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Sökning: WFRF:(Kumlien Christine)

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1.
  • Rystedt, Jenny, et al. (författare)
  • Postoperativa komplikationer
  • 2016. - 1
  • Ingår i: Omvårdnad och kirurgi. - : Studentlitteratur AB. - 9789144088860 ; 1, s. 221-236
  • Bokkapitel (populärvet., debatt m.m.)
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2.
  • Acosta, Stefan, et al. (författare)
  • Engaging patients and caregivers in establishing research priorities for aortic dissection
  • 2019
  • Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 7, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim of this study was to establish the top 10 research uncertainties in aortic dissection together with the patient organization Aortic Dissection Association Scandinavia using the James Lind Alliance concept. Methods: A pilot survey aiming to identify uncertainties sent to 12 patients was found to have high content validity (scale content validity index = 0.91). An online version of the survey was thereafter sent to 30 patients in Aortic Dissection Association Scandinavia and 45 caregivers in the field of aortic dissection. Research uncertainties of aortic dissection were gathered, collated and processed. Results: Together with research priorities retrieved from five different current guidelines, 94 uncertainties were expressed. A shortlist of 24 uncertainties remained after processing for the final workshop. After the priority-setting process, using facilitated group format technique, the ranked final top 10 research uncertainties included diagnostic tests for aortic dissection; patient information and care continuity; quality of life; endovascular and medical treatment; surgical complications; rehabilitation; psychological consequences; self-care; and how to improve prognosis. Conclusion: These ranked top 10 important research priorities may be used to justify specific research in aortic dissection and to inform healthcare research funding decisions.
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3.
  • Ahl, Matilda, et al. (författare)
  • Immune response in blood before and after epileptic and psychogenic non-epileptic seizures
  • 2023
  • Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 9:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Inflammatory processes may provoke epileptic seizures and seizures may promote an immune reaction. Hence, the systemic immune reaction is a tempting diagnostic and prognostic marker in epilepsy. We explored the immune response before and after epileptic and psychogenic non-epileptic seizures (PNES). Serum samples collected from patients with videoEEG-verified temporal or frontal lobe epilepsy (TLE or FLE) or TLE + PNES showed increased interleukin-6 (IL-6) levels in between seizures (interictally), compared to controls. Patients with PNES had no increase in IL-6. The IL-6 levels increased transiently even further within hours after a seizure (postictally) in TLE but not in FLE patients. The postictal to interictal ratio of additionally five immune factors were also increased in TLE patients only. We conclude that immune factors have the potential to be future biomarkers for epileptic seizures and that the heterogeneity among different epileptic and non-epileptic seizures may be disclosed in peripheral blood sampling independent of co-morbidities.
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4.
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5.
  • Angenete, Eva, et al. (författare)
  • Nedre mag-tarmkanalen
  • 2016. - 1
  • Ingår i: Omvårdnad & kirurgi. - 9789144088860 ; , s. 267-286
  • Bokkapitel (refereegranskat)
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6.
  • Axelsson, Malin, 1964-, et al. (författare)
  • A registry study of oral health problems and preventive interventions among older persons receiving municipal healthcare - PROSENIOR
  • 2023
  • Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:2, s. 525-534
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim was to identify planned and completed preventive interventions among older persons with oral health problems receiving municipal health care. A further aim was to determine the correspondence between oral health problems and planned preventive interventions among older persons with oral health problems receiving municipal health care. Design: Cross-sectional register study. Methods: Oral health data from the Swedish national quality registry, Senior Alert, were extracted for 4,024 older persons (>= 65 years) receiving municipal health care in a county in Southern Sweden. Data were statistically analysed. Results: A large majority of older persons (97.4%) with assessed oral health problems had at least one planned preventive intervention, and approximately three quarters of the planned interventions were completed. There seemed to be a mismatch between type of oral health problems and preventive interventions as not all older persons had a planned preventive intervention related to their specific oral health problem.
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7.
  • Axelsson, Malin, 1964-, et al. (författare)
  • Translation and validation of the Swedish version of the IPECC-SET 9 item version
  • 2022
  • Ingår i: Journal of Interprofessional Care. - : Taylor & Francis. - 1356-1820 .- 1469-9567. ; 36:6, s. 900-907
  • Tidskriftsartikel (refereegranskat)abstract
    • Interprofessional Education (IPE) is essential to prepare future health-care professionals for collaborative practice, but IPE requires evaluation. One psychometrically sound instrument is the Interprofessional Education Collaborative Competence Self-Efficacy Tool consisting of nine items (IPECC-SET 9). This tool does not, to date, exist in a Swedish version. Therefore, the aim of this study was to translate and validate the Swedish version of the IPECC-SET 9. The English version was translated into Swedish and tested among 159 students in the 3-year Bachelor Programs in Nursing and in Biomedical Laboratory Science. The psychometric analysis was guided by a Rasch model, which showed that the items functioned well together, confirming unidimensionality, and that the person misfit was also lower than the set criterion. The separation index was 2.98, and the Rasch-equivalent Cronbach-alpha measure was estimated to .92, supporting internal consistency. No systematic differences on item level in IPECC-SET 9 further supported fairness in testing. The Swedish IPECC-SET 9 demonstrates sound psychometric properties and has the potential to be used as a measure of self-efficacy for competence in interprofessional collaborative practice among health profession students. However, the IPECC-SET 9 is recommended to be further tested in larger samples representing the entirety of health-care teams.
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8.
  • Backlund, Anja, et al. (författare)
  • A registry study of nursing assessments, interventions and evaluations according to nutrition for persons living in municipal residential care homes
  • 2018
  • Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 5:3, s. 341-350
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim was to explore planned nursing interventions and evaluations of such interventions, in older people at risk for malnutrition living in municipal residential care homes. Designs: A registry study. Methods: The study was conducted using data from the Swedish national quality registry Senior Alert. Data on all persons assessed and registered in Senior Alert living in municipal residential care homes in a mid‐sized town between January and December 2014 were subjected to statistical analysis. Results: In total, 677 nutritional risk assessments were performed among the participants (N = 587), who were between 65‐109 years. A larger proportion of women were estimated as being at risk for malnutrition compared with men. The three most common prescribed nursing interventions were nutritional treatment, dietary support and weight control; however, interventions were not prescribed for all participants at risk for malnutrition. Lesser than 50% of the interventions were evaluated, with dietary support, pharmaceutical review and weight control the three most likely to be evaluated. Further, planned interventions for participants at risk of malnutrition were implemented more often for men than for women.
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9.
  • Bergerum, Carolina, 1967- (författare)
  • Patient and public involvement in hospital quality improvement interventions : the mechanisms, monitoring and management
  • 2022
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This dissertation focuses on the mechanisms, monitoring and management of patient and public involvement in hospital quality improvement (QI) interventions. Findings from a literature review generated an initial programme theory (PT) on active patient involvement in healthcare QI interventions (Paper 1). Empirical studies were also undertaken in order to describe what was actually happening in the hospital QI teams and what patients and professionals experience influence their joint involvement (Paper 2), and to compare hospital leaders’ and managers’ experiences of managing QI interventions involving patients and the public (Paper 3). Finally, it was studied how patient-reported measures stimulate patient involvement in QI interventions in practice (Paper 4). The research had a qualitative design. The approach was descriptive and comparative, and the studies were carried out prospectively. Data were collected in two hospital organisations in Sweden and in one hospital organisation in the Netherlands. Data collection methods were a literature search (Paper 1), interviews and field observations (Paper 2 and 3) and data collection meetings (Paper 4). Altogether, 93 team meetings and meetings between the team leaders and management were attended and a total of 20 days of study visits with different forms of meetings were made. Twelve patients, 12 healthcare professionals and 17 and 8 hospital leaders and managers, respectively, participated in the interviews and data collection meetings. Realist synthesis was used to formulate the initial PT (Paper 1). Constructivist grounded theory was used to analyse and describe what was happening in the QI teams and how it was experienced by the team members (Paper 2). To compare hospital leaders’ and managers’ different, contextual meanings in Sweden and the Netherlands, the reflexive thematic analysis informed by critical realism was used (Paper 3). To order, manage and map data from 31 examples of local QI interventions associated to patient-reported measures, the framework method was used (Paper 4). The results formulate a generic PT on the mechanisms, monitoring and management perspectives of co-produced QI interventions in hospital services where patients and the public are involved. The PT provides a hypothesis on the various mechanisms at play and outcomes obtained at the different levels of hospital organisations in the process. It is argued that focus should be on experiences, interaction, relationships and dialogue, integration of context, and the matching of hospital resources to patient and public demands and needs. Subsequently, the outcome will be the resources and reasoning interplay resulting in actions and processes, experiences and knowledge, ‘product’ benefits, emotions, judgements and motivations. Monitoring constitutes an important feedback loop to enable such learnings. The PT aligns the perspectives of the clinical microsystem, improvement science and the service-dominant logic, and has a potential to explain how patient and public involvement in QI interventions might work.
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10.
  • Berlin Hallrup, Leena, 1967-, et al. (författare)
  • Service managers' experiences of how the participation of people with intellectual disabilities can be promoted in Swedish group homes
  • 2019
  • Ingår i: JARID. - : John Wiley & Sons. - 1360-2322 .- 1468-3148. ; 32:2, s. 427-434
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: People with intellectual disabilities in staffed group homes often need lifelong support and dependency on others. Thereby, special demands are placed on staff and service managers to ensure opportunities for participation in everyday life. This study aims to explore how service managers promote participation in Swedish group homes for adults with intellectual disabilities. METHOD: A qualitative research design involving individual interviews with 14 service managers was used to gain an understanding of how the participation of adults with intellectual disabilities can be promoted in Swedish group homes. RESULTS: The results comprise two main themes; Creating preconditions for participation and Barriers for promotion of participation. CONCLUSIONS: Service managers experienced that promoting service user participation in group homes was an important part of their responsibility. The findings indicate that structural strategies such as coaching, supervision and reflection are important and should be further developed.
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11.
  • Carlson, Elisabeth, et al. (författare)
  • Perspective Transformationof Cultural Awareness : AQualitative Study on ResearchStudents’ Experiences of International Cross-Institutional Webinars
  • 2024
  • Ingår i: Journal of Transformative Education. - 1541-3446 .- 1552-7840.
  • Tidskriftsartikel (refereegranskat)abstract
    • Twenty-first century transformations have taken place within the framework ofglobalisation of the economy, the spread of information technology and global migrationresulting in increased cultural diversity in many societies. This qualitative studyinvestigated perspective transformation in 18 research students, from Australia, HongKong SAR, and Sweden, participating in an international online course by using Mezirow’stheory of perspective transformation and Kiely’s six forms of transformativechange (intellectual, moral, political, cultural, personal, and spiritual). The approach tolearning facilitated global networking and a commitment to support growth in thestudents’ research practice. Validating the link between research students’ learningexperiences and perspective transformation theory encourages educators to developfuture online educational materials to promote cognitive flexibility and reflexivity andincrease students’ cultural awareness to inform their research practices.
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12.
  • Ekelund, Mikael, et al. (författare)
  • Fetmakirurgi
  • 2016
  • Ingår i: Omvårdnad & Kirurgi. - 9789144088860 ; , s. 289-300
  • Bokkapitel (refereegranskat)
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13.
  • Elbe, Peter, et al. (författare)
  • Övre mag-tarm-kanalen
  • 2016. - 1
  • Ingår i: Omvårdnad & kirurgi. - 9789144088860 ; , s. 251-266
  • Bokkapitel (refereegranskat)
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14.
  • Ericsson, Anna, et al. (författare)
  • Impact on Quality of Life of Men with Screening-Detected Abdominal Aortic Aneurysms Attending Regular Follow ups : A Narrative Literature Review
  • 2019
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 57:4, s. 589-596
  • Forskningsöversikt (refereegranskat)abstract
    • Objective: This study aimed to review, summarise, and assess the available evidence regarding the impact on the quality of life (QoL) of men undergoing screening for abdominal aortic aneurysm (AAA) and attending regular follow ups. Methods: PubMed, MEDLINE, CINAHL, and PsycINFO were used for searching. The search was performed from April to July 2016, with an update in February-March 2018. The quality of the studies was appraised with respective checklists from the Critical Appraisal Skills Programme. A narrative synthesis of the included studies was performed. The analysis included studies evaluating QoL in relation to one or more of the following concepts: physical function, psychological impact and social life in men undergoing AAA screening, but excluded studies evaluating QoL in AAA patients diagnosed outside a screening program. Results: The initial results from the search were 128 articles. Duplicates were removed, titles and abstracts were screened, and 22 full text articles were collected. Based on the inclusion criteria, 11 quantitative studies were included. Inferior quality of life among men with detected AAA was identified compared to those without the diagnosis and the general population in the included studies. The self-perceived health decreased over time for the participants with AAA. Assessments after surgery showed that the participants returned to similar health as before the screening. A wide variety of factors regarding the methodologies, designs, measurements, sample sizes, and the time for the assessment were noted in the included studies. Conclusion: Quality of life is an important outcome for AAA screening and studies have been conducted in an attempt to address the imbalance between benefits and harm. However, it is still difficult to draw clear conclusions, possibly due to the heterogeneity of the original studies. Nevertheless, it is important to identify men with an AAA who develop conditions influencing their health and QoL in order to understand their care needs to further support them and improve their situation.
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15.
  • Ericsson, Anna, et al. (författare)
  • Partners' experiences of living with men who have screening-detected abdominal aortic aneurysms : A qualitative descriptive study
  • 2020
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:19-20, s. 3711-3720
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To describe partners' experiences of living with men with a screening-detected abdominal aortic aneurysm (AAA).BACKGROUND: Diagnosis of a chronic life-threatening disease affects the patients' as well as their partners' lives in different aspects. AAA, with rupture as the major consequence, is a life-threatening disease that can affect the whole family. Screening programmes for AAA have been introduced in several countries to reduce the mortality rate. Although the awareness of having an AAA influences the individuals' quality of life and well-being, it is still unclear how it affects their partners.DESIGN: Qualitative descriptive design.METHODS: . The data were analysed using qualitative content analysis. The study conforms to the COREQ checklist.RESULTS: Three categories were identified: (a) experiencing the unexpected; (b) being reminded of fragility; and (c) balancing a changing relationship. The partners had a positive attitude towards the screening process and were pleased that their husbands were under surveillance. Nevertheless, at the same time, the diagnosis caused worries and questions. The AAA diagnosis was constantly in the minds of the partners, which sometimes affected and limited daily activities. Furthermore, ambivalent feelings towards surgical treatment were described. The partners tried to support their men and encouraged them to achieve a healthy lifestyle.CONCLUSION: The partners' well-being and daily lives were impacted by the awareness of the screening-detected AAA. Different degrees of worry were the most common reaction and were pervasive in all three categories.RELEVANCE FOR CLINICAL PRACTICE: The result highlights the need to review routines or develop new strategies to include the partners in the process of screening and offer supplementary support and information.
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16.
  • Ericsson, Anna, et al. (författare)
  • Patients' Experiences During Carotid Endarterectomy Performed Under Local Anesthesia
  • 2018
  • Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 33:6, s. 946-955
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To describe patients' experiences undergoing a carotid endarterectomy (CEA) under local anesthesia. Design: Explorative qualitative design. Methods: Semistructured interviews with 15 participants who had undergone CEA under local anesthesia, analyzed by content analysis. Findings: Undergoing CEA under local anesthesia entails enduring stress with no possibility of withdrawal. Patients' lack of understanding of local anesthesia and experiencing pain and discomfort caused feelings of stress. The surgery resulted in a loss of control; patients had to surrender their autonomy to someone else. The nurse anesthetist was the link to the world outside the operating room (OR), and that nurse conveyed feelings of safety and security during the surgery. Conclusions: Patients' experiences ranged from being pleased with the surgical procedure and local anesthesia to vowing never to undergo such a procedure again. It is important to focus on the patients' experiences and feelings when choosing a method of anesthesia.
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17.
  • Ericsson, Anna, et al. (författare)
  • Psychosocial consequences in men taking part in a national screening program for abdominal aortic aneurysm
  • 2017
  • Ingår i: Journal of Vascular Nursing. - : Elsevier. - 1062-0303 .- 1532-6578. ; 35:4, s. 211-220
  • Tidskriftsartikel (refereegranskat)abstract
    • Screening for abdominal aortic aneurysm (AAA) has proven to reduce AAA-related mortality, but how the knowledge of having an untreated AAA affects health and daily life requires further clarification. The aim was to investigate the psychosocial consequences and sense of coherence (SOC) in 65-year-old men diagnosed with AAA and participating in a national screening program during a 6-month follow-up compared with men with no AAA. The single-center cohort study included 52 men with AAA and 118 men without AAA. A questionnaire including the Short Form 36 Health Survey, Hospital Anxiety and Depression Scale, SOC, questions concerning stress, and questions related to AAAwere answered at baseline and after 6 months. Men with AAA reported more problems with physical functioning, pain, and general health than men with a normal aorta at baseline. After 6 months, men with AAA still reported more problems with physical functioning and stress in relation to disease than men with normal aortic diameter. No differences were observed between groups in SOC, anxiety, and depression. A significantly higher satisfaction with information from the physician and desire to learn about the AAA diagnosis was reported at baseline compared with that at follow-up. Having knowledge about the AAA diagnosis may moderately impact physical health and perceived stress, and in combination with the increased prevalence of other cardiovascular diseases, may lead to impaired perceived health for men diagnosed with AAA.
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18.
  • Forsberg, Anna, et al. (författare)
  • Akuta buksmärtor
  • 2016
  • Ingår i: Omvårdnad & Kirurgi. - 9789144088860 ; , s. 41-56
  • Bokkapitel (refereegranskat)
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19.
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20.
  • Forsberg, Anna, et al. (författare)
  • Transplantationskirurgi
  • 2016
  • Ingår i: Omvårdnad & Kirurgi. - 9789144088860 ; , s. 435-452
  • Bokkapitel (refereegranskat)
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21.
  • Jakobsson, Jenny, 1975-, et al. (författare)
  • Everyday challenges following hospital discharge. A multi-method study identifying and describing areas of concern for patients during the first month after colorectal cancer surgery
  • 2023
  • Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:4, s. 2172-2181
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: Identify and describe areas of concern focusing on day-to-day variations during the first month after surgery for patients recovering from colorectal cancer surgery.DESIGN: A multi-method design was applied using diaries and interviews.METHOD: Data was collected using semi-structured diaries kept 1 month after surgery by seven patients recovering from colorectal cancer surgery. Also, face-to-face interviews were conducted 1 month after surgery. Data from the diaries constituted a framework for the following directed content analysis of interviews.FINDINGS: Low levels of pain were experienced but caused reduced mobility and tiredness. Practical matters in daily living were restricted, while social life could be hampered by a frequent need to defecate. Appetite and consequently the ability to eat and drink was the most prominent concern, due to changes in taste and ability to tolerate food. Worries were mainly related to changes in bowel movements. No Patient or Public Contribution.
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22.
  • Jakobsson, Jenny, et al. (författare)
  • Patient characteristics and surgery-related factors associated with patient-reported recovery at 1 and 6 months after colorectal cancer surgery
  • 2017
  • Ingår i: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 26:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Predictors for postoperative recovery after colorectal cancer surgery are usually investigated in relation to length of stay (LoS), readmission, or 30-day morbidity. This study describes patient characteristics and surgery-related factors associated with patient-reported recovery 1 and 6 months after surgery. In total, 153 consecutively included patients who were recovering from colorectal cancer surgery reported their level of recovery using the Postoperative Recovery Profile. Multiple logistic regression analysis was used to calculate associations with recovery, defined as good or poor, divided into five recovery dimensions: physical symptoms, physical functions, psychological, social and activity. Better preoperative health predicted good recovery regarding three dimensions 1 month after surgery. Regarding all dimensions 1 month after surgery, poor recovery was predicted by a poor recovery on the day of discharge within corresponding dimensions. Higher age was associated with good recovery 6 months after surgery, while chemotherapy showed negative associations. Overall, a majority of factors had a negative impact on recovery, but without any obvious relation to one specific dimension or point in time. Those factors were: high Body Mass Index, comorbidity, abdominoperineal resection, loop ileostomy, colostomy and LoS. This study illustrates the complexity of postoperative recovery and a need for individualised follow-up strategies.
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23.
  • Jakobsson, Jenny, et al. (författare)
  • The lived experience of recovery during the first 6 months after colorectal cancer surgery
  • 2017
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 4498-4505
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: To describe the lived experience of recovery during the first 6 months after colorectal cancer surgery. BACKGROUND: Colorectal cancer is the third most common cancer diagnosis worldwide. Early discharge places demands on healthcare professionals to prepare patients for their return home and to provide them with appropriate support throughout the recovery process. This requires knowledge of what it is like to recover from colorectal cancer surgery. DESIGN: A qualitative phenomenological design was used to describe the structure of recovery after colorectal cancer surgery. METHODS: Ten patients recovering from colorectal cancer surgery were interviewed at one month and six months after surgery. The descriptive phenomenological method by Giorgi was used throughout the study. RESULTS: Postoperative recovery was described as a progressive process. This process was accompanied by experiences of physical powerlessness, difficulties with food intake, altered bowel function and dependency on others. The experiences were most intense at the beginning of the recovery but disappeared as time went by and normality in life returned. CONCLUSION: While recovering from colorectal cancer surgery, patients experience obstacles that impede their ability to live life as normal. Six months after surgery, those experiences disappear or become adjusted to being part of normal life. RELEVANCE TO CLINICAL PRACTICE: Patients should be provided with information about the expected postoperative recovery before discharge from hospital. The need for professional support appears to be most frequently needed in early recovery, but it should be considered on an individual basis.
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24.
  • Kumlien, Christine, et al. (författare)
  • Evaluation of self-management program outcomes: Adaptation and testing of a Swedish version of the Health Education Impact Questionnaire (heiQ)
  • 2018
  • Ingår i: Journal of Applied Measurement. - : JAM Press. - 1529-7713. ; 19:3, s. 303-319
  • Tidskriftsartikel (refereegranskat)abstract
    • Self-management programs require a range of indicators to evaluate their outcomes. The Health Education Impact Questionnaire (heiQ) was developed to meet this need. The heiQ contains 40 items with 4 response categories, representing eight scales. We developed a Swedish version of the heiQ that was tested by cognitive interviews (n=15) and psychometrically (n=177) using classical test theory (CTT) and Rasch measurement theory (RMT). The Swedish heiQ was easily understood by interviewees and met CTT criteria, with supported scaling assumptions (corrected item-total correlations, ≥0.37) and reliability (ordinal alpha ≥0.78). General support was demonstrated for the measurement properties of the eight heiQ scales by acceptable RMT fit. However, there were signs of malfunctioning response categories for four items in two scales, and of suboptimal item coverage of the measurement continua. The Swedish heiQ appears comparable to other available language versions. Further efforts may be needed to optimize response categories and measurement precision.
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25.
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26.
  • Kumlien, Christine, et al. (författare)
  • Psychometric properties of a modified cultural awareness scale for use in higher education within the health and social care fields
  • 2020
  • Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Cultural awareness and cultural competence have become important skills in higher education as populations continue to grow in diversity around the world. However, currently, there are few instruments designed to assess student awareness of the aspects of culture, and the existing instruments need further development and testing for use with different target populations. Therefore, the aim of this study was to test the psychometric properties of a modified version of the Cultural Awareness Scale (CAS) for use in higher education within the health and social care fields.METHODS: A modified version of the CAS was developed, which was tested psychometrically using cross-sectional data. In total, 191 undergraduate students from different health and social care undergraduate programs in Sweden and Hong Kong responded to a call to test the modified instrument.RESULTS: The results showed that the modified CAS is a four-factor measure of cultural awareness and possesses satisfactory internal consistency. Results also support the use of the modified CAS as a generic tool to measure cultural awareness among students in higher education within the health and social care fields.CONCLUSION: The modified CAS showed satisfactory psychometric properties and can be recommended as a generic tool to measure cultural awareness among students in higher education within the health and social care fields. However, further psychometric testing on the effectiveness of the modified CAS as a tool to evaluate the efficacy of cultural awareness interventions is required.
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27.
  • Kumlien, Christine, et al. (författare)
  • Research priorities to prevent and treat diabetic foot ulcers-A digital James Lind Alliance Priority Setting Partnership
  • 2022
  • Ingår i: Diabetic Medicine. - : John Wiley & Sons. - 0742-3071 .- 1464-5491. ; 39:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim To establish outcomes of a priority setting partnership between participants with diabetes mellitus and clinicians to identify the top 10 research priorities for preventing and treating diabetic foot ulcers (DFUs). Methods Due to the COVID-19 pandemic, the James Lind Alliance Priority Setting Partnership process was adapted into a digital format which involved a pilot survey to identify understandable uncertainties with high relevance for participants tested by calculating the content validity index; a main survey answered by 53 participants living with diabetes and 49 clinicians; and a final digital workshop to process and prioritise the final top 10 research priorities. Results The content validity index was satisfactory for 20 out of 25 uncertainties followed by minor changes and one additional uncertainty. After we processed the 26 uncertainties from the main survey and seven current guidelines, a list of 28 research uncertainties remained for review and discussion in the digital workshop. The final top 10 research priorities included the organisation of diabetes care; screening of diabetes, impaired blood circulation, neuropathy, and skin properties; vascular surgical treatment; importance of self-care; help from significant others; pressure relief; and prevention of infection. Conclusion The top 10 research priorities for preventing and treating DFUs represent consensus areas from persons living with diabetes and clinicians to guide future research. These research priorities can justify and inform strategic allocation of research funding. The digitalisation of James Lind Alliance methodology was feasible.
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28.
  • Kumlien, Christine, et al. (författare)
  • Validity and test retest reliability of the vascular quality of life Questionnaire-6: a short form of a disease-specific health-related quality of life instrument for patients with peripheral arterial disease
  • 2017
  • Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Many existing patient-reported outcome measures are extensive regarding both patient burden and administration, and in terms of analysing and reporting results. The VascuQoL-6 (VQ6) - a short version of the original Vascular Quality of Life Questionnaire (VascuQoL), a disease-specific instrument for peripheral arterial disease - was recently developed. However, the VQ6 has not yet been empirical tested with regard to content validity, construct validity and test retest reliability. Our aim was, therefore, to explore both the validity and the reliability of the VQ-6 in a target population with established peripheral arterial disease. Methods: Two hundred patients treated at two vascular centres were consecutively recruited for the survey. Administered questionnaires included VQ6 and the Short Form Health Survey-36 (SF-36). Out of the 200 patients, 150 also received a second VQ6 questionnaire for a test-retest assessment. Further, a purposive sample of 22 patients consented to participate in cognitive interviews. All included patients suffer from peripheral arterial disease. The questionnaire data was tested by both Rasch analysis and traditional psychometric methods, while the cognitive interviews were analysed descriptively. Results: The validity and reliability of the VQ6, as tested in a target population without the surrounding 19 items from the original VascuQoL, was high, in general, and a good fit to the Rasch model was observed. Further, an excellent internal consistency and significant correlations between comparable dimensions in SF-36 were demonstrated. In the test-retest analysis, the percentage agreement was somewhat poor (<70%) in the six items. However, no systematic disagreements between the two assessments were seen in any of the six items, and the test-retest assessment for the VQ6 sum score showed an acceptable intraclass correlation coefficient (0.86). Finally, all items in the VQ6 were considered as both understandable and relevant by the interviewed patients. Conclusions: The VQ6 has acceptable to good psychometric properties with regard to data quality, scale assumptions, targeting, validity and reliability. Further, VQ6 seems to be easy to use and comprehend within the target population of patients with PAD.
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29.
  • Lampridou, Smaragda, et al. (författare)
  • Health Related Quality of Life Following Intervention for Thoracoabdominal Aortic Aneurysm : a Systematic Review and Narrative Synthesis
  • 2024
  • Ingår i: Annals of Vascular Surgery. - : Elsevier. - 0890-5096 .- 1615-5947. ; 101, s. 105-119
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Thoracoabdominal aortic aneurysms (TAAA) pose significant risks of morbidity and mortality. Considering the evolving techniques for TAAA intervention and the growing interest in quality of life (QoL) outcomes for decision-making, we aimed to evaluate the impact of patient and perioperative characteristics on short-, medium-, and long-term post-operative QoL in TAAA repair patients.METHODS: A systematic search was conducted in CINAHL, APA PsycINFO, EMBASE, Medline and Cochrane to identify primary research studies evaluating QoL post TAAA surgery, published in English or Swedish between 01 January 2012 and 26 September 2022. A narrative synthesis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence was assessed using the Critical Appraisal Skills Programme and Joanna Briggs Institute checklists.RESULTS: Eight studies of low or moderate quality with 455 patients were included. Preoperative QoL in TAAA patients was lower compared to the general population. While there is an initial short-term improvement in post-operative QoL, patients fail to reach baseline levels even after seven years, with physical activity and functioning domains being particularly affected. Experiencing post-operative complications, including paraplegia and cardiovascular events, negatively impacts post-operative QoL. Patients with uncomplicated postoperative status had improved QoL. Prolonged hospital stay negatively affects physical functioning.CONCLUSIONS: Individuals with TAAA are likely to have lower baseline QoL compared to the general population. Following TAAA repair, post-operative QoL may remain lower than baseline levels, persisting over the long-term. Comorbidities, post-operative complications, and hospitalisation duration appear to exert adverse effects on post-operative QoL.
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30.
  • Larsson, Helena, et al. (författare)
  • Spouses' existential loneliness when caring for a frail partner late in life : a hermeneutical approach.
  • 2020
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Spouses are in a vulnerable situation when caring for a frail partner late in life. Exploring their existential loneliness can be a way to understand more about their existential needs.Method: A hermeneutic approach was used. Multistage focus group interviews were conducted with two groups consisting of five spouses, respectively, who met three times each. To work with the text, an approach was adapted where quotations are converted into poems in a linguistic manner.Results: Existential loneliness can be understood as the following: 1) being in a transition from us to merely me, 2) being forced to make decisions and feeling excluded, 3) navigating in an unfamiliar situation and questioning oneself, and 4) longing for togetherness but lacking the energy to encounter other people. The main interpretation is that existential loneliness emerges when one is in moments of inner struggle, when one is forced to make impossible choices, when one is approaching and is in limit situations, and when one is experiencing the endless loss of the other.Conclusion: For health care professionals to achieve a holistic picture, person-centeredness can be a way to make the spouses' existential needs visible and to provide support based on their needs.
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31.
  • Larsson, Helena, et al. (författare)
  • Spouses' existential loneliness when caring for a frail partner late in life : a hermeneutical approach.
  • 2020
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor and Francis Ltd.. - 1748-2623 .- 1748-2631. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Spouses are in a vulnerable situation when caring for a frail partner late in life. Exploring their existential loneliness can be a way to understand more about their existential needs.Method: A hermeneutic approach was used. Multistage focus group interviews were conducted with two groups consisting of five spouses, respectively, who met three times each. To work with the text, an approach was adapted where quotations are converted into poems in a linguistic manner.Results: Existential loneliness can be understood as the following: 1) being in a transition from us to merely me, 2) being forced to make decisions and feeling excluded, 3) navigating in an unfamiliar situation and questioning oneself, and 4) longing for togetherness but lacking the energy to encounter other people. The main interpretation is that existential loneliness emerges when one is in moments of inner struggle, when one is forced to make impossible choices, when one is approaching and is in limit situations, and when one is experiencing the endless loss of the other.Conclusion: For health care professionals to achieve a holistic picture, person-centeredness can be a way to make the spouses' existential needs visible and to provide support based on their needs.
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32.
  • Larsson, Helena, et al. (författare)
  • Swedish family care advisors’ views on existential loneliness and existential support to informal caregivers of older people : A cross-sectional national survey
  • 2021
  • Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; , s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The number of older people needing care is increasing, and care is often provided by informal caregivers. The mission of family care advisors (FCAs) is to provide them with support; however, whether and how support in existential matters such as existential loneliness is provided is unclear. Therefore, the aim of this study was to describe FCAs’ views on existential loneliness, and existential support provided to relatives who act as informal caregivers to older people. A national survey was distributed to 349 FCAs in Sweden, response rate n = 120 (36%). The STROBE checklist was followed when presenting the study. Existential loneliness was viewed as thoughts about life and meaning (78%). Existential support was provided by dialogues (87%), visits (75%) and support groups (73%); 45% of FCAs stated that they had time to provide existential support and 27% reported having knowledge of how to encounter existential loneliness. FCAs provide existential support, but often lack experience, knowledge and time. Time and knowledge are important prerequisites for acknowledging existential needs.
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33.
  • Larsson, Helena, et al. (författare)
  • Swedish family care advisors’ views on existential loneliness and existential support to informal caregivers of older people : A cross-sectional national survey
  • 2021
  • Ingår i: Nordic journal of nursing research. - : SAGE Publications Ltd. - 2057-1585 .- 2057-1593. ; 42:2, s. 93-100
  • Tidskriftsartikel (refereegranskat)abstract
    • The number of older people needing care is increasing, and care is often provided by informal caregivers. The mission of family care advisors (FCAs) is to provide them with support; however, whether and how support in existential matters such as existential loneliness is provided is unclear. Therefore, the aim of this study was to describe FCAs’ views on existential loneliness, and existential support provided to relatives who act as informal caregivers to older people. A national survey was distributed to 349 FCAs in Sweden, response rate n = 120 (36%). The STROBE checklist was followed when presenting the study. Existential loneliness was viewed as thoughts about life and meaning (78%). Existential support was provided by dialogues (87%), visits (75%) and support groups (73%); 45% of FCAs stated that they had time to provide existential support and 27% reported having knowledge of how to encounter existential loneliness. FCAs provide existential support, but often lack experience, knowledge and time. Time and knowledge are important prerequisites for acknowledging existential needs.
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34.
  • Leung, Doris, et al. (författare)
  • Exploring research cultures through internationalization at home for doctoral students in Hong Kong and Sweden
  • 2017
  • Ingår i: Nursing and Health Sciences. - : John Wiley & Sons. - 1441-0745 .- 1442-2018. ; 19:4, s. 525-531
  • Tidskriftsartikel (refereegranskat)abstract
    • Cultural skills are fundamental to developing global academic scholars. Internationalization at home can facilitate the acquisition of these skills without students having to go abroad. However, research on the effect of internationalization of higher education is scarce, despite apparent benefits to incorporating cultural sensitivity in research. Further, little is known about the role information and communication technology plays. In this pilot study, we describe the experience of doctoral students with an internationalization‐at‐home program, and its impact on developing an understanding about different research cultures. Eight doctoral nursing students from Sweden and Hong Kong participated in five webinars as “critical friends”. The study followed a descriptive, qualitative design. The results demonstrated that students observed cultural differences in others' research training programs. However, while cultural differences reinforced friendship among local peers, they challenged engagement with critical friends. Challenges led to the perception of one another not as critical friends but as “distant” friends. We discuss the possible reasons for these outcomes, and emphasize a need to nurture connectivity and common goals. This would prepare students to identify, translate, and recognize cultural differences to help develop knowledge of diverse research cultures.
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35.
  • Leung, Doris Y, et al. (författare)
  • Using internationalization-at-home activities to enhance the cultural awareness of health and social science research students : A mixed-method study
  • 2021
  • Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 100
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Despite healthcare scholars valuing diversity, current cultural awareness training does not address mechanisms that drive societal patterns, that generates cultural insensitivity and reinforces stereotypes of minority groups. The influence of culture on thinking is an important issue because of potential ethnocentric biases on the design, data collection, analysis, and dissemination of research.OBJECTIVES: Using internationalization-at-home activities to explore the mechanisms that enhance the development of cultural awareness in postgraduate health and social science research students.DESIGN AND METHODS: A pragmatic critical realist study, qualitatively dominant, using mixed-methods to integrate and analyze qualitative and quantitative data. Data were collected pre- and post-internationalization-at-home activities. Qualitative data were collected from online discussion forums and focus groups, and quantitative data were collected from a pre-test and post-test measure of cultural awareness.SETTING AND PARTICIPANTS: Eighteen research students in postgraduate health and social science programs from three universities (Australia, Hong Kong, and Sweden) participated in five formal internationalization-at-home webinars and informal international group activities.RESULTS: Participants reported four mechanisms counteracting structures (i.e., ethnocentric biases) toward the emergence of cultural awareness: 1. awareness of cultural issues motivating people toward achieving a common goal; 2. reflexivity within psychological safety; 3. deliberations that challenge the veracity of individual assumptions; 4. courage coupled with curiosity. When some or all the mechanisms occurred, properties of enhanced cultural awareness emerged, as confirmed by the quantitative data.CONCLUSIONS: Cultural awareness training should emphasize social relations to allow cultural safety to develop for postgraduate health and social science research students. Without skills revealing unconsciously held ethical values, this study argues that postgraduate health and social science students may inadvertently reconstitute and reinforce in their research the discrimination of underserved groups.
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36.
  • Lie Ken Jie, Christopher, et al. (författare)
  • Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence : An Integrated Systematic Review
  • 2022
  • Ingår i: Academic Medicine. - : Lippincott Williams & Wilkins. - 1040-2446 .- 1938-808X. ; 97:11, s. 1707-1721
  • Forskningsöversikt (refereegranskat)abstract
    • PURPOSE: The COVID-19 pandemic revealed a global urgency to address health care provision disparities, which have largely been influenced by systematic racism in federal and state policies. The World Health Organization recommends educational institutions train clinicians in cultural competence (CC); however, the mechanisms and interacting social structures that influence individuals to achieve CC have received little attention. This review investigates how postgraduate health and social science education approaches CC and how it accomplishes (or not) its goals.METHOD: The authors used critical realism and Whittemore and Knafl's methods to conduct a systematic integrated review. Seven databases (MEDLINE, CINAHL, PsycINFO, Scopus, PubMed, Web of Science, and ERIC) were searched from 2000 to 2020 for original research studies. Inclusion criteria were: the use of the term "cultural competence" and/or any one of Campinha-Bacote's 5 CC factors, being about postgraduate health and/or social science students, and being about a postgraduate curriculum or a component of it. Thematic analysis was used to reveal the mechanisms and interacting social structures underlying CC.RESULTS: Thirty-two studies were included and 2 approaches to CC (themes) were identified. The first theme was professionalized pedagogy, which had 2 subthemes: othering and labeling. The second theme was becoming culturally competent, which had 2 subthemes: a safe CC teaching environment and social interactions that cultivate reflexivity.CONCLUSIONS: CC conceptualizations in postgraduate health and social science education tend to view cultural differences as a problem and CC skills as a way to mitigate differences to enhance patient care. However, this generates a focus on the other, rather than a focus on the self. Future research should explore the extent to which insight, cognitive flexibility, and reflexivity, taught in safe teaching environments, are associated with increasing students' cultural safety, cultural humility, and CC.
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37.
  • Lindsjö, Cecilia, et al. (författare)
  • Health promotion focusing on migrant women through a community based participatory research approach
  • 2021
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 21
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Migrants are often more vulnerable to health issues compared to host populations, and particularly the women. Therefore, migrant women's health is important in promoting health equity in society. Participation and empowerment are central concepts in health promotion and in community-based participatory research aimed at enhancing health. The aim of this study was to identify conditions for health promotion together with women migrants through a community-based participatory research approach. Methods A community-based participatory research approach was applied in the programme Collaborative Innovations for Health Promotion in a socially disadvantaged area in Malmo, Sweden, where this study was conducted. Residents in the area were invited to participate in the research process on health promotion. Health promoters were recruited to the programme to encourage participation and a group of 21 migrant women participating in the programme were included in this study. A qualitative method was used for the data collection, namely, the story-dialogue method, where a process involving issue, reflections and actions guided the dialogues. The material was partly analysed together with the women, inspired by the second-level synthesis. Results Two main health issues, mental health and long-term pain, were reflected upon during the dialogues, and two main themes were elaborated in the process of analysis: Prioritising spare time to promote mental health and Collaboration to address healthcare dissatisfaction related to long-term pain. The women shared that they wanted to learn more about the healthcare system, and how to complain about it, and they also saw the togetherness as a strategy along the way. A decision was made to start a health circle in the community to continue collaboration on health promotion. Conclusions The community-based participatory research approach and the story dialogues constituted an essential foundation for the empowerment process. The health circle provides a forum for further work on conditions for health promotion, as a tool to support migrant women's health.
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38.
  • Lindsjö, Cecilia, et al. (författare)
  • Migrant women's engagement in health-promotive activities through a women's health collaboration
  • 2023
  • Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.Aim: The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.Materials and methods: This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.Result: Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.Conclusion: The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.
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39.
  • Lyttkens, Linda (författare)
  • Health Related Quality of Life in patients with screening detected Sub-Aneurysmal aorta and Abdominal Aortic Aneurysm
  • 2023
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Objective Paper I: Most screening and opportunistically detected abdominal aortic aneurysms (AAA) are small and kept under surveillance for several years before preventive surgery. Living with the diagnosis of an AAA may have an influence on the patient’s life. The aim was to review systematically review the current knowledge of the effect on health related quality of life (HRQoL) and patients’ experiences of living with an AAA while under surveillance.Paper II: To investigate HRQoL and comorbidity in men with screening detected AAA, Sub-Aneurysmal aorta (SAA) and Controls at baseline screening and after long-term follow-up.Methods Paper I: A systematic literature review of quantitative and qualitative studies, which were quality assessed according to the GRADE system, was carried out. PubMed, Cochrane, Embase, CINAHL, PsycINFO, and MEDLINE were searched. Narrative synthesis and meta-analysis were performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Paper II: Between 2006 and 2015, 16 689 sixty-five-year old men participated in the aortic screening program in the county of Uppsala in Sweden. All 539 men diagnosed with an SAA or AAA were invited to participate in the study UpAAA and 324 accepted. Baseline questionnaires was distributed after screening, and at 5-year follow-up. For each year a control group of approx. 50 men, participating in the screening program with normal aorta, were included. ResultsPaper I: Synthesis and meta-analyses of studies based on the Short Form-36 demonstrated that patients with an AAA consistently rated their general health lower than controls and conveyed no significant negative impact for patients with an AAA when assessed at follow up and compared with pre-screening. Analysis of HRQoL estimates of mental health, anxiety, and depression demonstrated no significant differences for patients with AAA compared with controls, or within the AAA group. Qualitative studies revealed that patients with an AAA felt safe being under surveillance and receiving a diagnosis of AAA set thoughts and feelings in motion regarding health, ageing, and mortality. Patients’ lack of knowledge about the disease, its progression, and future planning can cause insecurity and worries.Paper II: AAA and SAA group both has impairment in the physical dimensions of HRQOL and a higher prevalence of co-morbidity at baseline, compared to controls. At 5-year follow-up, the similarities between AAA and SAA group remained with no difference in HRQOL but a higher prevalence of CVD, hypertension and diabetes in men with AAA. Compared with controls both AAA and SAA had significantly higher impairment in HRQoL, and prevalence of co-morbidity and the AAA group was most affected.
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40.
  • Monsen, Christina, et al. (författare)
  • Patients experience of negative pressure wound therapy at home for treatment of deep perivascular groin infection after vascular surgery
  • 2017
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 26:9-10, s. 1405-1413
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives To explore experiences of negative pressure wound therapy at home, in patients with deep perivascular groin infection after vascular surgery and management in daily life. Background Deep surgical site infection after vascular surgery with exposed vessels often requires long-term treatment with negative pressure wound therapy, and continued therapy at home has become routine. Design An explorative qualitative study. Methods Nine men and six women with a deep surgical site infection in the groin after vascular surgery, treated in their home with negative pressure wound therapy, were interviewed. The interviews were analysed using manifest and latent content analysis. Results Undergoing negative pressure wound therapy at home meant a transition from being a dependent patient to a person who must have self-care competence and be involved in their own care. A need to feel prepared for this before discharge from hospital was expressed. Lack of information and feelings of uncertainty prolonged the time before feeling confident in managing the treatment. The informants gradually accepted the need to be tied up to a machine, became competent in its management and found solutions to perform everyday tasks. Overall, it was a relief to be treated at home. Conclusions Several benefits of negative pressure wound therapy at home were expressed. However, unnecessary stress and anxiety were experienced due to a lack of information on the treatment and instruction concerning the equipment. Adequate information and education must therefore be provided to facilitate the transition from a patient to a person with self-care competence and ability to manage this treatment at home. Relevance to clinical practice The findings revealed a need for more support and knowledge in their transition from hospital care to home care with negative pressure wound therapy. Routines must be established that ensure patient safety and security in treatment at home.
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41.
  • Neziraj, Merita, et al. (författare)
  • Prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls : a register study among older persons receiving municipal health care in southern Sweden
  • 2021
  • Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Although pressure ulcers, malnutrition, poor oral health and falls are common among older persons, causing deteriorated health status, they have not been studied altogether among older persons receiving different types of municipal health care. The aim of this study was to determine the prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls among older persons aged ≥65 years receiving municipal health care in southern Sweden.METHODS: A retrospective cross-sectional study (n = 12,518 persons aged ≥65 years) using data from the national quality registry Senior Alert was conducted. The prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls was calculated based on categorical data from the instruments available in Senior Alert. T-tests, chi-square test, the Mantel- Haenszel test and logistic regression models were performed.RESULTS: The prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls was 27.9, 56.3, 34.2 and 74.5% respectively. Almost 90% of the older persons had at least one health risk. The prevalence of risk for pressure ulcers, poor oral health and falls was significantly higher in dementia care units compared to short term nursing care, home health care and nursing homes. The prevalence of risk for malnutrition was significantly higher among older persons staying in short term nursing care compared to other types of housing. The odds of having a risk for malnutrition were higher in short term nursing care compared to other types of housing. The oldest age group of 95-106 years had the highest odds of having a risk for falls. The presence of multiple health risks in one subject were more common in dementia homes compared to nursing homes and home health care but not compared to short term nursing care.CONCLUSION: The prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls was high, implying that these health risks are a great concern for older persons receiving municipal health care. A comprehensive supporting preventive process to prevent all the investigated health risks among older persons receiving municipal health care is recommended.
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42.
  • Neziraj, Merita, et al. (författare)
  • Prevention of pressure ulcers, malnutrition, poor oral health and falls in nursing homes : A focus group study with nurse aides, registered nurses and managers
  • 2021
  • Ingår i: International Journal of Nursing Studies Advances. - : Elsevier. - 2666-142X. ; 3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Despite available knowledge how to prevent the risk of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes, these risks still frequently occur and cause a major burden for older persons; furthermore, for the health care system, they are extremely costly. One way to combat these risks is to register the prevention process in quality registries. However, the increasing older population worldwide is going to put high demands on those working with this group of people. Objective: To explore how nurse aides, registered nurses and managers in nursing homes experience working with the prevention of pressure ulcers, malnutrition, poor oral health and falls in general and according to the quality register Senior Alert care process. Methods: A qualitative study was conducted in nursing homes in a municipality in southern Sweden. We purposively sampled nurse aides, registered nurses and managers (n = 21) working in nursing homes registered in the quality register Senior Alert, who then participated in one of five focus group semistructured digital interviews held between February and April 2020. The interviews were audio recorded. Data were analysed using reflexive thematic analysis. Results: Our findings explore how nurse aides, registered nurses and managers experience working with the prevention of pressure ulcers, malnutrition, poor oral health and falls in nursing homes both in general and according to Senior Alert. The following four themes were generated during the analysis: (1) is included in the everyday work, (2) requires team effort, (3) requires handling many challenges and (4) requires finding strategies. Conclusion: The prevention of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes is complex. There is a commitment and responsibility among nurse aides, registered nurses and managers regarding preventive work and team effort, and finding useful strategies is necessary for the work to be successful. However, challenges, both at the individual and organizational levels, are involved, which implies that smoother organizational routines facilitating this preventive work are needed. Although nurse aides, registered nurses and managers are good at finding strategies that facilitate this work, one of the main challenges seems to lie in the variety of knowledge found among those working in nursing homes, particularly among nurse aides. This challenge was voiced by all the professionals, which suggests the need for a tailored educational intervention aimed at increasing the related knowledge among those working in nursing homes to enhance preventive work.
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43.
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44.
  • Neziraj, Merita, et al. (författare)
  • The STAIR OF KNOWLEDGE-a codesigned intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes in Sweden : development of a complex intervention
  • 2023
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:8
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To describe the development of a codesigned complex intervention intended to prevent the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes.DESIGN: : Nursing homes in the municipality in southern Sweden.PARTICIPANTS: End users (n=16) in nursing homes (n=4) codesigned the intervention together with the research group in workshops (n=4) in March-April 2022. Additionally, stakeholders (n=17) who were considered to play an important role in developing the intervention participated throughout this process. Data were analysed using reflexive thematic analysis.RESULTS: Four workshops were conducted with end users (n=16) and 13 meetings with stakeholders (n=12) were held during the development process. The intervention aims to bridge the evidence-practice gap regarding the preventive care process of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The intervention is aimed at end users, lasts for 3 weeks and is divided into two parts. First, end users obtain knowledge on their own by following written instructions. Second, they meet, interact and discuss the knowledge acquired during part 1.CONCLUSION: The intervention is robustly developed and thoroughly described. The study highlights the extensive process that is necessary for developing tailored complex interventions. The description of the entire development process may enhance the replicability of this intervention. The intervention needs to be tested and evaluated in an upcoming feasibility study.TRIAL REGISTRATION NUMBER: NCT05308862.
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45.
  • Neziraj, Merita (författare)
  • The stair of knowledge – prevention of pressure ulcers, malnutrition, poor oral healthand falls among older persons in nursing homes : development and evaluation of the feasibility of an educational intervention
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Evidence exists on how to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes, but these health risks still occur frequently, causing suffering. Aim: The overall aim of the thesis was to develop and evaluate the feasibility of an educational intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. Methods: By combining methods, four studies were conducted to develop and evaluate the feasibility of an educational intervention. The educational intervention was developed in studies I-III, and its feasibility was evaluated in study IV. In study I, a quantitative study was conducted to determine the prevalence of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons receiving municipal healthcare. In study II, a qualitative study was conducted to explore nurse aides’, registered nurses’ and managers’ experiences of preventive work regarding pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. In study III, a qualitativ estudy was conducted to co-design the educational intervention together with nurse aides, registered nurses and managers to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. Additionally, key persons in the municipality participated in co-designing the educational intervention. The development process and the educational intervention itself was also described in study III. In study IV, a mixed methods study was conducted to evaluate the feasibility of the educational intervention. Results: The risks of pressure ulcers, malnutrition, poor oral health and falls was approximately 28%, 56%, 34% and 74%, respectively, and approximately 90% had at least one health risk (study I). Nurse aides, registered nurses and managers experienced prevention of pressure ulcers, malnutrition, poor oral health and falls as important but challenging (study II). The lack of knowledge among them was reported as a major challenge (studies II and III). The educational intervention, the STAIR OF KNOWLEDGE, was co-designed with nurse aides, registered nurses and managers in nursing homes, and stakeholders in the municipality, to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The content, format and delivery of the STAIR OF KNOWLEDGE intervention was co-designed to fit the need for knowledge to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in a local context (study III), and was proven as feasible but with some refinements required for a perfect fit (study IV). Conclusion: The educational intervention, the STAIR OF KNOWLEDGE, was developed together with and for nurse aides, registered nurses and managers to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The STAIR OF KNOWLEDGE intervention is therefore likely to provide end users with the knowledge needed to accomplish preventive work in nursing homes. The STAIR OF KNOWLEDGE intervention was proven to be feasible but with some amendments necessary before continuing to a definitive trial.
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46.
  • Nordanstig, Joakim, et al. (författare)
  • Assessment of Minimum Important Difference and Substantial Clinical Benefit with the Vascular Quality of Life Questionnaire-6 when Evaluating Revascularisation Procedures in Peripheral Arterial Disease
  • 2017
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 54:3, s. 340-347
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Patient reported outcomes are increasingly used to assess outcomes after peripheral arterial disease (PAD) interventions. VascuQoL-6 (VQ-6) is a PAD specific health-related quality of life (HRQoL) instrument for routine clinical practice and clinical research. This study assessed the minimum important difference for the VQ-6 and determined thresholds for the minimum important difference and substantial clinical benefit following PAD revascularisation. Materials and methods: This was a population-based observational cohort study. VQ-6 data from the Swedvasc Registry (January 2014 to September 2016) was analysed for revascularised PAD patients. The minimum important difference was determined using a combination of a distribution based and an anchor-based method, while receiver operating characteristic curve analysis (ROC) was used to determine optimal thresholds for a substantial clinical benefit following revascularisation. Results: A total of 3194 revascularised PAD patients with complete VQ-6 baseline recordings (intermittent claudication (IC) n ¼ 1622 and critical limb ischaemia (CLI) n ¼ 1572) were studied, of which 2996 had complete VQ-6 recordings 30 days and 1092 a year after the vascular intervention. The minimum important difference 1year after revascularisation for IC patients ranged from 1.7 to 2.2 scale steps, depending on the method of analysis. Among CLI patients, the minimum important difference after 1 year was 1.9 scale steps. ROC analyses demonstrated that the VQ-6 discriminative properties for a substantial clinical benefit was excellent for IC patients (area under curve (AUC) 0.87, sensitivity 0.81, specificity 0.76) and acceptable in CLI (AUC 0.736, sensitivity 0.63, specificity 0.72). An optimal VQ-6 threshold for a substantial clinical benefit was determined at 3.5 scale steps among IC patients and 4.5 in CLI patients. Conclusions: The suggested thresholds for minimum important difference and substantial clinical benefit could be used when evaluating VQ-6 outcomes following different interventions in PAD and in the design of Clinical trials.
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47.
  • Norfjord van Zyl, Maria (författare)
  • Access to and participation in mammographic screening within a region in Sweden
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The population-based mammographic screening programme offers every woman in Sweden between 40 and 74 years of age a mammogram with the purpose of early detection of potential breast cancer. The programme is seemingly equal in its setup; however, approximately 20 percent of the women do not participate in the screening. The overall aim of Sweden’s public health policy is to create prerequisites for good and equal health, and health care, a health determinant, falls under the responsibility of the self-governed Regions. Therefore, it is important to analyse regional participation in mammographic screening to develop strategies to reach those who refrain from screening.The aim of the doctoral dissertation was to describe, explore and understand access to and participation in health care using mammographic screening as an example. Study I was a quantitative cross-sectional study based on individual and aggregated data. The analysis consisted of frequencies of data, multivariate logistic regressions, and pairwise chi-square tests. Study II used group discussions with women participating in mammographic screening for data collection. In Study III, women who had not participated in mammographic screening for at least the last two invitational rounds were interviewed. In Study IV, interviews with regional politicians were conducted. The method of analysis for Studies II and III was qualitative content analysis, and in Study IV a reflexive thematic analysis was performed.The results show that access to and participation in mammographic screening involve both structural and individual conditions. Municipality of residency as a potential proxy for distance to the mammographic facility is indicated to impact participation, as is age. Getting to and from the facility and taking time off from work are examples of structural conditions. Facilitators for and barriers to participation in mammographic screening are similar for women who participate and women who lately have not. The phases of the screening process are addressed. Psychological preparation before the visit, encounters with the staff, and managing the wait for the results reflect individual determinants. Caring for health is perceived as a shared commitment between politicians and individuals. This responsibility requires information and understanding of the impact social determinants have on the decision to participate in the screening. It also requires resources for the lowering of thresholds for participation.Encounters with the health care system and the health care systems responsiveness are important for continuous participation in mammographic screening, whereas information and knowledge are pivotal to making well-informed decisions.
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48.
  •  
49.
  • Pettersson, Monica, et al. (författare)
  • Experiences of the screening process and the diagnosis abdominal aortic aneurysm among 65-year-old men from invitation to a 1-year surveillance.
  • 2017
  • Ingår i: Journal of Vascular Nursing. - : Elsevier. - 1062-0303 .- 1532-6578. ; 35:2, s. 70-77
  • Tidskriftsartikel (refereegranskat)abstract
    • The prevalence of abdominal aortic aneurysm (AAA) is reported to be 2.2%-8% among men >65 years. During recent years, screening programs have been developed to detect AAA, prevent ruptures, and thereby saving lives. Therefore, most men with the diagnosis are monitored conservatively with regular reviews. The objective of the study was to describe how men diagnosed with abdominal aortic aneurysm <55 mm discovered by screening experience the process and diagnosis from invitation to 1 year after screening. A total of eleven 65-year-old men were included in three focus groups performed in a University Hospital in Sweden. These were qualitatively analyzed using manifest and latent content analysis. The experience of the screening process and having an abdominal aortic aneurysm in a long-term perspective revealed three categories: "trusting the health care system," emphasizing the need for continual follow-ups to ensure feelings of security; "the importance size," meaning that the measure was abstract and hard to understand; and "coping with the knowledge of abdominal aortic aneurysm," denoting how everyday life was based mostly on beliefs, since a majority lacked understanding about the meaning of the condition. The men want regular surveillance and surrendered to the health care system, but simultaneously experienced a lack of support thereof. Knowing the size of the aorta was important. The men expressed insecurity about how lifestyle might influence the abdominal aortic aneurysm and what they could do to improve their health condition. This highlights the importance of communicating knowledge about the abdominal aortic aneurysm to promote men's feelings of security and giving space to discuss the size of the aneurysm and lifestyle changes.
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50.
  • Rosvall, Annica, et al. (författare)
  • Development and content validity testing of a colonoscopy-specific patient-reported experience measure : the Patient Experience Colonoscopy Scale (PECS)
  • 2024
  • Ingår i: Journal of Patient-Reported Outcomes. - : Springer Nature. - 2509-8020. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundIn endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity.MethodsThe colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items.ResultsThe Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM.ConclusionThe PECS is a new 30-item PREM instrument designed for adult elective colonoscopy patients after they have undergone the procedure. Each item in the PECS derives from a conceptual model based on a systematic literature review. Patients and healthcare professionals were involved in developing the PECS, which measures colonoscopy-specific patient experiences before, during and after the procedure. The content validity testing positively contributed to the development of the PECS. Psychometric properties need to be evaluated further.
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