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1.
  • Asp, Ann, et al. (author)
  • Transfer to adult care : experiences of young adults with congenital heart disease
  • 2015
  • In: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 30:5, s. e3-e10
  • Journal article (peer-reviewed)abstract
    • Mer än 90 % av barn med medfödda hjärtfel överlever upp i vuxen ålder tack vare utveckling av hjärtkirurgi och medicinsk behandling. Intervjuer med 16 unga vuxna med medfödda hjärtfel i syfte att undersöka deras upplevelser av hur överföringen från barnsjukvård till vuxenvård genomfördes. Analysen identifierade fem tema: Att känna trygghet i överföringen, Att känna tillit till vården, Att förväntas bli delaktig i vården, Att ta över ansvaret för sin hälsa är en process, och Att sakna kunskap leder till osäkerhet. Sammanfattningsvis, en strukturerad och gradvis överföring är nödvändig för att få informanterna att axla ansvaret för sin egenvård.
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2.
  • Astermark, Cathrine, et al. (author)
  • Health-related quality of life in children with Type 1 diabetes : an RCT of hospital-based care and hospital-based home care at diagnosis
  • 2017
  • In: International Diabetes Nursing. - : Taylor & Francis. - 2057-3316 .- 2057-3324. ; 14:2-3, s. 90-95
  • Journal article (peer-reviewed)abstract
    • Introduktion: När ett barn får diagnosen typ 1 diabetes betyder det omfattande ändringar i livsstilen för hela familjen. Det finns begränsad kunskap avseende den påverkan som den initiala vården har för barn och föräldrar. Syftet var att jämföra barns diabetesspecifika hälsorelaterade livskvalitet (HRQOL) i sjukhusbaserad vård och sjukhusbaserad hemsjukvård (HBHC), 12 respektive 24 månader efter debuten av typ 1 diabetes. Syftet var också att jämföra barnens och föräldrarnas beskrivning av barnens diabetesspecifika HRQOL efter 12 och 24 månader oavsett vårdform. Metod: Undersökningen genomfördes vid ett universitetssjukhus i Sverige och hade en randomiserad kontrollerad design för att utvärdera sjukhusbaserad vård och HBHC, med hänvisning till specialist vård i en hemmiljö. Barn i åldern 5-16 år och deras föräldrar besvarade enkäten PedsQLTM 3.0 Diabetes Module, 12 månader och 24 månader efter debuten av sjukdomen. Resultat: Resultatet visade ingen skillnad avseende barnens diabetes-specifika HRQOL. Däremot, 12 månader efter diagnos, upplevde barnen och deras föräldrar som fått HBHC mer oro jämfört med de som hade fått sjukhusbaserad vård vid diagnosen (p=0,012). Oaktat vilken vårdform som erbjudits rapporterade barnen mer obehag av sjukdomen jämfört med vad deras föräldrar upplevde att barnen kände (p=0.017). Konklusion: Sammanfattningsvis så indikerar resultatet att både sjukhusbaserad vård och HBHC erbjuder jämförbara resultat gällande barnens diabetes-specifika HRQOL. Dock verkar en vårdmodell mer lik vård i hemmet innebära större påfrestning för vissa familjer. Dessa familjer behöver bli identifierade och rutinerna behöver vara mer flexibla för att kunna möta dessa familjers behov.
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3.
  • Andersson, Maria, et al. (author)
  • Förekomst av förlossningsinduktion, indikationer och förlossningsutfall
  • 2014
  • Reports (other academic/artistic)abstract
    • Under de senaste tjugo åren har Socialstyrelsens rapporter visat på en ökning vad det gäller att sätta igång, inducera förlossningar. Statistik visar att förlossningar startade med induktion har ökat i Sverige från 8,1 % år 1990 till 13,2 % år 2007 . Överburen graviditet, de vill säga 42 graviditetsveckor eller mer, är den mest förekommande orsaken till att inducera en förlossning. Detta innebär en ökad risk för komplikationer och kan resultera i kejsarsnitt uterusrupturer och eller låg apgar hos barnet. Syftet med denna rapport var att beskriva förekomst av förlossningsinduktion, dess indikationer samt förlossningsutfall på kvinnokliniken i Malmö. Rapporten bygger på retrospektiv journalgranskning. Data har bearbetats i SPSS. Resultatet visar att inducerad förlossningar har ökat men ingen statistisk skillnad över tid kunde visas. Däremot visade det sig spontan förlossning som avslutades med sugklocka efter induktion var signifikant förhöjd i förhållande till spontanförlossningar utan induktion. Inducerad kvinnor är riskpatienter och kräver en ökad övervakning på grund av riskerna för uterus ruptur, överstimulering och påverkan på fostret. I flera studier framkommer det att induktion leder till smärtsammare latensfaser och ökat smärtlindringsbehov. Barnmorskor och läkare ska vara väl medvetna om att indikationen för induktionen måste vara klar för att kunna motivera den ökade risken för mor och barn Valet av induktion ska baseras på en samlad bedömning av moderns och barnets tillstånd och möjlighet att klara en inducerad förlossning. Det skall tydligt framgå orsak till induktionen, metod och dos av eventuella läkemedel så att inga tveksamheter föreligger, varken i journalen eller på läkemedelslistan.
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4.
  • Birgersson, Petra, et al. (author)
  • Uppfödning i korthet
  • 2009
  • In: Pediatrisk omvårdnad. - : Liber. - 9789147093274
  • Book chapter (other academic/artistic)
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5.
  • Bramhagen, Ann-Cathrine (author)
  • Children and pain in a 30 year perspective
  • 2012
  • Conference paper (other academic/artistic)abstract
    • Historiskt så har de kliniska besluten rörande huruvida ett barn upplever smärta eller inte varit baserade på de professionellas bedömning snarare än på vetenskapligt underlag. En vanlig missuppfattning är att barn inte upplever smärta i samma utsträckning som vuxna. Emellertid, definitionen på smärta är att det är en subjektiv och emotionell upplevelse associerad till verklig eller potentiell vävnadsskada, eller beskriven som sådan. Trots detta genomgår många barn smärtsamma procedurer under sin sjukhusvistelse utan smärtlindring. En litteraturgenomgång från 1985 baserad på 40 artiklar visade att 77 % av nyfödda barn endast fick muskelrelaxantia före hjärtkirurgi och ingen smärtlindring. Forskning från 1994 visade att, även intrauterint, invasiva procedurer är smärtsamma då fostret reagerade med förhöjda halter stresshormoner. Vidare, forskning från 1997 visade att barn som blivit utsatta för smärta tidigt i livet reagerade med ett starkare smärtsvar jämför med de som inte blivit utsatta. Studier från 2003 beskrev att nyfödda på en neonatal intensivvårdsavdelning blev utsatta för mer än 14 smärtsamma procedurer per dag. Forskning har visat att sjuksköterskors attityder är viktiga för smärthanteringen av barn. Andra studier har visat att sjuksköterskor saknar kunskap avseende smärtbehandling av barn. En nyligen genomförd studie visade att sjuksköterskor tyckte att mindre ingrepp kunde utföras utan smärtlindring. Dock har det visat sig att avancerad utbildning för sjuksköterskor och erfarenhet av att arbeta med barn påverkar deras attityder i viss mån. Barn är en sårbar grupp och sjuksköterskor har, eller borde ha, en stor betydelse för hanteringen av smärta hos barn. Hur kommer vi dit?
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6.
  • Bramhagen, Ann-Cathrine (author)
  • Do nurses change a child´s peripheral intravenous catheter when clinically indicated?
  • 2015
  • In: Vård i Norden. - : Sage Publications. - 0107-4083 .- 1890-4238. ; 35:1-2, s. 54-56
  • Journal article (peer-reviewed)abstract
    • Syfte. Syftet med studien var att undersöka om sjuksköterskor byter barns perifera venkateter vid klinisk indikation. Bakgrund. Att sätta en perifer venkateter är en vanligt förekommande procedur på sjukhus idag men detta kan vara smärtsamt och traumatiskt för barn. Det finns gudielines för när dessa ska bytas när det gäller vuxna men inga sådana riktlinjer för barn kunde identifieras. En Cochrane review från 2010 konkluderade att den perifera venkatetern ska bytas när det finns en klinisk indikation. Detta innebär vid tromboflebit men även vid smärta, rodnad, infiltration, svullnad läckage och ocklusion. Metod. Designen var prospektiv och observerande. Dagliga observationer gjordes på sjukhuset av en av forskarna och noteringar gjordes i ett protokoll. Resultat. Trettiotre barn med sammalagt 47 perifera venkatetrar deltog och 104 observationer gjordes. Sammanlagt utvecklade 42% (14/33) av barnen komplikationer. Bland de barn som fick grad 2 och 3 bytade sjuksköterskan inte den perifera venkatetern när det fanns klinisk indikation. Konklusion. Denna studie visar att tromboflebit kan utvecklas bland barn med en perifer venkateter och att den inte bytades när det fanns klinisk indikation. Det är de professionellas ansvar att reducera smärtsamma upplevelser för barn i samband med sjukhusvistelse och ytterligare forskning kring sjuksköterskors kliniska beslut behöver göras.
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7.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Factors influencing iron nutrition among one-year-old healthy children in Sweden
  • 2011
  • In: Journal of Clinical Nursing. - : Blackwell Munksgaard. - 0962-1067 .- 1365-2702. ; 20:13-14, s. 1887-1894
  • Journal article (peer-reviewed)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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8.
  • Bramhagen, Ann-Cathrine (author)
  • IRON NUTRITION DURING EARLY CHILDHOOD. Factors influencing iron status and iron intake.
  • 2006
  • Doctoral thesis (other academic/artistic)abstract
    • The overall aim of this thesis was to describe the prevalence of iron deficiency (ID) and factors influencing iron status and iron intake among otherwise healthy children. The specific aim in paper I+II was to describe the prevalence of ID among 2 ½-year-old children in relation to intake of cow's milk and follow-on formula. The design in the first two papers were cross-sectional and 367 2 ½-year-old children participated. Data collection included blood samples in order to determine the child's iron status and the parents were asked to estimate the child's intake of cow's milk and follow-on formula. The results showed that ten percent of the children were iron deficient, with or without anaemia, and received iron treatment. Transferrin receptor levels were measured and 14% had elevated levels indicating an iron need in the cell. The intake of cow's milk was significantly higher among children with iron deficiency than among those with sufficient iron status. Eleven percent of the children with ID consumed follow-on formula compared to 43% of the iron-sufficient children. The specific aims in paper III were to describe iron status, iron intake and possible influencing factors among one-year-old children. Ten percent of the participating children (n=90) were iron depleted and 2.2% had ID. Furthermore, 27% of the non-breast fed children had a daily iron intake below the Nordic Nutrition Recommendations. Twenty-five percent reported that they experienced feeding problems when the child was 12 months old and some stated that they had to manipulate the child in order to make it eat. The children with mothers reported an education < 9 years had significantly lower iron intake, lower Hb and lower MCV than children with mothers who had an education > 9 years. Information about iron rich food from the Child Health Service to the parents improved the child's iron status. The specific aim in paper IV was to elucidate mothers experiences concerning feeding situations. The design was qualitative and interviews with 18 mothers were conducted. The interviews were transcribed verbatim and analysed with content analysis. Two main categories were identified, positive or negative experiences. The mothers with positive experiences trusted the child's ability to regulate food intake and they describe the child as easy to interpret. Mothers with negative experiences describe their child as petulant and felt difficulties in interpret the child's signals. They had to control the child's food intake and one way was to manipulate the child with treats or reward in order to make the child eat. In conclusion, ID still exists among healthy children in Sweden during early childhood. The children with ID drank more cow's milk than those with sufficient iron status. Fewer with ID received follow-on formula compared to those without ID. Low maternal education correlated with low iron intake. Twenty-seven percent of the children had an iron intake below recommendations. Iron fortified follow-on formula and porridge contributed with a large proportion of the total iron intake among one-year-old children. Information about iron rich food resulted in improved iron status.
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9.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Iron status of children in southern Sweden: effects of cow's milk and follow-on formula
  • 1999
  • In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 88:12, s. 1333-1337
  • Journal article (peer-reviewed)abstract
    • Aim. The objective of the study was to investigate iron status in children in relation to intake of cow's milk and follow-on formula. Methods. In all, 367 healthy 2.5-y-old children were enrolled in the study. The amounts of cow's milk and formula consumed were recorded. B-haemoglobin, S-ferritin, S-iron, total iron binding capacity and mean corpuscular volume were analysed. Results. Seven percent of the children had iron deficiency anaemia (Hb <110 g/l) and 10% had S-ferritin <12 μg/1. Furthermore, 10% of the children were iron deficient, with or without anaemia. Children with iron deficiency had a higher intake of cow's milk (382 ml, 95% confidence interval (CI) 294-496, vs. 257 ml, CI 232–272, p< 0.0001), and fewer consumed follow-on formula (11% vs. 43%, p = 0.0002) compared to those with sufficient iron. Conclusion. Iron deficiency is still common during childhood in Sweden. Intake of cow's milk is significantly higher in children with iron deficiency. In contrast, iron deficiency is less frequent among those consuming follow-on formula.
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10.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Mothers' experiences of feeding situations : an interview study.
  • 2006
  • In: Journal of Clinical Nursing. - : Blackwell Munksgaard. - 0962-1067 .- 1365-2702. ; 15:1, s. 29-34
  • Journal article (peer-reviewed)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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11.
  • Bramhagen, Ann-Cathrine (author)
  • Pain Management at Skåne University Hospital, Malmö/Lund, Sweden
  • 2013
  • Conference paper (other academic/artistic)abstract
    • 1. Sjuksköterskors attityder till smärta bland barn. Tidigare forskning har visat att sjuksköterskor som arbetar med barn saknar kunskap kring smärthantering i viss utsträckning. Barn uttrycker smärta annorlunda än vuxna och forskning har visat att sjuksköterskors attityder är viktiga för att hantera smärta hos barn. Denna studien syftade till att undersöka sjuksköterskors attityder till smärta hos barn. Metoden utgjordes av en enkät till sjuksköterskors som arbetar med barn på en barnavdelning vid ett universitetssjukhus i södra Sverige. Enkäten, Views and knowledge about pain in children” översattes till svenska. Total 357 enkäter delades ut och 153 enkäter besvarades. Detta motsvarar en svarsfrekvens på 43 % av utdelade enkäter. Data analyserades deskriptivt och jämförelser mellan grupper gjordes. Resultatet visade att majoriteten av sjuksköterskor inte tyckte att barn yngre än en månad kunde bli intuberade utan narkotiska preparat men hela 22 % svarade att de inte visste. De uttryckte också vikten av frånvaro av smärta vid postoperativ och kronisk smärta. En del sjuksköterskor tyckte dock att mindre ingrepp kunde göras utan smärtlindring. Utbildning på avancerad nivå och erfarenheter påverkade i viss mån. Var sjuksköterskorna arbetade påverkade inte. 2. Barns smärta från barnets och från förälderns perspektiv. Smärthantering är viktigt för barnet ur många aspekter och kan leda till långvariga problem och påverkar livskvaliteten för barnet. Sverige saknar optimal hantering av akut och långvarig smärta avseende barn och tonåringar. Syftet med studien var att beskriva barns och föräldrars upplevelse av smärta på sjukhus och genomfördes som en prevalensstudie med hjälp av en enkät bestående av sju frågor. Totalt 182 enkäter lämnades ut och 146 besvarades. Resultatet visade att68 % av barnen hade upplevt smärta i samband med sjukhusvistelsen och smärtskalor användes inte i större utsträckning. "Frågade personalen dig och ditt barn om smärta?" 82% (79/97) svarade ja. "Fick du och ditt barn möjlighet att under de först 24 timmarna bedöma smärta med hjälp av en skala e.g. VAS?" Bara 23 % (22/97) svarade att de hade fått den möjligheten. Dessa resultat kan bidra till ökad kunskap om smärta och smärthantering av professionella, vilket kan utgöra en bas för fortsatta diskussioner och öka kvaliteten av smärtbehandling av barn på sjukhus.
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12.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Response
  • 2008
  • In: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 17:5, s. 697-698
  • Journal article (other academic/artistic)
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13.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Self-reported post-operative recovery in children : development of an instrument
  • 2016
  • In: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell. - 1356-1294 .- 1365-2753. ; 22:2, s. 180-188
  • Journal article (peer-reviewed)abstract
    • Rationale, aims and objectives: According to the United Nations (1989) , hildren have the right to be heard and to have their opinions respected. Since post-operative recovery is an individual and subjective experience and patient-reported outcome measures are considered important, our aim was to develop and test an instrument to measure self-reported quality of recovery in children after surgical procedures.Methods: Development of the instrument Postoperative Recovery in Children (PRiC) was influenced by the Quality of Recovery-24, for use in adults. Eighteen children and nine professionals validated the items with respect to content and language. A photo question- naire was developed to determine whether the children’s participation would increase compared with the text questionnaire. The final instrument was distributed consecutively to 390 children, ages 4–12 years, who underwent tonsil surgery at four hospitals in Sweden.Results: A total o f238 children with a mean age of 6.5 years participated. According to the parents, 23% circled the answers themselves and 59% participated to a significant degree. However, there was no significant difference in participation between those who received a photo versus a text questionnaire. Psychometric tests of the instrument showed that Cronbach’s alpha for the total instrument was 0.83 and the item-total correlations for 22 of the items were ≥0.20.Conclusion: Our results support use of the PRiC instrument to assess and follow-up on children’s self-reported post-operative recovery after tonsil operation, both in clinical praxis as well in research. 
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14.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Teachers' and nurses' perspective regarding sex education in primary school and influencing factors
  • 2024
  • In: Scandinavian Journal of Educational Research. - : Routledge. - 0031-3831 .- 1470-1170. ; 68:2, s. 115-125
  • Journal article (peer-reviewed)abstract
    • Sex education can be described as an important part of health education in school and one way of strengthening health education could be a collaboration between different professionals in the school team. The aim of this study was to describe teachers' and school nurses' experiences and perspectives with regard to sex education among students aged 11-12 years and to explore potential influencing factors. We employed a qualitative design, and the teachers and school nurses were interviewed individually. A thematic analysis was conducted on the interviews and the results showed that the classroom was considered to be the teacher's arena. Tradition and attitudes between professionals could be obstacles that affect collaboration between teachers and nurses and the study showed that there remains much to be done before collaboration at the same level between the groups can be established.
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15.
  • Bramhagen, Ann-Cathrine (author)
  • To publish a scientific article
  • 2016
  • Conference paper (other academic/artistic)abstract
    • ABSTRACT FOR CROATIA CONFERENS OCTOBER 2016 Att publicera en vetenskaplig artikel Flera av er har säkert någon ide´ för att förbättra vården eller kanske redan har genomfört något kvalitetsarbete. Denna workshop är tänkt att inspirera er att genomföra en studie alternativt att ta beslutet att publicera det arbete ni redan har genomfört. År 2014 publicerades en studie (Eiken et al, 2014) som konkluderade att sjuksköterskors utbildningsgrad och arbetsbelastning var relaterade till patientdödligheten. Detta resultat betyder att sjuksköterskors insatser är betydelsefulla och därmed bör det arbete som sjuksköterskor gör bli möjligt för andra att ta del av. För att komma vidare behövs strategier och under denna workshop ska vi diskutera hinder och möjligheter samt att dela med oss av våra erfarenheter. Ann-Cathrine Bramhagen, RN, PhD, Associated professor Malmö University Eiken et al (2014) Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Published Online February 26, 2014 http://dx.doi.org/10.1016/ S0140-6736(13)62631-8
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16.
  • Bramhagen, Ann-Cathrine, et al. (author)
  • Transferrin receptor in children and its correlation with iron status and types of milk consumption
  • 2003
  • In: Acta Paediatrica. - : Taylor & Francis. - 0803-5253 .- 1651-2227. ; 92:6, s. 671-675
  • Journal article (peer-reviewed)abstract
    • Syfte: Denna studie jämförde koncentrationen av transferrin receptor (TfR) med järnstatus parametrar i relation till barnets intag av komjölk och välling. Metod: TfR, β-Haemoglobin, serum ferritin och medelcellsvolumen (MCV) på de röda blodkropparna analyserades i en population av 263 barn i åldern 2.5 år. Mängden komjölk och välling som barnet drack registrerades. Resultat: Det fanns en signifikant skillnad i TfR/log. ferritin mellan barn vars intag av komjölk var < 500 ml respektive barn med intag av mjölk > 500 ml (p= 0.003). Där fanns ett signifikant högre värde av TfR/log. ferritin bland barn med en medelscellsvolum av de röda blodkropparna på < 75fL jämfört med de som hade > 75fL (p=<0.0001). Koncentrationen av TfR var signifikant högre efter järnbehandling. Konklusion: Högre koncentrationer av TfR var korrelerade med lägre koncentrationer av haemoglobin och MCV av röda bloda kroppar. Mjölk konsumtion ökade risken för högre kvot av TfR/log ferritin. TfR koncentrationen var signifikant lägre efter järnbehandling.
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17.
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18.
  • Carlsson, Anna, et al. (author)
  • Mothers´ awareness towards child injuries and injury prevention at home : an intervention study
  • 2016
  • In: BMC Research Notes. - : BioMed Central. - 1756-0500. ; 18:9, s. 223-228
  • Journal article (peer-reviewed)abstract
    • Flertalet skador som drabbar små barn sker i hemmet. Därför syftade denna studie till att undersöka om utvidgad individuell information till mödrar avseende skador bland barn i hemmet och möjliga preventiva åtgärder har någon effekt på deras medvetenhet kring problemet och om känslan av sammanhang har någon inverkan. Denna studie var designad som en kvasi-experimentell interventionsstudien med en jämförelsegrupp. Utvidgad individuell information med empowerment som förhållningssätt användes. Nittionio mödrar med barn under 7 månader deltog. Ett frågeformulär med sociodemografiska data och frågor angående medvetenhet om prevention användes. Mödrar som deltog i interventionen ökade signifikant sin medvetenhet kring att skador bland barn händer i hemmet jämfört med mödrar i jämförelsegruppen [OR 2.3, CI 1.3-4.3]. Å andra sidan fann studien ingen signifikant förbättring avseende medvetenhet kring prevention, ej heller någon association till mödrarnas känsla av sammanhang. Denna studie visade att interventionen hade en positiv effekt på mödrarnas medvetenhet angående att skador bland barn sker i hemmet, men ökade inte mödrarnas medvetenhet angående att förebygga skador.
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19.
  • Carlsson, Anna, et al. (author)
  • Precautions taken by mothers to prevent burn and scald injuries to young children at home : An intervention study
  • 2011
  • In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:5, s. 471-478
  • Journal article (peer-reviewed)abstract
    • AIM: The aim of this study was to investigate to what extent individual-based extended information given to mothers from city parts of low education can improve precautions taken by them to prevent burn and scald injuries involving young children in the home and further to compare the results with a group of mothers who had not received extended information. METHODS: This intervention study, with a comparison group, has a quasi-experimental design. Individual-based information, with an empowerment approach, was given to a group of mothers living in two separate areas of a city in southern Sweden with a low level of education. In total, 99 mothers of children under the age of 7 months participated. The mothers were selected through the local child healthcare authorities. Observations were made and bivariate analyses were established. RESULTS: The results showed that the intervention had a significant impact on improving the precautions the participating mothers introduced to protect their children against burn and scald injuries in the home and further, in relation to a comparison group. CONCLUSIONS: Through empowerment, workshops, and home visits aimed to increase their consciousness and knowledge, the participating mothers' precautions taken against child injuries in the home improved. It is of great importance that a framework for considering the problem of burn and scald injuries to children is presented from a preventive perspective which, in combination with evidence-based interventions, may enable the creation of injury prevention programmes for implementation by the community health care.
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20.
  • Dykes, Charlotta, et al. (author)
  • Parents experience a sense of guilt when their newborn is diagnosed small for gestational age, SGA : A grounded theory study in Sweden
  • 2022
  • In: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 62, s. e8-e15
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: To become a parent of a child who is born small for gestational age can lead to challenges in addition to the newly acquired parenting role. There is currently a lack of knowledge regarding parents' experiences of having a child born small for gestational age.PURPOSE: The purpose of this study was to describe the experience of becoming a parent of a child small for gestational age DESIGN AND METHOD: A qualitative inductive approach was chosen with grounded theory as a method, a strategic selection was used and individual interviews with open questions were performed.RESULTS: The results showed that the parents expressed guilt over the child's size and focused on the ability to nourish their child to keep their unexpectedly small child alive. An experienced concern about the child's food intake could be seen throughout the entire interview material and the need for information was great. A common experience of the parents was that constant feeding of the child dominates their lives.CONCLUSION: The conclusion is that the unexpectedly small size of the child awakens the parent's instinct to provide life-sustaining care and the parents need increased support and more information around the child's condition. This requires well-trained professionals, because parents to children born SGA often harbour feelings of unpreparedness and guilt.PRACTICE IMPLICATIONS: Increased understanding and knowledge about the parents' experience of having a child born SGA, healthcare services can optimize the potential for better attachment between parent and child as well as offer appropriate support.
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21.
  • Ericsson, Elisabeth, 1959-, et al. (author)
  • Experiences of a new self-report instrument for post-operative recovery in children
  • 2017
  • Conference paper (peer-reviewed)abstract
    • The objective was to develop and test an instrument that provides children, also of a younger age, with a quality recovery self-report measure after tonsil surgery.Methods: The development of Postoperative Recovery in Children (PRiC) was influenced by Quality of Recovery-24, for use in adults. It includes 23 items covering different aspects of recovery. PRiC was developed both as a traditional text-based instrument and as a version where each item is illustrated by a photo. It was distributed to 260 children undergoing tonsillotomy or total tonsillectomy in day-surgery, to be answered on post-operative days 1, 4 and 10.Results: In the photo-version, 27% of the children marked the answers on the instrument themselves, compared to 19% in the text-version (n.s.). Parents of 64% of the children in the photo-group reported that their child participated in answering the questions to a very high degree, compared to 58% in the text-group (n.s.). Some parents described that their children were very proud to fill in the instrument and return them by mail. The questions were mainly described as easy to understand and respond to, especially when illustrated with a photo. Some parents highlighted pain issues and asked for specific questions about what pain medication was given at home. One parent asked for the possibility to respond to the instrument online. Conclusion: PRiC can serve as a patient-reported outcome measure for children. PRiC can also provide parents with a tool for communicating with their child about post-operative recovery, especially when using the photo version.
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22.
  • Ericsson, Elisabeth, 1959-, et al. (author)
  • Experiences of a new self-report instrument for post-operative recovery in children
  • 2017
  • Conference paper (peer-reviewed)abstract
    • OBJECTIVESAccording the United Nations, children have the right to be heard and to have their opinions respected. Since postoperative recovery is an individual and subjective experience, our aim was to develop and test an instrument that provides children, also of a younger age, with a quality recovery self-report measure after tonsil surgery.METHODSThe development of Postoperative Recovery in Children (PRiC) was influenced by Quality of Recovery-24, for use in adults. It includes 23 items covering different aspects of recovery. PRiC was developed both as a traditional text-based instrument and as a version where each item is illustrated by a photo. It was distributed to 260 children undergoing tonsillotomy or total tonsillectomy in day surgery, to be answered on post-operative days 1, 4 and 10. The children and their parents were also asked to give their opinion about the instrument. The free-text answers were categorised to reflect the content and presentation of the two instrument versions.RESULTSIn the photo version, 27% of the children marked the answers on the instrument themselves, compared to 19% in the text version (n.s.). Parents of 64% of the children in the photo group reported that their child participated in answering the questions to a very high degree, compared to 58% in the text group (n.s.).  Some parents described that their children were very proud to fill in the instrument and return them by mail.The questions were mainly described as easy to understand and respond to, especially when illustrated with a photo. Some parents highlighted pain issues and asked for specific questions about what pain medication was given at home. One parent asked for the possibility to respond to the instrument online.CONCLUSIONPRiC can serve as a patient-reported outcome measure for children. PRiC can also provide parents with a tool for communicating with their child about post-operative recovery, especially when using the photo version.
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23.
  •  
24.
  • Ericsson, Elisabeth, 1959-, et al. (author)
  • Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy
  • 2017
  • Conference paper (peer-reviewed)abstract
    • Background: Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this aspect.Methods: 238 children (4-12 years) with a history of obstructive problems and/or recurrent tonsillitis were included. 48% were operated with tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery. Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument, Postoperative Recovery in Children (PRiC), which includes 23 items covering different aspects of recovery after tonsil surgery. Results: Daily life activities (sleeping, eating and playing), and physical (e.g., headache, stomach ache, throat ache, otalgia, dizziness, nausea, defecation, urination) and emotional aspects (sadness, frightening dreams) were affected during the recovery period.The TE-girls showed higher scores than the boys in many factors. Children above 6 years of age reported higher values for the physical comfort variables while the younger group showed worse emotional states. Postoperative recovery improved from day 1 to 10 in all surgical groups. The TE-group had lower recovery compared to the TT-group (p < 0.01 – 0.001) in most items.Conclusion: The goal of postoperative management is to minimise or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery after tonsil surgery, and thus, PRiC can serve as a PROM to obtain patient-centred data after tonsil surgery.
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25.
  • Ericsson, Elisabeth, 1959-, et al. (author)
  • Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy
  • 2017
  • Conference paper (peer-reviewed)abstract
    • OBJECTIVESTonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this aspect.METHODSTotally, 238 children (4-12 years old) with a history of obstructive problems and/or recurrent tonsillitis, undergoing tonsil surgery were included. Forty-eight per cent were operated with partial tonsil resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery.Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument PRiC, Postoperative Recovery in Children, which includes 23 items covering different aspects of recovery after tonsil surgery. PRiC was distributed both as a traditional text instrument and with photo illustrations. RESULTSDaily life activities (sleeping, eating and playing), and physical (e.g., headache, stomach ache, throat ache, otalgia, dizziness, nausea, defecation, urination) and emotional aspects (sadness, frightening dreams) were affected during the recovery period.The TE-girls showed significantly higher scores than the boys in many factors.Children above 6 years of age reported higher values for the physical comfort variables while the younger group showed worse emotional states.Postoperative recovery improved from day 1 to 10 in all surgical groups. The TE-group had lower recovery compared to the TT-group (p < 0.01 – 0.001) in most items.CONCLUSIONThe goal of postoperative management is to minimise or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery after tonsil surgery, and thus, PRiC can serve as a PROM to obtain patient-centred data after tonsil surgery.
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26.
  •  
27.
  • Eriksson, Mats, 1957-, et al. (author)
  • Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy
  • 2017
  • In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 96, s. 47-54
  • Journal article (peer-reviewed)abstract
    • Objectives: Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect.Methods: In total, 238 children (4–12 years old) with a history of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil surgery were included. Forty-eight per cent were operated with partial tonsil resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery.Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument PRiC, Postoperative Recovery in Children. This includes 23 items covering different aspects of recovery after tonsil surgery. A higher score indicates worse status in the respective items.Results: Daily life activities (sleeping, eating and playing), physical symptoms (e.g., headache, stomach ache, sore throat, otalgia, dizziness, nausea, defecation, urination), and emotional aspects (sadness, frightening dreams) were affected during the recovery period.The TE-girls showed higher scores than the boys regarding stomach ache, defecation and dizziness.Children above 6 years of age reported higher values for the physical comfort variables, while the younger group showed worse emotional states.Postoperative recovery improved from day 1–10 in all surgical groups. The TE-group showed lower recovery compared to the TT-group (p < 0.01–0.001) in most items.Conclusion: The goal of postoperative management is to minimize or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery, and thus, PRiC seems to be able to serve as a PROM to obtain patient-centered data after tonsil surgery. The recovery process after TT causes less postoperative morbidity and a quicker return to normal activity compared to TE.
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28.
  • Filej, Bojana, et al. (author)
  • Teaching experiences of digital education during the pandemic - multicentre study
  • 2024
  • In: PIELEGNIARSTWO XXI WIEKU-NURSING IN THE 21 CENTURY. - : Walter de Gruyter. - 1730-1912.
  • Journal article (peer-reviewed)abstract
    • Aim. The COVID-19 pandemic forced many teachers to switch from traditional face-to-face teaching to the use of various digital platforms in a short period of time. The research aimed to find out about teachers' experiences of digital education at nursing faculties in four countries (Croatia, Serbia, Slovenia, Sweden) which participated in the Erasmus+ Digital Education in Nursing project. Material and methods. Qualitative research with semi-structured group interviews was used. A total of 28 nursing teachers participated. The interviews were transcribed verbatim and analysed inductively, using qualitative content analysis. The interviews were analysed in accordance with the study aim by searching for codes which were grouped into subcategories and then into categories based on the similarity of the content. Results. Three important themes emerged from the analysis of the interviews: "conflicting feelings of teachers when switching to digital teaching", "lack of digital competences", "challenges for digital teaching in the future". Conclusions. Rapidly developing digital technology provides new possibilities and support for both teaching and learning. The research identified the need for further development of the digital competences of teachers, who recommended that a hybrid teaching method is the best for the education of nurses, since certain skills cannot be acquired by students solely in a digital way.
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29.
  • Flankegård, Gunilla, 1974- (author)
  • Childhood functional constipation : Parents' everyday life experiences
  • 2022
  • Licentiate thesis (other academic/artistic)abstract
    • Background: Functional constipation is the most common chronic disorder in childhood with a great impact on family life. Treatment focuses on the behavioural nature of the disorder with toilet training and laxatives, with the goal of daily stool passage without difficulties. Management of care is predominantly carried out at home by parents, making them key partners in the paediatric care.Aim: The overall aim of this thesis was to explore and understand childhood functional constipation through the experiences of parents.Design and method: This thesis comprise two studies based on a phenomenological research method and design with an inductive reflective lifeworld approach using qualitative individual interviews to gather data. A theoretical framework was used in the analysis to further elucidate the findings.Findings: Shame was the essential finding, providing the reason parents acted in certain ways and the result of the same actions. Study I showed that everyday life was put on hold due to the time and effort invested in the adaptations demanded by the constipation. This left the parents feeling lonely, guilty, and fighting frustrating battles as they tried to gain control by being always one step ahead. Study II showed that giving constipation treatment resulted in parents questioning their parental identity. Treatment needed to be affirmed, as doubt and second thoughts sometimes made parents give treatment against their own will as well as defying their child’s will, bordering on feelings of being abusive. The findings were interpreted in the light of theories of illness beliefs and good parenting beliefs, suggesting belief systems are the path into the parents’ feelings of shame. Re-evaluating the beliefs might diminish failure to adhere to treatment regimens.Conclusions: This project shows that functional constipation is like other childhood chronic illnesses in respect of its importance and impact on everyday family life. Shame is a prominent feature of functional constipation experiences. However, the shame felt might be mitigated by targeting and re-evaluating the belief systems that form the lifeworld of the parents and family.
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30.
  • Fåhraeus, Åsa, et al. (author)
  • Förekomst av lokala komplikationer efter kranskärlsintervention via artären i handleden
  • 2013
  • Reports (other academic/artistic)abstract
    • Kardiovaskulär sjukdom är en av västvärldens vanligaste sjukdomar. Diagnos och behandling av förträngda kranskärl kan tillföras med kontraströntgen och perkutan koronar intervention (PCI). Punktion via arteria radialis har i studier visat minskade blödningskomplikationer och minskade kardiella händelser jämfört med transfemoral punktion. Uppföljning avseende lokala komplikationer vid transradial procedur är angeläget. Syftet med denna studie var att retrospektivt utvärdera förekomsten av lokala komplikationer efter transradial kranskärlsintervention efter utskrivning. Patienterna (n=139) kontaktades per telefon efter 2-4 månader. Förfrågan gjordes enligt frågeformulär om lokala symtom relaterat till området kring handleden efter transradial kranskärlsintervention samt om palpabel radialispuls fanns I denna studie hade patienterna hade 91.4 % av patienterna inga lokala komplikationer efter transradial kranskärlsintervention. Alla patienterna hade palpabel radialispuls varav en hade svag radialispuls som verifierades med doppler. Tolv patienter (8.6 %) uppgav symtom på lokala komplikationer av något slag. Sju patienter (5 %) hade olika besvär som smärta känselnedsättning svullnad och hematom från handen. Två patienter (1.4 %) hade besvär från handleden och ytterligare två hade symtom från underarmen samt en hade smärta i axeln. Åtta patienter (6 %) hade olika typer av kvarstående besvär. Konklusionen är att radialispunktionen vid kranskärsintervention har fördelar som minskade blödningskomplikationer och förebyggande minskad hjärtrelaterad död jämfört med femoralispunktionen som vistas i flera studier. Resultatet i denna studie visade lindriga lokala komplikationer, framför allt i handen, hos knappt en tiondel av alla patienterna. Dessutom med tillägg av ökat välbefinnande postoperativt borde transradial procedur vara första handaval vid kranskärlsintervention.
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31.
  • Fässler, Lena, et al. (author)
  • Betydelsen av preoperativ information inför colorektal kirurgi - ett patientperspektiv
  • 2011
  • Reports (other academic/artistic)abstract
    • Information och utbildning är viktiga delar av vården inför colorektal kirurgi. Att ge evidensbaserad information som förberedande och tillräcklig för att patienterna skall kunna hantera den postoperativa tiden till snabb återhämtning är en förutsättning. Syftet var att beskriva och sammanställa vetenskapliga artiklar avseende betydelsen av den preoperativa patientinformationen som ges inför colorektal kirurgi ur ett patientperspektiv. Metoden var en litteraturstudie för att systematiskt finna evidens för patientinformation inför colorektal kirurgi med systematisk ansats. Resultatet visade att patienter beskriver den preoperatia upplevelsen som oro, osäkerhet, och stress inför det okända. De har behov av vårdgivare som genom mötet inger säkerhet och kontinuitet. Då patienterna får flerdimensionell, skriftlig och muntlig information är de mindre oroliga och har högre självkontroll postoperativt. De upplever också mindre smärta och kan mobiliseras tidigare. Om patienterna som skall erhålla stomi träffat en stomiterapeut preoperativ leder det till minskad oro, färre stomikomplikationer samt ett bättre psykiskt välbefinnande. Detta göra att patienterna kan hantera sin stomi tidigare. Noggrann preoperativ information ökar förståelsen av den postoperativa återhämtningsfasen och gör patienterna mer delaktiga, vilket leder till tidigare återhämtning och hemgång. Konklusionen är att patienter som ska genomgå colorektal kirurgi är i stort behov av preoperativa information. Då denna ges utifrån ett standardiserat vårdprogram med beaktande av individuellt behov blir patienterna bättre förberedd på sin operation och den postoperativa vården. Patienterna delta aktivt i sin vård och tar ansvar tidigt, vilket minskar komplikationerna och påskynda den postoperativa återhämtningen. Genom ett bra samarbete i teamet runt patienten kan de individuella behoven hos patienten optimeras. Om patienten tilldelas en patientsansvarig sjuksköterska kan det individuella behovet identifieras tidigare och vid behov följas upp postoperativt efter utskrivning.
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32.
  • Gunes, Aynur, et al. (author)
  • Heparin or Sodium Chloride for Prolonging Peripheral Intravenous Catheter Use in Children
  • 2018
  • In: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 43, s. E92-E99
  • Research review (peer-reviewed)abstract
    • Bakgrund: Barns välbefinnande bör alltid tas i beaktande men under sjukhusvistelse upplever många barn smärta relaterat till medicinska procedurer såsom att sätta en intravenös perifer katater. För att förlänga tiden som katetern fungerar och för att undvika onödiga byten av katetern så kan den antingen bli spolad med heparin eller med koksalt. Eftersom heparin har negativa sidoeffekter så syftade denna studien till att undersöka om det finns evidens för att intermittent spolning med heparin är mer effektivt för att förlänga den verksamma tiden jämfört med spolning av koksalt. Kriterier: En systematisk litteraturstudie genomfördes som strukturerades enligt PICO. Databaserna PubMed, CINAHL, och Cochrane Library användes och valda studiedesinger var systematiska reviews och randomiserade kontrollerade dubbelblindande studier inkluderades. Studierna granskades och syntetiserades för att sedan evedensgraderas. Urval: Två systematiska reviews och fyra randomiserade kontrollerade dubbel-blindade studier inkluderades. Results: De två systematiska reviews bedömdes vara av hög kvalitet och de randomiserade kontrollerade dubbel-blindade studierna bedömdes ha medelhög kvalitet. Resultatet visade både signifikanta skillnader men även icke signifikanta skillnader avseende tiden som katetern fungerade mellan grupperna som fick heparin och de som fick koksalt. Konklusion: Vår konklusin är att heparin kanske inte är nödvändig men att guidelines inte går att utveckla. Implikationser: Eftersom heparin har negativa sidoeffekter för barn och inga signifikanta resultat entydigt visade favörer för heparin fler studier behövs för att utforma evidensbaserad vård.
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33.
  •  
34.
  • Isma, Gabriella, et al. (author)
  • Childhood overweight and obesity conceived by Child Health Care nurses: a qualitative study.
  • 2012
  • In: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 13:57
  • Journal article (peer-reviewed)abstract
    • Background: Registered Sick Children's Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives childhood obesity. The aim of this study was to elucidate the conceptions of childhood overweight, including obesity, among nurses working in Child Health Care. Method: A qualitative study using a phenomenographic approach, based on open-ended interviews with 18 Child Health Care nurses (CHC-nurses) strategically selected from 17 Child Health Care Centres in the southern part of Sweden. Results: Four categories of description emerged from the data: Perception of childhood overweight changes, Overweight in younger children a neglected concern, Overweight a delicate issue and Importance of family lifestyle. The participating CHC-nurses conceived overweight in children, primarily obesity in children to be an extensive and serious problem which affects children, families and the surrounding society. Overweight in children was further perceived as a consequence of their parent's lifestyle and their awareness of the problem, which was considered by the CHC-nurses as a sensitive and a provoking issue. It was also perceived that overweight in children is not taken seriously during the pre-school period and that concerns regarding overweight in younger children were mainly about the appearance and not the health of the child. The CHC-nurses perceived that the proportion of overweight children has increased, which Swedish society and the CHC-nurses have adapted to. This adaptation makes it difficult for CHC-nurses to define those children who are overweight. Conclusion: CHC-nurses provide a comprehensive and complex picture of childhood overweight, which includes several difficulties dealing with this issue. Attention to CHC-nurse's conceptions of overweight in children is important since it can affect the parent-nurse relationship and thereby the nurse's, as well as the parent's efforts to influence the children's weight. It is suggested that CHC nurses should work with person centered counseling and empowerment concerning parent to child relations in cases involving overweight.
  •  
35.
  • Isma, Gabriella E, et al. (author)
  • Obstacles to the prevention of overweight and obesity in the context of child health care in Sweden
  • 2013
  • In: BMC Family Practice. - : BioMed Central. - 1471-2296. ; :14
  • Journal article (peer-reviewed)abstract
    • Overweight and obesity in younger children could better be brought in focus through a deeper understanding of how Child Health Care nurses (CHC-nurses) perceive their work with the problems of overweight at the CHC Centers. The aim of this study was to elucidate the CHC-nurses conceptions of their preventive work with childhood overweight and obesity in Child Health Care. A qualitative study, based on open-ended interviews, involving 18 CHC-nurses strategically selected from 17 CHC Centres in the southern part of Sweden using a phenomenographic approach. Two categories of description emerged from the data: (i) Internal obstacles to the CHC- nurses' work with overweight in children and (ii) External obstacles to the management of overweight in children. The CHC-nurses conceived their work with overweight in Child Health Care to be complicated and constrained by several obstacles depending on the nurses' personal priorities, knowledge, responsibility and the absence of resources and cooperation, as well as the lack of uniform guidelines for preventing and managing childhood overweight and further a deficient management organisation. Nurses' attention to monitoring overweight in children, and their initiative for prevention, is based on their conceptions of the obstacles that hinder them in their efforts. An increased awareness of the CHC-nurses conceptions of the priorities, their sense of responsibility and prevention practices is warranted. If measures in this direction are not taken there is a growing risk that overweight children will pass through the CHC without any formal recognition of their situation. There is an indication that the present level of the CHC-nurses' preventive work with childhood overweight has room for improvement in several areas. It is suggested that the specialist education of these health care professionals should be supplemented and that organisation of the management of childhood overweight should be also revised at the primary health care level.
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36.
  • Isma, Gabriella E, et al. (author)
  • Swedish Child Health Care nurses conceptions of overweight in children : a qualitative study
  • 2012
  • In: BMC Family Practice. - : BioMed Central. - 1471-2296. ; 13:57
  • Journal article (peer-reviewed)abstract
    • Abstract Background: Registered Sick Children’s Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives childhood obesity. The aim of this study was to elucidate the conceptions of childhood overweight, including obesity, among nurses working in Child Health Care. Method: A qualitative study using a phenomenographic approach, based on open-ended interviews with 18 Child Health Care nurses (CHC-nurses) strategically selected from 17 Child Health Care Centres in the southern part of Sweden. Results: Four categories of description emerged from the data: Perception of childhood overweight changes, Overweight in younger children a neglected concern, Overweight a delicate issue and Importance of family lifestyle. The participating CHC-nurses conceived overweight in children, primarily obesity in children to be an extensive and serious problem which affects children, families and the surrounding society. Overweight in children was further perceived as a consequence of their parent’s lifestyle and their awareness of the problem, which was considered by the CHC-nurses as a sensitive and a provoking issue. It was also perceived that overweight in children is not taken seriously during the pre-school period and that concerns regarding overweight in younger children were mainly about the appearance and not the health of the child. The CHC-nurses perceived that the proportion of overweight children has increased, which Swedish society and the CHC-nurses have adapted to. This adaptation makes it difficult for CHC-nurses to define those children who are overweight. Conclusion: CHC-nurses provide a comprehensive and complex picture of childhood overweight, which includes several difficulties dealing with this issue. Attention to CHC-nurse’s conceptions of overweight in children is important since it can affect the parent-nurse relationship and thereby the nurse’s, as well as the parent’s efforts to influence the children’s weight. It is suggested that CHC- nurses should work with person centered counseling and empowerment concerning parent to child relations in cases involving overweight. Keywords: Child, Conceptions, Nurses, Overweight, Perceptions, Primary health care, Qualitative research
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37.
  • Landgren, Kajsa, et al. (author)
  • Skrikiga och oroliga spädbarn
  • 2013. - 1
  • In: Hälsofrämjande arbete för barn och ungdomar. - 9789144077628 ; , s. 119-136
  • Book chapter (pop. science, debate, etc.)
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38.
  • Lundström, Mats, et al. (author)
  • Collaboration Between Teachers and School Nurses Concerning Sex Education in Upper Primary School
  • 2019
  • Conference paper (other academic/artistic)abstract
    • This proposal reports from a pilot study where primary teachers and school nurses were interviewed concerning their collaboration in sex education. These primary teachers and school nurses do not traditionally collaborate around sex education in Swedish schools. Albeit different projects where collaboration between them has been encouraged, earlier research demonstrates problems between the two groups of professionals to act jointly. The new Swedish school law from 2011 prompts such collaboration and asks for school health teams increased participation in sex education in compulsory school. In this pilot study, five primary teachers and five school nurses were interviewed about their collaboration. The purpose of the pilot study was to describe and analyse the teachers and school nurses’ experiences and perspectives of their collaboration concerning sex education among pupils aged 10-12 years. The interviews were analysed with thematic analysis. One overall theme emerged; The classroom is the teacher’s arena, and three sub themes; A collaboration needs two parts; Attitudes is a barrier and Organisation as a facilitator, were found. The results indicate a prevailing distance between the two groups. The nurses claim that the classroom is the teacher’s arena, an arena which is difficult for nurses to enter. The collaboration is usually initiated by teachers not nurses. The teachers assert that the school nurses are professional resources in school and experts on different health issues, such as menstruation. While the school nurses regard the head master as important for how sex education is facilitated and implemented in school, the teachers claim to manage sex education without the head master’s influence. The results indicate that the new school law where school health team is involved in the science education has not been implemented at the schools in the present study.
  •  
39.
  • Lundström, Mats, et al. (author)
  • Teachers’ and school nurses’ collaboration concerning HPV vaccination and sex education
  • 2018
  • Conference paper (other academic/artistic)abstract
    • Since 2010, vaccination against human papilloma virus (HPV) has been offered free of charge for all girls in Sweden. The school nurse administer the vaccination when the girls are 10-12 years old. The transmission of HPV is primarily connected to an active sex life, something that normally not has started in this age. Therefore, it is interesting to investigate if, and how the introduction of HPV-vaccination has influenced sex education in school. We have in a pilot study individually interviewed 5 primary teachers and 5 school nurses concerning infor-mation about the vaccination, sex education and their cooperation. The results demonstrate how the teach-ers see themselves mainly as distributor and collector of information and agreement documents about the vaccination. The vaccination information has not been integrated into sex education. Some of the teachers act as support when the pupils have questions connected to the vaccination. The school nurses described that they perform information about puberty, sexual life and HPV vaccination in groups of girls only, but also in the whole class. They experienced that there were limited cooperation between the teachers and themselves although they expressed that they wanted to collaborate. Most nurs-es felt that they were waiting for “an invitation” from the teachers to visit the classroom. One interviewee described how the principal of the school did not allow the school nurse and the teacher to share groups since the head master did not want to risk that the parents would not approve related to religion. The nurs-es did not have full insight concerning the teachers’ lectures but they had a feeling that the teachers fo-cused on biology and the nurses handled practical things like menstruation and also discussed psychologi-cal issues with the pupils. During the presentation we will present the results, but also some possible explanations to and implications of our results.
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40.
  • Mangrio, Elisabeth, et al. (author)
  • Antibiotic use among 8-month-old children in Malmö, Sweden--in relation to child characteristics and parental sociodemographic, psychosocial and lifestyle factors.
  • 2009
  • In: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 9:May 8
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: In the county of Scania, Sweden, antibiotic use among small children is among the highest in the country. The aim of this study was to investigate the associations between antibiotic use among 8-month-old children in Malmö and characteristics of the child as well as parental sociodemographic characteristics, lifestyle factors, and psychosocial support. METHODS: The study was a population-based cross-sectional survey. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmö for their 8-month health checkup during 2003-2006 and whose parents answered a self-administered questionnaire (n = 7266 children). The questionnaire was distributed to parents of children registered with the CHC and invited for an 8-month checkup during the study period. RESULTS: The odds of using antibiotics increased as parental educational level decreased. Using high educational level as a reference group, low maternal educational level was associated with an increased antibiotic use for the child, odds ratio (OR) = 1.61 (95% CI: 1.34-1.93). Furthermore, children whose parents were born outside Sweden showed higher antibiotic use, OR = 1.43 (95% CI: 1.24-1.65), in comparison with children whose parents were born in Sweden. Exposure to environmental smoking, parental experience of economic stress, and a low level of emotional support increased the odds for antibiotic use. Boys had higher odds of use of antibiotics than girls, OR = 1.40 (95% CI: 1.25-1.57). Having a low birth weight, having an allergy and having siblings also increased the odds for early antibiotic use, while breastfeeding seemed to have a protective role. CONCLUSION: There were clear associations between parental factors such as sociodemographic, psychosocial and lifestyle factors and antibiotic use at this early stage of life. Several characteristics of the child also affected the use of antibiotics.
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41.
  • Mangrio, Elisabeth, et al. (author)
  • Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months : a systematic review
  • 2018
  • In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 32:2, s. 451-465
  • Journal article (peer-reviewed)abstract
    • Bakgrund: WHO rekommenderar exklusiv amning som enda näring under spädbarnets första sex månader. Trots denna rekommendation, ammar inte alla kvinnor, varken helt eller delvis under denna period. Syfte: Syftet med denna systematiska litteraturstudie var att sammanställa evidens gällande sociodemografiska, fysiska, psykiska och sociala faktorers påverkan på att ammande mammor slutar att amma innan barnet är 6 månader. Sökmetod: En systematisk sökning utfördes i fyra olika databaser. Inkluderingskriterier: Studier med kvantitativ forskning inkluderades. Data kollektion och analys: Totalt lästes 186 abstrakt och utav dessa ansågs 83 vara relevanta och 18 var dubbletter. Slutligen inkluderades 27 artiklar eftersom de svarade mot syftet. Kvalitetsgranskning utfördes med hjälp av en granskningsmall från SBU och evidensgradering utfördes med hjälp utav GRADE. Resultat: Det visade sig finnas ett samband mellan avslut av amning och unga mammor, låg utbildningsnivå, återgång till arbetet inom 12 veckor efter barnets födsel, kejsarsnitt och otillräcklig mjölkproduktion och detta samband hade låg evidens. Sambandet mellan depression hos mamman och avslut av amning hade mycket låg evidens. Slutsats: Sociodemografiska faktorer verkade ha samband med avslut av amning i flertalet av dem inkluderade artiklarna. Det preventiva arbetet borde fokusera på hur kunskapen hos hälso-sjukvårdspersonal kan förbättras och hur riktade interventioner kan fokusera på mammor som riskerar att avsluta sin amning innan 6 månader Nyckelord: amning, litteraturstudie, riskfaktorer, avslut av amning
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42.
  • Mathias, Edlin Glane, et al. (author)
  • Effect of Distraction Interventions on Anxiety in Children Undergoing Surgery : A Meta-Analysis
  • 2023
  • In: Journal of Health and Allied Sciences. - : Thieme Medical Publishers. - 2582-4287 .- 2582-4953. ; 13:03, s. 323-331
  • Journal article (peer-reviewed)abstract
    • Due to the unfamiliarity of the surroundings, children having surgery endure worry and tension. Untreated anxiety in children impairs postoperative healing and causes changes in postoperative behavior. The purpose of this review was to determine the efficacy of distraction therapies on anxiety in children undergoing surgery. The systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. PubMed via MEDLINE, CINAHL, ProQuest, Web of Science, and the Cochrane Central Register of Controlled Trials were used to find relevant trials. Full-text papers published in English from January 1, 2000 to December 31, 2021 were included. Children undergoing surgery aged 1 to 18 years were included. A data extraction form was created to extract data from the selected studies. According to the Cochrane risk of bias assessment tool, studies were classified as "low risk, " "high risk, " or "unclear risk. " Review Manager software was used to do a quantitative meta-analysis. Thirteen studies looked at the effect of distraction intervention on children. Nine of them were selected for meta-analysis. The distraction interventions included in this review were: handheld video game, play dough and play with blocks and puzzles, tablet-based interactive distraction, animated video, painting and storytelling, age-appropriate video, distraction with video glasses, watching a movie, and bringing favorite toy during hospital stay. Meta-analysis showed that distraction interventions are effective on preoperative anxiety in children (standardized mean difference = -17.07, 95% confidence interval: 27.11-7.02, p = 0.0009).
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43.
  • Mathias, Edlin Glane, et al. (author)
  • Mothers’ satisfaction with distraction as a postoperative pain management intervention for their child : An interventional study
  • 2022
  • In: Journal of Perioperative Nursing. - : Australian College of Perioperative Nurses (ACORN). - 2209-1092. ; 35:4
  • Journal article (peer-reviewed)abstract
    • Aim: This study aimed to investigate mothers’ levels of satisfaction with distraction as a post-operative pain management intervention for their child.Background: Although the number of studies on paediatric pain management has increased over time, research into non-pharmacological post-operative pain management remains inadequate, indicating that more research is required.Design: A posttest-only control group design was adopted to measure mothers’ levels of satisfaction with distraction as a non-pharmacological post-operative pain management intervention for their child.Methods: The study included 160 mothers and their children undergoing elective surgery in a paediatric surgical unit. Mothers and children were randomly allocated to intervention and control groups (80 intervention, 80 control). The children in the intervention group received age-appropriate distraction interventions for three post-operative days along with the usual care. Children in the control group received only usual care. Data on parental satisfaction with pain management interventions was assessed on the day of discharge using a parental satisfaction questionnaire.Results: In the intervention group 48 mothers (60%) were ‘very satisfied’ and 22 mothers (40%) were ‘moderately satisfied’ with pain management interventions for their child. In the control group 27 mothers (34%) were ‘very satisfied’ and 53 (66%) were ‘moderately satisfied. The mean and standard deviation of mother’s satisfaction in the intervention group and control group was 42 ±5.23 and 34 ± 6.64 respectively. The present study identified that there was a significant difference in the level of mother’s satisfaction between the intervention and control groups (p<.05).Conclusion: The level of satisfaction with pain management intervention for their child was higher for mothers in the intervention group that the control group. The distraction intervention provided for the children during the postoperative period improved the mothers’ satisfaction level.
  •  
44.
  • Mathias, Edlin Glane, et al. (author)
  • Non-pharmacological interventions to reduce anxiety among children undergoing surgery : A systematic review
  • 2023
  • In: Journal of Child Health Care. - : Sage Publications. - 1367-4935 .- 1741-2889. ; 27:3, s. 466-487
  • Research review (peer-reviewed)abstract
    • A hospitalized child experiences anxiety more frequently as compared to non-hospitalized children. Surgery can be emotionally distressing for children, and subsequently their parents and caregivers, this distress can cause profound adverse impacts on children. We aimed to identify the effect of non-pharmacological interventions on children’s (1–18 years) anxiety undergoing surgery. The following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Proquest, Web" of Science, and Cochrane Central Register of Controlled Trials were systematically searched for full-text articles. The review included 15 randomized controlled trials. The risk of bias was assessed using Cochrane Risk of Bias tool. The interventions included in the study were preoperative education, puppet play, therapeutic play, distraction activities, parental presence, and clown therapy. The review presents a narrative reporting of the findings. This review identifies that non-pharmacological interventions are effective in reducing anxiety among children undergoing surgery. There are a limited number of studies from developing countries. Further research is required to underpin the use of these interventions with children before surgery. 
  •  
45.
  • Nilsson, Ulrica, 1960-, et al. (author)
  • Psychometric evaluation of the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery and postoperative behavior and recovery inchildren undergoing tonsil surgery
  • 2019
  • In: Journal of Perioperative Practice. - : Harrogate : Association for Perioperative Practice. - 1750-4589 .- 2515-7949. ; 29:4, s. 94-101
  • Journal article (peer-reviewed)abstract
    • The study comprised a prospective, comparative cross-sectional survey in 143 (of 390) children undergoing tonsil surgery. Parents answered the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS), and children answered the questionnaire Postoperative Recovery in Children (PRiC). The PHBQ-AS had positive correlation with the PRiC and with general health. On day 10 after surgery, up to one-third of the children still reported physical symptoms (PRiC). No gender or age differences concerning the items of behavior (PHBQ-AS) were found. The quality of postoperative recovery (PRiC) in girls was lower, with higher levels of nausea, dizziness, coldness, and headache compared to the boys. Children <6 years of age reported higher levels of dizziness and lower sleep quality and lower general health.
  •  
46.
  • Nylén, Sofie, et al. (author)
  • PATIENTERS UPPLEVELSER OCH ERFARENHETER AV FÖRÄNDRAD LIVSSITUATION EFTER EN BEN ELLER NEDRE EXTREMITETS AMPUTATION
  • 2013
  • Reports (other academic/artistic)abstract
    • Syfte. Denna litteraturstudie belyser patienter med diabetes mellitus och/eller perifer vaskulär sjukdom upplevelser och erfarenheter av förändrad livssituation efter en ben eller nedre extremitets amputation. Bakgrund. Att leva med kroniska sjukdomar som perifer kärlsjuka och/eller diabetes kan innebära stora påfrestningar i det dagliga livet med bland annat smärta, sömnsvårigheter, problem med svårläkta sår och rädsla för amputation. Att amputeras kan leda till chock och sorg postoperativt. Den mentala förberedelsen preoperativt är betydelsefull för patientens upplevelse postoperativt. Patienten behöver stöd och uppmuntran från sjukvårdspersonal och anhöriga för ökat välbefinnande och för ökad självständighet i den postoperativa fasen. Metod. För att besvara studiens frågeställning gjordes en systematisk litteraturstudie vilken bygger på granskning och sammanställning av kvalitativa studier. Tre artiklar bedömdes relevanta för studiens syfte. En studie bedömdes vara av hög kvalitet och två studier av medelhög kvalitet. Två av studierna utfördes i västerländsk och en i asiatisk kontext. Författaren använde SBU:s handbok som hjälpmedel i urvalsprocessen av litteratur. Resultat. Efter sammanställning av de tre studierna identifierades två övergripande tredje nivåns teman: Lidande och att återvinna hopp. Slutsats. Det föreligger vetenskapligt stöd för att en ben eller nedre extremitets amputation förändrar patientens livsituation. Detta kan leda till lidande inom olika dimensioner. I denna studie identifierades känslomässigt, psykosocialt och fysiskt lidande. Det föreligger även vetenskapligt stöd för att patienterna med tiden kan utveckla viss acceptans och anpassning till sin nya situation. Stöd från anhöriga och vänner är viktigt för motivationen att orka kämpa och återvinna hopp om framtiden. Liknande upplevelser/erfarenheter identifierades trots olika kulturella bakgrunder.
  •  
47.
  • Olofsson, Jonas, et al. (author)
  • Older migrants' experience of existential loneliness
  • 2021
  • In: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 28:7-8, s. 1183-1193
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: With rapidly ageing population worldwide, loneliness among older adults is becoming a global issue. Older migrants are considered being a vulnerable population and ethical issues are often raised in care for elderly. A deeper sense of loneliness, existential loneliness is one aspect of loneliness also described as the ultimate loneliness. Making oneself understood or expressing emotions, have shown to be particularly challenging for older migrants which could lead to experience of existential loneliness. Ageing and being a migrant are potential triggers for experiencing existential loneliness. There appears to be, however, little known about being a migrant experiencing existential loneliness in old age.AIM: This study explored older migrants' experience of existential loneliness.RESEARCH DESIGN: Qualitative study.PARTICIPANTS AND RESEARCH CONTEXT: Data were collected through interviews (n = 15) with older (>65) migrants' in Swedish nursing homes or senior citizen centres. A thematic analysis was performed to analyse the data.ETHICAL CONSIDERATIONS: The study was conducted in accordance with the principles of research ethics.FINDINGS: The result was described in terms of three themes: (1) Choices made in life, (2) seeking reconciliation with life and (3) thoughts about death and dying in a foreign country.DISCUSSION: Ethical reflection and knowledge about how older migrants' life story can lead to experiencing existential loneliness, could be of use in care for older migrants'.CONCLUSION: This study indicates that the experience of existential loneliness derived from being a migrant is a long-term and significant process. Migration was a hope of creating a meaningful life, the experience of existential loneliness occurred as migrants sought reconciliation with life, reflected upon their past choices, and thought about death and dying in a foreign country.
  •  
48.
  •  
49.
  • Vejzovic, Vedrana, et al. (author)
  • A private affair : children’s experiences prior to colonoscopy
  • 2015
  • In: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 24:7-8, s. 1038-1047
  • Journal article (peer-reviewed)abstract
    • Aims and objectives. To illuminate children’s experiences prior to colonoscopy. Background. It is well known that children need to be well prepared before undergoing stressful medical procedures, and the goal of such preparations should focus on minimising their level of anxiety. The clinical investigation of children with suspected inflammatory bowel disease involves several steps, with colonoscopy being routinely used to investigate the colon and the lower part of the small intestine. To minimise children’s anxiety during various medical procedures, it is important that information about their experiences is obtained directly from the children themselves. Design. A qualitative study. Method. The study was designed as a qualitative interview study involving 17 children aged 10–17 years undergoing colonoscopy at a children’s university hospital in Sweden. Verbatim transcripts were analysed using content analysis. Results. The children’s experiences prior to colonoscopy were identified as belonging to an overall theme, a private affair, and to four categories: preparing yourself, mastering the situation, reluctantly participating and feeling emotional support. Conclusion. This study shows that children’s experiences prior to colonoscopy are a private affair and that the preparation needs to be individually adapted for the ‘preprocedural’ preparation to be comprehended. Relevance to clinical practice. The children’s experiences ascertained in this study can contribute to a greater understanding of children’s needs prior to a colonoscopy and may provide professional care staff with the basis for future nursing assessments.
  •  
50.
  • Vejzovic, Vedrana, et al. (author)
  • Children still experience pain during hospital stay : a cross-sectional study from four countries in Europe
  • 2020
  • In: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 20:1
  • Journal article (peer-reviewed)abstract
    • Background Little is known whether children experience pain during hospital stay from the child's own perspective or not. The existing studies tend to be based on a small number of children and therefore have limitations concerning the generalisability of the results. Aim The aim of this study was to describe children's self-reported pain and experience concerning pain management during hospital stay. Methods This study has a quantitative cross-sectional design with descriptive statistics as data analysis. Results A total of 786 questionnaires, Pain in Children in Hospital, were distributed in four countries with the response rate of 75% which was almost equal between countries. Our result showed that 87% (503/579) children at hospital self-reported pain during the past 24 h. Nearly 63% of the children reported a pain score of > 5 the last 24 h. Most of children reported that they had received a question about pain from the hospital staff, and that the staff observed and assessed their pain. Totally 95% reported that they were satisfied with their pain relief during the last 24 h. Conclusion Our study showed that when children were given the possibility to self-report pain, nearly 2/3 expressed that they had experienced pain during hospital stay. However, most of them reported satisfaction with pain management and their pain relief.
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