| 1. |
|
|
| 2. |
|
|
| 3. |
- Adolfsson, Caroline, et al.
(författare)
-
Collaborative introspection as a methodological tool of reflexivity - from multidisciplinary to transdisciplinary co-production
- 2021
-
Ingår i: International Transdisciplinarity Conference (ITD21), 13-17 Sept: Creating spaces and cultivating mindsets for learning and experimentation.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper explores reflexivity through "collaborative introspection" as a methodological tool for transcending a multidisciplinary dialogue and achieving transdisciplinary co-production of knowledge. Reflexivity is argued to be applicable for critically addressing assumptions and ideologies of the research team (Popa et al., 2015), joint problem framing (Pearce & Ejderyan, 2019), experimentation (Popa et al., 2015), or more generally as a focal area to be used for addressing challenges in transdisciplinary projects (Jahn, et al., 2012; Polk, 2015). However, discussions on reflexivity rarely place focus on how a reflexive dialogue can be used to gather empirical material in a collaborative manner, making use of the participating researchers’ subjectivity, personal experiences and understandings of a specific topic. The authors of this text are part of a transdisciplinary research team exploring the role of tourism in multicultural societies. The team involves researchers from the fields of design, marketing, tourism studies, human-computer interaction, and migration studies. In the project we collaborate with each other across disciplines in different case studies. However, we have experienced a tendency to fall back into our disciplinary silos, where we explore the same topic from our own disciplinary lenses. As an attempt to bring ourselves together we decided to go personal. Instead of looking at the role of tourism in multicultural societies from our disciplinary viewpoints, we dug into our memories of acting as tourists ourselves in a reflective session. More specifically, inspired by the tool Tell your story by means of an object (td-net, 2021), we shared and reflected upon our own tourism experiences through our core project concepts, which are diversity, inclusivity and integration. The dialogue that emerged forced us to focus on our research topic not as researchers who are expected to maintain objectivity but rather as individuals allowing ourselves to be subjective. This created a feeling of working ‘together’ instead of ‘with’ each other. The reflections created genuine and honest dialogue highlighting our national, cultural, gender and racial differences. The differences and similarities of our personal experiences depend on the social categories and identities that we are part of. Thus, by bringing our personal stories as empirical material, we created an opportunity to listen to each other beyond our disciplinary boundaries. It made us understand the layers of hierarchy, privilege and disadvantages that we face in our lives as individuals, and to understand instances of inclusion and exclusion in tourism at a deeper level. From our experience, we propose what we term "collaborative introspection" as a reflexive methodological tool for transdisciplinary research and practice. Collaborative introspection exercises challenge the commonly held idea of neutrality. It can be used as a tool for a transdisciplinary group to come together, transform thoughts and develop empathy and ethics in research. References: Jahn, T., Bergmann, M. & Keil, F. (2018). Transdisciplinarity: between mainstreaming and marginalization, Ecological Economics 79 Pearce, B. J., & Ejderyan, O. (2020). Joint problem framing as reflexive practice: honing a transdisciplinary skill. Sustainability science, 15(3), 683-698. Polk, M. (2015). Transdisciplinary co-production: Designing and testing a transdisciplinary research framework for societal problem solving. Futures, 65, 110-122. Popa, F., Guillermin, M., & Dedeurwaerdere, T. (2015). A pragmatist approach to transdisciplinarity in sustainability research: From complex systems theory to reflexive science. Futures, 65, 45-56. Td-net (2021, April 7). Tell your Story by Means of an Object. Retrieved from: https://naturalsciences.ch/co-producing-knowledge-explained/methods/td-net_toolbox/_tell_your_story_by_means_of_an_object_
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Adolfsson, Emelie, et al.
(författare)
-
A system for remote dosimetry audit of 3D-CRT, IMRT and VMAT based on lithium formate dosimetry
- 2014
-
Ingår i: Radiotherapy and Oncology. - : Elsevier. - 0167-8140 .- 1879-0887. ; 113:2, s. 279-282
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this work was to develop and test a remote end-to-end audit system using lithium formate EPR dosimeters. Four clinics were included in a pilot study, absorbed doses determined in the PTV agreed with TPS calculated doses within ±5% for 3D-CRT and ±7% (k=1) for IMRT/VMAT dose plans.
|
|
| 7. |
- Adolfsson, Emelie, et al.
(författare)
-
END-TO-END AUDIT: COMPARISON OF TLD AND LITHIUM FORMATE EPR DOSIMETRY
- 2019
-
Ingår i: Radiation Protection Dosimetry. - : OXFORD UNIV PRESS. - 0144-8420 .- 1742-3406. ; 186:1, s. 119-122
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to test two different solid state dosimetry systems for the purpose of end-to-end audits of radiotherapy volumetric modulated arc therapy (VMAT) technique; a lithium formate electron paramagnetic resonance system and a lithium fluoride thermoluminescent dosimetry system. As a complement to the solid state systems, ion chamber measurements were performed. A polystyrene phantom with a planning target volume (PTV) and an organ at risk (OAR) structure was scanned using CT. A VMAT dose plan was optimized to deliver 2 Gy to the target volume and to minimize the dose to the OAR. The different detectors were inserted into the phantom and the planned dose distribution was delivered. The measured doses were compared to the treatment planning system (TPS) calculated doses. Good agreement was found between the TPS calculated and the measured doses, well accepted for the dose determinations in remote dosimetry audits of VMAT treatment technique.
|
|
| 8. |
|
|
| 9. |
- Adolfsson, Emelie, et al.
(författare)
-
Investigation of signal fading in lithium formate EPR dosimeters using a new sensitive method
- 2012
-
Ingår i: Physics in Medicine and Biology. - : Institute of Physics (IOP). - 0031-9155 .- 1361-6560. ; 57:8, s. 2209-2217
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate signal fading in lithium formate electron paramagnetic resonance (EPR) dosimeters used for clinical applications in radiotherapy. A new experimental method for determination of signal fading, designed to resolve small changes in signal from slowly decaying unstable radicals, was used. Possible signal fading in lithium formate due to different storage temperatures was also tested. Air humidity was kept at a constant level of 33% throughout the experiments. The conclusion drawn from the investigations was that the EPR signal from lithium formate is stable during at least 1 month after irradiation and is not sensitive to variations in storage temperature andlt;40 degrees C when kept at a relative air humidity of 33%. This makes lithium formate a suitable dosimeter for transfer dosimetry in clinical audits.
|
|
| 10. |
- Adolfsson, Emelie, 1985-
(författare)
-
Lithium formate EPR dosimetry for accurate measurements of absorbed dose in radiotherapy
- 2014
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Lithium formate has shown to be a material with properties suitable for electron paramagnetic resonance (EPR) dosimetry, among them up to 7 times higher sensitivity compared to alanine, which is a well-established EPR detector material for dose determinations in radiotherapy.The aim of this thesis was to further investigate the properties of lithium formate and develop the dosimetry system towards applications in radiotherapy. The intrinsic efficiency for energies of relevance to brachytherapy and the signal stability were investigated. The dosimetry system was expanded to include a smaller dosimeter model, suitable for measurements in dose gradient regions. An individual sensitivity correction method was applied to the smaller dosimeters to be able to perform dose determinations with the same precision as for the larger ones. EPR dosimetry in general is time consuming and effort was spent to optimize the signal readout procedure regarding measurement time and measurement precision.The system was applied in two clinical applications chosen for their high demands on the dosimetry system: 1) a dosimetry audit for external photon beam therapy and 2) dose verification measurements around a low energy HDR brachytherapy source.The conclusions drawn from this thesis were: dose determinations can be performed with a standard uncertainty of 1.8-2.5% using both the original size dosimeters and the new developed smaller ones. The dosimetry system is robust and useful for applications when high measurement precision and accuracy is prioritized. It is a good candidate for dosimetry audits, both in external beam therapy and brachytherapy.
|
|
| 11. |
- Adolfsson, Emelie, et al.
(författare)
-
Measurement of absorbed dose to water around an electronic brachytherapy source : Comparison of two dosimetry systems: lithium formate EPR dosimeters and radiochromic EBT2 film
- 2015
-
Ingår i: Physics in Medicine and Biology. - : Institute of Physics Publishing (IOPP). - 0031-9155 .- 1361-6560. ; 60:9, s. 3869-3882
-
Tidskriftsartikel (refereegranskat)abstract
- Interest in high dose rate (HDR) electronic brachytherapy operating at 50 kV is increasing. For quality assurance it is important to identify dosimetry systems that can measure the absorbed doses in absolute terms which is difficult in this energy region. In this work a comparison is made between two dosimetry systems, EPR lithium formate dosimeters and radiochromic EBT2 film.Both types of dosimeters were irradiated simultaneously in a PMMA phantom using the Axxent EBS. Absorbed dose to water was determined at distances of 10 mm, 30 mm and 50 mm from the EBS. Results were traceable to different primary standards as regards to absorbed dose to water (EPR) and air kerma (EBT2). Monte Carlo simulations were used in absolute terms as a third estimate of absorbed dose to water.Agreement within the estimated expanded (k = 2) uncertainties (5% (EPR), 7% (EBT2)) was found between the results at 30 mm and 50 mm from the x-ray source. The same result was obtained in 4 repetitions of irradiation, indicating high precision in the measurements with both systems. At all distances, agreement between EPR and Monte Carlo simulations was shown as was also the case for the film measurements at 30mm and 50mm. At 10mm the geometry for the film measurements caused too large uncertainty in measured values depending on the exact position (within sub-mm distances) of the EBS and the 10 mm film results were exculded from comparison.This work has demonstrated good performance of the lithium formate EPR dosimetry system in accordance with earlier experiments at higher photon energies (192Ir HDR brachytherapy). It was also highlighted that there might be issues regarding the energy dependence and intrinsic efficiency of the EBT2 film that need to be considered for measurements using low energy sources.
|
|
| 12. |
- Adolfsson, Emelie, et al.
(författare)
-
Optimisation of an EPR dosimetry system for robust and high precision dosimetry
- 2014
-
Ingår i: Radiation Measurements. - : Elsevier. - 1350-4487 .- 1879-0925. ; 70, s. 21-28
-
Tidskriftsartikel (refereegranskat)abstract
- Clinical applications of electron paramagnetic resonance (EPR) dosimetry systems demand high accuracy causing time consuming analysis. The need for high spatial resolution dose measurements in regions with steep dose gradients demands small sized dosimeters. An optimization of the analysis was therefore needed to limit the time consumption. The aim of this work was to introduce a new smaller lithium formate dosimeter model (diameter reduced from standard diameter 4.5 mm to 3 mm and height from 4.8 mm to 3 mm). To compensate for reduced homogeneity in a batch of the smaller dosimeters, a method for individual sensitivity correction suitable for EPR dosimetry was tested. Sensitivity and repeatability was also tested for a standard EPR resonator and a super high Q (SHQE) one. The aim was also to optimize the performance of the dosimetry system for better efficiency regarding measurement time and precision. A systematic investigation of the relationship between measurement uncertainty and number of readouts per dosimeter was performed. The conclusions drawn from this work were that it is possible to decrease the dosimeter size with maintained measurement precision by using the SHQE resonator and introducing individual calibration factors for dosimeter batches. It was also shown that it is possible reduce the number of readouts per dosimeter without significantly decreasing the accuracy in measurements.
|
|
| 13. |
- Adolfsson, Emelie, 1985-, et al.
(författare)
-
Response of Lithium Formate EPR Dosimeters at Photon Energies Relelvant to Brachytherapy
- 2009
-
Ingår i: IFMBE Proceedings. - Heidelberg : Springer Berlin Heidelberg. - 9783642034725 - 9783642034749 ; , s. 236-239
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- After development of sensitive dosimeter materials Electron Paramagnetic Resonance EPR dosimetry has been successfully used also in radiation therapy. The intensity of the EPR-signal is a measure of the amount of free radicals created by ionizing radiation which is proportional to the absorbed dose in the dosimeter. Lithium formate monohydrate is a dosimeter material with 2-6 times higher sensitivity than alanine, a linear dose response over a wide dose range and mass-energy absorption properties similar to water. These properties make lithium formate promising for verification of absorbed doses around high dose rate brachytherapy sources where the dose gradient is steep and the photon energy distribution changing with distance from the source. Calibration of the dosimeters is performed in 60Co or MV photon beams where high dosimetric accuracy is feasible. The use in brachytherapy field relies on the assumption that the production of free radicals per mean absorbed dose in the dosimeter is similar at the lower photon energies present there. The aim of this work was to test that assumption. The response of the dosimeters as a function of photon energy was determined by irradiations with four x-ray qualities in the range 100-250 kV and 137Cs, relative to the response when irradiated with 60Co, all photon beams with well-known air kerma rates at the Swedish Secondary Standards Dosimetry Laboratory. Monte Carlo simulations were used to convert air kerma free in air to mean absorbed dose to the dosimeter. The measured response relative 60Co as a function of photon energy was below unity for all qualities. The maximum deviation from unity was 2.5% (100 kV, 135 kV) with a relative standard deviation of 1.5% (k = 1).
|
|
| 14. |
- Adolfsson, Emelie, et al.
(författare)
-
Response of lithium formate EPR dosimeters at photon energies relevant to the dosimetry of brachytherapy
- 2010
-
Ingår i: Medical physics (Lancaster). - : American Association of Physicists in Medicine. - 0094-2405. ; 37:9, s. 4946-4959
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To investigate experimentally the energy dependence of the detector response of lithium formate EPR dosimeters for photon energies below 1 MeV relative to that at 60Co energies. High energy photon beams are used in calibrating dosimeters for use in brachytherapy since the absorbed dose to water can be determined with high accuracy in such beams using calibrated ion chambers and standard dosimetry protocols. In addition to any differences in mass-energy absorption properties between water and detector, variations in radiation yield (detector response) with radiation quality, caused by differences in the density of ionization in the energy imparted (LET), may exist. Knowledge of an eventual deviation in detector response with photon energy is important for attaining high accuracy in measured brachytherapy dose distributions.METHODS:Lithium formate EPR dosimeters were irradiated to known levels of air kerma in 25-250 kV x-ray beams and in 137Cs and 60Co beams at the Swedish Secondary Standards Dosimetry Laboratory. Conversions from air kerma free in air into values of mean absorbed dose to the detectors were made using EGSnrc MC simulations and x-ray energy spectra measured or calculated for the actual beams. The signals from the detectors were measured using EPR spectrometry. Detector response (the EPR signal per mean absorbed dose to the detector) relative to that for 60Co was determined for each beam quality.RESULTS:Significant decreases in the relative response ranging from 5% to 6% were seen for x-ray beams at tube voltages < or = 180 kV. No significant reduction in the relative response was seen for 137Cs and 250 kV x rays.CONCLUSIONS:When calibrated in 60Co or MV photon beams, corrections for the photon energy dependence of detector response are needed to achieve the highest accuracy when using lithium formate EPR dosimeters for measuring absorbed doses around brachytherapy sources emitting photons in the energy range of 20-150 keV such as 169Yb and electronic sources.
|
|
| 15. |
- Adolfsson, Eva Thors, et al.
(författare)
-
Reporting systems, reporting rates and completeness of data reported from primary healthcare to a Swedish quality register : The National Diabetes Register
- 2011
-
Ingår i: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 80:9, s. 663-668
-
Tidskriftsartikel (refereegranskat)abstract
- Objective:The aims of this paper were to study the reporting rate and completeness of data reported from primary healthcare centres (PHCCs) in Sweden to the Swedish National Diabetes Register (NDR), with a special attention on the relation between these measures and the reporting system used by the PHCCs.Method:A national survey conducted in Swedish primary healthcare covering the year 2006. A questionnaire was used to collect data from 523 PHCCs. Data on 87,099 adult diabetic patients attending these PHCCs and reported to the NDR were obtained from the register. In Sweden, participation in the NDR is voluntary. The data were reported through the Internet, either online using a web-based system or by direct transmission. The main outcome measures were reporting rate and completeness of reported data.Results:Of the 523 PHCCs, almost two-thirds had reported <75% of their diabetic patients to the NDR. The lowest reporting rate was found among the largest PHCCs, while the highest was found among small PHCCs (p < 0.001). Reasons given for not reporting data to the NDR were lack of time and lack of personnel resources. Altogether, 73.1% of the PHCCs reported data to the NDR online using a web-based system, 20.5% used direct transmission and 6.3% used both systems. The PHCCs that reported data through direct transmission systems reported almost 70% of their diabetic patients to the NDR, while PHCCs using web-based systems reported 54% of their diabetic patients to the NDR. Adjusted for other factors, using direct transmission increased the reporting rate by 13.0 percentage points. However, the web-based system contributed to a higher completeness of data than the direct transmission system.Conclusions:A direct transmission system facilitates a high reporting rate to the register at the expense of lower completeness of the reported data.
|
|
| 16. |
- Adolfsson, Eva Thors, et al.
(författare)
-
The Swedish National Survey of the Quality and Organization of Diabetes Care in Primary Healthcare—Swed-QOP
- 2010
-
Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 4:2, s. 91-97
-
Tidskriftsartikel (refereegranskat)abstract
- AIM:To describe the quality and organization of diabetes care in primary healthcare in Sweden regarding resources and ways of working.METHOD:A questionnaire was used to collect data from all 921 primary healthcare centres (PHCCs) in Sweden. Of these, 74.3% (n=684) responded to the questionnaire covering list size of the PHCCs, number of diabetic patients, personnel resources and ways of working.RESULTS:The median list size reported from the PHCCs was 9,000 patients, 294 of whom were diabetic patients. The majority (72%) of PHCCs had diabetes-responsible general practitioners (GPs) and almost all (97%) had diabetes specialist nurses (DSNs) with some degree of postgraduate education in diabetes. The PHCCs reported that they used regional/local diabetes guidelines (93%), were engaged in call-recall diabetic reviews by GP(s) (66%) and DSN(s) (89%), checked that patients had participated in the reviews by GP(s) (69%) and DSN(s) (78%), arranged group education programmes (23%) and reported data to a National Diabetes Register (82%).CONCLUSIONS:The presence of diabetes-responsible GP(s) and DSN(s) who use guidelines may contribute to good and equal quality of care. It is, however, necessary to improve the call-recall system and there is an urgent need for all diabetic patients to receive patient education.
|
|
| 17. |
- Adolfsson, Eva Thors, et al.
(författare)
-
Type 2 diabetic patients' experiences of two different educational approaches : A qualitative study
- 2008
-
Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 7:45, s. 986-994
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the current study was to explore patients' experiences of participating in an empowerment group education programme or receiving individual counselling. Method: In total, 28 patients from seven primary care centres were interviewed. Of these, 14 had received individual counselling and the remaining 14 had also participated in 4-5 empowerment group sessions. The semi-structured interviews were tape-recorded, transcribed verbatim and analysed using qualitative content analysis. Findings: Three main categories crystallized from the interviews: (I) relationships, (II) learning and (III) controlling the disease. The relationships in the individual counselling seemed vertical, characterized by one-way communication with care providers acting as superiors and patients as subordinates. The relationships in the empowerment group appeared to be horizontal, characterized by trust and mutual communication. Those who had received individual counselling talked about learning by compliance-care providers acted as superiors, giving advice they expected the patients to follow. In the empowerment groups the patients talked more about participatory learning, whereby the facilitators and patients shared their knowledge and experiences. Controlling the disease could be labelled external in individual counselling, which made it difficult for patients to take responsibility for and control of their diabetes self-care. On the contrary, the patients in the empowerment group achieved the insight that diabetes is a serious disease but can be influenced, which contributed to their experience of self-control. Conclusions: The current study indicates that vertical relationships, learning by compliance and external control seem to limit patients' ability to take responsibility for their disease, while horizontal relationships, participatory learning and self-control may contribute to strengthening patients' ability to influence and be actively involved in their own care.
|
|
| 18. |
|
|
| 19. |
- Adolfsson, Lena, 1955-
(författare)
-
Attityder till naturvetenskap : Förändringar av flickors och pojkars attityder till biologi, fysik och kemi 1995 till 2007
- 2011
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- I den här avhandlingen beskrivs hur hög- och lågpresterande flickors och pojkars attityder till biologi, fysik och kemi har förändrats från 1995 till 2007. Data från den svenska delen av TIMSS-studierna för årskurs 8 i Sverige används. För att definiera hög- och lågpresterande används resultatet på matematikprovet från TIMSS och attityderna undersöks med hjälp av fyra frågor från elevenkäterna. Resultatet diskuteras utifrån olika perspektiv som kan bidra till förståelsen av den komplexa bilden av olika faktorers betydelse för elevers attityder till naturvetenskap. Det första resultatet, pojkar är mer positiva till fysik och kemi och flickor till biologi, diskuteras utifrån ämnenas genuskodning. På ett symboliskt plan är fysik och kemi mer förknippade med maskulinitet än biologi. Det andra resultatet, högpresterande elever och särskilt pojkar, är mindre positiva till de tre ämnena 2007 än 1995. Det resultatet diskuteras mot bakgrund av ungdomars identitet och identitetskonstruktion. Det verkar som om unga människor i dag inte tycker att utbildningar och arbeten inom det naturvetenskapliga och tekniska området ger dem möjligheter att använda sina talanger, kreativitet och självförverkligande. Resultatet diskuteras också utifrån de förändringar av arbetsmetoder som har skett i svensk skola där det individuella arbetet har ökat och lärarledda genomgångar har minskat. Kan det ha påverkat de högpresterande eleverna så att de har blivit mindre stimulerade och fått färre utmaningar och på så sätt blivit mindre positiva till de naturvetenskapliga ämnena? Det tredje resultatet, en större andel hög- och lågpresterande pojkar tycker att de tre ämnena är tråkiga 2007 jämfört med 1995, diskuteras utifrån begreppen "antipluggkultur" och att vara "cool". Kan resultatet från denna studie indikera att det är viktigare för pojkar 2007 att ha en attityd att visa sig ”cool” och att inte plugga. Kan detta ha påverkat attityderna till de naturvetenskapliga ämnena negativt? Slutligen visar resultaten att lågpresterande flickor och pojkar tycker att de presterar bättre 2007 än 1995 och det diskuteras mot bakgrund av förändringarna av arbetsmetoder i den svenska skolan. Mer tid ägnas åt individuellt arbete vilket kan innebära att de lågpresterande eleverna väljer att inte arbeta med svårare uppgifter och att de därför upplever att de presterar bättre. Avhandlingen avslutas med mina egna reflektioner kring undervisningen i de naturvetenskapliga ämnena i grundskolan, kring förändringarna av flickors och pojkars attityder till naturvetenskap utifrån resultaten från denna studie och kring mina erfarenheter som lärare i dessa ämnen.
|
|
| 20. |
|
|
| 21. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
-
Code sets for everyday life situations of children aged 0-6: Sleeping, Mealtimes and Play - a study based on the International Classification of Functioning, Disability and Health for Children and Youth
- 2013
-
Ingår i: British Journal of Occupational Therapy. - : The College of Occupational Therapists Ltd.. - 0308-0226 .- 1477-6006. ; 76:3, s. 127-136
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: The complexity of the Child and Youth version of the International Classification of Functioning, Disability and Health, the ICF-CY, is a challenge for occupational therapists and other professionals in clinical work. Code sets including only essential categories help to make it more user-friendly. Thus far, code sets have been developed to reflect functioning for children in different developmental periods. However, there are no code sets that support screening of participation in everyday life situations and can be used across diagnoses. This exploratory study is the first attempt to develop code sets for preschoolers’ (age 0-6 years) everyday life situations.Method: Using sequential Delphi processes with expert panels consisting of 35 professionals in five interdisciplinary early intervention teams and six parents of children, the study identified content in three code sets: Sleeping, Mealtimes and Play.Results: A limited number of relevant categories were identified for three code sets: Sleeping (12), Mealtimes (21) and Play (30). Findings suggested a professional focus on Environmental factors compared with a parental focus on Body functions.Conclusion: It is important to consider the opinions of all involved when developing code sets to provide a common framework for screening of children’s everyday functioning.
|
|
| 22. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
-
Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY).
- 2010
-
Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 42:7, s. 670-678
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE This study explored how professionals in inter-disciplinary teams perceived the implementation of the World Health Organization's International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services. DESIGN Descriptive longitudinal mixed-methods design. METHODS Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years. RESULTS Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children's needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation. CONCLUSION Professionals indicated that the ICF-CY enhanced their awareness of families' views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation
|
|
| 23. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
-
ICF-CY as a Framework for Understanding Child Engagement in Preschool
- 2018
-
Ingår i: Frontiers in Education. - : Frontiers Media S.A.. - 2504-284X. ; 3
-
Tidskriftsartikel (refereegranskat)abstract
- Engagement in preschool predicts children's development, learning, and wellbeing in later school years. The time children engage in activities and social interactions is conditional for preschool inclusion. Engagement is part of the construct participation, which is determined by attendance and involvement. Two suggested underlying dimensions of engagement had been identified as essential when assessing children's participation in preschool activities. As engagement is a key question in inclusion of all children, and preschool becomes a common context for them, it is increasingly important to understand the concept of engagement in those settings. In Sweden most children attend preschool but children in need of special support tend not to receive enough support for their everyday functioning. This study aimed to conceptualize child engagement in preschool with ICF-CY as a framework to clarify core and developmental engagement dimensions included in Child Engagement Questionnaire (CEQ). The content of CEQ was identified through linking processes based on ICF linking rules with some exceptions. Specific challenges and solutions were acknowledged. To identify engagement dimensions in the ICF-CY, CEQ items related to ICF-CY chapters were integrated in the two-dimensional model of engagement. Findings showed that engagement measured for preschool ages was mostly related to Learning and Applying knowledge belonging to Activities and Participation but the linkage detected missing areas. Broader perspectives of children's everyday functioning require extended assessment with consideration to mutual influences between activities, participation, body functions, and contextual factors. Related to core and developmental engagement, findings highlight the importance for preschool staff to pay attention to how children do things, not only what they do. Activities related to core engagement include basic skills; those related to developmental engagement set higher demands on the child. Linking challenges related to preschool context were not consistent with those reported for child health. Using the ICF-CY as a framework with a common language may lead to open discussions among persons around the child, clarify the different perspectives and knowledges of the persons, and facilitate decisions on how to implement support to a child in everyday life situations in preschool and at home.
|
|
| 24. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
-
ICF-CY based code sets focusing on participation for pre-schoolers
- 2012
-
Konferensbidrag (refereegranskat)abstract
- Children with disabilities and their parents need opportunities to express opinions and take part of professional knowledge during habilitation processes. However, there is no structured model to identify and assess child participation in everyday life situations (EDLS). ICF-CY based code sets focusing on participation would support dialogues about what matters most for individual children, causes of failures, and needs of interventions. This study constituted a trial identifying content in code sets for Sleeping, Mealtimes, and Play.EDLS specific for children and youth was initially identified by integration of data from measures of participation, professional opinions, and parents’ perspectives. Linkage to the ICF-CY, using existing and additional linking rules, provided comparable data, resulting in two sets of ten EDLS. These were related to the Activities and Participation component, chapters 3-9, and adapted for younger and older children.ICF-CY categories relevant for children aged 0-6 years to be included in code sets for three of the EDLS were identified by a sequential Delphi process in 3 rounds. Participants were 5 interdisciplinary habilitation teams, altogether 35 professionals, and 7 parents of 13 typical developed preschool children from 6 families. There were no significant correlation between professionals and parents. Their partly different ICF-CY categories suggested high professional focus on Environmental factors compared with high parental focus on Body functions. Integration of data revealed 12 categories appropriate for Sleeping, 21 for Mealtimes, and 30 for Play. This highlights the importance to integrate opinions and adapt content in code sets to individual EDLS.
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
- Annika, Lindh, 1984-, et al.
(författare)
-
Description of inhalation technique in patients with COPD in primary care
- 2018
-
Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52:Suppl. 62
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: A recent systematic review showed that only about one third of the patients had a correct inhalation technique and the number had not improved the last 40 years¹.Aim: The aim was to describe errors, separated into errors related to devices and errors related to inhalation technique, that occur when patients with COPD inhale medications.Method: In this descriptive study, patients with a COPD diagnosis were recruited from a randomized controlled trial performed 2015-2016 in primary care in four county councils in Sweden. A COPD nurse assessed the inhalation technique using a checklist with errors related to devices and to inhalation technique with possibility to write additional comments.Results: In total, 167 patients using 287 inhalers were assessed, 52% (n = 86) were female, mean age 71 years. A total of 163 errors were noted in the checklist, of which 87 were related to inhalation technique and 76 were related to devices. Except from this the COPD nurse had written comments regarding 53 errors that were not included in the checklist. At least one error (range: 1-7 errors) was made by 46% (n = 76) of the patients.Conclusion: The results show that many patients do not use the device correctly. Both errors related to inhalation technique and related to devices were present. This implies that there is a need to focus on both aspects when teaching patients how to inhale their medication. The checklist used in this study needs to be further improved.
|
|
| 29. |
- Annika, Lindh, 1984-, et al.
(författare)
-
Incorrect inhalation technique is common in patients with COPD in primary care
- 2018
-
Konferensbidrag (refereegranskat)abstract
- The results show that many patients don’t use the inhaler correctly. Errors related to inhalation technique were twice as common as those related to devices. When teaching patients to use the inhalers it seems like there is a need to focus more on the inhalation technique itself. The checklist used in this study needs to be further improved.
|
|
| 30. |
- Beckmann, Kerri, et al.
(författare)
-
Androgen Deprivation Therapies and Changes in Comorbidity : A Comparison of Gonadotropin-releasing Hormone Agonists and Antiandrogen Monotherapy as Primary Therapy in Men with High-risk Prostate Cancer
- 2019
-
Ingår i: European Urology. - : ELSEVIER SCIENCE BV. - 0302-2838 .- 1873-7560. ; 75:4, s. 676-683
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Some studies suggest that gonadotropin-releasing hormone (GnRH) agonists are associated with higher risk of adverse events than antiandrogens (AAs) monotherapy. However, it has been unclear whether this is due to indication bias.Objective: To investigate rates of change in comorbidity for men on GnRH agonists versus AA monotherapy in a population-based register study.Design, setting, and participants: Men with advanced nonmetastatic prostate cancer (PCa) who received primary AA (n = 2078) or GnRH agonists (n = 4878) and age- and area-matched PCa-free men were selected from Prostate Cancer Database Sweden 3.0. Increases in comorbidity were measured using the Charlson Comorbidity Index (CCI), from 5 yr before through to 5 yr after starting androgen deprivation therapy (ADT).Outcome measures and statistical methods: Multivariable linear regression was used to determine differences in excess rate of CCI change before and after ADT initiation. Risk of any incremental change in CCI following ADT was assessed using multivariable Cox regression analyses.Results and limitations: Men on GnRH agonists experienced a greater difference in excess rate of CCI change after starting ADT than men on AA monotherapy (5.6% per yr, p < 0.001). Risk of any new CCI change after ADT was greater for GnRH agonists than for AA (hazard ratio, 1.32; 95% confidence interval, 1.20-144).Conclusions: Impact on comorbidity was lower for men on AA monotherapy than for men on GnRH agonists. Our results should be confirmed through randomised trials of effectiveness and adverse effects, comparing AA monotherapy and GnRH agonists in men with advanced nonmetastatic PCa who are unsuitable for curative treatment.Patient summary: Hormone therapies for advanced prostate cancer can increase the risk of other diseases (eg, heart disease, diabetes). This study compared two common forms of hormone therapy and found that the risk of another serious disease was higher for those on gonadotropin-releasing hormone agonists than for those on antiandrogen monotherapy.
|
|
| 31. |
- Berntsson, Tommy, et al.
(författare)
-
Ambulanssjukvården måste bli jämlik
- 2013
-
Ingår i: Helsingborgs Dagblad. - Helsingborg : Helsingborgs Dagblad. - 1103-9388. ; 2013-06-17
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Skiftande vårdkvalité hotar patientsäkerheten inom ambulanssjukvården. Nu måste regeringen och Socialstyrelsen skapa nationella riktlinjer, skriver Nätverket för utbildning av ambulanssjuksköterskor .
|
|
| 32. |
|
|
| 33. |
- Björck-Åkesson, Eva, et al.
(författare)
-
ICF-CY as a common language in early childhood intervention : Work shop
- 2012
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The workshop covers ICF-CY as a framework in collaborative problem solving together with families and in preschool. A short introduction to ICF-CY will be presented. The workshop will be based on case studies where the participants will use ICF-CY as a tool in assessment and intervention. The model for collaborative problem solving developed by the CHILD group includes problem formulations, problem explanations, goal setting, design of methods, implementation and follow-up. The tool uses checklists based on ICF-CY for formulation of difficulties and problems in terms of activity and participation, problem explanations in terms of body structures and functions and environmental factors. An individual intervention plan for a child with disability based on functioning in everyday life is developed based on the assessment. The utility and feasibility of ICF-CY as a tool and a common language in early childhood intervention will be discussed.
|
|
| 34. |
- Björck-Åkesson, Eva, 1952-, et al.
(författare)
-
The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention - feasibility and usefulness as a common language and frame of reference for practice
- 2010
-
Ingår i: Disability and Rehabilitation. - London : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 32:S1, s. S125-S138
-
Tidskriftsartikel (refereegranskat)abstract
- Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.
|
|
| 35. |
- Costa, Tatiana, et al.
(författare)
-
CHARACTERIZATION OF A LITHIUM FORMATE EPR-DOSIMETRY SYSTEM FOR PROTON RADIATION THERAPY
- 2019
-
Ingår i: Radiation Protection Dosimetry. - : OXFORD UNIV PRESS. - 0144-8420 .- 1742-3406. ; 186:1, s. 83-87
-
Tidskriftsartikel (refereegranskat)abstract
- The specific aim for the characterization of the lithium formate dosimetry system is to determine response and stability in a proton beam. The long-term goal for this investigation is an audit system for proton therapy like the end-to-end dose determinations performed for radiotherapy with photons. For a 150-MeV proton beam, the dose response was found to be linear in the dose interval 0-8.8 Gy. The accuracy of dose reconstruction was controlled in a blind test, in which the dose of 6.63 Gy was measured in samples irradiated with a real dose of 6.70 Gy. The stability was determined by irradiations of sets of four dosimeters every week during 1 month and analyzed at the same day thereafter. The fitting of the fading curve was done with a second-order polynomial resulting in a 6.6% lower value compared to the reference after 31 d.
|
|
| 36. |
- Fattibene, P, et al.
(författare)
-
The 4th international comparison on EPR dosimetry with tooth enamel Part 1: Report on the results
- 2011
-
Ingår i: Radiation Measurements. - : Elsevier. - 1350-4487 .- 1879-0925. ; 46:9, s. 765-771
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents the results of the 4th International Comparison of in vitro electron paramagnetic resonance dosimetry with tooth enamel, where the performance parameters of tooth enamel dosimetry methods were compared among sixteen laboratories from all over the world. The participating laboratories were asked to determine a calibration curve with a set of tooth enamel powder samples provided by the organizers. Nine molar teeth extracted following medical indication from German donors and collected between 1997 and 2007 were prepared and irradiated at the Helmholtz Zentrum Munchen. Five out of six samples were irradiated at 0.1, 0.2, 0.5, 1.0 and 1.5 Gy air kerma; and one unirradiated sample was kept as control. The doses delivered to the individual samples were unknown to the participants, who were asked to measure each sample nine times, and to report the EPR signal response, the mass of aliquots measured, and the parameters of EPR signal acquisition and signal evaluation. Critical dose and detection limit were calculated by the organizers on the basis of the calibration-curve parameters obtained at every laboratory. For calibration curves obtained by measuring every calibration sample three times, the mean value of the detection limit was 205 mGy, ranging from 56 to 649 mGy. The participants were also invited to provide the signal response and the nominal dose of their current dose calibration curve (wherever available), the critical dose and detection limit of which were also calculated by the organizers.
|
|
| 37. |
- Frid, Hanna, et al.
(författare)
-
Agreement between different methods of measuring height in elderly patients
- 2013
-
Ingår i: Journal of human nutrition and dietetics. - : Wiley. - 0952-3871 .- 1365-277X. ; 26:5, s. 504-511
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe present study aimed to examine the agreement between measurements of standing height and self-reported height, height measured with a sliding caliper, and height estimated from either demispan or knee height in elderly patients.MethodsFifty-five patients (mean age 79 years) at a Swedish hospital were included in this observational study. The participants' heights were evaluated as the standing height, self-reported height, height measured in a recumbent position with a sliding caliper, and height estimated from the demispan or knee height.ResultsThe measurements made with a sliding caliper in the recumbent position agreed most closely with the standing height. Ninety-five percent of the individuals' differences from standing height were within an interval of +1.1 to −4.8 cm (limits of agreement). Self-reported height and height estimated from knee height differed relatively strongly from standing height. The limits of agreement were +5.2 to −9.8 cm and +9.4 to −6.2 cm, respectively. The widest distribution of differences was found in the height estimated from the demispan, with limits of agreements from +11.2 to −9.3 cm.ConclusionsWhen measuring the height of patients who find it difficult to stand upright, a sliding caliper should be the method of choice, and the second choice should be self-reported height or the height estimated from knee height. Estimating height from the demispan should be the method of last resort.
|
|
| 38. |
- Glimelius, Bengt, et al.
(författare)
-
Total neoadjuvant treatment using short-course radiotherapy and four CAPOX cycles in locally advanced rectal cancer with high-risk criteria for recurrence: a Swedish nationwide cohort study (LARCT-US)
- 2024
-
Ingår i: ECLINICALMEDICINE. - : Elsevier. - 2589-5370. ; 75
-
Tidskriftsartikel (refereegranskat)abstract
- Background Total neoadjuvant treatment (TNT) for locally advanced rectal cancer (LARC) increases pathologic complete response (pCR) rate and reduces the risk of systemic recurrences over chemoradiotherapy (CRT) in randomised trials, e.g., the RAPIDO trial. A modified fi ed RAPIDO schedule was prospectively explored in Sweden to evaluate TNT in routine health care before the RAPIDO results were published. Methods Between July 2016 and June 2020, 273 patients with high-risk LARC (clinical tumour stage cT4, clinical nodal stage cN2, extramural vascular invasion, involved mesorectal fascia or enlarged lateral lymph nodes) were treated in a prospective observational cohort study at 16 hospitals (LARCT-US). Another 189 patients at 18 (including the 16) hospitals were similarly treated (ad ad modum LARCT-US, AdmL) during the same period. Inclusion and exclusion criteria were identical to the RAPIDO trial. Patients received short-course radiotherapy (5 x 5 Gy for 5 days) followed by four cycles of CAPOX or six FOLFOX-6, followed by total mesorectal excision or, if clinical complete response (cCR), inclusion into a watch-and-wait (W&W) study. The primary endpoint was complete response (CR), i.e., the sum of pCR in specimens and cCR exceeding one year in W&W patients. Safety was assessed in all patients. Findings Compared to the RAPIDO trial, patients were older, and tumours more advanced. Median follow-up was 4.8 years (IQR 4.2-5.2). - 5.2). In LARCT-US all patients received radiotherapy and 268 (98%) started chemotherapy whereas in AdmL all patients received radiotherapy and chemotherapy. In LARCT-US 34 patients had pCR and 31 sustained cCR resulting in a CR-rate of 24% (95% CI 20-28). - 28). In AdmL, results were similar (23%, 95% CI 17-30). - 30). Locoregional recurrences were 6% (95% CI 4-10) - 10) and 5% (95% CI 2-9), - 9), respectively, both at 3 years and at last follow-up. Neurotoxicity, recorded in LARCT-US, was lower than in RAPIDO (EORTC-QLQ-CIPN20 tingling toes or feet mean score 24 (SD 31) vs 43 (SD 37)). One treatment-associated death occurred. Interpretation Despite older patients and more advanced tumours, results similar to the RAPIDO trial were obtained. Hence, two chemotherapy cycles less do not compromise the results maintaining a high CR-rate. This TNT schedule resulted in favourable outcomes in a nation-wide real-life situation. Funding Swedish Cancer Society.
|
|
| 39. |
- Gothefors, Dan, et al.
(författare)
-
Swedish clinical guidelines-Prevention and management of metabolic risk in patients with severe psychiatric disorders
- 2010
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 64:5, s. 294-302
-
Tidskriftsartikel (refereegranskat)abstract
- Individuals with severe psychiatric disorders are more likely than the population at large to develop metabolic derangements such as overweight and diabetes. Cardiovascular disease is also more frequently seen in this group. Contributing factors may include inappropriate diet or lack of physical activity, but antipsychotic medication may also play a role. Seven Swedish specialist medical societies have collaborated in formulating a set of concise clinically applicable guidelines-reproduced here in modified form-for the prevention and management of metabolic risk in this patient group. The importance of implementation is emphasized.
|
|
| 40. |
- Granlund, Mats, et al.
(författare)
-
Differentiating activity and participation of children and youth with disability in Sweden : a third qualifier in the International Classification of Functioning, Disability, and Health for Children and Youth?
- 2012
-
Ingår i: American Journal of Physical Medicine & Rehabilitation. - 0894-9115 .- 1537-7385. ; 91:13:S1, s. S84-S96
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:This article discusses the use of a third qualifier, subjective experience of involvement, as a supplement to the qualifiers of capacity and performance, to anchor activity and participation as separate endpoints on a continuum of actions.DESIGN:Empirical data from correlational studies were used for secondary analyses. The analyses were focused on the conceptual roots of the participation construct as indicated by the focus of policy documents, the support for a third qualifier as indicated by correlational data, differences between self-ratings and ratings by others in measuring subjective experience of involvement, and the empirical support for a split between activity and participation in different domains of the activity and participation component.RESULTS:Participation seems to have two conceptual roots, one sociologic and one psychologic. The correlational pattern between the qualifiers of capacity, performance, and subjective experience of involvement indicates a possible split between activity and participation. Self-ratings of participation provide information not obtained through ratings by others, and later domains in the activities and participation component fit better with measures of experienced involvement than earlier domains did.CONCLUSIONS:The results from secondary analyses provide preliminary support for the use of a third qualifier measuring subjective experience of involvement to facilitate the split between activity and participation in the International Classification of Functioning, Disability and Health, Children and Youth version, activity and participation domain.
|
|
| 41. |
- Gusdal, Annelie K, 1963-
(författare)
-
Family caregiving for persons with heart failure : Perspectives of family caregivers, persons with heart failure and registered nurses
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Heart failure is a growing public health problem associated with significant morbidity and mortality. Family support positively affects outcomes for the person with heart failure while also leading to caregiver burden. Registered nurses have a key role in supporting and meeting the needs of family caregivers.The overall aim was to explore the situation and needs of family caregivers to a person with heart failure, and explore requisites and ways of supporting and involving family caregivers in heart failure nursing care.Two interview studies, one web survey study and one intervention study were conducted between 2012 and 2017. A total of 22 family caregivers, eight persons with heart failure and 331 registered nurses participated in the studies.Family caregivers' daily life was characterized by worry, uncertainty and relational incongruence but salutogenic behaviours restored new strength and motivation to care. Family caregivers experienced that their caregiving was taken for granted by health care professionals. Family caregivers expressed a need for a permanent health care contact and more involvement in the planning and implementation of their near one’s health care together with health care professionals. Registered nurses acknowledged family caregivers’ burden, lack of knowledge and relational incongruence. A registered nurse was suggested as a permanent health care contact to improve continuity and security. Registered nurses neither acknowledged family caregivers as a resource nor their need for involvement. Registered nurses working in primary health care centres, in nurse-led heart failure clinics, with district nurse specialization, with education in cardiac nursing care held the most supportive attitudes toward family involvement in heart failure nursing care. Family health conversations via telephone in nurse-led heart failure clinics were found to successfully support and involve families. The conversations enhanced nurse-family relationship and relations within the family. They also provided registered nurses with new, relevant knowledge and understanding about the family as a whole. Family health conversations via telephone were feasible to both families and registered nurses, although fewer and shorter conversations were preferred by registered nurses.This thesis highlights the divergence between family caregivers’ experiences and needs, and registered nurses’ perceptions about family caregivers’ situation and attitudes toward the importance of family involvement. It adds to the knowledge on the importance to acknowledge family caregivers as a resource and to support and involve them in heart failure nursing care. One feasible and successful way is to conduct Family health conversations via telephone in nurse-led heart failure clinics.
|
|
| 42. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
-
Family Health Conversations Conductedby Telephone in Heart Failure Nursing Care : A Feasibility Study
- 2018
-
Ingår i: Sage Open Nursing. - : SAGE Open. - 2377-9608. ; 4, s. 1-13
-
Tidskriftsartikel (refereegranskat)abstract
- Registered nurses (RNs) in heart failure (HF) nursing care have a key role in providing family support, which positively affectsthe outcome for the patient. Telephone interventions conducted by RNs have been reported to be successful in HF nursingcare, but Family Health Conversations (FamHCs) involving the patient and the family, have not previously been tested. Thepurpose of the current study was to explore the experiences and feasibility of nurse-led FamHCs conducted by telephonewith patients and their family caregivers. A single-group intervention study with a pretest–posttest design was conducted inthree regional hospitals that had a nurse-led HF clinic. Five RNs, eight patients, and eight family caregivers participated. ThreeFamHCs were conducted by telephone with each family every 2 weeks. Qualitative and quantitative data were collectedthrough semistructured interviews and questionnaires. FamHCs improved the nurse–family relationships and relationshipswithin the families and provided RNs with new knowledge about the families. FamHCs conducted by telephone wereconsidered to be feasible for both families and RNs, although RNs preferred fewer and shorter FamHCs. The RNs preferredmeeting face-to-face with the families as nonverbal communication between the family members could be missed because oflack of visual input. On the other hand, RNs appreciated to focus entirely on the conversation without the need to performillness-related routine checks. In conclusion, the advantages of FamHCs conducted by telephone outweighed the disadvantages.Visual contact, provided by video telephony, and a shorter version of the tested FamHC would facilitate the use in HFnursing care.
|
|
| 43. |
|
|
| 44. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
-
Informal caregivers’ experiences and needs when caring for a relative with heart failure: An interview study
- 2016
-
Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 31:4, s. 1-8
-
Tidskriftsartikel (refereegranskat)abstract
- AbstractBackground: Informal caregivers play an important role for persons with heart failure in strengthening medication adherence, encouraging self-care, and identifying deterioration in health status. Caring for a relative with heart failure can affect informal caregivers' well-being and cause caregiver burden.Objective: The objective of this study was to explore informal caregivers' experiences and needs when caring for a relative with heart failure living in their own home.Methods: The study has a qualitative design with an inductive approach. Interviews were conducted with 14 informal caregivers. Data were analyzed using qualitative content analysis.Results: Two themes emerged: "living in a changed existence" and "struggling and sharing with healthcare." The first theme describes informal caregivers' experiences, needs, and ways of moving forward when living in a changed existence with their relative. Informal caregivers were responsible for the functioning of everyday life, which challenged earlier established roles and lifestyle. They experienced an ever-present uncertainty related to the relative's impending sudden deterioration and to lack of knowledge about the condition. Incongruence was expressed between their own and their relative's understanding and acceptance of the heart failure condition. They also expressed being at peace with their relative and managed to restore new strength and motivation to care. The second theme describes informal caregivers' experiences, needs, and ways in which they handled the healthcare. They felt counted upon but not accounted for, as their care was taken for granted while their need to be seen and acknowledged by healthcare professionals was not met. Informal caregivers experienced an ever-present uncertainty regarding their lack of involvement with healthcare. The lack of involvement with healthcare had a negative impact on the relationship between informal caregivers and their relative due to the mutual loss of important information about changes in medication regimens and the relative's symptoms and well-being. Another cause of negative impact was the lack of opportunity to talk with healthcare professionals about the emotional and relational consequences of heart failure. Healthcare professionals had provided them neither with knowledge on heart failure nor with information on support groups in the municipality. Informal caregivers captured their own mandate through acting as deputies for their relative and claiming their rights of involvement in their relative's healthcare. They also felt confident despite difficult circumstances. The direct access to the medical clinic was a source of relief and they appreciated the contacts with the registered nurses specialized in heart failure. Informal caregivers' own initiatives to participate in meetings were positively received by healthcare professionals.Conclusions: Informal caregivers' daily life involves decisive changes that are experienced as burdensome. They handled their new situations using different strategies to preserve a sense of "self" and of "us." Informal caregivers express a need for more involvement with healthcare professionals, which may facilitate informal caregivers' situation and improve the dyadic congruence in the relation with their relative.
|
|
| 45. |
- Gusdal, Annelie K, et al.
(författare)
-
Nurses’ Attitudes toward Family Importance in Heart Failure Care
- 2017
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 16:3, s. 256-266
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure (HF). To involve family members in HF care is thus valuable for the patients. Registered nurses (RNs) frequently meet family members to patients with HF and the quality of these encounters are likely to be influenced by the attitudes RNs hold toward families.Aims: To explore RNs' attitudes toward the importance of families' involvement in HF nursing care and to identify factors that predict the most supportive attitudes.Methods: Cross-sectional, multicentre web-survey study. A sample of 303 RNs from 47 hospitals and 30 primary health care centres (PHCC) completed the instrument Families’ Importance in Nursing Care - Nurses’ Attitudes.Results: Overall, RNs were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in HF nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a PHCC, a HF clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and or HF nursing care, and a competence to work with families.Conclusions: Experienced RNs in HF nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. RNs who have designated consultation time with patients and families, as in a nurse-led HF clinic, may have the most favourable condition for implementing a more supportive approach to families.
|
|
| 46. |
- Gusdal, Annelie K, et al.
(författare)
-
Registered nurses' perception about the situation of family caregivers to patients with hearth failure - A focus group interwiev study
- 2016
-
Ingår i: PLOS ONE. - San Francisco : Public Library of Science (PLoS). - 1932-6203. ; , s. 1-18
-
Tidskriftsartikel (refereegranskat)abstract
- IntroductionHeart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes.AimsThe aims of this study are to explore registered nurses’ perceptions about the situation of family caregivers to patients with heart failure, and registered nurses’ interventions, in order to improve family caregivers’ situation.MethodsThe study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis.ResultsTwo content areas were identified by the a priori study aims. Four categories and nine subcategories emerged in the analysis process. The content area “Family caregivers' situation” includes two categories: “To be unburdened” and “To comprehend the heart failure condition and its consequences”. The content area “Interventions to improve family caregivers' situation” includes two categories: “Individualized support and information” and “Bridging contact”.
|
|
| 47. |
- Gusdal, Annelie, et al.
(författare)
-
Nurses’ attitudes toward family importance in heart failure care
-
Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151 .- 1873-1953.
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure (HF). To involve family members in HF care is thus valuable for the patients. Registered nurses (RNs) frequently meet family members to patients with HF and the quality of these encounters are likely to be influenced by the attitudes RNs hold toward families. Aims: To explore RNs' attitudes toward the importance of families' involvement in HF nursing care and to identify factors that predict the most supportive attitudes. Methods: Cross-sectional, multicentre web-survey study. A sample of 303 RNs from 47 hospitals and 30 primary health care centres (PHCC) completed the instrument Families’ Importance in Nursing Care - Nurses’ Attitudes. Results: Overall, RNs were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in HF nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a PHCC, a HF clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and or HF nursing care, and a competence to work with families. Conclusions: Experienced RNs in HF nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. RNs who have designated consultation time with patients and families, as in a nurse-led HF clinic, may have the most favourable condition for implementing a more supportive approach to families.
|
|
| 48. |
- Hagel, Eva, et al.
(författare)
-
PCBaSe Sweden : a register-based resource for prostate cancer research
- 2009
-
Ingår i: Scandinavian Journal of Urology and Nephrology. - London : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 43:5, s. 342-9
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To construct a database for clinical epidemiological prostate cancer research based on linkages between the National Prostate Cancer Register (NPCR) of Sweden, a population-based, nationwide quality database, and other nationwide registries. Material and methods. By use of the individually unique Swedish Personal Identity Number, the NPCR was linked to the Swedish Cancer Registry, the Cause of Death Register, the Prescribed Drug Register, the National Patient Register and the Acute Myocardial Infarction Register, all held at the Centre for Epidemiology at the National Board of Health and Welfare, and the Register of the Total Population, the Longitudinal Integration Database for Health Insurance and Labor Market Studies and the Multi-Generation Register, held at Statistics Sweden, and to the Swedish Hernia Register. Results. Record linkages between the NPCR and the Swedish Cancer Registry, the Cause of Death Register and the Register of the Total Population generated a database, named PCBaSe Sweden, including 80 079 prostate cancer cases, diagnosed between 1 January 1996 and 31 December 2006. Record linkage between PCBaSe Sweden and the Prescribed Drug Register generated 59 721 unique matches and linkage to the Acute Myocardial Infarction Register resulted in 11 459 matches. Conclusion. PCBaSe Sweden is a newly created and unique database with over 80 000 cases of prostate cancer with comprehensive data on inpatient and outpatient care, patterns of use of prescribed drugs and socioeconomic and familial factors. Many topics in clinical prostate cancer epidemiology can be investigated. using PCBaSe Sweden.
|
|
| 49. |
- Hemmingsson, Eva-Stina, et al.
(författare)
-
Antiviral treatment associated with reduced risk of clinical Alzheimer's disease : A nested case-control study
- 2021
-
Ingår i: Alzheimer’s & Dementia. - : John Wiley & Sons. - 2352-8737. ; 7:1
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: In this nested case-control study, we investigated if antiviral treatment given prior to onset of Alzheimer's disease (AD) could influence incident AD.Methods: From a large population-based cohort study in northern Sweden, 262 individuals that later developed AD were compared to a non-AD matched control group with respect to prescriptions of herpes antiviral treatment. All included subjects were herpes simplex virus 1 (HSV1) carriers and the matching criteria were age, sex, apolipoprotein E genotype (ε4 allele carriership), and study sample start year.Results: Among those who developed AD, 6 prescriptions of antivirals were found, compared to 20 among matched controls. Adjusted for length of follow-up, a conditional logistic regression indicated a difference in the risk for AD development between groups (odds ratio for AD with an antiviral prescription 0.287, P = .018).Discussion: Antiviral treatment might possibly reduce the risk for later development of HSV1-associated AD.
|
|
| 50. |
|
|
