| 1. |
- Andersson, Lena, et al.
(författare)
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Differences between heart failure clinics and primary health care
- 2013
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Ingår i: British Journal of Community Nursing. - London : MA Healthcare Limited. - 1462-4753 .- 2052-2215. ; 18:6, s. 288-292
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Tidskriftsartikel (refereegranskat)abstract
- There is a paucity of knowledge concerning how people with heart failure experience differences between specialised heart failure clinics and primary healthcare in Sweden. This study aimed to describe differences regarding information and follow- up in heart failure clinics and primary healthcare. The study was conducted in Sweden in 2011. Four people (three men, one woman: aged 60 to 84) with heart failure (NYHA II) were interviewed. The interviews were analysed with qualitative content analysis. The findings revealed after referral from the heart failure clinic to primary healthcare, follow-ups were omitted. Still, the patients needed care, support and information. The findings are illuminated in four themes. The patients' varying and individual needs can be difficult to recognise and manage unless they are followed-up from either HFC or PHC on a regular basis.
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| 2. |
- Andersson, Lena, et al.
(författare)
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Differences between heart failure clinics and primary health care regarding information and follow-up
- 2013
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Ingår i: British Journal of Community Nursing. - : Mark Allen Group. - 1462-4753 .- 2052-2215. ; 18:6, s. 288-292
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Tidskriftsartikel (refereegranskat)abstract
- There is a paucity of knowledge concerning how people with heart failure experience differences between specialised heart failure clinics and primary healthcare in Sweden. This study aimed to describe differences regarding information and followup in heart failure clinics and primary healthcare. The study was conducted in Sweden in 2011. Four people (three men, one woman; aged 60 to 84) with heart failure (NYHA II) were interviewed. The interviews were analysed with qualitative content analysis. The findings revealed after referral from the heart failure clinic to primary healthcare, follow-ups were omitted. Still, the patients needed care, support and information. The findings are illuminated in four themes. The patients' varying and individual needs can be difficult to recognise and manage unless they are followed-up from either HFC or PHC on a regular basis.
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| 3. |
- Andersson, Lena, et al.
(författare)
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Heart Failure Patients' Perceptions of Received and Wanted Information : A Cross-Sectional Study
- 2019
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Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 28:3, s. 340-355
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate heart failure patients’ perceptions of received and wanted information and to identify differences regarding received and wanted information in relation to sociodemographic variables. A cross-sectional descriptive design was used. Patients with heart failure (n = 192) were recruited from six primary health care centers in Sweden. Data were collected by a postal questionnaire. A majority of the respondents had received information about the condition and the medication. Within primary health care, most respondents had been informed about medication. The respondents wanted more information about continued care and treatment, medication, and the condition. There were significant differences between sociodemographic groups concerning what information they wanted. Clinical nurses can support patients with heart failure by using evidence-based methods that strengthen the patients’ self-efficacy and by individualized information that increases patients’ knowledge and improves their self-care behaviors. Future studies are needed to identify informational needs of particular fragile groups of patients.
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| 4. |
- Andersson, Lena, et al.
(författare)
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Living with heart failure without realising : A qualitative patient study
- 2012
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Ingår i: British Journal of Community Nursing. - : MA Healthcare Ltd.. - 1462-4753 .- 2052-2215. ; 17:12, s. 630-637
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Tidskriftsartikel (refereegranskat)abstract
- Heart failure is an important problem in Swedish primary healthcare as in the UK. In spite of that little is known about how people with heart failure experience support from primary healthcare. This paper investigates how people with heart failure experience support in primary healthcare. Semi structured interviews were conducted with five men and five women, born 1922-1951. The interviews were analyzed with qualitative content analysis in accordance with Graneheim and Lundman (2004). The participants experienced they had not received information about their diagnosis or about the cause of their condition. They had not been informed they had heart failure. Instead the participants believed their symptoms were caused by age, thus being part of normal ageing. They did not experience they needed care or support to cope with illness or disease. Instead their main needs for support in daily life concerned help with practical matters.There is a risk primary healthcare abandons people with heart failure meaning the patients are forced to develop strategies on their own in order to manage symptoms. When inadequately informed there is also a risk they make up their own explanations signifying possible difficulties to handle their health situation.
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| 5. |
- Karlsson, Louise, 1989-, et al.
(författare)
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Taking control of one's everyday life - a qualitative study of experiences described by participants in an occupational intervention
- 2023
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Ingår i: BMC Public Health. - London : BioMed Central (BMC). - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sick leave due to stress-related ill-health is increasing and is often caused by occupational imbalance. These types of issues tend to affect both the ability to work and cope with everyday life, as well as the overall experience of health, negatively. There is still little knowledge on how to prepare people and workplaces for the return-to-work process after participation in a work rehabilitation program due to stress and occupational ill-health. Therefore, this study aimed to describe what is needed to achieve a balanced everyday life that includes paid work as experienced by individuals who had participated in a ReDO® intervention due to occupational imbalance and ill-health. METHODS: The concluding notes from 54 informants' medical records were used for qualitative content analysis. The informants had participated in an occupational therapy group intervention to promote occupational health and regain full work capacity. RESULTS: The analysis resulted in one major theme and four categories describing how the informants perceive that they must take control of their everyday life as a whole. By doing so, they need to work with structurization and prioritization, social interaction, boundary setting, and occupational meaningfulness. CONCLUSION: The study indicates a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. Its contribution includes the formulation of perceived needs in the transition between intervention and return to work and could, through further research, be used to generate a more effective and sustainable return- and rehabilitation models. © 2023. The Author(s).
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| 6. |
- Karlsson, Louise, 1989-, et al.
(författare)
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What if we should add activites rather than scale them down during stress-related ill-health to promote health?
- 2023
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Ingår i: 10th Nordic Health Promotion Research Conference. Sustainability and the impact on health and well-being. - Halmstad : Halmstad University Press. - 9789189587410 ; , s. 34-34
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Stress-related ill-health is one of the fastest-growing reasons for sick leave and an extensive societal problem. It affects the individual, the workplace, and society at large. People can experience stress in all areas of everyday life and often cope by stopping prioritizing themselves. Agenda 2030 third goal aims to promote good health and well-being for all and ensure people's opportunity to reach their full potential and contribute to society's development. However, the focus is often on interventions to rehabilitate people back from ill health, not to promote their health.The aim was to explore what the risk factors, and what promotes well-being in people with stress-related ill-health from both a work and everyday perspective.Method Through mixed methods with both quantitative tree analysis of 218 people before entering a work rehabilitation program, and qualitative content analysis of concluding notes of 54 people after the intervention a compilation was made. Results The findings of the studies show a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. It also indicates that risk factors aren’t about gender, age, or education- but about complex occupational patterns in daily life and a lack of social context.Conclusion: Work and everyday life are highly intertwined. Perhaps the key to promoting our health and preventing stress-related ill-health is not to scale down on occupations and sleep more, but to add more meaningful occupations that give us a sense of participation and fellowship.
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| 7. |
- Säfström, Emma, et al.
(författare)
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Patient Continuity of Care Questionnaire in a cardiac sample : A Confirmatory Factor Analysis
- 2020
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:7, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Objective Even though continuity is essential after discharge, there is a lack of reliable questionnaires to measure and assess patients' perceptions of continuity of care. The Patient Continuity of Care Questionnaire (PCCQ) addresses the period before and after discharge from hospital. However, previous studies show that the factor structure needs to be confirmed and validated in larger samples, and the aim of this study was to evaluate the psychometric properties of the PCCQ with focus on factor structure, internal consistency and stability. Design A psychometric evaluation study. The questionnaire was translated into Swedish using a forward-backward technique and culturally adapted through cognitive interviews (n=12) and reviewed by researchers (n=8). Setting Data were collected in four healthcare settings in two Swedish counties. Participants A consecutive sampling procedure included 725 patients discharged after hospitalisation due to angina, acute myocardial infarction, heart failure or atrial fibrillation. Measurement To evaluate the factor structure, confirmatory factor analyses based on polychoric correlations were performed (n=721). Internal consistency was evaluated by ordinal alpha. Test-retest reliability (n=289) was assessed with intraclass correlation coefficient (ICC). Results The original six-factor structure was overall confirmed, but minor refinements were required to reach satisfactory model fit. The standardised factor loadings ranged between 0.68 and 0.94, and ordinal alpha ranged between 0.82 and 0.95. All subscales demonstrated satisfactory test-retest reliability (ICC=0.76-0.94). Conclusion The revised version of the PCCQ showed sound psychometric properties and is ready to be used to measure perceptions of continuity of care. High ordinal alpha in some subscales indicates that a shorter version of the questionnaire can be developed.
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| 8. |
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| 9. |
- Al-Adili, Lina, et al.
(författare)
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Nutrition intervention goals from the perspectives of patients at risk of malnutrition : A qualitative study
- 2024
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Ingår i: Journal of human nutrition and dietetics. - : John Wiley & Sons. - 0952-3871 .- 1365-277X. ; 37:1, s. 217-226
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Nutrition counselling is characterized by a collaborative approach whereby the patient and the dietitian establish goals that promote health and self-management. Little is known about goal-setting in nutrition interventions of patients at risk of malnutrition. This study describes the perspectives and needs of patients at risk of malnutrition regarding goals of nutrition interventions.Methods: Semi-structured interviews were conducted with 15 patients from three primary care centres and one hospital in mid-Sweden. Interview transcripts were analysed using reflexive thematic analysis to identify themes and patterns in the data. Results: Findings highlight that the participants rarely reflected on their personal goals of the nutrition intervention. Instead, they strived to maintain strength and energy, with the nutrition counselling being seen as supportive in managing nutrition impact symptoms. They described discrepancies between their perspectives and the dietitian’s regarding weight goals and the diet prescribed to gain weight.Conclusion: Elucidating patients’ goals is key to counteracting the discrepancies between the dietitians’ clinically oriented goals and patients’ perspectives. New strategies and tools that support collaborative goal-setting in nutrition interventions are needed to provide person-centred nutrition care.
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| 10. |
- Almerud Österberg, Sofia, 1969-, et al.
(författare)
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Att vara patient inom intensivvården
- 2012. - 1
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Ingår i: Akut vård ur ett patientperspektiv. - Lund : Studentlitteratur AB. - 9789144071008 ; , s. 75-89
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 11. |
- Andersson, Jonas, 1983-, et al.
(författare)
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Long emergency department length of stay : A concept analysis
- 2020
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 53
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Emergency Department (ED) Length of stay (LOS) has been associated with poor patient outcomes, which has led to the implementation of time targets designed to keep EDLOS below a specific limit. The cut-offs defining long EDLOS varies across settings and seem to be arbitrarily chosen. This study aimed to clarify the meaning of long EDLOS.METHODS: A concept analysis using the Walker and Avant approach was conducted. It included a literature search aiming to identify all uses of the concept, resulting in a set of defining attributes and a way of measuring the concept empirically.RESULTS: Long EDLOS was primarily used as proxy for other phenomena, e.g. boarding or crowding. The definitions had cut-offs ranging between 4 and 48 h. The attributes defining long EDLOS was waiting, a crowded ED environment and an inefficient organization.DISCUSSION: Time targets are probably more suitable when directed towards and tailored for specific sub-groups of the ED population.
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| 12. |
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| 13. |
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| 14. |
- Bjurling-Sjöberg, Petronella, 1968-, et al.
(författare)
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Action research improved general prerequisites for evidence-based practice
- 2021
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Ingår i: Heliyon. - : Elsevier BV. - 2405-8440. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- The present study was part of an action research project that was performed to implement a clinical pathway for patients on mechanical ventilation and simultaneously explore the implementation process in a Swedish intensive care unit. The aim of this questionnaire study was to evaluate whether an action research methodology could affect the general prerequisites for evidence-based practice (EBP). Informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework, the study included registered nurses, assistant nurses and anesthesiologists in the unit at start of the project (n = 50) and at follow-up (n = 44). Data was collected with the Evaluation Before Implementation Questionnaire and the Attitudes towards Guidelines Scale. The results revealed that the general prerequisites for EBP in the setting improved. Compared to baseline measurements, the staff at follow-up conversed significantly more about the importance of the patients' experiences, research utilization, context and facilitation, while changes with respect to clinical experiences were not significant. The attitudes towards guidelines were perceived as positive at baseline as well as at follow-up and did not significantly change. Longer professional experience was associated with a slightly lower probability of perceiving that the importance of research utilization was discussed and reflected upon, while belonging to a profession with longer education was associated with a higher probability of this perception. Compared to registered nurses and assistant nurses, the anesthesiologists perceived, to a greater extent, that the importance of clinical experience was discussed and reflected upon in the setting, while there was no significant association with the length of professional experience and/or specific professions regarding the other components. In conclusion, using action research to implement a clinical pathway methodology seems to set in motion various mechanisms that improve some but not all prerequisites that, according to the PARIHS framework, are advantageous for EBP.
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| 15. |
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| 16. |
- Bjurling-Sjöberg, Petronella, et al.
(författare)
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Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice
- 2017
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Ingår i: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 31:2, s. 233-244
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was balancing intertwined responsibilities. In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon's contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.
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| 17. |
- Bjurling-Sjöberg, Petronella, 1968-
(författare)
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Clinical Pathway Implementation and Teamwork in Swedish Intensive Care : Challenges in Evidence-Based Practice and Interprofessional Collaboration
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Suboptimal quality of care is an evident issue in current healthcare services. Clinical pathways (CPs) have the potential to facilitate evidence-based practice and interprofessional teamwork, and thereby improve patient safety and quality of care.The overall aim of the thesis was to develop comprehensive empirical knowledge and understanding of CP implementation and teamwork in Swedish intensive care units (ICUs). Four studies were included (I-IV).Study I was a survey including all Swedish ICUs (N84) and a document analysis of CP examples (n12). In total, 17 (20%) ICUs used CPs and many had implementation plans. The quality, extent and content of the CPs (n56) varied greatly, with sometimes insufficient interprofessionalism, evidence base and renewal.Study II was a mixed method including ICUs using CPs. The implementation processes were retrospectively explored through questionnaire data (n15) and qualitative content analysis of interviews with key informants (n10). The CP implementation was revealed as a process directed at realizing the usefulness and creating new habits, which requires enthusiasm, support and time.Studies III and IV were grounded theory studies in an action research project in an ICU. Study III explored everyday teamwork through focus group interviews with registered nurses, assistant nurses and anesthesiologists, as well as an individual interview with a physiotherapist (n38). Teamwork was revealed as an act of ‘balancing intertwined responsibilities.’ The type of teamwork fluctuated as the team processes were affected by circumstantial factors and involved individuals. Study IV prospectively explored the implementation process of a CP during a five-year period through repeated focus groups and individual interviews, questionnaires and logbooks/field notes, including the interprofessional project group, staff and managers (n71), and retrospective screening of health records (n136). ‘Struggling for a feasible tool’ was revealed as a central phenomenon. The implementation process included contextual and processual circumstances that enforced negotiations to achieve progress, which made the process tentative and prolonged and had consequences on the process output.In conclusion, CP implementation processes are affected by multiple interplaying factors. Although progress has been achieved in evidence-based practice and interprofessional collaboration there is still potential for substantial improvements, emphasizing a need for further facilitation.
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| 18. |
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| 19. |
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| 20. |
- Bjurling-Sjöberg, Petronella, et al.
(författare)
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Factors affecting the implementation process of clinical pathways : A mixed method study within the context of Swedish intensive care
- 2015
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 21:2, s. 255-261
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives Clinical pathways (CPs) can improve quality of care on intensive care units (ICUs), but are infrequently utilized and of varying quality. Knowledge regarding factors that facilitate versus hinder successful implementation of CPs is insufficient and a better understanding of the activities and individuals involved is needed. The aim of this study was to explore the implementation process of CPs within the context of ICUs. Methods An exploratory design with a sequential mixed method was used. A CP survey, including all Swedish ICUs, was used to collect quantitative data from ICUs using CPs (n = 15) and interviews with key informants (n = 10) were used to collect qualitative data from the same ICUs. Descriptive statistics and qualitative content analysis were used, and the quantitative and qualitative findings were integrated. Results The CP implementation was conceptualized according to two interplaying themes: a process to realize the usefulness of CPs and create new habits; and a necessity of enthusiasm, support and time. Multiple factors affected the process and those factors were organized in six main categories and 14 subcategories. Conclusions Bottom-up initiatives, interprofessional project groups and small ICUs seem to enhance successful implementation of CPs while inadequate electronic health record systems, insufficient support and time constrains can be barriers. Support regarding the whole implementation process from centralized units at the local hospitals, as well as cooperation between ICUs and national guidance, has the potential to raise the quality of CPs and benefit the progress of CP implementation.
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| 21. |
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| 22. |
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| 23. |
- Bjurling-Sjöberg, Petronella, 1968-, et al.
(författare)
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Resilient performance in healthcare during the COVID-19 pandemic (ResCOV) : study protocol for a multilevel grounded theory study on adaptations, working conditions, ethics and patient safety.
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:12
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Since early 2020, the COVID-19 pandemic has challenged societies and revealed the built-in fragility and dependencies in complex adaptive systems, such as healthcare. The pandemic has placed healthcare providers and systems under unprecedented amounts of strain with potential consequences that have not yet been fully elucidated. This multilevel project aims to explore resilient performance with the purpose of improving the understanding of how healthcare has adapted during the pandemic's rampage, the processes involved and the consequences on working conditions, ethics and patient safety.METHODS: An emerging explorative multilevel design based on grounded theory methodology is applied. Open and theoretical sampling is performed. Empirical data are gathered over time from written narratives and qualitative interviews with staff with different positions in healthcare organisations in two Swedish regions. The participants' first-person stories are complemented with data from the healthcare organisations' internal documents and national and international official documents.ANALYSIS: Experiences and expressions of resilient performance at different system levels and times, existing influencing risk and success factors at the microlevels, mesolevels and macrolevels and inter-relationships and consequences in different healthcare contexts, are explored using constant comparative analysis. Finally, the data are complemented with the current literature to develop a substantive theory of resilient performance during the pandemic.ETHICS AND DISSEMINATION: This project is ethically approved and recognises the ongoing strain on the healthcare system when gathering data. The ongoing pandemic provides unique possibilities to study system-wide adaptive capacity across different system levels and times, which can create an important basis for designing interventions focusing on preparedness to manage current and future challenges in healthcare. Feedback is provided to the settings to enable pressing improvements. The findings will also be disseminated through scientific journals and conferences.
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| 24. |
- Bjurling-Sjöberg, Petronella, 1968-, et al.
(författare)
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Struggling for a feasible tool - the process of implementing a clinical pathway in intensive care: a grounded theory study
- 2018
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Ingår i: BMC Health Serv Res. - : Springer Science and Business Media LLC. - 1472-6963. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundClinical pathways can enhance care quality, promote patient safety and optimize resource utilization. However, they are infrequently utilized in intensive care. This study aimed to explain the implementation process of a clinical pathway based on a bottom-up approach in an intensive care context.MethodsThe setting was an 11-bed general intensive care unit in Sweden. An action research project was conducted to implement a clinical pathway for patients on mechanical ventilation. The project was managed by a local interprofessional core group and was externally facilitated by two researchers. Grounded theory was used by the researchers to explain the implementation process. The sampling in the study was purposeful and theoretical and included registered nurses (n31), assistant nurses (n26), anesthesiologists (n11), a physiotherapist (n1), first- and second-line managers (n2), and health records from patients on mechanical ventilation (n136). Data were collected from 2011 to 2016 through questionnaires, repeated focus groups, individual interviews, logbooks/field notes and health records. Constant comparative analysis was conducted, including both qualitative data and descriptive statistics from the quantitative data.ResultsA conceptual model of the clinical pathway implementation process emerged, and a central phenomenon, which was conceptualized as Struggling for a feasible tool,' was the core category that linked all categories. The phenomenon evolved from the Triggers' (Perceiving suboptimal practice' and Receiving external inspiration and support'), pervaded the Implementation process' (Contextual circumstances,' Processual circumstances' and Negotiating to achieve progress'), and led to the process Output' (Varying utilization' and Improvements in understanding and practice'). The categories included both facilitating and impeding factors that made the implementation process tentative and prolonged but also educational.ConclusionsThe findings provide a novel understanding of a bottom-up implementation of a clinical pathway in an intensive care context. Despite resonating well with existing implementation frameworks/theories, the conceptual model further illuminates the complex interaction between different circumstances and negotiations and how this interplay has consequences for the implementation process and output. The findings advocate a bottom-up approach but also emphasize the need for strategic priority, interprofessional participation, skilled facilitators and further collaboration.
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| 25. |
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| 26. |
- Dean, Elizabeth, et al.
(författare)
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An Exploration of the Scientific Writing Experience ofNon-native English-speaking Doctoral Supervisors and Students Using a Phenomemngraphic Approach
- 2015
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Ingår i: Journal of Biomedical Education. - : Hindawi Limited. - 2314-503X .- 2314-5021. ; 2015
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Tidskriftsartikel (refereegranskat)abstract
- Nonnative English-speaking scholars and trainees are increasingly submitting their work to English journals. The study’s aim was to describe their experiences regarding scientific writing in English using a qualitative phenomenographic approach. Two focus groups (5 doctoral supervisors and 13 students) were conducted. Participants were nonnative English-speakers in a Swedish health sciences faculty. Group discussion focused on scientific writing in English, specifically, rewards, challenges, facilitators, and barriers. Participants were asked about their needs for related educational supports. Inductive phenomenographic analysis included extraction of referential (phenomenon as a whole) and structural (phenomenon parts) aspects of the transcription data. Doctoral supervisors and students viewed English scientific writing as challenging but worthwhile. Both groups viewed mastering English scientific writing as necessary but each struggles with the process differently. Supervisors viewed it as a long-term professional responsibility (generating knowledge, networking, and promotion eligibility). Alternatively, doctoral students viewed its importance in the short term (learning publication skills). Both groups acknowledged they would benefit from personalized feedback on writing style/format, but in distinct ways. Nonnative English-speaking doctoral supervisors and students in Sweden may benefit from on-going writing educational supports. Editors/reviewers need to increase awareness of the challenges of international contributors and maximize the formative constructiveness of their reviews.
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| 27. |
- Frank, Catharina, 1961-, et al.
(författare)
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Healthcare professionals’ perceptions of their work with patients of working age with heart failure
- 2018
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Ingår i: Nordic journal of nursing research. - : SAGE Publications Ltd. - 2057-1585 .- 2057-1593. ; 38:3, s. 160-166
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about healthcare professionals’ perspectives on rehabilitation in relation to heart failure. Still, collaboration between different professionals can impact patients. The purpose of this study was to describe healthcare professionals’ perceptions of their work with patients of working age with heart failure. The sample population consisted of six nurses, one physiotherapist and one cardiologist. One individual interview and two focus-group interviews were conducted. The interviews were analyzed using qualitative content analysis. Three descriptive categories were constructed: ‘the impact of heart failure on patients’ life situations’, ‘heart failure service’, and ‘patients’ process of returning to work’. To support patients, healthcare professionals need to find ways to combine patients’ personal needs with protocol-driven care. © The Author(s) 2017.
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| 28. |
- Frank, Catharina, et al.
(författare)
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Social insurance administrative officers’ perceptions of their assignment and problematic issues in their work with heart failure clients in the sick-leave and rehabilitation process
- 2015
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Ingår i: Nordic Social Work Research. - 2156-857X .- 2156-8588. ; 5:2, s. 173-188
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Tidskriftsartikel (refereegranskat)abstract
- This article explores social insurance administrative officers’ (AOs’) perceptions of the sick-leave process for heart failure clients. The work situation and the sick-leave process for people with heart failure tend to be complex and problematic. The problems are often caused by a lack of understanding from professionals, such as social insurance AOs. The study draws on two focus group interviews with social insurance AOs from two different social insurance agencies. The interviews were guided by an open approach, and analysis was performed on the interviews’ manifest content through a qualitative content analysis. The findings demonstrate that the AOs were concerned about the clients’ ability to return to work, but they were hindered in fulfilling their duties through insufficient collaboration with physicians and unclear sickness certificates. There seems to be a gap between the AOs’ assignment and their ability to make well-founded decisions about their clients’ ability to work. This can have consequences for the individual who lives with heart failure. In the sociopolitical agenda of Sweden, this can have consequences for the development of collaboration between AOs and the medical experts who provide the foundations for decisions about work ability of the client with heart failure.
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| 29. |
- Hagbom, Marie, et al.
(författare)
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Replication in Human Intestinal Enteroids of Infectious Norovirus from Vomit Samples
- 2021
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 27:8, s. 2212-2214
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Tidskriftsartikel (refereegranskat)abstract
- A typical clinical symptom of human norovirus infection is projectile vomiting. Although norovirus RNA and viral particles have been detected in vomitus, infectivity has not yet been reported. We detected replication-competent norovirus in 25% of vomit samples with a 13-fold to 714-fold increase in genomic equivalents, confirming infectious norovirus.
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| 30. |
- Haraldsson, Johanna, et al.
(författare)
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Confidentiality matters! Adolescent males’ views of primary care in relation to psychosocial health : a structural equation modelling approach
- 2022
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis Group. - 0281-3432 .- 1502-7724. ; 40:4, s. 438-449
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate to what degree adolescent males (1) value confidentiality, (2) experience confidentiality and are comfortable asking sensitive questions when visiting a general practitioner (GP), and (3) whether self-reported symptoms of poor mental health and health-compromising behaviours (HCB) affect these states of matters.Design: Cross-sectional.Setting: School-based census on life, health and primary care in Region Sörmland, Sweden.Subjects: 2,358 males aged 15–17 years (response rate 84%).Main outcome measures: The impact of poor mental health and HCBs on adolescent males’ valuing and experiencing private time with the GP, having professional secrecy explained, and being comfortable asking about the body, love and sex, analysed with structural equation modelling.Results: Almost all respondents valued confidentiality regardless of their mental health or whetherthey engaged in HCBs: 86% valued spending private time with the GP, and 83% valued receivinga secrecy explanation. Among those who had visited a GP in the past year (n¼1,200), 74% had experienced private time and 42% a secrecy explanation. Three-quarters were at least partly comfortable asking sensitive questions. Adolescent males with HCBs were more likely to experience a secrecy explanation (approximative odds ratio [appOR] 1.26;p¼0.005) and to be comfortable asking about sex than their peers (appOR 1.22;p¼0.007). Respondents reporting experienced confidentiality were more comfortable asking sensitive questions (appOR 1.25–1.54;p0.010).Conclusion: Confidentiality matters regardless of poor mental health or HCBs and makes adolescent males more comfortable asking sensitive questions. We suggest that GPs consistently offerprivate time and explain professional secrecy.KEY POINTSConfidentiality for adolescent males has been scantily studied in relation to mental healthand health-compromising behaviours.In this study, most adolescent males valued confidentiality, regardless of their mental healthand health-compromising behaviours.Health-compromising behaviours impacted only slightly, and mental health not at all, on experiences of confidentiality in primary care.When provided private time and an explanation of professional secrecy, adolescent males were more comfortable asking the GP sensitive questions.
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| 31. |
- Haraldsson, Johanna, 1976-
(författare)
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Exploring adolescent males’ consultations with general practitioners in the context of psychosocial health
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis aimed to explore adolescent males’ experiences of consultations with general practitioners (GPs) with a particular focus on confidentiality in relation to poor mental health and health-compromising behaviours.First, a model describing the covariation of poor mental-health symptoms, associated somatic symptoms, and health-compromising behaviours was developed through explorative and confirmative factor analysis (paper I). The model was then applied in a structural equation modelling approach to study whether these symptoms and behaviours influenced how adolescent males valued and experienced confidentiality as well as whether they were comfortable asking sensitive questions during their GP consultations (paper II).Next, to gain a deeper understanding, adolescent males’ experiences with GP consultations were further explored through a qualitative lifeworld-based approach. Interviews were analysed with thematic analysis (paper III) and video observations with a phenomenological–hermeneutical method (paper IV). The findings revealed that by providing confidentiality, here defined as private time without parents and explaining the meaning and boundaries of professional secrecy, GPs can facilitate discussions on sensitive topics and make adolescent males feel more comfortable to raise their own concerns. This might be a fruitful approach to address any unmet health needs, which can be achieved through the split-visit consultation model.Another finding was that the studied consultations were very complex. Due to their ongoing development, inexperience with GP consultations, and notions of masculinity, the adolescent males struggled with cognitive, emotional, and relational difficulties while negotiating their right to define the problem and be responsible for their health. The adolescent males emphasized the importance of being listened to and taken seriously, which entails that all aspects of the consultation must be adapted to their individual needs and to their lifeworld. This aligns with Larsen’s consultation model, where the GP strives to understand the patient’s experience and to connect their medical findings to the patient’s lifeworld. Given that both the split-visit consultation model and Larsen’s consultation model offer valuable frameworks for addressing essential, but different, aspects in adolescent males’ GP consultations, the thesis proposes a synthesis of the two approaches.
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| 32. |
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| 33. |
- Haraldsson, Johanna, et al.
(författare)
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They are my worries, so it's me the doctor should listen to-adolescent males' experiences of consultations with general practitioners.
- 2024
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Ingår i: BMC Primary Care. - 2731-4553. ; 25:1, s. 169-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many adolescent males visit a general practitioner regularly, yet many report unmet health needs and negative experiences. This indicates a gap between provided healthcare and the needs of adolescent males. In order to improve adolescent males' possibilities to discuss their health concerns with general practitioners, the study's aim was to explore and describe how adolescent males understand and assign meaning to their experiences of consultations with general practitioners.METHODS: This qualitative study was conducted at two healthcare centres in mid-Sweden in 2022. Nine males 15 to 19 years old described their experiences in semi-structured interviews immediately after consulting a general practitioner, regardless of reason for the consultation and whether or not accompanied by a parent. The analysis was guided by thematic analysis according to Braun & Clarke and reflective lifeworld theory's concepts of openness and sensitivity.RESULTS: One overarching theme, To be listened to, and three themes were developed: To handle insecurity and uneasiness, To be understood and cared for, and To get parental support on his terms. In a good appointment, the general practitioner cares about him, listens attentively, and takes him seriously. More importantly, the general practitioner's understanding permeates the consultation, so that all aspects of it is adapted to him. The adolescent males doubted their ability to express themselves and to understand what would happen in the consultation, and therefore feared being dismissed without receiving any help. Such difficulties may be due to unfinished neurocognitive development and inexperience. They struggled with embarrassment, partly due to notions of masculinity, and strived to balance their needs of parental support, privacy, and being the one that the doctor listens to.CONCLUSIONS: We argue that adolescent males are particularly vulnerable due to on-going neurocognitive and emotional development, inexperience, and notions of masculinity. However, good experiences can be generated through rather simple means. Adolescent males need individual adaptations demonstrating that they are cared for, understood and taken seriously. Furthermore, they need an unhurried pace to facilitate understanding, verbal affirmations to mitigate embarrassment, and help in navigating parental involvement.
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| 34. |
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| 35. |
- Haraldsson, Johanna, et al.
(författare)
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Understanding adolescent males' poor mental health and health-compromising behaviours : A factor analysis model on Swedish school-based data
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:2, s. 232-244
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim was to develop a factor model of the clustering of poor mental-health symptoms and health-compromising behaviours (HCBs) in adolescent males.METHODS: The study was based on two cross-sectional school-based Swedish surveys in 2011 (response rate 80%, N=2823) and 2014 (response rate 85%, N=2358), both of which comprised questionnaires from males aged 15-16 and 17-18 years. A factor model was developed by exploratory factor analysis on the 2011 survey and validated by confirmatory factor analysis on the 2014 survey.RESULTS: Four aspects of poor mental health and HCBs emerged in the exploratory factor analysis: (a) deviancy as a tendency to substance use and delinquency, (b) unsafety as an inclination towards feelings of unsafety in different environments, (c) gloominess as a tendency towards pessimism and feeling unwell and (d) pain as an inclination to experience physical pain. The model was validated with good model fit. Age did not affect the model structure, but older adolescent males were more influenced by deviancy and gloominess and less by unsafety compared to their younger peers.Conclusions: Separating symptoms of poor mental health and HCBs into four areas - deviancy, unsafety, gloominess and pain - brings new perspectives to the understanding of adolescent males' health. To the best of our knowledge, our factor model is the first to include unsafety and pain in this context. Whenever a comprehensive approach to the health of adolescent males is needed in the clinic or in the field of public health, this factor model may provide guidance.
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| 36. |
- Hilton, Emma N, et al.
(författare)
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Left-sided embryonic expression of the BCL-6 corepressor, BCOR, is required for vertebrate laterality determination.
- 2007
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Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 16:14, s. 1773-1782
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Tidskriftsartikel (refereegranskat)abstract
- Oculofaciocardiodental (OFCD) syndrome is an X-linked male lethal condition encompassing cardiac septal defects, as well as ocular and dental anomalies. The gene mutated in OFCD syndrome, the BCL-6 corepressor (BCOR), is part of a transcriptional repression complex whose transcriptional targets remain largely unknown. We reviewed cases of OFCD syndrome and identified patients exhibiting defective lateralization including dextrocardia, asplenia and intestinal malrotation, suggesting that BCOR is required in normal laterality determination. To study the function of BCOR, we used morpholino oligonucleotides (MOs) to knockdown expression of xtBcor in Xenopus tropicalis, thus creating an animal model for OFCD syndrome. The resulting tadpoles had cardiac and ocular features characteristic of OFCD syndrome. Reversed cardiac orientation and disorganized gut patterning were seen when MOs were injected into the left side of embryos, demonstrating a left-sided requirement for xtBcor in lateral determination in Xenopus. Ocular defects displayed no left-right bias and included anterior and posterior segment disorders such as microphthalmia and coloboma. Expression of xtPitx2c was shown to be downregulated when xtBcor was depleted. This identifies a pathway in which xtBcor is required for lateral specification, a process intrinsically linked to correct cardiac septal development.
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| 37. |
- Husdal, Rebecka, et al.
(författare)
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Diabetes care provided by national standards can improve patients' self‐management skills : A qualitative study of how people with type 2 diabetes perceive primary diabetes care
- 2021
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Ingår i: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 24:3, s. 1000-1008
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Tidskriftsartikel (refereegranskat)abstract
- Background The increasing incidence of type 2 diabetes mellitus [T2DM] has resulted in extensive research into the characteristics of successful primary diabetes care. Even if self-management support and continuity are increasingly recognized as important, there is still a need for deeper understanding of how patients' experiences of continuity of care coincide with their needs for self-management and/or self-management support.Objective To gain a deeper understanding of how people with T2DM perceive Swedish primary diabetes care and self-management support.Methods This qualitative study used focus groups as the means for data collection. Participants were identified through a purposive sampling method differing in age, sex, diabetes duration and latest registered glycated haemoglobin level. Twenty-eight participants formed five focus groups. Qualitative content analysis was applied to interview transcripts.Results The main theme emerging from the focus group data was that diabetes care provided by national standards improved self-management skills. Two themes that emerged from the analysis were (a) the importance of a clarification of structures and procedures in primary diabetes care and (b) health-care staff 'being there' and providing support enables trust and co-operation to enhance self-management.Conclusions Individual patients' self-management resources are strengthened if the importance of providing relational continuity, management continuity and informational continuity is considered. Patients also need assistance on 'how' self-management activities should be performed.Patient contribution Prior to the study, one pilot focus group was conducted with patients to obtain their perspectives on the content of the planned focus groups; thus, patients were involved in both planning and conduct of the study.
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| 38. |
- Johnsson, Linus, 1978-, et al.
(författare)
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How general practitioners decide on maxims of action in response to demands from conflicting sets of norms : a grounded theory study
- 2019
-
Ingår i: BMC Medical Ethics. - : Springer Science and Business Media LLC. - 1472-6939. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Background: The work of general practitioners (GPs) is infused by norms from several movements, of which evidence based medicine, patient-centredness, and virtue ethics are some of the most influential. Their precepts are not clearly reconcilable, and structural factors may limit their application. In this paper, we develop a conceptual framework that explains how GPs respond, across different fields of interaction in their daily work, to the pressure exerted by divergent norms.Methods: Data was generated from unstructured interviews with and observations of sixteen Swedish GPs (who have by definition more than five years of experience after license to practice) and family medicine residents (with less than five years of experience) between 2015 and 2017. Straussian Grounded Theory was used for analysis.Results: We found that GPs’ maxims of action can be characterised in terms of dichotomous responses to demands from four distinct sets of norms, or “voices”: the situation, the self, the system, and the profession. From the interactions between these voices emerge sixteen clusters of maxims of action. Based on the common features of the maxims in each cluster, we have developed a conceptual framework that appears to be rich enough to capture the meaning of the ethical decisions that GPs make in their daily work, yet has a high enough level of abstraction to be helpful when discussing the factors that influence those decisions.Conclusions: Our four-dimensional model of GPs' responses to norms is a first step toward a middle-range theory of quality from GPs' perspective. It brings out the complexity of their practice, reveals tensions that easily remain invisible in more concrete accounts of their actions, and aids the transferability of substantive theories on GPs' ethical decision making. By explaining the nature of the ethical conflicts that they experience, we provide some clues as to why efforts to improve quality by imposing additional norms on GPs may meet with varying degrees of success.
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| 39. |
- Johnsson, Linus, 1978-, et al.
(författare)
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The voice of the profession : how the ethical demand is professionally refracted in the work of general practitioners
- 2023
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Ingår i: BMC Medical Ethics. - : BioMed Central (BMC). - 1472-6939. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Among the myriad voices advocating diverging ideas of what general practice ought to be, none seem to adequately capture its ethical core. There is a paucity of attempts to integrate moral theory with empirical accounts of the embodied moral knowledge of GPs in order to inform a general normative theory of good general practice. In this article, we present an empirically grounded model of the professional morality of GPs, and discuss its implications in relation to ethical theories to see whether it might be sustainable as a general practice ethic.METHODS: We observed and interviewed sixteen GPs and GP residents working in health care centres in four Swedish regions between 2015-2017. In keeping with Straussian Grounded Theory, sampling was initially purposeful and later theoretically guided, and data generation, analysis and theoretical integration proceeded in parallel. The focal concept of this article was refined through multidimensional property supplementation.RESULTS: The voice of the profession is one of four concepts in our emerging theory that attempt to capture various motives that affect GPs' everyday moral decisionmaking. It reflects how GPs appreciate the situation by passing three professional-moral judgments: Shall I see what is before me, or take a bird's-eye view? Shall I intervene, or stay my hand? And do I need to speak up, or should I rather shut up? By thus framing the problem, the GP narrows down the range of considerations, allowing them to focus on its morally most pertinent aspects. This process is best understood as a way of heeding Løgstrup's ethical demand. Refracted through the lens of the GP's professional understanding of life, the ethical demand gives rise to specific moral imperatives that may stand in opposition to the express wishes of the other, social norms, or the GP's self-interest.CONCLUSIONS: The voice of the profession makes sense of how GPs frame problematic situations in moral terms. It is coherent enough to be sustainable as a general practice ethic, and might be helpful in explaining why ethical decisions that GPs intuitively understand as justified, but for which social support is lacking, can nevertheless be legitimate.
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| 40. |
- Johnsson, Linus, 1978-, et al.
(författare)
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The voice of the self : a typology of general practitioners' emotional responses to situational and contextual stressors
- 2022
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 40:2, s. 289-304
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To develop a comprehensive typology of emotional reactions associated with stress among general practitioners (GPs), grounded in their own experiences.DESIGN: Data was generated using observations and unstructured interviews, using Straussian grounded theory as the overarching methodology. The typology was built using multidimensional property supplementation.SETTING: Eleven health care centres in urban and rural communities in four Swedish regions.SUBJECTS: Sixteen GPs and GP residents.MAIN OUTCOME MEASURES: Characteristics of GPs' emotional reactions in everyday work situations.RESULTS: Accounts of negative emotions connected to stress revealed four principal personal needs of the GP: trust, efficacy, understanding, and knowledge. Simultaneous threats to more than one of these needs invariably increased the level of tension. From these more complex accounts, six second-order needs could be identified: integrity, judgment, pursuit, authority, autonomy, and competence. The most extreme encounters, in which all four principal needs were threatened, were characterised by the experience of being reduced into an assistant.CONCLUSION: The considerable resilience of GPs may belie some of the pressures that they are facing while being far from a fail-safe defence against being diverted from purposeful and morally responsible action. Our typology distinguishes between different forms of stress that may affect how GPs carry out their work, and connects to the vast literature on GP wellness. The results of this study could be used to develop tools for self-reflection with the aim of countering the effects of stress, and are potentially relevant to future research into its causes and consequences.
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| 41. |
- Kårefjärd, Ann, et al.
(författare)
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Effects of dog-assisted intervention on quality of life in nursing home residents with dementia
- 2019
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 26:6, s. 433-440
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: People with dementia often have a poor quality of life. Therefore, methods that can improve their life situation must be identified. One promising method is dog-assisted intervention.AIM: This study aimed to investigate the effects of dog-assisted intervention on quality of life in nursing home residents with dementia.MATERIALS AND METHODS: A one-group, pretest post-test study design was used. Quality of life was measured using the QUALID in 59 nursing home residents prior to and after a dog-assisted intervention. Non-parametric tests were used to analyze the data, and effect sizes were calculated.RESULTS: The participants' total scores improved significantly between baseline and post-test 1 (p = < 0.001) and worsened significantly at post-test 2 (p = 0.025). The largest effect size was found for the item 'Verbalization suggests discomfort' (p = 0.001).CONCLUSION: The results indicate that dog-assisted interventions can have positive effects on quality of life in nursing home residents with moderate to severe dementia.SIGNIFICANCE: The results contribute to a growing knowledge base about non-pharmacological methods that can be used in dementia care. Occupational therapists should consider dog-assisted interventions when planning activities that can reduce the illness burden and improve the quality of life for people with dementia.
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| 42. |
- Langenskiöld, Marcus, 1972, et al.
(författare)
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Differential Prognostic Impact of uPA and PAI-1 in Colon and Rectal Cancer.
- 2009
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Ingår i: Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine. - : Springer Science and Business Media LLC. - 1423-0380. ; 30:4, s. 210-220
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Degradation of extracellular matrix is important for tumour growth and invasion, which in part is regulated by the plasminogen activation system. The aim of the study was to evaluate the protein expression of urokinase plasminogen activator (uPA) and plasminogen-activating inhibitor-1 (PAI-1) in plasma, tumour-free mucosa and tumour tissue regarding their prognostic value in colon and rectal cancer. Methods: Patients (n = 221) undergoing surgery for colorectal cancer were prospectively included. Samples were assayed by ELISA technique. Results: PAI-1 in tumour tissue (p = 0.006), plasma (<0.0001) and uPA in tumour-free mucosa (p = 0.006) were associated with survival in rectal cancer in univariate analysis. An uPA expression level below 1.1 ng/mg (log rank test, p < 0.0001) in tumour-free mucosa was associated with poor survival in rectal cancer. This was true also for patients without disseminated disease (M(0), p = 0.02). PAI-1 in plasma correlated with metastatic disease (p < 0.0001). uPA and PAI-1 were not associated with survival in either tumour tissue, mucosa or plasma in patients with colon cancer. Conclusions: uPA and PAI-1 have a differential prognostic impact in colon and rectal cancer. Preoperative mucosal uPA and plasma PAI-1 protein expression could possibly be used as prognostic factors in rectal cancer.
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| 43. |
- Lindbäck, Camilla, et al.
(författare)
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To be on sick-leave due to heart failure : A qualitative perspective
- 2015
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 37:19, s. 1732-1738
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the present study was to explore and describe meanings of being on sick leave due to heart failure. Methods: The study was conducted in Sweden during 2011-2012. Five men and one woman, aged 46 to 62, were interviewed. A reflective life-world research approach based on phenomenological philosophy was used. The result of the analysis is presented in three themes. Results: To be on sick leave due to heart failure implies a life situation characterized by anxiety, insecurity and uncertainty. When rehabilitation professionals do not take on their professional responsibility, sick listed people with heart failure perceive they are dismissed and abandoned. If rehabilitation professionals take on their professional responsibility it can be experienced as supportive. Conclusions: People who are on sick leave due to heart failure are abandoned by rehabilitation professionals and they lack opportunities to participate in their own sick leave/rehabilitation processes. Rehabilitation professionals need to take more responsibility and allow the patients to participate by connecting and recognizing patients as equal human beings. The present results can be used by rehabilitation professionals to reflect on and discuss the needs of people on sick leave due to heart failure.Implications for RehabilitationHeart failure is a chronic condition implying a complicated life-situation.People with heart failure experience abandonment by rehabilitation professionals and lack participation in their own rehabilitation process.In order to support people on sick leave due to heart failure collaboration and coordination between rehabilitation professionals are needed. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.
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| 44. |
- Nimborg, Jennie, et al.
(författare)
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Routine conversations about violence conducted in Swedish child health services : A mixed methods study of nurses' experiences
- 2023
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 112:3, s. 442-451
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate an intervention where nurses in child health care services routinely talk to and inform parents about violence.METHODS: The intervention included providing information during home visits and individual conversations with mothers and fathers/partners in connection with screening for parental depression. A convergent mixed-methods design was used with a documentation form for each child (n = 475) and results from focus group interviews with nurses. Quantitative data were analysed using descriptive statistics and qualitative with manifest content analysis.RESULTS: Almost all families participated in the intervention; individual conversations were conducted with nearly all the mothers, and to a somewhat lesser extent with the fathers/partners. Initially, the nurses felt slightly uncomfortable about these conversations, but described experiencing development and professionalisation in their role of talking about violence. Parents' reactions were generally positive and they expressed appreciation for this topic being raised.CONCLUSION: The results show that the intervention has been carried out successfully. The newborn period is a phase in which mothers and fathers are interested and receptive to knowledge and support in sensitive matters. Prerequisites for implementation were the preparation phase for the nurses, the use of routine questioning and a questionnaire as a basis for the conversations.
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| 45. |
- Nordgren, Lena, Docent, 1963-, et al.
(författare)
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An evidence-based structured one-year programme to sustain physical activity in patients with heart failure in primary care : A non-randomized longitudinal feasibility study
- 2020
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Ingår i: Nursing Open. - : WILEY. - 2054-1058. ; 7:5, s. 1388-1399
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Tidskriftsartikel (refereegranskat)abstract
- Aim The primary objective of this non-randomized feasibility study was to test a 1-year model programme for sustaining/increasing patients' motivation to perform daily physical activity. Design Non-randomized longitudinal feasibility study with a one-group repeated measures design. Methods The study took place at a primary care centre in mid-Sweden in 2017-2018. The model programme included individual and group-based support, individualized physical activity prescriptions, a wrist-worn activity tracker and an activity diary. The main outcomes were the participants' perceptions of programme feasibility and scores on the Exercise Self-Efficacy Scale. Results Seven patients were recruited. Six patients completed the programme that was perceived to imply learning, motivation and support. Compared with baseline, the median score of the Exercise Self-Efficacy Scale improved 3 months after participants completed the programme.
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| 46. |
- Nordgren, Lena, et al.
(författare)
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An exploration of formal care from the perspective of middle-aged heart failure patients
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953.
-
Konferensbidrag (refereegranskat)abstract
- PurposeTo explore and describe the phenomenon: Formal care from the perspective of middle-aged persons living with HF.MethodsData was collected in seven unstructured interviews with middle-aged people (four men, three women) living with moderate-severe HF. It was analysed using a phenomenological approach.ResultsPeople with HF are dependent on care and treatment. Formal care, in the form of medication or other treatments, balances the life situation and gives hope for relief and access to a rich and meaningful life again. Care, thus, means hope for a change or improvement and makes life possible to live.Within the context of formal care patients are able to surrender to a secure retreat. When they surrender to care they should be the ones to whom care is given, but instead they turn into objects to be examined and treated, almost as if they were not there. As carers reduce patients to objects, to someone or something which is categorised, treated or informed on basis of standard guidelines, they feel powerless and that they have no value in the carer's eyes. The patients feel betrayed and they do not trust or rely on carers or on the care that they receive and need.Formal care is performed within an organisation with a structure which patients perceive as unclear. It is an organisation in which individuals are not seen or the individual's needs are not provided for. The organisation is to a great extent governed by routines, financial values and bureaucracy. The hospital environment and its routines depersonalise patients, which increases their feelings of uncertainty towards carers and to the caregiving organisation. Patients experience that carers expect them to be active in their health process and to participate in decision-making, but nobody clearly explain to them what they are up against, what they have do deal with. Instead of an opportunity to gain increased access to life, which in spite of illness and limits can be a bearable and meaningful life, patients are left with confusion and existential uncertainty.ConclusionDemands on high quality medical care signify that routines and recommendations must be followed. However, there is a danger, if care is performed solely on basis of routines and recommendations, that carers disregard the uniqueness in each patient's life situation. Carers need to find approaches to formal care that acknowledges individuals and at the same time ensures good quality medical care for patients.
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| 47. |
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| 48. |
- Nordgren, Lena, et al.
(författare)
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An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:2, s. 121-129
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite a considerable amount of research into heart failure there remains a divergence between the care available and patient's needs. The predominant biomedical perspective is more focused on the disease rather than the patient. In order to deliver formal care appropriate to the needs of middle-aged patients with moderate-severe HF it is imperative to gain the perspective of the individual patient. AIMS: The aim of the current study was to explore and understand the phenomenon: Formal care as experienced from the perspective of middle-aged patients living with HF. METHODS: The study was performed using a lifeworld perspective. Data was collected in seven unstructured interviews with middle-aged people living with moderate-severe HF. Data was analysed using a phenomenological approach. RESULTS: Formal care, as experienced by middle-aged patients living with moderate to severe HF, means hope to once again be able to have access to life. However, the meaning of formal care is ambiguous, which signifies that care means both health and suffering at the same time. The essence's meaning constituents are: dependency of care, surrender to care and unclear participation. CONCLUSION: The experience of formal care means both well-being and suffering at the same time. Patients' suffering in relation to formal care can be reduced if formal carers act from an ethical patient perspective point of view and if carers regard patients' lived experiences.
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| 49. |
- Nordgren, Lena, et al.
(författare)
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Animal-Assisted Intervention in Dementia : Effects on Quality of Life
- 2014
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Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 23:1, s. 7-19
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Tidskriftsartikel (refereegranskat)abstract
- There is a need to develop nonpharmacological treatments and methods which can serve as alternatives or complements to medications in dementia care. Previous research indicates that animal-assisted intervention (AAI) can be beneficial. The purpose of the present pilot project was to evaluate effects of AAI on quality of life (QoL) in people with dementia in four Swedish nursing homes. A pretest/posttest research design was used. Twenty people (12 women, 8 men; aged 58 to 88) were included. Nine people completed the intervention which comprised 10 training sessions with a certified therapy dog team. QoL improved in the expected direction after the intervention (p = .035). Even though the effects of AAI may not be discernible over longer periods of time, there are still immediate effects which can promote better QoL for people living with dementia diseases.
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| 50. |
- Nordgren, Lena, et al.
(författare)
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Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden : a cross-sectional study
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:2, s. 168-173
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to investigate associations between socio-demographic factors, experiences of positive/negative encounters with healthcare professionals, and the encounters' impact on the ability to return to work in a population of people on sick leave due to heart failure.METHODS: This was a cross-sectional study. Data were collected from two official registries in Sweden and from a postal questionnaire. In all, 590 people with heart failure responded to the questionnaire. Associations between variables were calculated with bivariate correlation analyses and logistic regression analyses.RESULTS: For people on sick leave due to heart failure, positive encounters with healthcare professionals are associated with being Swedish-born, female gender, and high income. People with high income are more likely to be supported back to work by positive encounters with healthcare professionals. To perceive that healthcare professionals believe in person's ability to return to work can be facilitating.CONCLUSIONS: Women, people who are not foreign-born, and people with high income are more likely to perceive encounters with healthcare professionals as positive. Healthcare professionals who work with rehabilitation for people with heart failure need to be aware of social inequalities and that being on sick leave is a process of change. Implications for Rehabilitation A failing heart limits everyday life implying risk for long-term sick leave. Even though there are rehabilitation programs for people with heart failure, vocational rehabilitation is often over-looked. The knowledge about factors associated with sick leave due to heart failure is scarce. Experiences of positive encounters with healthcare professionals were associated with being Swedish-born, female gender, and high income. People with high income were more likely to be supported back to work by positive encounters with healthcare professionals. Healthcare professionals who work with rehabilitation for people with heart failure can support patients with heart failure by showing them confidence and trust. However, they need to be aware that sick leave implies a process of change.
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