| 1. |
- Näslund, Ulf, et al.
(författare)
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Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) : a pragmatic, open-label, randomised controlled trial
- 2019
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 393:10167, s. 133-142
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention.METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575.FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]).INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification.
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| 2. |
- Stephen, Divya Anna, 1986-, et al.
(författare)
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Psychosocial Self-efficacy and its Association with Selected Potential Factors Among Adults with Type 1 Diabetes : A Cross-Sectional Survey Study
- 2024
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Ingår i: Diabetes Therapy. - : Springer. - 1869-6953 .- 1869-6961. ; 15:6, s. 1361-1373
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person's psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes.Methods A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (n = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables.Results Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy.Conclusions In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.
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| 3. |
- Stephen, Divya Anna, et al.
(författare)
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Using mHealth applications for self-care – An integrative review on perceptions among adults with type 1 diabetes
- 2022
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Ingår i: BMC Endocrine Disorders. - : Springer Nature. - 1472-6823. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Individually designed interventions delivered through mobile health applications (mHealth apps) may be able to effectively support diabetes self-care. Our aim was to review and synthesize available evidence in the literature regarding perception of adults with type 1 diabetes on the features of mHealth apps that help promote diabetes self-care, as well as facilitators and barriers to their use. An additional aim was to review literature on changes in patient reported outcome measures (PROMs) in the same population while using mHealth apps for diabetes self-care.Methods: Quantitative and qualitative studies focusing on adults aged 18 years and over with type 1 diabetes in any context were included. A systematic literature search using selected databases was conducted. Data was synthesised using narrative synthesis.Results: We found that features of mHealth apps designed to help promote and maintain diabetes self-care could be categorized into self-care data monitoring, app display, feedback & reminders, data entry, data sharing, and additional features. Factors affecting the use of mHealth apps reported in the literature were personal factors, app design or usability factors, privacy and safety factors, or socioeconomic factors. Quality of life and diabetes distress were the most commonly reported PROMs in the included studies.Conclusion: We are unable to reach a conclusive result due to the heterogeneity of the included studies as well as the limited number of studies reporting on these areas among adults with type 1 diabetes. We therefore recommend further large-scale studies looking into these areas that can ultimately improve mHealth app use in type 1 diabetes self-care.
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| 4. |
- Andersson, Maria, 1969-, et al.
(författare)
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Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study
- 2022
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 72
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe critical care nurses’ perception of moral distress during the second year of the COVID-19 pandemic.Design/Methods: A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants’ intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys.Setting: Critical care nurses (n = 71) working in Swedish adult intensive care units.Results: Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress.Conclusions: During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.
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| 5. |
- Andersson, Maria, 1969-, et al.
(författare)
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Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic
- 2023
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Ingår i: Sage Open Nursing. - : SAGE Publications Inc.. - 2377-9608. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care.Aims: To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave.Method: Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire.Results: Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork.Conclusions: Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.
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| 6. |
- Andersson, Maria, et al.
(författare)
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The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic
- 2023
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 78
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe the Person-Centred Practice Framework’s four domains (prerequisites, care environment, person-centred processes, and person-centred outcomes) through the perspectives of critical care nurses working in intensive care units during the second year of the COVID-19 pandemic. Furthermore, the aim was to investigate the relationships between prerequisites, care environment, person-centred processes, and person-centred outcomes. Design/methods: A cross-sectional study involving questionnaires. Prerequisites were measured using person- related conditions, the care environment by using the Person-Centred Climate Questionnaire–Staff version, the person-centred processes by using the Person-Centred Care Assessment Tool and person-centred outcomes were measured with one question about present health and well-being and by using Self-rated Exhaustion Disorder. Descriptive and analytic statistics were used. Data was collected from July 2021 to November 2021. Setting: Critical care nurses (n =217) working in 15 Swedish adult intensive care units. Results: Participants’ average length of experience in intensive care units was 14 years, and most participants experienced increased nursing care responsibilities. They perceived the climate as safe but had limitations in terms of its everydayness and community. Participants perceived the organisations both supported and hindered personalized care. Most participants experienced a variety of exhaustion symptoms, and their health had positive relationship with community. Conclusion: By showing how prerequisites, care environment, person-centred process influences critical care nurses’ health and well-being, organisations might identify aspects in the work environment that require targeted interventions to reach healthy workplaces. Implications for clinical practice: To preserve the health and well-being of critical care nurses and to flourish as humans in their professional roles, they need to interact with and form relationships with their colleagues, patients, and relatives. Organisations should have a person-centred approach for every individual in the workforce to harness each critical care nurses’ knowledge and skills for individuals to growth in their roles.
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| 7. |
- Bengtsson, Anna, 1973-, et al.
(författare)
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The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk : results from the VIPVIZA randomized clinical trial
- 2021
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Ingår i: American Journal of Preventive Cardiology. - : Elsevier. - 2666-6677. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to ob- tain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to individuals and physicians gave sustained effects on cardiovascular risk beyond the previously reported effect after 1 year and up to 3 years. Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 ran- domized to intervention ( n = 1749; pictorial information with additional prevention materials to participants and physicians) or control group ( n = 1783; no pictorial information to participants and physicians). Preventive measures were managed within primary care. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. Results: A beneficial effect on cardiovascular risk was observed at 3-year follow-up; Framingham Risk Score (FRS) was 13.38 for the intervention group and 14.08 for the control group ( p = 0.047) and SCORE was 1.69 vs. 1.82 ( p = 0.022). The effect observed at 1-year was sustained over 3 years after adjustment for sex and education and more pronounced among participants with a severe atherosclerotic picture at baseline.Conclusions: This study provides evidence of sustained beneficial effects on the adherence to prevention guidelines over 3 years of pictorial information about subclinical carotid atherosclerosis, resulting in lower cardiovascular risk regardless of sex and educational level. Direct visualization of the underlying still subclinical atherosclerotic disease, rather than just indirect information about risk factors and statistical risk of future myocardial infarction, stroke and death, is one way to tackle the problem of non-adherence to prevention of cardiovascular diseases.
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| 8. |
- Engström, Åsa, et al.
(författare)
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Institutional Constraints as an Obstacle for Prioritizing Nursing Interventions During the COVID-19 Pandemic—Critical Care Nurses’ Experiences
- 2022
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The demands of the pandemic such as staff shortages and limited resources combined with new guidelines regarding infection control may have required the prioritizing of nursing interventions.Objectives: The aim of this study was to describe critical care nurses’ experiences of prioritizing nursing interventions for patients with COVID-19 in intensive care units (ICUs) during the pandemic.Method: A qualitative descriptive study was gathered from open-ended questions included in a cross-sectional online questionnaire. Characteristics were presented using descriptive statistics, and open-ended questions were analyzed using qualitative content analysis with an inductive approach. The study was conducted in Sweden and focused on critical care nurses working in ICUs during spring 2021 and the second year of the COVID-19 pandemic.Results: During the COVID-19 pandemic, 87% of the critical care nurses had provided orientations for new co-workers, and 52% had supervised intensive care nursing students. In all, 70 answered the question of whether they had prioritized nursing care differently during the pandemic; 86% reported that they had and 14% had not. The qualitative analysis resulted in one theme, Institutional constraints as an obstacle for nursing interventions, with three categories: Prioritizing lifesaving interventions, Performing nursing interventions less frequently, and Not able to provide the nursing care I wish to provide.Conclusion: Institutional constraints as an obstacle for nursing interventions is the overall theme. It illustrates how critical care nurses have been forced to prioritize, thereby not being able to provide the nursing interventions they wanted to do provide, and it describes their feelings in this situation. The nurses need recovery and possibilities for reflection. The organization must also recover and not only return to how it was before the pandemic but also to learn from recent events and take actions to reduce the long-term effects on staffing.
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| 9. |
- Engström, Åsa, et al.
(författare)
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The Meaning of Critical Illness for People Suffering From COVID-19 : When a Frightening Unreality Becomes Reality
- 2022
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 32:1, s. 135-144
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate the meaning of critical illness for people with COVID-19. This study used a qualitative design. Thirteen people who were critically ill with COVID-19 during 2020 and admitted to a COVID-19 intensive care unit in northern Sweden participated in the study. Data collection was conducted as individual interviews with a narrative approach, and data were analyzed with phenomenological hermeneutic interpretation. The participants did not think they would get critically ill with this unexpected illness. They experienced terrible nightmares where their relatives had been killed, and they missed their relatives both in their dreams and in reality, as they had not been allowed to be with them due to the virus. Gratefulness was described for surviving. Participants described thoughts of not being able to imagine going through this again. They felt fear and loneliness, as a terrifying unreality had become a reality.
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| 10. |
- Eriksson, Inger, 1952-, et al.
(författare)
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Enabling students’ participation in algebraic reasoning with ‘learning models’ as tools for theoretical work
- 2019
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Ingår i: NOFA7 Abstracts.
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Konferensbidrag (refereegranskat)abstract
- The issue for this paper is to discuss conditions for students’ participation in theoretical classroom discussions. In order to develop students’ ability to reason and solve problems algebraically Lins and Kaput (2004) argue that it is important to introduce algebra early in mathematics education. In line with this, researchers working within the sociocultural tradition argue that this may start as early as in first grade (Lins & Kaput, 2004). The so-called Davydov programme (e.g. Schmittau, 2005) is referred to as a promising alternative type of teaching, enhancing young students’ capability to reason algebraically. Central to the Davydov programme is the concept of ’learning model’. Such models (not to be confused with mathematical models) are used to enable students’ elaboration of mathematical phenomena. The characteristics of a learning model is that it materialises central theoretical aspects of a content. Further, it creates specific conditions necessary for students to understand and elaborate on each other’s arguments. However, there are many demanding issues related to the design of such learning models that needs to be further developed. In this paper we address the following research question: What in students’ classroom discussions can be taken as signs of emergent ability to reason algebraically? In this paper we use data from two learning studies conducted in 2017–2018. One in grade 1 (age 7) with three iteratively designed and revised lessons, and one in grade 5 (age 11) with four iteratively designed and revised lessons. We focus especially on how students use learning models as tools to enforce and maintain a collective reasoning indifferent communicative situations. To identify possible algebraic reasoning we have analyzed the communicative situations by drawing upon Toulmin’s (2003) model of argumentation with claim, data, warrant and backing. The tentative results indicate that the ability to work with the learning models not only facilitated an individual student to clarify and substantiate his or her arguments, but also enabled other students to follow and elaborate on the reasoning. This paper also contributes with examples of tasks and especially how to set the tasks in motion to enable students’ theoretical work.
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| 11. |
- Eriksson, Inger, 1952-, et al.
(författare)
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Tasks, tools, and mediated actions – promoting collective theoretical work on algebraic expressions
- 2021
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Ingår i: Nordisk matematikkdidaktikk, NOMAD. - 1104-2176. ; 26:3–4, s. 29-52
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to exemplify and discuss what teachers using learning activity need to consider when planning and supporting students’ collective theoretical work on algebraic expressions. Data are from two iteratively developed research lessons in two Grade 7 classes. The analysis focuses on students’ tool-mediated actions, the mathematical content processed, how the content is dealt with, and on identifying the crucial aspects that enable collective theoretical work. The result provides examples of how the content of the task, its design, and its tools, as well as the teacher’s and students’ tool-mediated actions are crucial factors in the promotion of collective theoretical work.
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| 12. |
- Fredholm, Angelica, et al.
(författare)
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Learning in intensive care during the COVID-19 pandemic - postgraduate critical care nursing students’ experiences
- 2022
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Ingår i: International Journal of Medical Education. - : NLM (Medline). - 2042-6372. ; 13, s. 335-344
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study explored postgraduate critical care nursing students' experiences of learning in the ICU during the COVID-19 pandemic and to understand these experiences in relation to self-directed learning and professional development. Methods: An explorative qualitative design was used. Eight postgraduate critical care nursing students from two different universities were interviewed. Questions focused on learning, supervision, ethically difficult situations, issues regarding communication, as well as the impact of the pandemic on students' health. Interviews thematically analyzed, and further analyzed using a theoretical framework focusing self-directed learning and professional development containing the concepts of autonomy, authenticity, and attachment. Results: The result consists of three themes: 1) Attachment with subthemes Attachment to the patient, Attachment to family and friends, Attachment to the ICU-context, and Attachment to the clinical supervisor. 2) Authenticity with subthemes Experiencing a varying degree of authenticity, Clinical reasoning about how to prioritize care. 3) Autonomy with subthemes Being just a student - with limited responsibility, taking responsibility, and having worries regarding one's professional development. Conclusion: Findings show the need for participation in the ICU community of practice without the demands and responsibility of full participation. Students need to be given the opportunity to form a relationship with practice. For attachment, participation, and consequently professional development to take place, there is need for inviting students to be a part of the team even during such straining circumstances as an ongoing pandemic. These findings can advance the understanding of how to organize clinical education during future crisis such as a new pandemic.
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| 13. |
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| 14. |
- Fredriksson, Anna, Dr. 1967-, et al.
(författare)
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The Deductionis coloniarum rationes & causae (1668) : Building Arguments for Swedish Colonisation
- 2021
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Ingår i: Lias. - : Peeters Publishers. - 2033-4753 .- 2033-5016. ; 48:1, s. 123-193
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Tidskriftsartikel (refereegranskat)abstract
- The dissertation Deductionis coloniarum rationes & causae, submitted at Uppsala University in 1668 under the presidency of Johannes Schefferus, appears to be the first contribution to the Swedish discourse on the subject of colonisation and colonialism. In this paper, a translation of the text is presented with a commentary and a list of sources. In an introduction to the translation, which discusses the text against the background of academic, political, and cultural contexts, we suggest that the dissertation relates to Swedish seventeenth-century colonial experiences in general, and, more specifically, to the colonial endeavour in Sápmi (i.e. the land of the Sámi) in the northern parts of Fennoscandia. Johannes Schefferus was one of the leading intellectuals of seventeenth-century Sweden, known for important contributions to archaeology, history, and philology. The writing of Deductionis coloniarum rationes & causae is put in relation to Schefferus’ influential Lapponia (Frankfurt 1673), a work dealing with Sámi culture, economy, religion and history, which was published during a period of intensive Swedish colonial expansion in Sápmi.
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| 15. |
- Fritzson, Magdalena, et al.
(författare)
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A mobile application for early labour support -feasibility pilot study
- 2023
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 36:6, s. 495-503
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Tidskriftsartikel (refereegranskat)abstract
- Background: Use of mobile applications (apps) Use of mobile applications (apps) are increasing during pregnancy but few of these are evidence-based or evaluated in research.Aim: To examine the feasibility, including perceived usefulness and usability, and the preliminary effects of an app based on the Confident birth method.Methods: A mixed-method approach, including 48 women, was used to evaluate acceptability, usability and to test study design and procedures. iPhone-users (n = 24) tested the app during pregnancy while the remaining (n = 24) formed a control group. Background characteristics and outcome measurements were collected from all women at baseline. Women in the app group received two follow-up phone calls from a midwife concerning usefulness and ease of use of the app. A follow-up questionnaire after birth were used to measure preliminary effects of the intervention as well as system usability of the app.Results: Women using the app found the app exercises simple, understandable, and useful. System usability score showed a mean score of 85.3 indicating excellent system usability. Notes from phone calls resulted in four categories: positive feedback about the app, negative feedback about the app, partners involvement, and knowledge. Preliminary effects of labour experience showed no significant differences between the two groups, in terms of early labour or childbirth experience.Conclusion: The app tested in this feasibility study, was perceived as useful and appreciated by women. Areas for improvement of the app were identified. The result shows promise for further efficacy testing in a forthcoming randomised controlled trial.
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| 16. |
- Hall-Lord, Marie Louise, 1951-, et al.
(författare)
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The Swedish version of the TeamSTEPPS (R) teamwork attitudes questionnaire (T-TAQ) : A validation study
- 2021
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Ingår i: BMC Health Services Research. - : BMC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundEffective teamwork is essential for delivering safe health care. It is important to increase patient safety in healthcare by conducting interprofessional team training with both healthcare professionals and undergraduate students. Validated questionnaires that evaluate team training activities contribute to valuable knowledge regarding changes in attitudes toward teamwork. The aim of the study was to test the reliability and structural validity of the Swedish version of the TeamSTEPPS (R) Teamwork Attitudes Questionnaire (T-TAQ).MethodsThe study had a cross-sectional design. Four hospitals in three health care regions in Sweden participated in the study. In total, 458 healthcare professionals, response rate 39.4%, completed the questionnaire. The T-TAQ, which consists of 30 items and covers five dimensions (Team Structure, Leadership, Situation Monitoring, Mutual Support and Communication), was translated to Swedish. A paper version of the T-TAQ was distributed to healthcare professionals (physicians, registered nurses, midwives, nursing assistants and allied health professionals) from the hospitals. Reliability and validity were tested using Cronbach's alpha and confirmatory factor analysis.ResultsCronbach's alpha was 0.70 for the total T-TAQ and ranged from 0.41 to 0.87 for the individual dimensions. The goodness-of-fit indexes in the confirmatory factor analysis (Model 2) revealed a normed chi-square of 2.96, a root mean square error of approximation of 0.068, a Tucker-Lewis index of 0.785 and a comparative fit index of 0.808.ConclusionsThe Swedish version of the T-TAQ has some potential to measure healthcare professionals' general attitudes toward the core components of teamwork in hospital settings. Further validation studies of the Swedish version of the T-TAQ are required, with samples representing both healthcare professionals and students from various healthcare disciplines and educational levels.
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| 17. |
- Hall-Lord, Marie Louise, 1951-, et al.
(författare)
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The Swedish Version of the TeamSTEPPS (R) Teamwork Perceptions Questionnaire (T-TPQ) : A Validation Study
- 2020
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Ingår i: Journal of Multidisciplinary Healthcare. - : DOVE MEDICAL PRESS LTD. - 1178-2390. ; 13, s. 829-837
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The delivery of effective and safe healthcare to patients is highly dependent on careful collaboration between healthcare professionals. Although teamwork is an important component for patient safety, effective teamwork is not always carried out in hospital wards, leading to negative consequences for the patients. Teamwork measurements can be used to evaluate and provide feedback to healthcare professionals to support team performance and to identify areas for improvement. The TeamSTEPPS (R) Teamwork Perceptions Questionnaire (T-TPQ) evaluates Team Structure and four core competences of teamwork (Leadership, Situation Monitoring, Mutual Support, and Communication) among healthcare professionals in various healthcare settings. The questionnaire was judged to be relevant in a Swedish healthcare context and was translated into Swedish. This study aimed to test the reliability and construct validity of the Swedish version of the T-TPQ. Methods: A total of 450 (of 1176) frontline healthcare professionals working at four hospitals responded to the questionnaire. A confirmatory factor analysis was carried out to test the factor structure. Cronbach's alpha was used to measure internal consistency. Results: The hypothesized five-factor model of the five dimensions showed acceptable goodness-of-fit indexes. Cronbach's alpha coefficient for the total T-TPQ was 0.94, and the Cronbach's alpha coefficients for the dimensions ranged from 0.79 to 0.92. The intercorrelation coefficients ranged from 0.27 to 0.74. Conclusion: The Swedish version of the T-TPQ showed acceptable reliability and validity for measuring healthcare professionals' individual perceptions of teamwork at the group level. Due to the low response rate, further studies are required to test the validity of the Swedish T-TPQ.
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| 18. |
- Iwaya, Leonardo H, et al.
(författare)
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Early Labour App: Developing a practice-based mobile health application for digital early labour support
- 2023
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Ingår i: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 177
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pregnant women in early labour have felt excluded from professional care, and their partners have been restricted from being involved in the birthing process. Expectant parents must be better prepared to deal with fear and stress during early labour. There is a need for evidence-based information and digital applications that can empower couples during childbirth.Objective: To develop and identify requirements for a practice-based mobile health (mHealth) application for Digital Early Labour Support.Methods: This research started with creating an expert group composed of a multidisciplinary team capable of informing the app development process on evidence-based practices. In consultation with the expert group, the app was built using an agile development approach (i.e., Scrum) within a continuous software engineering setting (i.e., CI/CD, DevOps), also including user and security tests.Results: During the development of the Early Labour App, two main types of challenges emerged: (1) user challenges, related to understanding the users’ needs and experience with the app, and (2) team challenges, related to the software development team in particular, and the necessary skills for translating an early labour intervention into a digital solution. This study reaffirms the importance of midwife support via blended care and the opportunity of complementing it with an app. The Early Labour App was easy to use, the women needed little to no help, and the partner's preparation was facilitated. The combination of the app together with blended care opens up awareness, thoughts and feelings about the method and provides good preparation for the birth.Conclusion: We propose the creation of the Early Labour App, a mHealth app for early labour support. The preliminary tests conducted for the Early Labour App show that the app is mature, allowing it to be used in the project's Randomised Control Trial, which is already ongoing.
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| 19. |
- Nordin, Anna, 1972-, et al.
(författare)
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Body-Area Sensing in Maternity Care : Evaluation of Commercial Wristbands for Pre-birth Stress Management
- 2022
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Ingår i: Lecture Notes of the Institute for Computer Sciences Social Informatics and Telecommunications Engineering. - Cham : Springer. - 9783030955922 ; , s. 168-175
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Konferensbidrag (refereegranskat)abstract
- Many women use digital tools during pregnancy and birth. There are many existing mobile applications to measure quantity and length of contractions during early labour, but there is a need to offer evidence-based, credible electronic and digital solutions to parents-to-be. This article presents ongoing research work in a research project regarding mobile telemetric supported maternity care. It summarizes an approach for stress management in late maternity and under birth preparation that is based on body area sensing, our investigation of the properties of commercially available wearable wristbands for body sensing, and the insights gained from testing the wristbands from the project's perspective. We found that sensing precision is very variable depending on the wristband model, while the flows of medical personal data exclusively are routed through vendor cloud platforms outside the EU. The impact of our findings for the use of commercial wristbands in European medical research and practice is discussed in the conclusion.
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| 20. |
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| 21. |
- Nordin, Anna, 1972-, et al.
(författare)
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Health care staffs’ perception of patient safety culture in hospital settings and factors of importance for this
- 2013
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Ingår i: Open Journal of Nursing. - 2162-5336 .- 2162-5344. ; 3, s. 28-40
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Tidskriftsartikel (refereegranskat)abstract
- Many hospital patients are affected by adverse events. Managers are important when improving safety. The perception of patient safety culture varies among health care staff. Health care staff (n = 1023) working in medical, surgical or mixed medical-surgical health care divisions answered the 51 items (14 dimensions) Swedish Hospital Survey on Patient Safety Culture (S-HSOPSC). Respondents with a managerial func- tion scored higher than non-managers for 11 of 14 dimensions, indicating patient safety culture strengths for a majority of dimensions. Enrolled nurses and staff with experience > 10 years also scored high for several dimensions. The 12 dimensions and sample characteristics explained 49% and 26% of the vari- ance for the outcome dimensions Overall Perceptions of Safety and Frequency of Incident Reporting, re- spectively. RNs, ENs and physicians have different views on patient safety culture. Hospital Management Support and Organisational Learning is some im- portant factors influencing patient safety culture. Bridging the gap in health care staff’s perceptions of safety in order to improve patient safety is of utmost importance. Managers have the responsibility to fos- ter patient safety culture at their workplace and can thus benefit from results when improving safety for patients.
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| 22. |
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| 23. |
- Nordin, Anna, 1972-, et al.
(författare)
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Measuring moral distress in Swedish intensive care: Psychometric and descriptive results
- 2023
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 76
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the construct validity and psychometric properties of the Swedish version of the Moral Distress Scale–Revised and to describe moral distress in an intensive care context.Research Methodology/Design: The Italian Moral Distress Scale–Revised was translated and semantically adjusted to the Swedish intensive care context. A web survey with 14 moral distress items, as well as three additional and eight background questions was answered by critical care nurses (N = 71) working in intensive care units during the second year of the coronavirus disease pandemic. Inferential and descriptive statistics were used to investigate the Italian four-factor model and to examine critical care nurses’ moral distress.Results: The result shows a factor model of four components differing from the previous model. Critical care nurses demonstrated significant differences in moral distress regarding priorities compared to before the pandemic, type of household; experience as critical care nurses and whether they had supervised students during the pandemic.Conclusion: The component structure might have originated from the specific situation critical care nurses perceived during the pandemic. The health care organisations’ role in preventing and healing the effects of moral distress is important for managers to understand.Implications for clinical practice: Moral distress is common in intensive care and it is necessary to use valid instrument when measuring it. A psychometrical investigation of the Swedish version of the Moral Distress Scale–Revised, adapted for intensive care shows need for further semantic and cultural adaptation. Perceived priorities during the pandemic, household type, supervising during the pandemic and working experience were related to critical care nurses’ experience of moral distress and managers need to be aware of conditions that may trigger such a response.
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| 24. |
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| 25. |
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| 26. |
- Nordin, Anna, 1972-, et al.
(författare)
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Swedish Hospital Survey on Patient Safety Culture : Psychometric properties and health care staff’s perception
- 2013
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 3, s. 41-50
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the psychometric properties of the Swedish and the original version of the Hospital Survey on Patient Safety Culture within a Swedish hospital setting and described health care staff’s per- ceptions of patient safety culture. A web-survey was used to obtain data from registered nurses, enrolled nurses and physicians (N = 1023). Psychometric properties were tested using Confirmatory Factor Analysis and internal consistency using Cronbach’s alpha coefficient. Root mean square error of ap- proximation and other fit indices indicated psycho- metric properties for both versions to be acceptable. Internal consistency for the dimensions varied be- tween 0.60 and 0.87. Staff scored the dimension “Teamwork Within Units” highest and the dimension “Hospital Management Support” the lowest. The safety was graded as very good or excellent by 58.9% of the respondents and one third had reported more than one event in the past 12 months. The question- naire is considered to be useful for measuring patient safety culture in Swedish hospital settings. Managers have a great responsibility to work with improving patient safety culture.
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| 27. |
- Nordin, Therese, et al.
(författare)
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Constructing loneliness : home care providers' notions of older adults' social needs and the possibilities of the home care profession to support social participation
- 2023
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Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 65
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Tidskriftsartikel (refereegranskat)abstract
- Quality of care is determined not only by political decisions but also by how those policies are understood and managed by professionals when put into action. Home care services, the most common form of elder care in Sweden today, should include social support, which is very important for health and wellbeing. And yet, support for social participation seems to be lacking. Understanding prevalent social constructs and their possible impacts on focus and content of social practice in home care could reveal ways to address social support in home care. Therefore, this article highlights how professionals in home care provision talk about older home care recipients' loneliness and social needs, and how these repertoires are related to professionals' opportunities and obligations to support those social needs. The study included 22 persons from different professions in home care provision, from two municipalities in northern Sweden. Nine individual interviews and four group interviews were conducted, recorded, transcribed, and analyzed using a discourse psychology approach. The results show two interpretative repertoires in which notions of otherness and likeness guided definitions and support regarding loneliness, social needs, and social support. This study reveals assumptions that underpin and structure the practices of home care. As the interpretative repertoires provided differing and partly opposing views on how to provide social support and combat loneliness, it seems important to also address the broader issues of professional identities and how loneliness is defined and approached.
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| 28. |
- Rafsten, Lena, et al.
(författare)
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Gothenburg Very Early Supported Discharge study (GOTVED) : a randomised controlled trial investigating anxiety and overall disability in the first year after stroke
- 2019
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 19, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine.METHODS: A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients' degree of overall disability, measured by the modified Rankin Scale (mRS).RESULTS: No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke.CONCLUSIONS: The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit.TRIAL REGISTRATION: Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).
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