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- Backman, Sara, et al.
(författare)
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Material Wear of Polymeric Tracheostomy Tubes : A Six-Month Study
- 2009
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 119:4, s. 657-664
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objectives were to study long-term material wear of tracheostomy tubes made of silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU) after 3 and 6 months of clinical use. Study Design: The study has a prospective and comparative design. Methods: Nineteen patients with long-term tracheostomy, attending the National Respiratory Center in Sweden, were included, n = 6 with Si tubes, n = 8 with PVC tubes, and n = 5 with PU tubes. The tubes were exposed to the local environment, in the trachea for 3 and 6 months and analyzed by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy, and differential scanning calorimetry. Results: All tubes revealed severe surface changes. No significant differences were established after 3 or 6 months of exposure between the various materials. The changes had progressed significantly after this period, compared to previously reported changes after 30 days of exposure. The results from all analyzing techniques correlated well. Conclusions: All tubes, exposed in the trachea for 3-6 months, revealed major degradation and changes in the surface of the material. Polymeric tracheostomy tubes should be changed before the end of 3 months of clinical use.
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- Björling, Gunilla, Docent, et al.
(författare)
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A retrospective survey of outpatients with long-term tracheostomy
- 2006
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 50:4, s. 399-406
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Respiratory Unit (RU) at Danderyd University Hospital opened in 1982, with the expressed goal of supporting outpatients with long-term tracheostomy. The primary aim of this retrospective study in tracheostomized patients was to compare the need for hospital care in the 2-year period before and after the tracheostomy.Methods: Data were collected from patient medical records at the RU, from the National Board of Health and Welfare, Sweden and from the Official Statistics of Sweden. The subjects were RU patients in 1982 (Group 1, n = 27) and in 1997 (Group 2, n = 106) with long-term tracheostomy surviving at least 4 years after the tracheostomy.Results: Both groups had few and unchanged needs for hospital care after tracheostomy. They spent ≥ 96% of their time out of hospital. In 1997, (group 2) the number of patients, diagnoses and need for home mechanical ventilation had increased. Life expectancy was assessed for patients in Group 1. Data showed that they lived as long as an age-matched and gender-adjusted control cohort.Conclusions: Long-term tracheostomy may not increase the need for hospital care and does not reduce life expectancy. These clinical observations were made in a setting where patients had regular access to a dedicated outpatient unit.
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| 8. |
- Björling, Gunilla, Docent, et al.
(författare)
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Clinical use and material wear of polymeric tracheostomy tubes
- 2007
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Ingår i: The Laryngoscope. - : Lippincott Williams & Wilkins. - 0023-852X .- 1531-4995. ; 117:9, s. 1552-1559
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objectives were to compare the duration of use of polymeric tracheostomy tubes, i.e., silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU), and to determine whether surface changes in the materials could be observed after 30 days of patient use. METHODS: Data were collected from patient and technical records for all tracheostomized patients attending the National Respiratory Center in Sweden. In the surface study, 19 patients with long-term tracheostomy were included: six with Bivona TTS Si tubes, eight with Shiley PVC tubes, and five with Trachoe Twist PU tubes. All tubes were exposed in the trachea for 30 days before being analyzed by scanning electron microscopy (SEM) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). New tubes and tubes exposed in phosphate-buffered saline were used as reference. RESULTS: Si tubes are used for longer periods of time than those made of PVC (P < .0001) and PU (P = .021). In general, all polymeric tubes were used longer than the recommended 30-day period. Eighteen of the 19 tubes exposed in patients demonstrated, in one or more areas of the tube, evident surface changes. The morphologic changes identified by SEM correlate well with the results obtained by ATR-FTIR. CONCLUSIONS: Si tracheostomy tubes are in general used longer than those made of PVC and PU. Most of the tubes exposed in the trachea for 30 days suffered evident surface changes, with degradation of the polymeric chains as a result.
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- Björling, Gunilla, Docent, et al.
(författare)
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Tracheostomy inner cannula care : a randomized crossover study of two decontamination procedures
- 2007
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 35:9, s. 600-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Today several methods for decontaminating inner cannulae exist. These methods are not based on scientific data, but often on local clinical tradition. This study compares two different decontamination methods. The aim was to find a practical and safe decontamination method. It is a randomized, single-blinded, comparative crossover study. METHODS: Fifty outpatients with long-term tracheostomy with an inner cannula were consecutively included and randomly allocated to begin with one of two different treatment sequences: detergent and chlorhexidine-alcohol (A) or detergent (B). Samples for bacterial culture were taken before and after decontamination, and the number of bacteria colonies was counted. RESULTS: Before decontamination, the inner cannulae grew high numbers of bacteria, which were parts of the normal flora of the upper respiratory tract and did not differ significantly between the two sequences (AB; BA). The primary variable was the culture count value after chlorhexidine-alcohol/detergent (A) and detergent (B). The effects of both methods were larger than expected, and the results showed a nearly total elimination of organisms. The equivalence criterion, ratio of mean colony counts (A/B) >0.8, was met at a significance level of P<0.001. CONCLUSIONS: Cleaning the tracheostomy inner cannula with detergent and water is sufficient to achieve decontamination.
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- Franzén, Karin
(författare)
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”Is i magen och ett varmt hjärta” : Konstruktionen av skolledarskap i ett könsperspektiv
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to investigate the discursive construction of school leadership in a gender perspective and the meanings attached to school leadership. Theoretically, I draw on discourse analysis, and feminist poststructuralist theories have been my source of inspiration. Discourse, subjectivity, subject positions and power are key concepts applied to the analysis of the data. Four male and four female school leaders representing eight primary and secondary schools were interviewed. Furthermore, interviews were carried out with two teachers at each of these schools: in total nine female and seven male teachers were interviewed.The leaders and teachers talk about leadership in relation to four different arenas, which I have labelled the teachers’, the children’s, the parents’ and the societal arena respectively. Three main positions have been identified for the school leaders: (1) the supporter, (2) the manager and (3) the pedagogical leader. Most of the statements deal with the relation to the teachers, whereas the parents’ arena is not much talked about.As for gender, both male and female school leaders construct themselves as leaders in rather similar ways. Both men and women activate the three positions in similar ways. Women do not repeat the supporter position more often than men, and men do not position themselves as managers more frequently than women. This indicates that traditional gender discourses do not govern the school leaders’ talk about school leadership. For the position of pedagogical leader, some gender differences have been distinguished. The men position themselves as pedagogical leaders, whose mission it is to take the lead in pedagogical issues, whilst the women talk about the importance of evaluating and reflecting on their pedagogical leadership. Gender discourses seem to affect the way teachers construct school leadership, as male leaders who act as supporters are sometimes positioned as deviant. Instead, especially female teachers expect their male leader to act as a manager. Furthermore, the female teachers construct female school leaders as supporters to a higher extent than the male teachers.
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- Helgesson, Anita, et al.
(författare)
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Coordinated care planning for elderly patients using videoconferencing
- 2005
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Ingår i: Journal of Telemedicine and Telecare. - 1357-633X. ; 11:2, s. 85-92
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Tidskriftsartikel (refereegranskat)abstract
- We studied the transfer of information during coordinated care planning between a university hospital and a local health care centre/social welfare department about 35 km away. During a seven-month study period, 10 sessions were conducted by videoconferencing and seven sessions were conducted by face-to-face conferencing. Videoconferencing reduced the time required for each coordinated care-planning session from an average of 60 to 45 min. There was also an increase in the number of participating professional categories. Travel time for the staff in the face-to-face group was 60-180 min each. Use of a care-planning report during the sessions resulted in improved quality of documentation, which contributed to better care following discharge. The technical problems that occurred did not detract from the beneficial experience of participating. Interviews with next of kin showed that they had been able to influence the content of the care during the care-planning sessions. Videoconferencing proved useful in coordinated care planning. It resulted in time saved due to reduced travel time, participation by more staff categories and an enhancement of the documentation quality.
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- Hällgren Graneheim, Ulla, et al.
(författare)
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Family caregivers' experiences of relinquishing the care of a person with dementia to a nursing home : insights from a meta-ethnographic study
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 28:2, s. 215-224
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Tidskriftsartikel (refereegranskat)abstract
- Many people with dementia are cared for in their homes by family caregivers. As the dementia progresses, admission of the family member to a nursing home becomes inevitable. The aim of this meta-ethnographic study was to describe caregivers' experiences of relinquishing the care of a family member with dementia to a nursing home. A systematic literature search of PubMed, Cinahl and PsychInfo, between the years 1992 and 2012, was performed, and 10 qualitative articles, based on 180 family caregivers' experiences, were included. The family caregivers' described their experiences as a process that went from being responsible for the decision, through living with the decision, adjusting to a new caring role and having changed relationships. They felt unprepared and lonely with these changes. They experienced loss, guilt and shame, but also feelings of relief. Their roles in the nursing home environment were to make sure that the individual needs of the person with dementia were respected and to monitor the quality of care. They wished to maintain their relationship with the person with dementia and to establish meaningful relationships with caring staff. The process of relinquishing care is similar to a crisis process, which starts with a turning point, followed by a coping face and finally the outcome of the process. The adaption to the new situation can be facilitated if the family caregivers are recognised as partners in the care of the person with dementia. The family caregivers' unique knowledge of their relatives' previous life story should be acknowledged in both care planning and daily care. Welcoming family caregivers to regular meetings with staff can contribute to increase the feeling of partnership. Offering staff clinical supervision could be one way of preparing them to deal with the emotional strain reported by family caregivers.
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| 15. |
- Johansson, Anneli, et al.
(författare)
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Remaining connected despite separation : former family caregivers’ experiences of aspects that facilitate and hinder the process of relinquishing the care of a person with dementia to a nursing home
- 2014
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Ingår i: Aging & Mental Health. - : Routledge. - 1360-7863 .- 1364-6915. ; 18:8, s. 1029-1036
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This qualitative study aimed to illuminate former family caregivers’ experiences of aspects that facilitate and hinder the process of relinquishing the care of a person with dementia to a nursing home. METHOD: Ten narrative interviews with former family caregivers were performed and subjected to qualitative content analysis. RESULTS: An overall theme showed that family caregivers were remaining connected to the person with dementia despite separation. They experienced being ‘caught by surprise’ when the placement occurred. Negative expectations of dementia care made the separation more difficult. Lacking adequate information increased feelings of insecurity. Despite these hurdles, family caregivers found meaning in the new situation as they felt that they could remain connected to their loved one. Being recognized as partners in care of the person with dementia after placement was a facilitating aspect. Family caregivers regarded a well-functioning interaction with staff and a supportive social network as reassuring since they facilitated staying in touch. CONCLUSION: Knowledge of the relinquishing process and adequate information about dementia and its progression may help family caregivers better prepare for and adapt to the situation. Family caregivers need to be recognized as partners in care and a welcoming nursing home environment is of utmost importance.
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| 17. |
- Wilhelmsson, Anna-Britta, 1949-, et al.
(författare)
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Everyday life experiences among relatives of persons with mental disabilities
- 2010
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Ingår i: Procedia - Social and Behavioral Sciences. - : Elsevier BV. - 1877-0428. ; 2:2, s. 4896-4900
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Tidskriftsartikel (refereegranskat)abstract
- Mental disability is one of the most significant health problems facing Europe today. For example Statistics reveal that between 20 and 40 percent of the Swedish population suffer from some forms of mental disease, ranging from grave psychoses to less serious anxiety and fear. This study has aimed to illuminate the experiences of relativeś in terms of contacts with persons with mental disabilities. Eighteen tape-recorded interviews were conducted with close relatives of persons suffering from mental disabilities within the health care district of Umeå, Sweden. The results indicate that the daily lives guilt about not providing enough support for their relatives. In addition to feeling physically exhausted and worn out they felt as though they carried a large responsibility and lacked support and back-up in their daily life.
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