| 1. |
- Åhman, Sara, et al.
(author)
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Long-term follow-up of patients with mild traumatic brain injury : a mixed-methods study
- 2013
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In: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 45:8, s. 758-764
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To characterize the long-term consequences of mild traumatic brain injury regarding post-concussion symptoms, post-traumatic stress, and quality of life; and to investigate differences between men and women.DESIGN: Retrospective mixed-methods study.Subjects/patients and methods: Of 214 patients with mild traumatic brain injury seeking acute care, 163 answered questionnaires concerning post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire; RPQ), post-traumatic stress (Impact of Event Scale; IES), and quality of life (Short Form Health Survey; SF-36) 3 years post-injury. A total of 21 patients underwent a medical examination in connection with the survey. The patients were contacted 11 years later, and 10 were interviewed. Interview data were analysed with content analysis.RESULTS: The mean total RPQ score was 12.7 (standard deviation; SD 12.9); 10.5 (SD 11.9) for men and 15.9 (SD 13.8) for women (p = 0.006). The 5 most common symptoms were fatigue (53.4%), poor memory (52.5%), headache (50.9%), frustration (47.9%) and depression (47.2%). The mean total IES score was 9.6 (SD 12.9) 7.1 (SD 10.3) for men and 13.0 (SD 15.2) for women (p = 0.004). In general, the studied population had low scores on the Short Form Health Survey (SF-36). The interviews revealed that some patients still had disabling post-concussion symptoms and consequences in many areas of life 11 years after the injury event.CONCLUSION: Long-term consequences were present for approximately 50% of the patients 3 years after mild traumatic brain injury and were also reported 11 years after mild traumatic brain injury. This needs to be taken into account by healthcare professionals and society in general when dealing with people who have undergone mild traumatic brain injury.
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| 2. |
- Åkesson, Kerstin, 1952-, et al.
(author)
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Health care consumers' experiences of information communication technology : A summary of litterature
- 2007
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In: International Journal of Medical Informatics. - 1386-5056. ; 76:9, s. 633-645
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Journal article (peer-reviewed)abstract
- Background: There is an increasing interest in reaching consumers directly through the Internet and different telecommunication systems. The most important contacts in health care will always be the face-to-face meetings, but the tools of health informatics can be seen as a means to an end, which is to provide the best possible health care. A variety of applications have been described in different references. To our knowledge there has been no review of a research-based state of the art in the field of consumers’ experiences in using different applications in health informatics. According to the benefits in using information communication technology (ICT) as being cost-effective and timesaving it is of great importance to focus on and examine consumers’ experiences. It is important that it is user friendly and regarded as valuable and useful.Aim: The aim of this study was to describe consumers’ subjective experiences of using electronic resources with reference to health and illness.Design and/or method: A systematic literature search was performed in databases CINAHL, Medline and Cochrane, as well as a manual search. Retrieved references (n = 14) were appraised according to their scientific structure and quality. A broad search was performed in order to find as many different applications as possible. Our primary intention was to identify existing references describing consumers’ experiences with ICT.Results: In spite of this broad search few references were found. Twelve references remained and three themes were identified: support and help, education and information, and telecommunication instead of on-site visiting. Consumers felt more confident and empowered, their knowledge increased and their health status improved due to the ICT resources. Lack of face-to-face meetings or privacy did not appear to be a problem.Conclusion: ICT can improve the nurse–patient relationship and augment well-being for consumers. More research is needed to measure consumers’ experiences and factors that influence it.
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| 3. |
- Ahlm, Kristin, et al.
(author)
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Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs : a retrospective study, 1992-2009
- 2013
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In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 13, s. 216-
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Journal article (peer-reviewed)abstract
- Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.
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| 4. |
- Ahlm, Kristin, et al.
(author)
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Suicidal drowning deaths in northern Sweden 1992-2009 : the role of mental disorder and intoxication
- 2015
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In: Journal of Forensic and Legal Medicine. - : Elsevier. - 1752-928X .- 1878-7487. ; 34, s. 168-172
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Journal article (peer-reviewed)abstract
- Suicides by drowning have received limited attention by researchers. A recent finding that almost onethird of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.
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| 5. |
- Erlingsson, Christen L., et al.
(author)
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Perception of elder abuse in Sweden : voices of older persons
- 2005
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In: Brief Treatment and Crisis Intervention. - 1474-3310 .- 1474-3329. ; 5:2, s. 213-227
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore the perceptions of elder abuse held by older persons in Sweden. Six focus group interviews were conducted. Through qualitative content analysis, the text revealed four themes: causes of elder abuse, conceptions of elder abuse, consequences of elder abuse, and coping with elder abuse. Changing society and families, as well as individual determinants, were believed to be causes of elder abuse. The main conception of elder abuse was that of robbery or assault, and the main consequence was fear. Coping with abuse included individual strategies and improvements in society. Issues of age discrimination were intrinsic in the findings. Gender differences were evident in the group dynamics. Nurses and other health care personnel need to be aware of what older persons believe to be the cause of elder abuse and what they consider abusive. Awareness of the results of this study can help in refining interview and assessment techniques and in designing training manuals.
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| 6. |
- Hanberger, Anders, 1953-, et al.
(author)
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Metodologiska utgångspunkter för forskningsprogrammet ”Säkerhetsarbetets relevans och effekter”
- 2010
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Reports (other academic/artistic)abstract
- Rapporten har utvecklat och sammanfattat programmets metodologiska utgångspunkter. Centrala begrepp har definierats och motiverats. Principiella frågor kring utvärdering av relevans och effekter av säkerhetsarbeten och säkerhetsprogram har också diskuterats. De överväganden som diskuteras och de ställningstaganden som gjorts i rapporten kommer att vägleda arbetet och konkretiseras i forskningsprocessen. Utgångspunkterna kommer att vid behov anpassas till de utmaningar som forskarna ställs inför. I slutrapporten kommer programmets metodologiska lärdomar att redovisas och diskuteras.
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| 7. |
- Johansson, Pauline, 1968-, et al.
(author)
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Kan någon annan tala om hur jag mår? : En studie med patienter, familjemedlemmar och personal om skattning och hantering av sjukdomsrelaterade symtom vid avancerad cancer.
- 2007
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Reports (other academic/artistic)abstract
- Människor som har en avancerad cancer drabbas ofta av multipla både fysiska, psykiska, sociala och existentiella symtom. När de sjuka inte längre orkar eller kan förmedla sina symtom är de beroende av andra personers förmåga att tolka dem istället. Samstämmigheten mellan hur patienter upplevelser sina symtom och hur familjemedlemmar och vårdpersonal uppfattar att patienterna mår är avgörande för att patienterna ska kunna hantera sin sjukdom på bästa sätt. Flera studier visar att det finns skillnader mellan hur patienter uppfattar sina symtom med hur andra uppfattar att patienten upplever dem. Tidigare studier visar en tendens till att familjemedlemmar överskattar patientens symtom medan vårdpersonal underskattar, men det finna även studier med motsägande resultat. Syftet med denna studie är att beskriva skattningar av cancerrelaterade symtom och hantering av sin situation hos patienter med avancerad cancer. Studien syftar vidare till att belysa patienters, familjemedlemmars och primäransvarig personals (läkare och/eller sjuksköterska) skattningar av patienters symtom. Det var sju patienter, sju familjemedlemmar och tolv personal (sjuksköterskor/ läkare) som deltog i studien. Totalt genomfördes 45 intervjuer varav 15 intervjuer med respektive patienter, familjemedlemmar och personal, och totalt genomfördes 75 skattningar med the Edmonton Symptoms Assessment Scale (ESAS), 25 med respektive patienter, familjemedlemmar och personal. Första analysen av intervjuerna mynnade ut i en kärnberättelse om hur det kan se ut över tid för en patient, familjemedlem och primäransvarig personal, dvs. en triad. Därefter delades texterna in i kategorier utifrån skattnings-skalans symtom. Tre huvudkategorier, fysisk domän och psykisk, existentiell domän, hantering av sin sjukdom och 13 subkategorier bildades. En korrelationsanalys med Pearsons korrelations koefficient och en signifikansnivå på p<0.05 användes för att hantera data från ESAS. Resultatet visade att det råder en bättre samstämmighet inom den fysiska domänen än inom den psykisk existentiella domänen. Mellan patienterna och familjemedlemmarna ses svaga korrelationer i skattningar av andfåddhet, oro/ångest och välbefinnande, och mellan patienterna och personalen råder lägst samstämmighet för smärta och oro/ångest. Både familjemedlemmarna och personalen tenderar att överskatta patientens symtom. För att hantera situationen var familjemedlemmarna det största stödet, men även vårdpersonal och tron på Gud angavs som stöd i sjukdomssituationen. Jämförs skattningar mellan patienter och familjemedlemmar och mellan patienter och personal, kan det konstateras att samstämmigheten trots allt var ganska god. Detta ger stöd för att främst familjemedlemmar, men även vårdpersonal kan vara ett gott alternativ för att agera som patientens proxy.
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| 8. |
- Johansson, Pauline, 1968-, et al.
(author)
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Sjuksköterskors inställning till familjers betydelse i omvårdnaden
- 2006
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Reports (other academic/artistic)abstract
- Sjuksköterskor kommer ofta i kontakt med familjemedlemmar i sitt arbete och familjer intar en allt större roll i omvårdnaden. Det är viktigt i sjuksköterskans omvårdnadsarbete att se den sjuke som en del av sin familj, eftersom alla i familjen påverkas när någon av dess medlemmar blir sjuk. Till dags datum är kunskapen om svenska sjuksköterskors inställning i denna fråga begränsad. Denna studie är därför baserad på ett generellt urval av landets sjuksköterskor. Syftet med denna studie var att beskriva sjuksköterskors inställningar till familjers betydelse i omvårdnaden och att relatera dessa till personliga och organisatoriska bakgrundsdata. Enkäten, Familjers betydelse i omvårdnaden (FAMBO), som utvecklats för studien, består av 26 påståenden och avser att mäta sjuksköterskors inställning till familjers betydelse i omvårdnaden utifrån deras professionella perspektiv. Enkätens fyra delskalor handlar om Familjen som en resurs i omvårdnaden (Fam-RO), Familjen som en samtalspartner (Fam-SP), Familjen som en börda (Fam-B) och Familjen som sin egen resurs (Fam-ER). Enkäten skickades ut till ett slumpmässigt urval av 1000 sjuksköterskor från Vårdförbundets medlemsregister. Sjuksköterskorna skulle vara klinisk verksamma inom den direkta patientvården. Urval och utskick administrerades helt av Vårdförbundets personal, deltagarna blev därigenom anonyma för forskarna. Responsen var 65 % (n=634) och de som svarade kan anses som representativa för landets sjuksköterskor eftersom flera bakgrundsvariabler var jämförbara med medlemsregistrets data. Data har behandlats som ordinaldata och analyserats med Mann-Whitney U-test, Kruskal Wallis test samt med Post hoc test (Mann-Whitney U-test med reducerat p-värde enligt Bonferroni). För att se vilka variabler som predicerade för lägst skattning genomfördes en multipel logistisk regressionsanalys. Resultatet visade att sjuksköterskorna var mycket positivt inställda till familjers betydelse i omvårdnaden, men det fanns skillnader i den totala skattningen gällande all bakgrundsdata, förutom kön. De som var yngre (≤30 år) skattade lägre än de som var äldre och likvärdiga resultat visade sig för hur länge sedan det var som sjuksköterskorna tagit sin examen. De som varit legitimerade kortast tid (≤5 år) skattade lägre än sina mer erfarna kollegor. Manliga sjuksköterskor skattade lägre på vissa skalor i förhållande till sina kvinnliga kollegor, samtidigt som de som inte hade någon erarenhet av att vara familjemdlem till någon som varit svårt sjuk skattade lägre i jämförelse med dem som hade denna erfarenhet. Bland de organisatoriska bakgrundsdata som efterfrågades visade det sig bland annat att sjuksköterskorna som arbetade med barn skattade högst på samtliga skalor medan de som arbetade inom akutsjukvården skatta lägst (förutom på Fam-RO). De som hade ett gemensamt synsätt angående familjer på sin arbetsplats skattade högre än de som inte hade detta synsätt. De variabler som predicerade för en lägre inställning till familjers betydelse i omvårdnaden var att: vara man eller att ha en legitimationstid ≤5 år eller om det inte fanns ett gemensamt synsätt angående omvårdnad av familjer på arbetsplatsen. Skillnaderna som påvisades i förhållande till flera variabler, till exempel kön och ålder, finns mycket sparsamt beskrivet i tidigare forskning och är intressanta att studera vidare. Samtidigt som studiens resultat påvisar att sjuksköterskornas inställning till familjers betydelse i omvårdnaden är mycket positiv så vet vi inget om hur de verkligen agerar i möten med familjer.
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| 9. |
- Malmedal, Wenche, et al.
(author)
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The dark side of Norwegian nursing homes : factors influencing inadequate care
- 2014
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In: Journal of Adult Protection. - : Emerald Group Publishing Limited. - 1466-8203 .- 2042-8669. ; 16:3, s. 133-151
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Journal article (peer-reviewed)abstract
- Purpose– The purpose of this paper is to investigate factors that influence the probability that staff will commit acts of inadequate care, abuse, and neglect. Design/methodology/approach– A cross-sectional survey study was carried out in one county in the middle of Norway (Sør-Trøndelag). Random sampling, stratified by size of nursing homes, and location (rural or urban areas), was used to select a variety of nursing homes from a total population of 55 nursing homes. All staff working in 16 nursing homes working were asked to participate in the study. A response rate of 79 per cent was achieved (n=616). Findings– Findings reveal that location and size of the nursing home, age of the staff, education level, job satisfaction, resident aggression, and conflicts between residents and staff predict inadequate care, abuse, and neglect. The most consistent findings are that resident aggression increases the risk for all three types of inadequate care, and that conflicts predict different types of inadequate care depending on whether the conflicts are related to direct care-giving activities or not. Practical implications– Nursing home care is an important part of care for the elderly, and should be characterized by good-quality services. The relation between inadequate care and resident aggression, conflicts, and other factors shown in this study points to the relevance of further improvements in nursing home practices to minimize the occurrence of episodes of inadequate care, abuse, and neglect. Originality/value– This study investigated the relationships between 11 specific factors and different types of inadequate care in a nursing home context.
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| 10. |
- Saveman, Britt-Inger, 1950-
(author)
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Formal carers in health care and the social services witnessing abuse of the elderly in their homes
- 1994
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Doctoral thesis (other academic/artistic)abstract
- The purpose was to elucidate the reactions of formal carers as witnesses and helpers in situations of elder abuse, to illuminate abusive situations and to reflect on the findings from an ethical point of view. Twenty-one district nurses from one county council were interviewed (I, II, III, IV). They described the problems they had when dealing with cases of elder abuse, the uncertainty they felt when they approached the family, identified the abuse and intervened (I). They used no distinct definition of elder abuse but described it as ’overstepping the boundaries of a person’s integrity/autonomy’ (II). In the 44 cases narrated the elderly people were mostly physically and/or psychologically impaired, the person abused could either be the impaired elderly person, the informal carer or both. Abuse was related to the inability of one party to meet the demands made on him/herself, the other person, or to a history of violence (III). The cases narrated were analysed for reliability and were considered reliable (IV). Questionnaires submitted to 163 district nurses revealed 33 cases of elder abuse (V) and to home service assistants 97 cases (VI). The abused elderly people were often very old women, mostly healthy or unhealthy in equal proportions. The perpetrators were mostly close relatives, responsible or not responsible for the caring. The abusive acts often involved a combination of psychological, physical, and financial abuse and neglect. Mental disturbance and alcohol abuse, as well as financial reasons were reported as contributing to the abuse (V, VI). The attitudes of general practitioners, district nurses and home service assistants towards elder abuse and the interventions suggested in hypothetical cases of elder abuse were investigated (VII). All groups were uncertain about their attitudes towards elder abuse. Their suggested interventions were amalgamated into three groups; sparse and of the social type, more specific and of the health care and voluntary type, or overall types of intervention. The situation, profession and organization seemed to result in different interventions (VII). The findings were reflected on using Lögstrup’s ethic as a framework, and the conclusion was that in order to be able to intervene successfully formal carers need to find solutions on a meta-level. Conventions and norms must be developed and public responsibility is needed.
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