| 1. |
- Beausang, Angela, et al.
(författare)
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"Möjligheten att rädda några av dessa kvinnors liv har inte vägts in"
- 2014
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Ingår i: Dagens Medicin. - : Dagens Medicin.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Namnet på Socialstyrelsens vägledning lyder: Hur upptäcka våldsutsatthet? Ja, det kan man verkligen fråga sig efter att ha läst detta föga vägledande dokument, skriver ett stort antal kritiska debattörer.
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| 2. |
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| 3. |
- Anderzen-Carlsson, Agneta, 1966-, et al.
(författare)
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CHILDREN'S NARRATIVES OF SUPPORT FROM PARENTS WHEN EXPERIENCING FEAR RELATED TO ACUTE LYMPHOBLASTIC LEUKEMIA
- 2022
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 69:Suppl. 5, s. S528-S528
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aims: Children diagnosed with Acute Lymphoblastic Leukemia (ALL) typically undergo intense treatment with frequent hospitalizations. Medical, as well as existential fears have been identified. It has also been found that children's coping strategies develop during their illness trajectory. The literature on what children with ALL find to be valuable support from parents when experiencing fear is sparse. Thus, the aim of this presentation is to describe what young children find to be important support from their parents when experiencing fear related to ALL.Methods: The study had a longitudinal descriptive qualitative design. Thirteen children (3 girls and 10 boys), initially 5-9 years old were interviewed once to three times during their treatment period (approximately 2 months after the diagnosis, after 1 year, and at end of treatment). Data were analyzed using a matrix-based qualitative analysis method.Results: The parents’ physical and emotional closeness was the most frequently reported support. It eased the children's medical and existential fears. The children also found it supportive when the parents facilitated for them to participate in their care and when the parents acted as their advocate. Other supportive measures were offering distraction, talking to the child about their fears, assisting the professionals in alleviating pain and fear, being playful and encouraging. Five children also appreciated when their parents restricted them, during medical procedures. The experiences of support varied between children and between different time points during treatment.Conclusions: Although being quite young, the children were able to describe what they found to be supportive when experiencing fear, or for preventing fear. The parental support had an impact on the child's emotional, social and physical wellbeing. Professionals should encourage parents to stay with their child, and offer support to the parents, so that they in turn can support their child.
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| 4. |
- Anderzén Carlsson, Agneta, 1966-, et al.
(författare)
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Children’s Narratives of Support From Professionals when Experiencing Fear Related to Acute Lymphoblastic Leukemia
- 2020
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 67:S4, s. 120-120
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Tidskriftsartikel (refereegranskat)abstract
- Children diagnosed with Acute Lymphoblastic Leukemia (ALL) typically face 2.5 years treatment, which initially is intense and includes frequent hospitalizations. Previous research has identified various fears during treatment: fear of getting needles, removal of adhesive tapes, having a feeding tube, taking tablets and the physical changes related to ALL itself, as well as to treatments. The children’s coping strategies develop during the course of illness. The literature on what children with ALL find to be supportive when experiencing fear is sparse. The aim of this presentation is thus to describe what children 5-9 years old find to be important support from professionals when experiencing fear related to ALL.
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| 5. |
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| 6. |
- Anderzen Carlsson, Agneta, 1966-, et al.
(författare)
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Fear and coping during treatment for acute lymphatic leukemia : from the perspective of children 5-9 years old
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: The concept of fear can be defined as ”an unpleasant often strong emotion caused by expectation of danger”. It is reasonable to believe that fear and coping of fear, can vary during the course of treatment for ALL. The aim of the present study was to describe a longitudinal perspective on fear related to having ALL, based on children’s perspective, as well as to describe the strategies these children use when experiencing fear.Design: The study has a longitudinal descriptive qualitative design. Three girls and 10 boys, initially aged 5-9 were interviewed once to three times during their treatment period (approximately two months after the diagnosis, after one year and at the end of the 2.5-year long treatment). In total, 35 interviews were conducted. Data were analyzed using a matrix-based qualitative analysis method.Results: The children described fear of being subjected to needles and related to having a feeding tube, to remove adhesive tape and taking tablets, as well as fear related to the bodily changes caused by the ALL. Existential fears were most frequently mentioned at end of treatment. The children wanted to participate in their care. They used cognitive strategies, such as ”thinking the right way” and emotional strategies, such as crying out loud and kicking. The fears changed over time, but the fear of being subjected to needles remained for half of the children, but was less intense at the end of treatment. The strategies developed, and became more sophisticated over the treatment period.Conclusion: The fear changed throughout the course of treatment, and so did the strategies used. It is reasonable to believe that the need for support also vary, which is a topic for future research.
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| 7. |
- Anderzen-Carlsson, Agneta, 1966-, et al.
(författare)
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Qualitative matrix based analysis : a useful alternative for analyzing longitudinal data of children’s experiences
- 2020
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Konferensbidrag (refereegranskat)abstract
- Background: Previously, researchers have pointed out the importance of giving voice to children’s experiences of health care, as well to follow these experiences over time.Objective: To describe experiences of fear in 5-9 year-old children, related to having Acute Lymphoblastic Leukemia (ALL).Method: 3 girls and 10 boys participated in one to three interviews during their treatment period. The interviews were performed approximately two months after diagnosis, after one year and at the end of treatment (after 2.5 years). The data comprised 35 interviews in total, with an average length of 35 minutes. To capture the longitudinal perspective, a qualitative matrix methodology was adopted. First, individual matrices for each child was developed, where all narratives about their fears during the entire treatment period were inserted. Next, a cross-case matrix was developed, where all text from all the individual case-matrices were compiled for each time point. The general idea of the matrices was to visualize data, thus enabling the researchers to easier identify common patterns, between cases and over time. In this step, common fears experienced by the children were identified, and finally, summary cross-case matrices were created. These were used to summarize how many children who had experienced various fears at the three time points, during treatment.Results: Fear of needles was the most commonly reported fear. This fear was most prominent and most often reported at the start of treatment. For >50% of the children this fear remained at the end of treatment. Fear related to the physical changes caused by the ALL or treatment, on the other hand increased during the treatment period.Conclusion: The qualitative matrix based methodology was found to be useful when analyzing qualitative longitudinal interview-data from children with ALL. The analysis was quite manifest, which suited the data derived from young children.
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| 8. |
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| 9. |
- Andreasson, Ingela, 1953, et al.
(författare)
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Individual Educational Plans in Swedish schools - forming identity and governing function in pupils' documentation
- 2013
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Ingår i: International Journal of Special Education. - 0827-3383 .- 1917-7844. ; 28:3, s. 58-67
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Tidskriftsartikel (refereegranskat)abstract
- The documentation of pupils in Swedish schools is extensive and a documentation culture has come to characterize the schools in recent years. In the context of decentralization and changing governance, focus has increasingly been directed towards assessment, follow-up and evaluation of pupils’ learning and social development. This article examines the Individual Educational Plans (hereafter IEP) used for pupils with special educational needs in Swedish compulsory schools from the perspective of text analyses based on discourse theory. The aim of this study is to shed light on how pupils are constructed in the school’s documentation. The study examines how these IEPs are used as a pedagogical technique for new ways of governing in order to impose self-regulation, individual responsibility and social control.The documents, which comprise the empirical material in this article, are gathered from 14 different schools and consist of documents for a total of 136 pupils with special educational needs.
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| 10. |
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| 11. |
- Asplund Carlsson, Maj, 1948-, et al.
(författare)
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Bedömnings-, dokumentationspraktiker och pedagogiska identiteter
- 2015
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Ingår i: Educare. - 1653-1868 .- 2004-5190. ; 2015:2, s. 206-233
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Tidskriftsartikel (refereegranskat)abstract
- When competition and an increasing level of marketisation characterises school life, the number of evaluations and the level of control has grown out of proportion. Through comparisons, assessments and ranking systems, also called ‘the terrors of performativity’ according to Ball (2003) commercial agents have gained influence over practices of assessment and documentation within the education system. Increased demands on pupils’ and parents’ participation and a belief that written documentation will lead to better results has caused an extensive use of different web based tools like Unikum. With the point of departure in a collected material of more than a hundred Individual Educations Plans (IEP) where commercial web based tools have been used, we make an analysis with Basil Bernstein’s (1996, 2000) concepts Pedagogic Identity, and Instructional and Regulative discourse in relation to expectations and constructions manifest in the plans. The results show that all four identities are expressed in the plans however, with an emphasis on a neo-liberal identity. We discuss the results in relation to the instructional and regulative discourses. The conclusion is that the tools both shape and determine possible identities and possible discourses in the web based interaction between children, parents and teachers.
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| 12. |
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| 13. |
- Bratt, Ola, et al.
(författare)
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Undertreatment of Men in Their Seventies with High-risk Nonmetastatic Prostate Cancer
- 2015
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838 .- 1873-7560. ; 68:1, s. 53-58
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many elderly men with high-risk nonmetastatic prostate cancer (HRnMPCa) do not receive radical treatment, despite the high mortality associated with conservative management. Objective: To investigate how age and comorbidity affect treatment of men with HRnMPCa. Design, setting, and participants: This was an observational nationwide register study during 2001-2012. We identified 19 190 men of <80 yr of age diagnosed with HRnMPCa in the National Prostate Cancer Register of Sweden and 95 948 age-matched men without prostate cancer in the register of the total population. Outcome measurements and statistical analysis: The outcome was the proportion of men with HRnMPCa receiving radical treatment (radical prostatectomy or radiotherapy). Vital status and the Charlson comorbidity index (CCI) were obtained from nationwide registers. The 10-yr survival of men without prostate cancer, stratified by age and CCI, was used as a measure of the life expectancy of the men with prostate cancer. Results and limitations: The proportions receiving radical treatment varied with life expectancy among men younger than 70 yr, whereas use of these treatments did not match the long life expectancy of men in their seventies with CCI 0-1. Only 10% of men aged 75-80 yr with CCI 0 received radical treatment despite 52% probability of 10-yr life expectancy, compared with approximately half of the men younger than 70 yr with a similar life expectancy. The use of radical treatment for HRnMPCa increased with time in all Swedish counties, but a threefold difference between counties remained in 2009-2012 for patients aged 70-80 yr with CCI 0-1. Uncertain external validity is a study limitation, and the impact of physician versus patient preferences on treatment selection could not be assessed. Conclusions: Otherwise healthy men in their seventies with HRnMPCa were less likely to receive radical treatment than younger men with a similar life expectancy, although increasing use of radical treatment was observed during the study period. Our findings highlight the need for improved methods for clinical decision-making, including improved assessment of life expectancy. Patient summary: We performed a nationwide register study that showed that many healthy men in their seventies live for at least another 10 yr. Despite this long life expectancy, men in their seventies with high-risk nonmetastatic prostate cancer were often not treated with radical prostatectomy or radiotherapy, possibly because their life expectancy was underestimated. Our study highlights the need for improved clinical decision-making, which should incorporate an assessment of the patient's life expectancy.
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| 14. |
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| 15. |
- Carlsson, Ingela
(författare)
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Cold Sensitivity in injured and normal hands. Consequences for daily life
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cold sensitivity is a common and persistent complaint after various hand injuries and diseases. The general aim of the thesis was to investigate the consequences of cold sensitivity for daily life in patients with traumatic hand injuries and hand-arm vibration syndrome (HAVS). To obtain a richer and more comprehensive picture reflecting the aim, studies with a quantitative and a qualitative design were performed. Questionnaires comprising patients’ experience of cold sensitivity were translated into Swedish according to the cross-cultural adaptation process and content and construct validity, internal consistency and test-retest reliability were established. In addition, a cut-off for abnormal cold sensitivity was defined as a total score > 50 on the Cold Intolerance Symptom Severity (CISS) questionnaire based on a normal population. Patients with abnormal self-reported cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity. The engagement in occupations was limited because of cold induced symptoms despite access to relieving strategies. The consequences and adaptation in daily life meant a change of occupational patterns and performance, a struggle with self-image and a change in life roles. Factors associated with abnormal cold sensitivity after a hand injury were a larger number of repaired vessels and use of vascular grafts at reconstruction, presence of trauma to bones and a high HISS score, suggesting multifactorial causes of cold sensitivity. Behavioural treatment offered relief to a majority of patients with a traumatic hand injury in contrast to patients with HAVS. Patients with HAVS had in comparison to hand injured patients overall significantly more severe problems with cold sensitivity.
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| 16. |
- Carlsson, Ingela, et al.
(författare)
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Cut-Off Value for Self-Reported Abnormal Cold Sensitivity and Predictors for Abnormality and Severity in Hand Injuries
- 2010
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Ingår i: Journal of Hand Surgery: European Volume. - : SAGE Publications. - 2043-6289 .- 1753-1934. ; 35E:5, s. 409-416
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to identify a cut-off value for self-reported, abnormal cold sensitivity and to identify cold sensitivity predictors after hand injuries. The Cold Intolerance Symptom Severity (CISS) questionnaire and a VAS question concerning discomfort on exposure to cold were investigated in 94 normal people and 88 patients. A CISS score >450 was defined as abnormal cold sensitivity. Multiple injured digits, an increased number of injured vessels, complete nerve injury and replantation were variables associated with high VAS scores. Factors linked to both abnormality and worse CISS or VAS scores were: the presence of bone injury; a larger number of repaired vessels; the use of vascular grafts and a high Hand Injury Severity Score (HISS). The causes of abnormality and severity suggest a multifactorial aetiology with bony, vascular and neural components. A cut-off for abnormality is useful for descriptive, comparative and assessment purposes.
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| 17. |
- Carlsson, Ingela, et al.
(författare)
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Hand-injured Patients' Experiences of Cold Sensitivity and the Consequences and Adaptation for Daily Life: A Qualitative Study.
- 2010
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Ingår i: Journal of Hand Therapy. - : Elsevier BV. - 1545-004X .- 0894-1130. ; 23, s. 53-61
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Qualitative descriptive. INTRODUCTION: Cold sensitivity is a common and persistent complaint after hand injuries. PURPOSE OF THE STUDY: To explore the experiences of severe cold sensitivity, its consequences for daily life, and the strategies for enduring and enabling occupation. METHODS: Fifteen hand-injured patients with abnormal cold sensitivity were interviewed. The transcribed text was analyzed using manifest and latent content analysis. Experiences of triggering factors, symptoms, and relieving strategies were described. RESULTS: The consequences and adaptation in daily life entailed a change in life roles, a struggle to maintain self-image and changed occupational performance and/or occupational patterns. CONCLUSIONS: Our findings highlight the importance of a holistic approach, including a screening of patients' occupational roles and patterns as well as psychosocial needs, to obtain the information needed to support patients with severe cold sensitivity to achieve a sense of control and self-mastery. LEVEL OF EVIDENCE: not applicable.
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| 18. |
- Carlsson, Ingela, et al.
(författare)
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Hand injuries and cold sensitivity: Reliability and validity of cold sensitivity questionnaires.
- 2008
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 30:25, s. 1920-1928
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. Sensitivity to cold is a common consequence of hand injuries and other conditions, and this phenomenon has a profound effect on health-related quality of life and upper-extremity disability. The aim of the present study was to examine the reliability and validity of the Swedish version of the Cold Sensitivity Severity (CSS) scale and Cold Intolerance Symptom Severity (CISS) questionnaire and the reliability of the Potential Work Exposure Scale in a group of patients with traumatic hand-injury or vibration-induced problems. Method. We translated the self-administered questionnaires into Swedish and performed tests of reliability and validity. The questionnaire was sent to 159 patients with hand injuries. Results. Validity and internal-consistency results are based on a sample of 122. Test - retest results are based on a sample of 100. Good construct validity was demonstrated via correlation statistics. There were high correlations for both the CSS scale and CISS questionnaire scores with single questions concerning cold sensitivity, with the Disability of the Arm, Shoulder and Hand scale, and with the bodily-pain subscale of the SF-36 questionnaire. Reliability (both internal consistency and test - retest) was excellent. Conclusions. We conclude that the Swedish versions of the CSS scale and CISS questionnaire are reliable, and that this study provides evidence of the validity of the scales. The Potential Work Exposure Scale is reliable method of assessing exposure in the workplace.
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| 19. |
- Carlsson, Ingela K., et al.
(författare)
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Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire : a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery
- 2021
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Ingår i: Hand Therapy. - : SAGE Publications. - 1758-9983 .- 1758-9991. ; 26:1, s. 3-16
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of this study was to evaluate the construct validity, floor and ceiling effects, data completeness and magnitude of change over time for the eight-item patient questionnaire (HQ-8) in the Swedish Healthcare Quality Registry for hand surgery (HAKIR). Methods: Construct validity was investigated through predefined hypotheses and correlation statistics between the single items in HQ-8 (pain on load, pain on motion without load, pain at rest, stiffness, weakness, numbness, cold sensitivity and ability to perform daily activities) and QuickDASH. Floor and ceiling effects and data completeness were analysed at preoperative (n = 13,197), three months (n =10,702) and one year (n = 9,986) responses from hand surgery patients. Effect sizes were calculated for pre- and postoperative change scores in elective conditions and postoperative scores for acute conditions. Results: Correlation coefficients at pre, 3 and 12 months ranged from 0.44 to 0.79 in the total group. No ceiling effect occurred, but a floor effect for the total group was noted for all items at all follow-ups. Missing responses were < 2.6% except for cold sensitivity. The effect sizes varied from small to large for individual items in elective diagnoses. For acute injuries, small effect sizes were found. Discussion: This study provides evidence of construct validity of HQ-8, lack of ceiling effect, expected floor effect, good data completeness and an ability to detect changes over time. The results indicate that HQ-8 measures unique aspects of disability. The HQ-8 could complement the Quick-DASH in describing patient-reported outcomes after hand surgery.
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| 20. |
- Carlsson, Ingela, et al.
(författare)
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Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome
- 2010
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS) and in normal subjects. Methods: Responses to the Cold Intolerance Symptom Severity (CISS) questionnaire, Potential Work Exposure Scale (PWES), Disability of the Arm, Shoulder and Hand (DASH) and Short-Form 36 questionnaire (SF-36) were investigated in normal subjects (n = 94), hand injured patients (amputation and nerve injuries, n = 88) and patients with HAVS (n = 30). The results are presented as median (range), percent and mean deviation from norms. The Kruskal Wallis Test or Mann-Whitney U-Test were used to identify significant differences between multiple groups or subgroups. The Spearman rank correlation was used to study the relationship between cold sensitivity and disability. Results: Abnormal cold sensitivity (CISS score > 50) was seen in 75% and 45% of patients with HAVS and a traumatic hand injury, respectively. Patients were significantly more exposed to cold in their work environment than the normal population, with a consequently negative effect on work ability due to cold sensitivity. Patients with abnormal cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity [higher DASH scores and e. g. significantly larger mean deviation from norms in the subscales Role Physical and Bodily Pain (SF-36)]. Conclusion: Severe and abnormal cold sensitivity may have a profound impact on work capacity, leisure, disability and health-related quality of life. It is frequently seen in patients with traumatic hand injuries and particularly apparent in patients with HAVS.
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| 21. |
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| 22. |
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| 23. |
- Carlsson, Maria, et al.
(författare)
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Anhörigkonsulenters erfarenheter av att uppmärksamma och bemöta anhöriga i sorg i samband med att en närstående avlidit : En kvalitativ intervjustudie
- 2022
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Förlust och sorg innebär att den som drabbas mår psykiskt och fysiskt dåligt och det finns risk att utveckla ytterligare ohälsa. Det är betydelsefullt att uppmärksamma anhörigas behov av stöd i sorgen när en närstående avlidit, men det är oklart om vuxna anhöriga får det stöd de behöver. Sveriges kommuner har enligt lag skyldighet att ge stöd till anhörigvårdare som vårdar närstående i hemmet. Ett sådant stöd är anhörigkonsulenter i kommunen. Syfte: Syftet var att utforska erfarenheter hos kommunens anhörigkonsulenter av att uppmärksamma och bemöta vuxna anhöriga i ordinärt boende som drabbats av sorg i samband med att en närstående avlidit. Metod: Data samlades in genom individuella intervjuer med tio kommunanställda anhörigkonsulenter från Skåne och Blekinge. Intervjuerna analyserades induktivt med kvalitativ innehållsanalys. Resultat: Vid analysen utvecklades ett huvudtema, fyra teman med tillhörande subteman. Huvudtema: I samtalet se, lyssna på, ge tid, bekräfta och stödja de anhöriga framåt i sin individuella sorgeprocess samt erbjuda annat stöd utifrån behov. Teman var: (i) Att se och notera de anhörigas sorg; (ii) I mötet samtala om närståendes död och sorgen (iii) I mötet stödja sorgeprocessen framåt; (iv) Erbjuda övriga stödformer efter behov. Slutsats: Ur anhörigkonsulenters perspektiv är sorgeprocessen individuellt unik och utrymmet att samtala om sorgen verkar vara begränsad i den anhörigas vardagliga kontakter. Väntesorg ansågs som en stor del i sorgeprocessen och viktig att uppmärksamma. Anhörigkonsulenterna uppmärksammar anhörigvårdares sorg, erbjuder individanpassat stöd, stödjer de anhöriga framåt i sin sorgeprocess och lotsar vidare till andra professioner vid behov. Anhörigkonsulenter uttrycker att deras roll behöver tydliggöras i kommunen och efterlyser riktlinjer om hur anhörigstöd ska se ut och fördelas.
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| 24. |
- Carlsson, Martin, et al.
(författare)
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Erythrocyte fatty acid composition does not influence levels of free, bioavailable, and total 25-hydroxy vitamin D
- 2017
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Taylor & Francis. - 0036-5513 .- 1502-7686. ; 77:1, s. 45-52
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Tidskriftsartikel (refereegranskat)abstract
- In vitro, mono- and polyunsaturated fatty acids (FAs) may decrease the binding affinity of vitamin D metabolites for vitamin D-binding protein, which in turn may influence their bioavailability. FAs incorporated as phospholipids in erythrocyte (ery-) cell membranes reflect dietary intake. The purpose of this study was to investigate ery-FA composition in relation to markers for vitamin D. In healthy females (age 22.6 +/- 2.0 years) total 25(OH)D was measured by LC-MS/MS (n=78), free 25(OH)D with ELISA (n=64 of 78), and bioavailable 25(OH)D was calculated. Analysis of ery-FA composition was by gas chromatography (n=56 of 78). A strong correlation between total 25(OH)D and free 25(OH)D was seen (r=.66, p<.001), and between total-25(OH)D and bioavailable 25(OH)D (r=.68, p<.001). No correlations between 25(OH)D fractions and specific fatty acids were found, and in particular, no associations with mono- and poly-unsaturated FA compositions. All 25(OH)D fractions were correlated with leptin (total 25(OH)D (r=-.33, p<.003); bioavailable 25(OH)D (r=-.47, p<.001); free 25(OH)D (r=-.44, p<.001). Associations were found between PTH and total 25(OH)D (r=-.35, p=.002) and weaker between bioavailable 25(OH)D (r=-.35, p=.040) and free 25(OH)D (r=-.28, p=.079). All fractions of 25(OH)D appear to correlate in a similar way to PTH, BMI and body fat (leptin). No association was found between ery-FA composition and free/bioavailable 25(OH)D. It is unlikely that FAs are a strong uncoupling factor of DBP-bound 25(OH)D.
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| 25. |
- Carlsson, Martin, et al.
(författare)
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Evidence of Daytime Variation of Asymmetric Dimethylarginine: An Intervention Study with Rosiglitazon in Type 2 Diabetes
- 2011
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Ingår i: The Open Endocrinology Journal. - : Bentham Open. ; :5, s. 14-18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Asymmetric dimethylarginine (ADMA) has in some, but not all studies been associated with insulin resistance (IR). We wanted to challenge the hypothesis that plasma ADMA levels are associated with IR in an intervention study using an insulin sensitizing drug. Another aim of the study was to study daytime ADMA variation and if food intake influence ADMA concentration.Methods: Nine patients with diet treated type 2 diabetes were investigated with daytime profiles of ADMA (8 am-5 pm) before and during treatment with rosiglitazone for 8 weeks. A control group matched for age and sex underwent a similar investigation at baseline.Results: After treatment with rosiglitazone, ADMA (0.63- 0.64 mmol/L; p=0.26) and homocysteine (10.3 -10.6 mol/L; p=0.61) concentrations did not change. Postprandial (10 am – 5 pm) ADMA concentrations were 10% higher than fasting morning levels (p=0.006) and this difference was similar for controls and diabetes patients both pre and post treatment with rosiglitazone.Conclusions: Treatment with rosiglitazone aiming to improve insulin sensitivity did not affect ADMA concentration in type 2 diabetes patients. The ADMA daytime variation and the relation to food intake appear to be a novel finding and should be considered in future studies.
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| 26. |
- Carlsson, Sigrid, 1982, et al.
(författare)
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Population-based study of long-term functional outcomes after prostate cancer treatment
- 2016
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Ingår i: BJU International. - : John Wiley & Sons. - 1464-4096 .- 1464-410X. ; 117:6B, s. E36-E45
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate long-term urinary, sexual and bowel functional outcomes after prostate cancer treatment at a median follow-up of 12 years (IQR 11-13).PATIENTS AND METHODS: In this nationwide, population-based study, we identified from the National Prostate Cancer Register, Sweden, 6,003 men diagnosed with localized prostate cancer (clinical local stage T1-2, any Gleason score, prostate specific antigen < 20 ng/mL, NX or N0, MX or M0) between 1997 and 2002 who were ≤70 years at diagnosis. 1,000 prostate cancer-free controls were selected, matched for age and county of residence. Functional outcomes were evaluated with a validated self-reported questionnaire.RESULTS: Responses were obtained from 3,937/6,003 cases (66%) and 459/1,000 (46%) controls. Twelve years post diagnosis, at a median age of 75 years, the proportion of cases with adverse symptoms was 87% for erectile dysfunction or sexually inactive, 20% for urinary incontinence and 14% for bowel disturbances. The corresponding proportions for controls were 62%, 6% and 7%, respectively. Men with prostate cancer, except those on surveillance, had an increased risk of erectile dysfunction, compared to control men. Radical prostatectomy was associated with increased risk of urinary incontinence (odds ratio; OR 2.29 [95% CI 1.83-2.86] and radiotherapy increased the risk of bowel dysfunction (OR 2.46 [95% CI 1.73-3.49]) compared to control men. Multi-modal treatment, in particular including androgen deprivation therapy (ADT), was associated with the highest risk of adverse effects; for instance radical prostatectomy followed by radiotherapy and ADT was associated with an OR of 3.74 [95 CI 1.76-7.95] for erectile dysfunction and OR 3.22 [95% CI 1.93-5.37] for urinary incontinence.CONCLUSION: The proportion of men who suffer long-term impact on functional outcomes after prostate cancer treatment was substantial.
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| 27. |
- Carlsson, Ulla, 1950, et al.
(författare)
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Maskiner kan inte göra statistik
- 2015
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Ingår i: Sundsvalls Tidning. - 1104-005X. ; :2015-05-22
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 28. |
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| 29. |
- Carlsson, Ylva, 1975, et al.
(författare)
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Parents’ experiences of the information provided at the antenatal clinic regarding foetal diagnostics – A qualitative interview study
- 2021
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Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to examine the pregnant women's and their partner's experience of the information given at the antenatal clinic regarding screening methods. Methods: A qualitative interview study was conducted in the Gothenburg area in Sweden. Ten women and seven partners expecting their first child were interviewed adjacent to the second-trimester ultrasound examination. The data were analysed using qualitative content analysis. Results: The findings present an overall theme, three main categories, and ten subcategories. The overall theme showed a nonhomogeneous and individually based picture concerning the meaning and purpose of the methods, need for improvement of information, parents own information seeking, and the encounter with the midwife was also experienced as an influential encounter. The main categories show that diversity relates to the level of information given, voluntariness, the possibility of abnormal findings, and varying needs to thorough information and pre-existing knowledge. The midwifés impact was related to attitude, openness for questions, time for explanations, and the balance between providing enough information to support without worrying the parents. Conclusions: Although previous research has pointed out a decade ago that information regarding foetal diagnostics is lacking, this study shows that these shortcomings still exist and that improvement is needed. The given information should be explicit concerning the purpose, limitations, and voluntariness of prenatal testing. Sufficient time for questions and discussion is as important as considering the parents’ pre-existing knowledge, individual thoughts or questions, and a neutral attitude from the midwife is desirable.
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| 30. |
- Cazzaniga, W., et al.
(författare)
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Mini Review on the Use of Clinical Cancer Registers for Prostate Cancer: The National Prostate Cancer Register (NPCR) of Sweden
- 2019
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Ingår i: Frontiers in Medicine. - : Frontiers Media SA. - 2296-858X. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Given the increasing prevalence of cancer, it is vital to systematically collect data in order to monitor disease trends and quality of cancer care. For this purpose, clinical cancer registries have been developed in some countries. These registers are intended to be used as a basis for quality assurance and quality improvement, but they also constitute a rich resource of real world data for research. The aim of thismini-review was to describe the structure and the organization of the National Prostate Cancer Register (NPCR) with some examples on how data in NPCR have affected prostate cancer care in Sweden.
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| 31. |
- Chemnitz, Anette, et al.
(författare)
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Consequences and adaptation in daily life - patients' experiences three decades after a nerve injury sustained in adolescence
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: To explore the patients' experiences during the three decades following repair of a nerve injury in the forearm and its consequences for daily life. Strategies that were used to facilitate adaptation were also investigated. Methods: Fifteen participants with a complete median and/or ulnar nerve injury repaired in the ages from 13-20 years were interviewed using a semi-structured interview guide. The median follow-up time was 31 years (range 23-40). The participants were asked to describe the past and present symptoms of the injured hand, the consequences of the injury for daily life, personal qualities and support from others. In addition, they were asked to describe strategies used to facilitate adaptation. The interviews were subjected to content analysis. Results: The nerve injury lead to sensory and motor deficits in the injured hand, as well as sensitivity to cold and secondary back problems. Emotional reactions to trauma and symptoms related to post-traumatic stress disorder were described, as well as how they managed to cope with such reactions. There was a noticeable impact on education, leisure, professional or domestic life for some, while others could continue by changing e. g. their performance pattern. The participants' life roles and relations were also affected. Both emotion-and problem-based strategies were used to manage challenges in daily life. Conclusions: The present qualitative study can help us to provide the patient with honest and realistic information about what to expect after a nerve injury at forearm level, without eliminating hope. Emotional reactions to trauma should be identified and dealt with. In addition, health-care professionals can promote a variety of coping mechanisms to facilitate daily living for the injured patients.
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| 32. |
- Djukanovic, Ingrid
(författare)
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Depression in late life-prevalence and preventive intervention
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundDepression in older people often goes undetected but has severe consequences on physical health, functioning and quality of life. As the aging population is growing, mental ill-health already is and will continue to be an important public health problem. There is a need for adequate strategies to meet this challenge.Aims(1) To investigate the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex in a random Swedish sample in the age group 65-80 years, and to investigate to what extent those scoring ≥ 8 in the depression dimension of the Hospital Anxiety and Depression Scale (HAD) had visited health care professionals and/ or used antidepressive medication.(2) To evaluate the effect of group discussions, in which structured reminiscence and a Problem Based Method (PBM) were used, on depressive symptoms, Quality of Life (QoL) and Self-Rated Health (SRH) among older people.(3) To describe the individual´s experiences of the year before and the time after retirement.(4) To evaluate the factorial structure of the HAD in a general older population 65-80 years and to examine the possible presence of differential item functioning (DIF) related to sex.ResultMore men than women reported depressive symptoms, few were offered psychological treatment and a quarter used antidepressant medication. Depressive symptoms were associated with loneliness and this association decreased with increasing age. Participation in group discussions resulted in a decrease in depressive symptoms and an increase in QoL and SRH. Both expectations and fears were experienced the year before and the time after retirement.The psychometric evaluation of the HAD showed a two-factorial structure and invariance regarding sex.ConclusionThe result highlights the importance of detecting depressive symptoms and loneliness in older people and offer adequate treatment. Transition into retirement should receive more attention both from a health care and organizational perspective. Group discussions with structured reminiscence and PBM as a nursing intervention, seem to be a promising method to prevent depressive symptoms in older people, but further research is needed. The HAD can be recommended to assess anxiety and depression among a general population 65-80 years old.
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| 33. |
- Fallara, Giuseppe, et al.
(författare)
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Prostate cancer diagnosis, staging, and treatment in Sweden during the first phase of the COVID-19 pandemic
- 2021
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 55:3, s. 184-191
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The first case of COVID-19 in Sweden was diagnosed in late January 2020, the first recommendations against the spread of the virus were released in mid-March, and the peak of the first wave of the pandemic was reached in March-June. The aim of this cross-sectional study was to assess the short-term effects of the first wave of the COVID-19 pandemic on prostate cancer (PCa) diagnosis, staging, and treatment. Materials and methods Data in the National Prostate Cancer Register (NPCR) of Sweden on newly diagnosed PCa cases and on the number of diagnostic and therapeutic procedures performed between 18 March 2020 and 2 June 2020 were compared with those in the corresponding time periods in 2017-2019, as reported until January 31 of the year after each study period. Results During the study period in 2020, 36% fewer PCa cases were registered in NPCR compared with the corresponding time period in previous years: 1458 cases in 2020 vs a mean of 2285 cases in 2017-2019. The decrease in new PCa registrations was more pronounced in men above age 75 years, down 51%, than in men aged 70-75, down 37%, and in men below age 70, down 28%. There was no decrease in the number of radical prostatectomies and number of radical radiotherapy courses increased by 32%. Conclusions During the peak of the first phase of the COVID-19 pandemic, the number of men diagnosed with PCa in Sweden decreased by one third compared with previous years, whereas there was no decrease in the number of curative treatments.
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| 34. |
- Giöstad, Alice, et al.
(författare)
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Experience of living with chronic pain in conjunction with surgery for ulnar nerve entrapment at the elbow-A qualitative study
- 2024
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 19:6
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Pain in conjunction with surgery for ulnar nerve entrapment at the elbow is seldom highlighted in the literature. This study aimed to explore patients' experiences of living with chronic pain (>= 3 months duration) in conjunction with surgery for ulnar nerve entrapment at the elbow, the consequences and the coping strategies applied.Material and methods In-depth interviews were conducted with 10 participants aged 18-60 years. The narratives were analyzed using an inductive approach and content-analysis.Results The analysis revealed seven main categories: "Physical symptoms/impairments" and "Mood and emotions"comprise symptoms caused by ulnar nerve entrapment at the elbow and chronic pain; "Consequences in daily life" includes challenges and obstacles in every-day life, impact on leisure activities and social life; "Struggling with self-image" embraces experiences closely related to identity; "Coping strategies" covers adaptive resources; "Experience of relief "describes perceived improvements; "Key message for future care" comprises important aspects for healthcare providers to consider.Conclusions The results clarify the need for healthcare personnel to adopt a biopsychosocial approach when treating patients with ulnar nerve entrapment at the elbow. Emotional symptoms and sleep disturbances should be identified and treated properly since they contribute to the heavy burden experienced by the individual.
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| 35. |
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| 36. |
- Hansson, Malin, 1975, et al.
(författare)
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Job satisfaction in midwives and its association with organisational and psychosocial factors at work : a nation-wide, cross-sectional study
- 2022
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Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 22:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMidwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives’ job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks.MethodsThis nation-wide, cross-sectional web survey study analysed midwives’ assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives’ results with Swedish benchmarks.ResultsA multivariable regression model with 13 scales explained the variance in job satisfaction (R2 = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives’ job satisfaction (R2 = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively.ConclusionsMidwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
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| 37. |
- Hansson, Malin, et al.
(författare)
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Midwives marching to own drum in the Baby Factory - other professions perspectives of midwifery work in labour wards
- 2018
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Konferensbidrag (refereegranskat)abstract
- There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. Classical Grounded Theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers to explore their views of midwifery work during childbirth. The substantive theory of ‘veiled midwifery’ emerged as an explanation of the social process between the professions in the ‘baby factory’ context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives´ work. The main concern for the other professions was that the midwives were ‘marching to own drum’. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability and led to feelings of frustration and exclusion. Which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Streamlining, Scrutinising and Collaborating admittance. The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation.
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| 38. |
- Hansson, Malin, 1975, et al.
(författare)
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Midwives marching to own drum : other professions perspective of midwifery work in labour wards
- 2018
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Ingår i: COST Action BIRTH Conference : Lisbon, Sept 17-18, 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. Classical Grounded Theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers to explore their views of midwifery work during childbirth. The substantive theory of ‘veiled midwifery’ emerged as an explanation of the social process between the professions in the ‘baby factory’ context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives´ work. The main concern for the other professions was that the midwives were ‘marching to own drum’. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability and led to feelings of frustration and exclusion. Which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Streamlining, Scrutinising and Collaborating admittance. The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation.
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| 39. |
- Hansson, Malin, 1975, et al.
(författare)
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Professional courage to create a pathway within midwives’ fields of work : a grounded theory study
- 2021
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Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Therefore, the aim of this study was to explore health-promoting facilitative conditions in the work situation on labour wards according to midwives.
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| 40. |
- Hansson, Malin, 1975, et al.
(författare)
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Professional courage to create a pathway within midwives’ fields of work
- 2022
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Ingår i: https://njfcongress.fi/abstracts-and-posters.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Aim: To explore health-promoting facilitative conditions in the work situation on labour wards according to midwives. Methods: Face-to-face interviews with midwives constituted the empirical material in this classical grounded theory study. Results: The substantive theory of Professional courage to create a pathway within midwives’ fields of work emerged as an explanation of the health-promoting facilitative conditions in midwives’ work situation. The theory consists of a four-stage process with prerequisite contextual conditions: visualising midwifery, organisational resources and a reflective and learning environment, that were needed to fulfil the midwives’ main concern a Feasibility of working as a midwife. This meant being able to work according to best-known midwifery theory and practice in each situation. Positive consequences of a fulfilled main concern were a professional identity and grounded knowledge that enabled the development of the resistant resource professional courage. The courage made it feasible for midwives to move freely on their pathway within the different fields of work extending between normal and medicalised birth and being autonomous and regulated. Conclusions: Professional courage could be seen as a resistance resource, enabling midwives to become resilient when dealing with the unpredictable work situation. The theory can be used to foster health-promoting and sustainable work environments for midwives, which is possible if the organisational preconditions are met, visualising midwifery, having organisational resources and a reflective and learning environment. This could be a key factor in retaining midwives in the profession.
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| 41. |
- Hansson, Malin, 1975, et al.
(författare)
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Veiled midwifery in the baby factory - A grounded theory study
- 2019
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Ingår i: Women and Birth. - Amsterdam : Elsevier BV. - 1871-5192 .- 1878-1799. ; 32:1, s. 80-86
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Tidskriftsartikel (refereegranskat)abstract
- Background: Midwives' professional role has been changing drastically over time, from handling births in home settings to being part of a team in labour wards in hospitals. This demands a greater effort of interprofessional collaboration in childbirth care. Aim: Explore midwives' work in a hospital-based labour ward from the perspectives of other professions, working in the same ward. Method: Classical grounded theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers to explore their views of midwifery work during childbirth. Findings: The substantive theory of 'veiled midwifery' emerged as an explanation of the social process between the professions in the 'baby factory' context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives' work. The main concern for the other professions was that the midwives were 'marching to own drum'. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability and led to feelings of frustration and exclusion. Which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Streamlining, Scrutinising and Collaborating admittance. Conclusions: Findings provide a theoretical conceptualisation of a 'veiled midwifery ' that causes problems for the surrounding team. This generates a desire to streamline and control midwifery in order to increase interprofessional collaboration. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 42. |
- Hansson, Malin, 1975, et al.
(författare)
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Veiled midwifery in the baby factory – Midwives marching to own drum - Other professions perspective of midwifery work in labour wards.
- 2019
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Ingår i: The 21st Congress of the Nordic federation of Midwives. Midwifery across borders. Reykjavik 2-4 maj 2019.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. This demands a greater effort of interprofessional collaboration. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. Method: Classical Grounded Theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers. Findings: The substantive theory of ‘veiled midwifery’ emerged as an explanation of the social process between the professions in the ‘baby factory’ context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives´ work. The main concern for the other professions was that the midwives were ‘marching to own drum’. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability, which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Scrutinising, Streamlining and Collaborating admittance. Conclusion: Findings provide a theoretical conceptualisation of a ‘veiled midwifery ‘that causes problems for the surrounding team. This generates a desire to streamline and control midwifery in order to increase interprofessional collaboration. The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation.
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| 43. |
- Hansson, Malin, 1975, et al.
(författare)
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Veiled midwifery in the baby factory : The social pattern between other professions and midwives.
- 2018
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Ingår i: CONFERENCE: Improving Maternal Health – From Evidence into Action, Dublin (October 23,2018).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: There has been a paradigm shift in midwifery over time where different professions now work together in childbirth care. This demands a greater effort of interprofessional collaboration. There is little research on midwives’ work from other professionals’ perspectives, which is of importance to improve midwives work situation and women-centred care. Therefore, the aim of this article was to explore other professions´ views of midwifery work during childbirth. Method: Classical Grounded Theory, using a constant comparative analysis, was applied to focus group interviews with obstetricians, assistant nurses and managers. Result: The substantive theory of ‘veiled midwifery’ emerged as an explanation of the social process between the professions in the ‘baby factory’ context. The other professionals perceive midwifery through a veil that filters the reality and only permits fragmentary images of the midwives´ work. The main concern for the other professions was that the midwives were ‘marching to own drum’. The midwives were perceived as both in dissonance with the baby factory, and therefore hard to control, or, alternatively more compliant with the prevailing rhythm. This caused an unpredictability, which in turn resulted in attempts to cooperate and gain access to the midwifery world, by using three unveiling strategies: Scrutinising, Streamlining and Collaborating admittance. Conclusion: The theory of veiled midwifery could be used as a theoretical basis for future studies, and could be a foundation for a dialogue of philosophical differences in the way birth is viewed in the clinical setting, to improve the work situation and women-centred care.
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| 44. |
- Janson, M., et al.
(författare)
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Randomized clinical trial of the costs of open and laparoscopic surgery for colonic cancer
- 2004
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Ingår i: The British journal of surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 91:4, s. 409-17
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There has been no randomized clinical trial of the costs of laparoscopic colonic resection (LCR) compared with those of open colonic resection (OCR) in the treatment of colonic cancer. METHODS: A subset of Swedish patients included in the Colon Cancer Open Or Laparoscopic Resection (COLOR) trial was included in a prospective cost analysis; costs were calculated up to 12 weeks after surgery. All relevant costs to society were included. No effects of the procedures, such as quality of life or survival, were taken into account. RESULTS: Two hundred and ten patients were included in the primary analysis, 98 of whom had LCR and 112 OCR. Total costs to society did not differ significantly between groups (difference in means for LCR versus OCR euro1846; P = 0.104). The cost of operation was significantly higher for LCR than for OCR (difference in means euro1171; P < 0.001), as was the cost of the first admission (difference in means euro1556; P = 0.015) and the total cost to the healthcare system (difference in means euro2244; P = 0.018). CONCLUSION: Within 12 weeks of surgery for colonic cancer, there was no difference in total costs to society incurred by LCR and OCR. The LCR procedure, however, was more costly to the healthcare system.
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| 45. |
- Kristjansdottir, Freyja, et al.
(författare)
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Social participation in persons with upper limb amputation receiving an esthetic prosthesis
- 2020
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Ingår i: Journal of Hand Therapy. - : Elsevier BV. - 0894-1130. ; 33:4, s. 520-527
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: Qualitative study. Introduction: An amputation injury to the hand may lead to not only impaired hand function but also psychosocial consequences. Purpose of the Study: The purpose of the study was to explore personal experiences of social participation for persons provided with an esthetic prosthesis after acquired upper limb amputation. Methods: Thirteen persons with acquired upper limb amputation, who were in need of and had received an esthetic prosthesis, were interviewed. The transcribed text was subjected to content analysis. Results: The emotional reactions to a visibly different hand were linked to a changed appearance and a feeling of being exposed. Recollecting the accident could result in nightmares and sleeping disorders. A change of personality, due to sadness after the amputation was expressed, as well as social insecurity and impact on relations and life roles. Adapting to social challenges comprised hiding or exposing the hand, using personal internal resources and receiving support from others. The esthetic prosthesis contributed to an intact appearance and could serve as a facilitator for initial or long-term social participation. The time that had passed since the injury made it easier to deal with the consequences or in achieving acceptance. Discussion: Coping with emotions and social relations after an acquired amputation can be difficult and complex. Conclusions: Individual needs must be considered and questions about appearance and how it may affect social participation must be asked. An esthetic prosthesis can normalize the appearance and offer the confidence needed to facilitate social participation in those struggling with appearance-related concerns.
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| 46. |
- Larsson, Sara, et al.
(författare)
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Patients' experiences before and after total wrist fusion or total wrist arthroplasty:A qualitative study of patients with wrist osteoarthritis
- 2022
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Ingår i: Journal of Hand Therapy. - : Elsevier BV. - 0894-1130. ; 35:1, s. 41-50
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: For patients with advanced wrist osteoarthritis (OA), total wrist fusion (TWF) is the standard surgical treatment, although total wrist arthroplasty (TWA) has become a plausible motion-preserving alternative. Purpose: To explore patients' experiences of living with advanced wrist OA before and after surgery with either a TWF or a TWA. Furthermore, we wanted to explore the expectations of surgery, appraisal of results, and the adaptation strategies used to overcome challenges in everyday life. Study Design: Qualitative descriptive. Methods: A purposive sample of 13 patients with advanced wrist OA surgically treated with TWF (n = 7) or TWA (n = 6) was recruited. Semistructured interviews were conducted and analyzed using qualitative content analysis. Results: Four categories are described: the problematic wrist, the breakpoint, appraisal of the results, and adaptation to challenges in everyday life. Pain relief was the primary expectation of surgery, and involvement in the discussion regarding different surgical options had a positive effect on the appraisal of results. The participants' ability to perform tasks in everyday life appeared to be more related to their level of pain than the range of wrist motion. Successful coping strategies were developed, enabling the participants to become more independent and adapt to challenges in daily life. Conclusions: Previous surgical experiences, occupation, and amount of wrist motion influenced the participants' expectations, surgical choice with either a TWF or a TWA, and the appraisal of results. The findings contribute valuable insights to both surgeons and hand therapists about the importance of having the patient's individual expectations and needs in focus.
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| 47. |
- Leibring, Ingela, et al.
(författare)
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Fear and Coping in Children 5-9 years old Treated for Acute Lymphoblastic Leukemia - A Longitudinal Interview Study
- 2019
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 46, s. E29-E36
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to describe the fears of 5- to 9-year-old children related to having acute lymphoblastic leukemia (ALL) and their strategies for coping with those fears. Design and methods: The study had a qualitative descriptive longitudinal design and included a total of 35 interviews with 13 children at three different times during their treatment period. Data were analyzed using a matrixbased method inspired by the work of Miles et al. Results: Initially, most children reported a fear of needles. but during the treatment period, fewer children reported this fear. Children's coping strategies also changed over time, as they wanted more involvement and control during needle-related procedures. Other fears were having adhesive tapes removed, having a nasogastric tube, and taking tablets. During the treatment period, existential fears related to the seriousness of ALL and its consequences, such as having impaired physical fitness and being different from before and different from others, became more prominent and caused feelings of loneliness and alienation. Conclusions: The children described various fears through their treatment period, which they coped with using cognitive, emotional, and functional strategies. Over the 2.5-year period, their strategies changed. Practical implications: Because fears changed over time and varied among these different children, each child must be approached individually and attentively in every encounter.
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| 48. |
- Leibring, Ingela, et al.
(författare)
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Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia
- 2024
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe experiences of fear, coping, and support in 10–17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). Methods: A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. Results: The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals’ attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. Conclusions: Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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- Leibring, Ingela, et al.
(författare)
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Young children's experiences of support when fearful during treatment for acute lymphoblastic leukaemia-A longitudinal interview study
- 2021
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Ingår i: Nursing Open. - : Wiley-Blackwell. - 2054-1058. ; 9:1, s. 527-540
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Tidskriftsartikel (refereegranskat)abstract
- Aim and objectives: To describe young children's experiences of valuable support in managing their fears about treatment for acute lymphoblastic leukaemia. The focus was specifically on support from parents and healthcare professionals. Design: The study had a qualitative descriptive longitudinal design. Methods: The study analysed 35 interviews with 13 children at three different times during their treatment period. Data were analysed using a matrix-based method. The Consolidated criteria for reporting qualitative research (COREQ) guidelines have been followed. Results: Parents and healthcare professionals provide important support to children undergoing treatment for acute lymphoblastic leukaemia, although their roles differ. Children valued their parents' closeness and advocacy, being able to participate in their own care, and being given pain relief during procedures known to create pain. Valued support from healthcare professionals changed over time, from providing information and showing the tools that would be used in procedures, to paying attention to the child's needs and desires. It was more important for children to be able to choose between different alternatives in medical procedures than deciding on major treatment issues.
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