| 1. |
- Backteman-Erlanson, Susann, 1958-, et al.
(författare)
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Exploration of the WOCQ tool in relation to gender and psychometric properties among Swedish patrolling police officers
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Police work is a stressful occupation with frequent exposure to traumatic events. In Sweden knowledge about coping strategies among police personnel is absent probably due to lack of validated measurements. Aim of this study was to explore psychometric properties of the Ways of Coping Questionnaire (WOCQ) among Swedish police personnel, including testing differential item functioning (DIF) for gender. The WOCQ was sent out to 1554 randomly selected patrolling police officers in Sweden. Exploratory factor analysis and confirmatory factor analysis were used. A six factor solution was confirmed with differences and similarities compared to the original eight factor solution. DIF analysis showed similarities and differences in relation to gender. We suggest that the WOCQ can be used when investigating coping strategies in a Swedish police context.
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| 2. |
- Hellström Ängerud, Karin, 1967-, et al.
(författare)
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Longer pre-hospital delay in first myocardial infarction among patients with diabetes : an analysis of 4266 patients in the Northern Sweden MONICA Study
- 2013
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Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reperfusion therapy reduces both morbidity and mortality in myocardial infarction, but the effectiveness depends on how fast the patient receives treatment. Despite the time-dependent effectiveness of reperfusion therapy, many patients with myocardial infarction have delays in seeking medical care. The aim of this study was to describe pre-hospital delay in a first myocardial infarction among men and women with and without diabetes and to describe the association between pre-hospital delay time and diabetes, sex, age, symptoms and size of residential area as a proxy for distance to hospital.Methods: This population based study was based on data from 4266 people aged 25-74 years, with a first myocardial infarction registered in the Northern Sweden MONICA myocardial infarction registry between 2000 and 2008.Results: The proportion of patients with delay times >= 2 h was 64% for patients with diabetes and 58% for patients without diabetes. There was no difference in delay time >= 2 h between men and women with diabetes. Diabetes, older age and living in a town or rural areas were factors associated with pre-hospital delay times >= 2 h. Atypical symptoms were not a predictor for pre-hospital delay times >= 2 h, OR 0.59 (0.47; 0.75).Conclusions: A higher proportion of patients with diabetes have longer pre-hospital delay in myocardial infarction than patients without diabetes. There are no differences in pre-hospital delay between men and women with diabetes. The largest risk difference for pre-hospital delay >= 2 h is between women with and without diabetes. Diabetes, older age and living in a town or rural area are predictors for pre-hospital delay >= 2 h.
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| 3. |
- Hellström Ängerud, Karin, 1967-, et al.
(författare)
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Patients with diabetes are not more likely to have atypical symptoms when seeking care of a first myocardial infarction : an analysis of 4028 patients in the Northern Sweden MONICA Study
- 2012
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Ingår i: Diabetic Medicine. - : John Wiley & Sons. - 0742-3071 .- 1464-5491. ; 29:7, s. e82-e87
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe symptoms of a first myocardial infarction in men and women with and without diabetes.Methods: We conducted a population-based study of 4028 people aged 25-74 years, with first myocardial infarction registered in the Northern Sweden Multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) myocardial infarction registry between 2000 and 2006. Symptoms were classified as typical or atypical according to the World Health Organization MONICA manual.Results: Among patients with diabetes, 90.1% reported typical symptoms of myocardial infarction; the corresponding proportion among patients without diabetes was 91.5%. In the diabetes group, 88.8% of women and 90.8% of men had typical symptoms of myocardial infarction. No differences were found in symptoms of myocardial infarction between women with and without diabetes or between men with and without diabetes. Atypical symptoms were more prevalent in the older age groups (> 65 years) than in the younger age groups (< 65 years). The increases were approximately equal among men and women, with and without diabetes. Diabetes was not an independent predictor for having atypical symptoms of myocardial infarction.Conclusions: Typical symptoms of myocardial infarction were equally prevalent in patients with and without diabetes and there were no sex differences in symptoms among persons with diabetes. Diabetes was not a predictor of atypical symptoms.© 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.
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| 4. |
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| 5. |
- Hellström Ängerud, Karin, 1967-, et al.
(författare)
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The Process of Care-seeking for Myocardial Infarction Among Patients With Diabetes
- 2015
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Ingår i: Journal of Cardiovascular Nursing. - : Wolters Kluwer. - 0889-4655 .- 1550-5049. ; 30:5, s. E1-E8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: People with diabetes have a higher risk for myocardial infarction (MI) than do people without diabetes. It is extremely important that patients with MI seek medical care as soon as possible after symptom onset because the shorter the time from symptom onset to treatment, the better the prognosis.OBJECTIVE: The aim of this study was to explore how people with diabetes experience the onset of MI and how they decide to seek care.METHODS: We interviewed 15 patients with diabetes, 7 men and 8 women, seeking care for MI. They were interviewed 1 to 5 days after their admission to hospital. Five of the participants had had a previous MI; 5 were being treated with insulin; 5, with a combination of insulin and oral antidiabetic agents; and 5, with oral agents only. Data were analyzed according to grounded theory.RESULTS: The core category that emerged, "becoming ready to act," incorporated the related categories of perceiving symptoms, becoming aware of illness, feeling endangered, and acting on illness experience. Our results suggest that responses in each of the categories affect the care-seeking process and could be barriers or facilitators in timely care-seeking. Many participants did not see themselves as susceptible to MI and MI was not expressed as a complication of diabetes.CONCLUSIONS: Patients with diabetes engaged in a complex care-seeking process, including several delaying barriers, when they experienced symptoms of an MI. Education for patients with diabetes should include discussions about their increased risk of MI, the range of individual variation in symptoms and onset of MI, and the best course of action when possible symptoms of MI occur.
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| 6. |
- Härgestam, Maria, 1963-, et al.
(författare)
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Communication in interdisciplinary teams : Exploring closed-loop communication during in situ trauma team training
- 2013
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 3:10
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Investigate the use of call-out (CO) and closed-loop communication (CLC) during a simulated emergency situation, and its relation to profession, age, gender, ethnicity, years in profession, educational experience, work experience and leadership style.Design: Exploratory study.Setting: In situ simulator-based interdisciplinary team training using trauma cases at an emergency department.Participants: The result was based on 16 trauma teams with a total of 96 participants. Each team consisted of two physicians, two registered nurses and two enrolled nurses, identical to a standard trauma team.Results: The results in this study showed that the use of CO and CLC in trauma teams was limited, with an average of 20 CO and 2.8 CLC/team. Previous participation in trauma team training did not increase the frequency of use of CLC while ≥2 structured trauma courses correlated with increased use of CLC (risk ratio (RR) 3.17, CI 1.22 to 8.24). All professions in the trauma team were observed to initiate and terminate CLC (except for the enrolled nurse from the operation theatre). The frequency of team members’ use of CLC increased significantly with an egalitarian leadership style (RR 1.14, CI 1.04 to 1.26).Conclusions: This study showed that despite focus on the importance of communication in terms of CO and CLC, the difficulty in achieving safe and reliable verbal communication within the interdisciplinary team remained. This finding indicates the need for validated training models combined with further implementation studies.
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| 7. |
- Härgestam, Maria, 1963-, et al.
(författare)
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Trauma team leaders' non-verbal communication : video registration during trauma team training
- 2016
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central. - 1757-7241. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training.METHODS: Eighteen trauma teams were audio and video recorded during trauma team training in the emergency department of a hospital in northern Sweden. Quantitative content analysis was used to categorize the team members' positions and the leaders' non-verbal communication: gaze direction, vocal nuances, and gestures. The quantitative data were interpreted in relation to the specific context. Time sequences of the leaders' gaze direction, speech time, and gestures were identified separately and registered as time (seconds) and proportions (%) of the total training time.RESULTS: The team leaders who gained control over the most important area in the emergency room, the "inner circle", positioned themselves as heads over the team, using gaze direction, gestures, vocal nuances, and verbal commands that solidified their verbal message. Changes in position required both attention and collaboration. Leaders who spoke in a hesitant voice, or were silent, expressed ambiguity in their non-verbal communication: and other team members took over the leader's tasks.DISCUSSION:In teams where the leader had control over the inner circle, the members seemed to have an awareness of each other's roles and tasks, knowing when in time and where in space these tasks needed to be executed. Deviations in the leaders' communication increased the ambiguity in the communication, which had consequences for the teamwork. Communication cannot be taken for granted; it needs to be practiced regularly just as technical skills need to be trained. Simulation training provides healthcare professionals the opportunity to put both verbal and non-verbal communication in focus, in order to improve patient safety.CONCLUSIONS: Non-verbal communication plays a decisive role in the interaction between the trauma team members, and so both verbal and non-verbal communication should be in focus in trauma team training. This is even more important for inexperienced leaders, since vague non-verbal communication reinforces ambiguity and can lead to errors.
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| 8. |
- Jacobsson, Maritha, 1960-, et al.
(författare)
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Flexible knowledge repertoires : Communication by leaders in trauma teams
- 2012
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central. - 1757-7241. ; 20:1, s. 44-
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Tidskriftsartikel (refereegranskat)abstract
- Background: In emergency situations, it is important for the trauma team to efficiently communicate their observations and assessments. One common communication strategy is “closed-loop communication”, which can be described as a transmission model in which feedback is of great importance. The role of the leader is to create a shared goal in order to achieve consensus in the work for the safety of the patient. The purpose of this study was to analyze how formal leaders communicate knowledge, create consensus, and position themselves in relation to others in the team.Methods: Sixteen trauma teams were audio- and video-recorded during high fidelity training in an emergency department. Each team consisted of six members: one surgeon or emergency physician (the designated team leader), one anaesthesiologist, one nurse anaesthetist, one enrolled nurse from the theatre ward, one registered nurse and one enrolled nurse from the emergency department (ED). The communication was transcribed and analyzed, inspired by discourse psychology and Strauss’ concept of “negotiated order”. The data were organized and coded in NVivo 9.Results: The findings suggest that leaders use coercive, educational, discussing and negotiating strategies to work things through. The leaders in this study used different repertoires to convey their knowledge to the team, in order to create a common goal of the priorities of the work. Changes in repertoires were dependent on the urgency of the situation and the interaction between team members. When using these repertoires, the leaders positioned themselves in different ways, either on an authoritarian or a more egalitarian level.Conclusion: This study indicates that communication in trauma teams is complex and consists of more than just transferring messages quickly. It also concerns what the leaders express, and even more importantly, how they speak to and involve other team members.
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| 9. |
- Padyab, Mojgan, 1976-, et al.
(författare)
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Burnout, coping, stress of conscience and psychosocial work environment among patrolling police officers
- 2016
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Ingår i: Journal of Police and Criminal Psychology. - : Springer. - 0882-0783 .- 1936-6469. ; 31:4, s. 229-237
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Tidskriftsartikel (refereegranskat)abstract
- Police personnel work under different circumstances in various environments involving stressful situations which can increase the risk of burnout. Aim of this study was to investigate the association between burnout (emotional exhaustion, EE vs. depersonalization, DP) and psychosocial work environment, stress of conscience as well as coping strategies among patrolling police officers in Sweden. Most of the independent variables; psychological demand, decision latitude, social support, and coping scales were correlated with EE and DP. A hierarchical multiple regression was performed to investigate the predictive impact of; psychological demand, decision latitude, social support, coping strategies and stress of conscience. Findings revealed that risk of EE increased with a troubled conscience for both women and men when coping strategies were added to the model. For men risk of DP increased with troubled conscience. Only low decision latitude was associated with risk of DP for women when coping strategies were added to the model. Results from this study indicate that stress of conscience has to be taken into consideration and also levels of social support and decision latitude when studying the influence of the psychosocial work environment on burnout.
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| 10. |
- Sävenstedt, Stefan, et al.
(författare)
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Establishing joint attention in remote talks with the elderly about health : a study of nurses' conversation with elderly persons in teleconsultations
- 2005
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 19:4, s. 317-24
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Tidskriftsartikel (refereegranskat)abstract
- This study is a contribution to the sparsely studied field of nurses' teleconsultations with frail elderly people. The aim was to describe how talk and interaction are accomplished and by what means problems are handled that emerge from the fact that the communication is conducted via videoconferencing techniques. Recordings were made of 22 sessions of teleconsultation between nurses and elderly nursing home residents aided by enrolled nurses. The data were analysed with a qualitative method inspired by conversation and discourse analysis. The findings indicate that in order to create a joint attention the participants often had to verbally confirm and reconfirm that contact had been established. The triad of participants played a special part in maintaining the joint attention through compensating for the contextual aspect of the medium's limitations and the demented elderly person's communication problems. 'Talks about the communication' and passages of social talk took place when the nurse or the staff member wanted to re-establish and maintain joint attention. The joint attention seemed connected to a special sort of eye contact and gaze and to the type of camera projection that was used. One conclusion was that to create joint attention in nurses' teleconsultations with frail elderly people, the limitations in transferring communication cues and the limitations of what the camera can reveal of the general context could, to some extent, be made up for by verbal communication within the triad of participants. Another conclusion was that these limitations in the context of interaction in some situations also seemed to be an advantage for the demented elderly and contributed to increased attention
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