the sense of coherence was seen in both programmes but also significant improvements in the intervention group compared to controls at the follow-up.Conclusions: Structured activities in the form of life style intervention programmes with a sufficient level of challenge that encourage persons with psychiatric disabilities to participate in activities in a social context may contribute to a significant increase in the sense of coherence.Relevance to clinical practice: Improving physical health with life style programmes in the form of study circles and when involving their cares will in addition to increased physical health end in improved sense of coherence.
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25.
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26.
  • Hallström, Inger, et al. (författare)
  • Decision-making during hospitalization: parents' and children's involvement.
  • 2004
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 13:3, s. 367-375
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Ethical duties of health professionals include the obligation to enhance their patients' competence and ability to participate. Aims and objectives. To explore what kind of decisions and how these decisions were made during a child's hospitalization. Design. During a 9-week period 24 children and their parents were followed during the course of events at the hospital. In total 135 hours of observations were made and analysed in two steps. Results. In most of the situations one or both parents were present with the child. Most decisions were of a medical nature, and commonly decisions were made in consultation with those affected by the decision. Although one or more persons protested in 83 of the 218 described situations, decisions were seldom reconsidered. Conclusions. The children and their parents were usually involved in the decision-making process. Children and parents made few decisions themselves and even if they disagreed with the decision made, few decisions were reconsidered. Relevance to clinical practice. Having a voice in decision-making helps the child to develop a sense of himself as a person and gives the parents a feeling that they are part of a team giving their child optimal care during hospitalization. Promoting children's rights is one of the most important roles for the children's nurse.
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27.
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28.
  • Hallström, Inger, et al. (författare)
  • Increased parental participation in a paediatric surgical day-care unit
  • 1997
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 6:4, s. 297-302
  • Tidskriftsartikel (refereegranskat)abstract
    • Day care is currently a common way of providing treatment for minor and average paediatric surgical procedures. The purpose of this study was to assess possible benefits of increasing parental involvement in the care of operated children in a day-care surgery unit. By giving parents information and education about post-operative care, the goal was to facilitate recovery and minimize time spent in hospital. Results show that parents in the intervention group were well prepared to assume a greater part of the care of their children. Children in the intervention group appeared to have less pain and fewer children vomited post-operatively than children in the control group.
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29.
  • Hallström, Inger, et al. (författare)
  • Pain and nutrition as experienced by patients with hip fracture
  • 2000
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 9:4, s. 639-646
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to investigate patients' experiences of care in connection with hip fracture. The care process was examined through non-participant observation, informal field interviews and healthcare records. The findings showed that many factors in the healthcare services directly or indirectly influence patients' perceptions of the quality of care. Some of these factors may depend upon a varying knowledge and empathy, while others are due to a lack of agreed protocols/procedures. Patients' needs with respect to pain relief and nutrition are discussed.
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30.
  • Hallström, Inger (författare)
  • Strategies for feeling secure influence parents' participation in care
  • 1999
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 8:5, s. 586-592
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigates what makes parents of hospitalized children feel secure and factors influencing their level of participation. It also studies, whether the degree to which parents participate affects their child's pain and sleep during hospitalization. Questionnaires were distributed to a series of parents whose children were discharged from two paediatric surgical wards and one paediatric medical-surgical ward at two university hospitals in Sweden. Parental security is almost equally distributed among three given alternatives: security derived from trusting that professionals know how to take care of the child; security derived from having control over what is happening to the child; and security derived from being the one who knows the child best. Depending upon the strategy chosen, parents want to participate at different levels in their child's care. The results indicate a relationship between parental participation and their estimation of their child's pain. The study confirms a pattern, developed in a previous study, in how parents adopt different strategies affecting their participation during their child's hospitalization. Some parents who wanted to participate in more aspects of their child's care seemed to think that their child had less pain than parents who preferred more limited participation.
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31.
  • Hasselberg, Daniella, et al. (författare)
  • The handling of peripheral venous catheters - from non-compliance to evidence-based needs.
  • 2010
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 19, s. 3358-3363
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. To study nurses' compliance to national guidelines (Sweden) for peripheral venous catheters and to establish the complication frequency connected to time in situ and bore size. Background. Worldwide, there are no standard peripheral venous catheters guidelines, and the need for elective replacement has been challenged. Furthermore, the time interval and need for elective change of peripheral venous catheters has cost implications for hospitals. Design. Prospective register study. Methods. The health care professionals in one surgical ward in a university hospital in the south of Sweden prospectively registered peripheral venous catheters parameters. Four hundred and thirteen peripheral venous catheters were registered for time in situ, size and complications. A cost analysis was performed. Non-parametric statistics were used, and p < 0·05 was regarded as significant. Result. Compliance to the guideline of time in situ was 30·2%, and the frequency of thrombophlebitis was 6·5%. Peripheral venous catheters left in situ for more than 72 hours caused more thrombophlebitis (p = 0·03). There was no difference in thrombophlebitis rate when peripheral venous catheters were changed within 24 hours compared with peripheral venous catheters that were changed within 72 hours. No difference was seen regarding complications between peripheral venous catheters sized 0·9 mm/22 gauge or 1·1 mm/20 gauge. Conclusion. The present Swedish national guidelines, advocating peripheral venous catheter change every 24 hours, should be altered since peripheral venous catheters left in situ for up to 72 hours were not found to be related to a greater risk of developing thrombophlebitis. Nor is it compatible with a greater risk to use a peripheral venous catheter of 1·1 mm/20 gauge instead of 0·9 mm/22 gauge. The change in guidelines would decrease money spent, 250 100 Euro in Sweden, thus allowing time for the nurses to do other tasks and save discomfort for the patients. Relevance to clinical practice. National guidelines should be based on evidence and current facts, and evaluation of guidelines should be given priority.
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32.
  • Hasson, Henna, et al. (författare)
  • Care recipients and family members’ perceptions of quality of elderly care: a comparison of home-based care and nursing homes
  • 2011
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 20:9-10, s. 1423-1435
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims. To compare care recipients' and their relatives' perceptions of quality of care in nursing homes and home-based care. Background. Older people care is increasingly being provided in community care facilities and private homes instead of hospitals. A few studies have compared care recipients' and relatives' perceptions of care quality in nursing homes as opposed to home-based care. Design. Cross-sectional surveys. Methods. Care recipients' and relatives' perceptions of quality of care were measured by questionnaire in 2003 in two older people care organisations. Quality measures were compared between care settings. Multiple regression was used to determine the predictors of overall quality ratings for each group, and possible interactions between quality measures and care settings were tested. Results. Care recipients rated their opportunities for activities significantly lower in home care than in nursing homes. Relatives of care recipients in home-based care rated several aspects of care quality significantly lower than relatives of nursing home residents. No significant interaction effects regarding predictors of overall quality ratings between the care settings were found. Staff behaviour was the strongest predictor of care recipients' overall quality rating, and staff professional skills were the strongest predictor of relatives' overall quality rating. Conclusions. Compared with nursing homes, home-based older people care seems to be in greater need of development regarding staff competence, staff interaction with relatives and activities offered to older people. In both settings, nursing staff behaviour influences these stakeholders' satisfaction with care. Relevance to clinical practice. These results point to a need to improve services in both care settings, but especially in home-based care. It is suggested that care recipients' preferences for social and physical activities be investigated on a regular basis in both care settings. Efforts should also be made to improve communication and interaction between family members and older people care staff, especially in home-based care.
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33.
  • Hasson, Henna, et al. (författare)
  • Nursing staff competence, work strain, stress and satisfaction in elderly care : a comparison of home-based care and nursing homes
  • 2008
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:4, s. 468-481
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims. The aims of this study were to: (1) compare older people care nursing staff's perceptions of their competence, work strain and work satisfaction in nursing homes and home-based care; and (2) to examine determinants of work satisfaction in both care settings. Background. The shift in older people care from hospitals to community-based facilities and home care has had implications for nursing practice. Lack of competence development, high levels of work strain and low levels of work satisfaction among nursing staff in both care settings have been associated with high turnover. Few studies have compared staff perceptions of their competence and work in nursing homes as opposed to home-based care. Design. A cross-sectional questionnaire survey. Methods. Nursing staff perceptions of their competence, work strain, stress and satisfaction were measured by questionnaire in 2003 in two older people care organizations in Sweden. Comparisons of all outcome variables were made between care settings both within and between the two organizations. Multiple regression analysis was used to determine predictors of work satisfaction in home care and nursing homes respectively. Results. In general, staff in home-based care reported significantly less sufficient knowledge compared with staff in nursing homes. However, home care staff experienced significantly less physical and emotional strain compared with staff in nursing homes. Ratings of work-related exhaustion, mental energy and overall work satisfaction did not differ significantly between care settings. In both care settings, work-related exhaustion was the strongest (inverse) predictor of work satisfaction. Conclusions. Future interventions should focus on counteracting work-related exhaustion and improving competence development to improve work satisfaction among older people care nursing staff in both care settings. Relevance to clinical practice. Work-related exhaustion and lack of competence development may have significant negative implications for work satisfaction among older people care nursing staff in both home care and nursing homes.
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34.
  • Hjelm, Katarina, 1958-, et al. (författare)
  • Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden.
  • 2012
  • Ingår i: Journal of Clinical Nursing. - Molden, MA, USA : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 21:9-10, s. 1374-1386
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims.  Exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. Further , to study the influence of beliefs on self-care and care seeking. Design: Exploratory descriptive study. Methods.  Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied. Results.  Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting. Conclusions.  Health/illness beliefs differed and affected self-care and care seeking. Relevance to clinical practice.  Individual beliefs and risk awareness must be elicited, and adequate information must be given to prevent negative health effects of gestational diabetes.
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35.
  • Hjelm, Katarina, 1958-, et al. (författare)
  • Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapy
  • 2009
  • Ingår i: Journal of Clinical Nursing. - Malden, MA, USA : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 18:14, s. 1975-1985
  • Tidskriftsartikel (refereegranskat)abstract
    • To our knowledge there are no patients" evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given. Aim:  To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber.                   Design/participants: An explorative study.  Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44-83 years (Md 70), with diabetic foot ulcers, participated.     Method: Focus-group interviews were held by an external evaluator.   Results: Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation.   Conclusions and implications: From patients" perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease.                                        
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36.
  • Hjelm, Katarina, 1958-, et al. (författare)
  • Gestational diabetes: prospective interview-study of the developing beliefs about health, illness and health care in migrant women.
  • 2012
  • Ingår i: Journal of Clinical Nursing. - Hoboken, NJ, USA : Wiley. - 0962-1067 .- 1365-2702. ; 21:21-22, s. 3244-3256
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore the development over time of beliefs about  health, illness and health care in migrant women with gestational diabetes mellitus born in the Middle East and living in Sweden. Further to study the influence of beliefs on self-care and care seeking behaviour. There is an extensive global migration and contact with the new society and health care confronts the migrant's culture of origin with the culture of the host country. The question is whether the migrants' patterns of beliefs about health, illness and health-related behaviour change over time? A qualitative prospective exploratory study was implemented. Semi-structured interviews were held with 14 women, aged 28-44 years, in gestational weeks 34-38 and three and 14  months after delivery.The results showed a U-shaped development of beliefs, from focusing on worries about the baby's health during pregnancy and trying to comply with advice from health care staff, particularly a healthy diet, through regression to dietary habits (with intake of more sugar and less fibre) and lifestyle held before being diagnosed with gestational diabetes mellitus three months after delivery but then back to a healthy diet and lifestyle and worries focusing on their own risk, as mothers, of developing type 2 diabetes and being unable to care for the child after one year. Over time, the number of persons perceiving gestational diabetes mellitus as a transient condition decreased. Respondents lacked information about the disease, diet and follow-ups.  Beliefs changed over time and influenced health-related behaviour. Beliefs about the seriousness of gestational diabetes mellitus among health professionals'  influence development of patients' beliefs. Pregnancy should be used as an opportunity to provide complete information about the disease and future health risks. Continous information should be given after delivery and wishes for regular follow-ups should be met.
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37.
  • Hjelm, Katarina, et al. (författare)
  • Management of gestational diabetes from the patient's perspective - a comparison of Swedish and Middle-Eastern born women.
  • 2007
  • Ingår i: Journal of Clinical Nursing. - Oxon, UK : Wiley. - 1365-2702 .- 0962-1067. ; 16:1, s. 168-178
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. To explore patients' evaluation of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care. Background. No studies comparing patients' perceptions of healthcare in women of different origin with gestational diabetes have been found. A perceived clinical problem in specialized diabetes care is of lower activity level in self-care in foreign- than Swedish-born women and the question is whether the healthcare organization is optimal in meeting different individuals' needs. Design. Explorative study. Method. Semi-structured individual interviews by external evaluators. Participants. Consecutive sample. Females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East. Results. The healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation. Conclusions. The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately. Relevance to clinical practice. Cultural differences in coping strategies and attitudes to gestational diabetes need to be considered. Training of staff working with gestational diabetes patients is urgently needed.
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38.
  • Hjoerleifsdottir, Elisabet, et al. (författare)
  • Satisfaction with care in oncology outpatient clinics: psychometric characteristics of the Icelandic EORTC IN-PATSAT32 version
  • 2010
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 19:13-14, s. 1784-1794
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim and objectives. To assess the psychometric characteristics of the Icelandic European Organisation for Research and Treatment of Cancer IN-PATSAT32 (EORTC IN-PATSAT32) version and to compare satisfaction with care between gender and different age groups. Background. The majority of patients with cancer receive either chemotherapy or radiotherapy on an outpatient basis. There is a need to evaluate satisfaction with care and service for these patients using reliable and valid instruments. Design. Cross-sectional comparative study. Method. Participants (n = 217) who received treatment for cancer as outpatients answered the EORTC IN-PATSAT32 questionnaire. Participants were 22-91 years old and 57% of them were female. Results. Overall high satisfaction was found with communication, information and care that patients receive from doctors and nurses. Principal component analysis extracted four factors: 'satisfaction with nurses' conduct', 'satisfaction with doctors' conduct', 'satisfaction with information' and 'satisfaction with service and care organisation'. Patients were most satisfied with nurses' conduct but least satisfied with service and care organisation. Cronbach's alpha for the four factors ranged from 0 center dot 95-0 center dot 67. Conclusion. Although the validity of this instrument including its sensitivity to patients' level of dissatisfaction as well as satisfaction with care and service was evident, this needs to be further explored in future studies. The psychometric strengths of the EORTC IN-PATSAT32 are its internal consistency and its construct validity, but there are several issues indicating a need to change and develop the instrument and specifically adopting it to outpatient care. Relevance to clinical practice. Outpatient treatment options offered to cancer patients have increased, and this calls for knowledge of their satisfaction with care and service. Sparse studies are available, and there is a need for further development of reliable instruments. Our study indicates that outpatients with cancer are quite satisfied with the care they receive. Findings may contribute to improvement in outpatients' clinics that provide treatment to patients with cancer.
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39.
  • Holst, Marie, 1959-, et al. (författare)
  • Description of self-reported fluid intake and its effects on body weight, symptoms, quality of life and physical capacity in patients with stable chronic heart failure
  • 2008
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:17, s. 2318-2326
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. To describe the self-reported fluid intake and its effects on body weight, signs and symptoms of heart failure, quality of life, physical capacity and thirst, in patients with stabilised chronic heart failure. Background. Patients with chronic heart failure are often recommended a fluid restriction of 1.5 l/day but there is no evidence in the literature for this recommendation and little is known about the fluid intake consequences. Design. Crossover study. Methods. Chronic heart failure patients, clinically stabilised after an unstable state, were randomised to a 32-week cross-over study assessing the clinical importance of fluid prescription. In a secondary analysis of 63 patients, efficacy variables were analysed in relation to the self-reported median fluid intake of 19 ml/kg body weight/day. Results. The mean fluid intake was 16 ml/kg/day in the below-median group and 24 ml/kg/day in the above-median group. No between-group differences were found in change in body weight, signs and symptoms, diuretic use, quality of life or physical capacity. However, the above-median group significantly decreased sense of thirst and difficulties to adhere to the fluid prescription compared with the below-median group. Conclusion. In clinically stabilised chronic heart failure patients on optimal pharmacological treatment, a larger fluid intake was associated with decreasing thirst without any measurable negative effects on signs and symptoms of heart failure, diuretic use or physical capacity. Thus, a more liberal fluid intake may be advisable in chronic heart failure patients who have been stabilised after an initial unstable clinical state. Relevance to clinical practice. Nurses involved in the care for patients with heart failure known how troublesome thirst can be and how difficult it can be to follow a restricted fluid intake. This study indicates that it is possible to reassess and recommend a less strict fluid intake in stabilised patients with chronic heart failure. © 2008 The Authors.
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40.
  • Ivarsson, Bodil, et al. (författare)
  • Heart or lung transplanted patients' retrospective views on information and support while waiting for transplantation.
  • 2013
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 22:11-12, s. 1620-1628
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: To describe the patients' retrospective experiences of the information and support they received while on the heart or lung transplant waiting list. BACKGROUND: Patients differ in the way that they cope with the time spent waiting for a heart or lung transplant. Patients must already before the transplantation be taught about a new lifestyle, risk factors, medication, food restrictions and exercise, so they can take an active role and responsibility for disease management after transplantation. Little is known about patients' experiences of information and support in these situations. DESIGN: Qualitative descriptive design. METHODS: Sixteen patients (16-67 year) were strategically selected from one transplant centre in Sweden and interviewed six months after heart or lung transplantation. Using content analysis, transcribed data were organised into subcategories that reflected emerging categories. RESULTS: Three categories that describe patients' experiences of information and support have been identified: 'Achieving confidence and trust by information and support', 'Experiencing a lack of input and understanding' and 'Struggling with a life-threatening illness and an insecure future'. Each category consists of different subcategories. CONCLUSIONS: Information and support in connection to heart or lung transplantation are a complex and multifaceted issue involving patient-related, family-related, disease-related and treatment-related factors as well as experiences related to the social situation, the healthcare system and society. Transplant patients are very vulnerable, and a deeper understanding of patients' experiences should help healthcare providers in optimising the care for these very sick patients. RELEVANCE TO CLINICAL PRACTICE: A holistic approach to the patient is necessary in meeting the needs of patients with chronic illness, especially patients with children at home, as well as the needs of their families. An important implication is the necessity to enhance awareness about transplant patients in society in general, in particular in other institutions, by sharing knowledge and by improving cooperation.
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41.
  • Jakobsson, Liselotte, 1953-, et al. (författare)
  • Sexual problems in men with prostate cancer in comparison with men with benign prostatic hyperplasia and men from the general population
  • 2001
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 10:4, s. 573-582
  • Tidskriftsartikel (refereegranskat)abstract
    • • In a questionnaire study, men with prostate cancer (n=155) or benign prostatic hyperplasia (n=131) identified more sexual problems than did men from the general population (n=129). Sexual dysfunction was acknowledged regarding sexual pleasure and attraction, erectile function and sexual satisfaction and sexual performance. • Lowered rates of sexual desire, pleasure and attraction were found when comparing their situation in recollection of pre-treatment situation to the current situation. Lower intercourse frequency and sexual satisfaction were also found. • Medication, masturbation and artificial aids to achieve erection were not used as substitutes for shortcomings of erectile function either by men with prostate cancer and benign prostatic hyperplasia nor by their partners. • There seemed to be a lack of information about the illness and treatment consequences for sexual life, including what physical dysfunction to expect after surgery and also what possible help to expect to compensate for the shortcomings.
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42.
  • Jakobsson, Liselotte, et al. (författare)
  • Sexual problems in men with prostate cancer in comparison with men with benign prostatic hyperplasia and men from the general population
  • 2001
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 10:4, s. 573-582
  • Tidskriftsartikel (refereegranskat)abstract
    • In a questionnaire study, men with prostate cancer (n = 155) or benign prostatic hyperplasia (n = 131) identified more sexual problems than did men from the general population (n = 129). Sexual dysfunction was acknowledged regarding sexual pleasure and attraction, erectile function and sexual satisfaction and sexual performance. Lowered rates of sexual desire, pleasure and attraction were found when comparing their situation in recollection of pre-treatment situation to the current situation. Lower intercourse frequency and sexual satisfaction were also found. Medication, masturbation and artificial aids to achieve erection were not used as substitutes for shortcomings of erectile function either by men with prostate cancer and benign prostatic hyperplasia nor by their partners. There seemed to be a lack of information about the illness and treatment consequences for sexual life, including what physical dysfunction to expect after surgery and also what possible help to expect to compensate for the shortcomings.
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43.
  • Jakobsson, Ulf, et al. (författare)
  • Exploring determinants for quality of life among older people in pain and in need of help for daily living
  • 2007
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:3a, s. 95-104
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. The aim of the study was to investigate the quality of life and related factors among older people who are in pain and in need of help to manage daily living. Background. To intervene against the low quality of life in nursing care knowledge about factors affecting it is needed and this is especially important for vulnerable people such as those who suffer from pain and who are in need of help to manage daily living. Methods. Five hundred and twenty-six people, aged 75–102 years participated in this study. Results. Those in pain reported a significantly higher degree of all complaints and lower quality of life in all measures compared with those not in pain. Overall quality of life was associated with mobility problems, sleeping problems and depressed mood, while health-related quality of life was associated with living in special accommodations, walking problems, mobility problems and fatigue. Conclusions. Those in need of help to manage daily living and in pain seem to be at higher risk of lowered quality of life than those not in pain and the lower quality of life among those in pain is probably caused by the complex of complaints rather than pain per se. Relevance to clinical practice. Daily nursing care should identify and treat the complex of complaints related to pain as well as pain itself, to improve everyday life and quality of life for older people in pain.
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44.
  • Jakobsson, Ulf, et al. (författare)
  • Exploring determinants for quality of life among older people in pain and in need of help for daily living.
  • 2007
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 16:3A, s. 95-104
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. The aim of the study was to investigate the quality of life and related factors among older people who are in pain and in need of help to manage daily living. Background. To intervene against the low quality of life in nursing care knowledge about factors affecting it is needed and this is especially important for vulnerable people such as those who suffer from pain and who are in need of help to manage daily living. Methods. Five hundred and twenty-six people, aged 75–102 years participated in this study. Results. Those in pain reported a significantly higher degree of all complaints and lower quality of life in all measures compared with those not in pain. Overall quality of life was associated with mobility problems, sleeping problems and depressed mood, while health-related quality of life was associated with living in special accommodations, walking problems, mobility problems and fatigue. Conclusions. Those in need of help to manage daily living and in pain seem to be at higher risk of lowered quality of life than those not in pain and the lower quality of life among those in pain is probably caused by the complex of complaints rather than pain per se. Relevance to clinical practice. Daily nursing care should identify and treat the complex of complaints related to pain as well as pain itself, to improve everyday life and quality of life for older people in pain.
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45.
  • Jakobsson, Ulf, et al. (författare)
  • Pain and quality of life among older people with rheumatoid arthritis and/or osteoarthritis: a literature review.
  • 2002
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 11:4, s. 430-443
  • Forskningsöversikt (refereegranskat)abstract
    • The aim of this study was to review the research literature on pain and quality of life (QoL) and the relationship between these variables among people aged 75 years and above with rheumatoid arthritis and/or osteoarthritis. A Medline and CINAHL search was carried out using MeSH terms rheumatoid arthritis, osteoarthritis, QoL and pain in various combinations. Seventeen articles were identified that met the requirements for methodological quality and inclusion criteria. No study focused only on respondents aged 75 years or over. The studies had varying representation of this age group. Pain was common in both groups and was found to increase with age and disease duration among those with rheumatoid arthritis but not among those with osteoarthritis. Increased pain could lead to depression. Pain, functional limitation and increased age were found to decrease QoL among those with rheumatoid arthritis and osteoarthritis alike. Social support was found to buffer against negative effects on QoL among those with osteoarthritis while no moderating effects were found in rheumatoid arthritis. Increased age was found to relate to pain (rheumatoid arthritis) and decrease QoL (both rheumatoid arthritis and osteoarthritis). It is, however, hard to draw any firm conclusions about older people's pain and QoL because of the lack of studies including respondents aged 75 years or over. Thus, research about pain and QoL, especially focusing on the old and the very elderly with rheumatoid arthritis/osteoarthritis, is needed. It also seems justified to say that nursing care should especially focus on older people and that these people should be assessed for their level of pain, functional limitations and QoL especially in the case of having rheumatoid arthritis and/or osteoarthritis.
  •  
46.
  • Jumisko, Eija, et al. (författare)
  • The meaning of feeling well in people with moderate or severe traumatic brain injury
  • 2009
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 18:16, s. 2273-2281
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. The aim of this study was to elucidate the meaning of feeling well for people with moderate or severe traumatic brain injury. Background. Considerable attention has been given to research consequences, quality of life and satisfaction with life in people with traumatic brain injury. Most studies reveal negative aspects of living with traumatic brain injury. Knowledge that provides an understanding of the meaning of feeling well for people with a traumatic brain injury entails the possibility that they could receive support to feel well, despite their injury. Design. This study used a qualitative research approach, as the aim was to elucidate meaning. Methods. Data were collected through qualitative research interviews with two women and six men with moderate or severe traumatic brain injury who had lived with the injury for between 7-15 years. A phenomenological hermeneutic method was used to interpret the data. Results. The meaning of feeling well for people with moderate or severe traumatic brain injury was that the initially unfamiliar life with traumatic brain injury became familiar. This included finding strength, regaining control over everyday life, being close to someone and being good enough. People with traumatic brain injury felt well when they became reconciled with the circumstances of their life and created a new entity in that life, in which their complete health had been lost. Relevance to clinical practice. This study helps professionals to enhance their understanding and awareness of the possibilities for people with moderate or severe traumatic brain injury to feel well. The study showed that people with traumatic brain injury needed a lot of strength to achieve this. Professionals can help them to feel well by getting to know them and thus find ways to support the person's feeling of wellbeing.
  •  
47.
  • Kristensson Ekwall, Anna, et al. (författare)
  • Anxiety as a factor influencing satisfaction with emergency department care: perspectives of accompanying persons.
  • 2009
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 18, s. 3489-3497
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. To measure levels of anxiety among people accompanying consumers to the emergency department and to explore how anxiety influences satisfaction with care. Background. When people seek treatment in an emergency department they are often accompanied by a next-of-kin, family member or friend. While the accompanying person plays a vital role in providing psycho-social support to consumers, little is known about how they perceive the quality of care. Learning more about how accompanying persons perceive care may inform the development of strategies to enhance communication processes between staff, consumers and accompanying persons. Design. A prospective cross-sectional survey design. Methods. Data were collected from a consecutive sample of accompanying persons at one Australian metropolitan teaching hospital. Of all eligible individuals approached, 128/153 (83.7%) returned completed questionnaires. The questionnaire comprised a series of open- and close-ended questions about perceptions of medical need, urgency and satisfaction with the overall visit. Anxiety was assessed using the Visual Analogue Scale for Anxiety (VAS-A). Results. There was a significant association between the accompanying person's levels of anxiety and satisfaction at point of discharge. In the satisfied group, mean VAS-A scores were 17.4 (SD 17.5) compared to 42.9 (SD 26.6) in the not satisfied group (p = 0.011). Moreover, those participants who were not satisfied with the visit did not show a significant reduction in VAS-A scores from triage to point of discharge. Conclusion. The lower the level of anxiety reported by accompanying persons when leaving the emergency department, the more satisfied they are likely to be with their emergency department visit. Ultimately, well informed and confident accompanying persons are beneficial for ensuring quality patient support. Relevance to clinical practice. Asking accompanying persons about their anxiety level before discharge gives them the opportunity to pose clarifying questions and is, therefore, an effective way of improving their satisfaction with the emergency department visit.
  •  
48.
  • Kristensson Ekwall, Anna, et al. (författare)
  • The association between caregiving satisfaction, difficulties and coping among older family caregivers.
  • 2007
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 16:5, s. 832-844
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. The aim was to study the association between gender, extent and content of care, satisfaction, coping and difficulties in the caregiving situation among older (75+) caregivers and to identify clusters of caregivers. The aim was also to explore psychometrically two instruments assessing satisfaction and difficulties in family caregivers. Background. Caregiving is a complicated phenomenon. Much of the research has focused on negative aspects, such as the burden, stress and emotional strain. Caregiving is known to affect health negatively for the caregivers. Little is known about satisfaction and motivation in voluntary work, such as informal caregiving, especially among older persons. Design and methods. Cross-sectional. The sample for this study consisted of 171 informal caregivers aged 75 and over, identified from an age-stratified sample in a postal survey among older people in the southern part of Sweden. Results. Male caregivers proved to be more satisfied than female caregivers; caregiving had seemingly widened their horizon and had helped them to grow as persons. Based on satisfaction scores, those satisfied had a higher proportion of male caregivers and a significantly higher amount of caregiving hours per week. They used other coping strategies than the respondents in the other cluster, i.e. less satisfied in using more problem-solving strategies. Conclusions. The instruments tested were appropriate for work in clinical and research settings, although the internal dropout indicates that a shorter version would be more useful. Those who found satisfaction in care used more problem-focused coping strategies and were more often men than women. From a salutogenic point of view, this may give important knowledge about factors that can promote health. The findings indicate that women deserve extra attention as informal caregivers as they did not find caregiving as rewarding as the men did. This may in turn make them less protected against the negative consequences of caregiving. Relevance to clinical practice. Reinforcing the health-promoting qualities in caregivers who are not feeling well, with women as a particularly vulnerable group, may restrict unnecessary suffering for both the caregiver and the person cared for.
  •  
49.
  • Lindskov, Susanne, et al. (författare)
  • A controlled trial of an educational programme for people with Parkinson's disease
  • 2007
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:11C, s. 368-376
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVE: To evaluate patient-reported health outcomes of a multidisciplinary group educational programme for people with Parkinson's disease (PD), delivered as part of routine clinical practice. BACKGROUND: Studies suggest that educational programmes for people with PD have potential to improve patients' perceived health and well-being. However, controlled trials of multidisciplinary group educational programmes are lacking. DESIGN: Naturalistic non-randomized controlled trial. METHODS: Following ethical approval and informed consent, 48 people with PD (58% men; mean age, 69.3) received the intervention and 48 (52% men; mean age, 72) were allocated to a delayed intervention control group. The intervention was a six-week (two hours per week) multidisciplinary group educational programme. Patient-reported health outcomes were assessed by the 12-item short-form health survey (SF-12) at baseline and one month postintervention. RESULTS: Changes in SF-12 scores at follow-up did not differ between the groups and there were no within-group differences over time. Daily dopaminergic medication increased in the control group but not in the intervention group. CONCLUSIONS: Slightly, but significantly, increased drug requirement in the control group may in part have masked deterioration in perceived health. However, failure to demonstrate improved patient-reported health may relate to the intervention design, response shift (i.e. change in how people perceive their health), and/or quality and choice of outcome measures. Further studies that take these aspects into consideration are needed to determine the potential for patient education interventions in PD. RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals need to document the effects of patient educational programmes and to be aware of the importance of intervention design and challenges associated with evaluating programme outcomes. Otherwise, there is a risk that benefits cannot be demonstrated and that decision makers will not invest resources in interventions that actually are beneficial for chronically ill people.
  •  
50.
  • Lindskov, Susanne, et al. (författare)
  • A controlled trial of an educational programme for people with Parkinson's disease
  • 2007
  • Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 16:11C, s. 368-376
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objective. To evaluate patient- reported health outcomes of a multidisciplinary group educational programme for people with Parkinson's disease ( PD), delivered as part of routine clinical practice. Background. Studies suggest that educational programmes for people with PD have potential to improve patients' perceived health and well- being. However, controlled trials of multidisciplinary group educational programmes are lacking. Design. Naturalistic non- randomized controlled trial. Methods. Following ethical approval and informed consent, 48 people with PD ( 58% men; mean age, 69 center dot 3) received the intervention and 48 ( 52% men; mean age, 72) were allocated to a delayed intervention control group. The intervention was a six- week ( two hours per week) multidisciplinary group educational programme. Patient-reported health outcomes were assessed by the 12-item short-form health survey ( SF-12) at baseline and one month postintervention. Results. Changes in SF-12 scores at follow-up did not differ between the groups and there were no within-group differences over time. Daily dopaminergic medication increased in the control group but not in the intervention group. Conclusions. Slightly, but significantly, increased drug requirement in the control group may in part have masked deterioration in perceived health. However, failure to demonstrate improved patient- reported health may relate to the intervention design, response shift ( i. e. change in how people perceive their health), and/ or quality and choice of outcome measures. Further studies that take these aspects into consideration are needed to determine the potential for patient education interventions in PD.
  •  
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