| 1. |
- Hagelin, Elisabeth, et al.
(författare)
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Utilization of Child Health Services during the first 18 months of life : aspects of health surveillance in Swedish preschool children based on information in health records
- 1998
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Ingår i: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 87:9, s. 996-1002
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate some aspects of care given within the preventive Child Health Services (CHS) during the first 18 months of Life. A national random sample performed on child health records of 172 Swedish preschool children horn between 1982 and 1987 was analysed regarding services recorded as having been provided and used within and beyond the national programme of health surveillance. Most families had mode visits within the core programme of health surveillance to an optimal or at least sufficient extent. First-time parents visited the CHS more frequently than did more experienced parents. Procedures within the programme, such as growth monitoring, hip examination and immunizations, were documented to have been optimally performed on a majority of the children. Conversely, screening for hearing impairment and assessment of developmental milestones were performed less frequently, as were health information and postnatal parental education. To improve the quality of care, national recommendations ought to be more specific regarding both the performance and the documentation of the service.
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| 2. |
- Hedov, Gerth, et al.
(författare)
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First information and support provided to parents of children with Down syndrome in Sweden : clinical goals and parental experiences
- 2002
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Ingår i: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 91:12, s. 1344-1349
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Tidskriftsartikel (refereegranskat)abstract
- When parents are informed that their newborn child has Down syndrome (DS), they often respond with a traumatic crisis reaction. The aims of this study were to assess the clinical goals regarding the first information and support provided to parents of newborn children with DS at the Swedish paediatric departments, and to analyse the parents' experiences of how they were first informed and treated. Data were collected during 1992-1993 from all of the 51 departments of paediatrics in Sweden. Information on the parents' experiences, collected retrospectively in 1996, was based on recollection by 165 parents of 86 children with DS born between 1989 and 1993 at 10 of the paediatric departments considered representative for Sweden. Seventy-five percent of the families were informed about the diagnosis within 24 h post partum. Some parents felt they were informed too late, and a few parents that they were told too soon. Half of the parents were satisfied with the timing. About 70% of the parents considered the information insufficient and 60% felt that they had been unsupported. Seventy percent would have liked more frequent information. Parental criticisms concerning the way in which the information was provided were that they received too much negative information about DS and that both the communication skills and the basic knowledge of DS on the part of the professionals could have been better. CONCLUSION: The Swedish paediatric departments fall short of their reported strong clinical goals regarding the initial information in Sweden, and improvements in this area are desirable.
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| 3. |
- Raak, Ragnhild, 1948-, et al.
(författare)
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Catastrophizing and health related quality of life : A 6-year follow-up of patients with chronic low back pain
- 2002
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Ingår i: Rehabilitation Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0278-4807. ; 27:3, s. 110-117
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Tidskriftsartikel (refereegranskat)abstract
- A pain rehabilitation model that focused on emotions was implemented to influence catastrophizing by, and health-related quality of life (HRQL) for, persons with chronic low back pain. Twelve individuals, 7 men and 5 women (aged 33 to 57 years), all with long-term pain despite treatment, were included in the study and a single case research experimental design (SCRED) was used to follow the patterns of coping with pain for 6 years. The HRQL was measured before and 6 years after the intervention. Coping strategies and HRQL were evaluated with the Coping Strategy Questionnaire (CSQ) and the SF-36, respectively. The evaluation of pain coping strategies after 3 years found decreased catastrophizing, a decrease that had continued 3 years later. HRQL showed significantly improved mental health and impaired physical capacity at the 6-year follow-up. Changes in catastrophizing or in HRQL did not appear to influence self-scored bodily pain. Altered catastrophizing appeared to be a long-term process. This research indicates the need for rehabilitation programs to assess and evaluate patients' pain and their need for improved quality of life, rather than focusing only on the elimination of pain.
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| 4. |
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| 5. |
- Abdelgadir, Moawia, et al.
(författare)
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Health related quality of life and sense of coherence in Sudanese diabetic subjects with lower limb amputation
- 2009
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Ingår i: Tohoku journal of experimental medicine. - : Tohoku University Medical Press. - 0040-8727 .- 1349-3329. ; 217:1, s. 45-50
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Tidskriftsartikel (refereegranskat)abstract
- Quality of life is an important outcome measure in diabetic patients with lower limb amputation (LLA). The aim of this study was to investigate the influence of lower limb amputation on health-related quality of life (HRQOL) in Sudanese diabetic subjects. Additionally the Sense of Coherence scale (SOC-13) and a symptom check list was used in subjects with LLA. A total of 60 (M/F; 40/20) diabetic subjects with LLA and 60 (M/F; 23/37) diabetic reference subjects without LLA, were studied. For both groups HRQOL was measured using The Medical Outcomes Study questionnaire (MOS). Subjects with LLA had significantly poorer HRQOL compared to the reference group in most HRQOL domains (p < 0.0001). Duration of diabetes had the greatest negative impact on HRQOL in both groups, those with LLA (p < 0.0001), and in those without LLA (p < 0.0001), although subjects who were amputated earlier had poorer HRQOL than recently amputated (p < 0.0001). Higher SOC scores were recorded in LLA patients who have greater ratings of positive feelings, family satisfaction and sleep in the HRQOL examination (p < 0.0001). In conclusion, Sudanese diabetic subjects with LLA have a poor quality of life. The triad of diabetes duration, symptoms and amputations, has turned to be important risk factor for poorer HRQOL. Functional and mobility status were suggested to be an important determinant of HRQOL among this population. As the Sudanese population has coherent social relationships, this poor performance of the diabetic subjects will certainly increase the burden on the whole family, in both integrity and economical status. Nevertheless, these deep-rooted social interrelations together with increasing diabetes awareness have substantially improved the family satisfaction among our patients.
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| 6. |
- Adolfsson, Emelie, et al.
(författare)
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Implementing empowerment group education in diabetes
- 2004
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 53:3, s. 319-324
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Forskningsöversikt (refereegranskat)abstract
- The overall aim was to gain insight into and understand how physicians and nurses view the implementation of empowerment group education (EGE) in diabetes. Prior to the study the physicians and nurses attended a 2-day empowerment workshop. Further, they had implemented the empowerment approach in two groups of patients with type II diabetes. Three to 9 months later they (five physicians and 11 nurses from six family practices) participated in focus group interviews to evaluate the implementation of the EGE. The interviews were audio-taped, transcribed and analysed using the constant comparative method. The main result showed a conflict in roles. The physicians and nurses knew their role in the traditional approach but not with respect to the empowerment approach, which they needed to grow into. At the same time as they started a new way of working, their role had changed from being an expert to being a facilitator. As experts they felt secure, as facilitators they needed support in their educational process. To implement EGE they required support both from the family practice and from a supervisor in direct connection with the EGE. © 2004 Elsevier Ireland Ltd. All rights reserved.
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| 7. |
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| 8. |
- Adolfsson, Eva Thors, et al.
(författare)
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The Swedish National Survey of the Quality and Organization of Diabetes Care in Primary Healthcare—Swed-QOP
- 2010
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 4:2, s. 91-97
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Tidskriftsartikel (refereegranskat)abstract
- AIM:To describe the quality and organization of diabetes care in primary healthcare in Sweden regarding resources and ways of working.METHOD:A questionnaire was used to collect data from all 921 primary healthcare centres (PHCCs) in Sweden. Of these, 74.3% (n=684) responded to the questionnaire covering list size of the PHCCs, number of diabetic patients, personnel resources and ways of working.RESULTS:The median list size reported from the PHCCs was 9,000 patients, 294 of whom were diabetic patients. The majority (72%) of PHCCs had diabetes-responsible general practitioners (GPs) and almost all (97%) had diabetes specialist nurses (DSNs) with some degree of postgraduate education in diabetes. The PHCCs reported that they used regional/local diabetes guidelines (93%), were engaged in call-recall diabetic reviews by GP(s) (66%) and DSN(s) (89%), checked that patients had participated in the reviews by GP(s) (69%) and DSN(s) (78%), arranged group education programmes (23%) and reported data to a National Diabetes Register (82%).CONCLUSIONS:The presence of diabetes-responsible GP(s) and DSN(s) who use guidelines may contribute to good and equal quality of care. It is, however, necessary to improve the call-recall system and there is an urgent need for all diabetic patients to receive patient education.
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| 9. |
- Adolfsson, Eva Thors, et al.
(författare)
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Type 2 diabetic patients' experiences of two different educational approaches : A qualitative study
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 7:45, s. 986-994
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the current study was to explore patients' experiences of participating in an empowerment group education programme or receiving individual counselling. Method: In total, 28 patients from seven primary care centres were interviewed. Of these, 14 had received individual counselling and the remaining 14 had also participated in 4-5 empowerment group sessions. The semi-structured interviews were tape-recorded, transcribed verbatim and analysed using qualitative content analysis. Findings: Three main categories crystallized from the interviews: (I) relationships, (II) learning and (III) controlling the disease. The relationships in the individual counselling seemed vertical, characterized by one-way communication with care providers acting as superiors and patients as subordinates. The relationships in the empowerment group appeared to be horizontal, characterized by trust and mutual communication. Those who had received individual counselling talked about learning by compliance-care providers acted as superiors, giving advice they expected the patients to follow. In the empowerment groups the patients talked more about participatory learning, whereby the facilitators and patients shared their knowledge and experiences. Controlling the disease could be labelled external in individual counselling, which made it difficult for patients to take responsibility for and control of their diabetes self-care. On the contrary, the patients in the empowerment group achieved the insight that diabetes is a serious disease but can be influenced, which contributed to their experience of self-control. Conclusions: The current study indicates that vertical relationships, learning by compliance and external control seem to limit patients' ability to take responsibility for their disease, while horizontal relationships, participatory learning and self-control may contribute to strengthening patients' ability to influence and be actively involved in their own care.
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| 10. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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Parent's perception of their children's health, quality of life and burden of diabetes : testing reliability and validity of 'Check your Health' by proxy.
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:3, s. 497-504
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To test the validity and reliability of the 'Check your Health by proxy' instrument in parents to children with diabetes aged 8-17 years.METHODS: One hundred and ninety-one caregivers and their children, aged 8-17 years, were included. All completed the 'Check your Health' questionnaire measuring quality of life and burden of diabetes, DISABKIDS self- or proxy version, and 45 completed the same questionnaires 2 weeks later.RESULTS: Test-retest reliability on the 'Check your Health' questionnaire by proxy was moderate to strong (r = 0.48-0.74), p < 0.002). Convergent validity was weak to moderate (r = 0.15-0.49, p < 0.05). The instrument showed acceptable discriminant validity. Parents reported lower scores than the children on emotional health and social relations and higher scores on physical and emotional burden and higher burden on quality of life. Poorer social relationships and quality of life were associated with higher reported disease severity. The diabetes burden domain of the questionnaire correlated to perceived severity of diabetes and to perceived health. Discriminant validity showed that poorer social relationships and quality of life were associated with higher severity of the disease. The diabetes burden domain of 'Check your Health' by proxy showed discriminant validity on perceived severity of diabetes.CONCLUSIONS: The instrument 'Check your Health' by proxy showed acceptable psychometric characteristics in parents to young people (8-17 years of age) with diabetes. We also concluded that parents reported that their children had lower health and higher burden of diabetes than the children did, and it correlated to reported disease severity.
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| 11. |
- Elf, Marie, et al.
(författare)
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Satisfaction with information and quality of life in cancer patients undergoing chemotherapy. The role of individual differences in information preferences.
- 2001
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Ingår i: Cancer Nursing. - 0162-220X .- 1538-9804. ; 24:5, s. 351-356
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Earlier studies have shown that patients are dissatisfied with the information they receive from doctors and nurses. The purpose of this study was to analyze satisfaction with information and quality of life in patients with cancer undergoing chemotherapy, considering the patient's information preference. Data were collected during interviews with 30 consecutive patients undergoing chemotherapy for cancer. The subject of the interviews was the satisfaction of patients with the information they received, and additional measures used were the Miller Behavioral Styles Scale and EORTC-QLQ-30. The results showed that 21 of 30 patients were satisfied with the information they received from health care. Married patients or cohabitants were satisfied more often than single patients. No significant differences in quality of life could be found between satisfied and dissatisfied patients. Regarding information preferences, the dissatisfied patients reported more information-avoiding behavior than those who were satisfied. The results must be interpreted cautiously because of the study's limitations, but one clinical implication can be stated: There is value in being aware of patients' information-seeking/avoiding behavior before starting to inform them.
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| 12. |
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Hagert, Britt, 1945-, et al.
(författare)
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Side effects after surgical treatment of snoring
- 2000
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Ingår i: Journal for Oto-Rhino-Laryngology. - 0301-1569 .- 1423-0275. ; 62:2, s. 76-80
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Tidskriftsartikel (refereegranskat)abstract
- In a questionnaire study detailed side effects after snoring surgery were examined in 415 individuals 2-8 years after surgery. Three years later a new questionnaire was answered by those with side effects affecting taste, smell and voice (n = 74). At the first follow-up 255 had side effects of globus, regurgitation, taste, smell and voice. The globus was the most common (40%). In all spheres except the globus, a significant improvement was seen 3 years later. However, pharyngeal dryness and phlegm had a reported frequency of nearly 60%. No significant differences were seen between the uvulopalatopharyngoplasty and laser uvulopalatoplasty methods. Taste disturbances might be due to surgical damage to the nerves or oral dryness. The olfactory impairment present in 7 patients still needs to be explained.
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| 17. |
- Hedov, Gerth, et al.
(författare)
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First information and support provided to parents of children with Down syndrome : clinical goals and parental experiences
- 2002
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 91:2, s. 1344-1349
-
Tidskriftsartikel (refereegranskat)abstract
- When parents are informed that their newborn child has Down syndrome (DS), they often respond with a traumatic crisis reaction. The aims of this study were to assess the clinical goals regarding the first information and support provided to parents of newborn children with DS at the Swedish paediatric departments, and to analyse the parents' experiences of how they were first informed and treated. Data were collected during 1992-1993 from all of the 51 departments of paediatrics in Sweden. Information on the parents' experiences, collected retrospectively in 1996, was based on recollection by 165 parents of 86 children with DS born between 1989 and 1993 at 10 of the paediatric departments considered representative for Sweden. Seventy-five percent of the families were informed about the diagnosis within 24 h post partum. Some parents felt they were informed too late, and a few parents that they were told too soon. Half of the parents were satisfied with the timing. About 70% of the parents considered the information insufficient and 60% felt that they had been unsupported. Seventy percent would have liked more frequent information. Parental criticisms concerning the way in which the information was provided were that they received too much negative information about DS and that both the communication skills and the basic knowledge of DS on the part of the professionals could have been better. CONCLUSION: The Swedish paediatric departments fall short of their reported strong clinical goals regarding the initial information in Sweden, and improvements in this area are desirable.
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| 18. |
- Hedov, Gerth, et al.
(författare)
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Self-perceived health in Swedish parents of children with Down's syndrome
- 2000
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Ingår i: Quality of Life Research. - 0962-9343 .- 1573-2649. ; 9:4, s. 415-422
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Tidskriftsartikel (refereegranskat)abstract
- In this comparative study, self-perceived health was investigated in 165 parents of 86 children with Down's syndrome (DS), using the Swedish version of the SF-36 questionnaire. Questionnaires were mailed to parents of children with DS in a defined Swedish population. The results were compared with those in a randomised control group of parents from the Swedish SF-36 norm population. Mothers and fathers replied separately. Student's t-test with the Bonferroni correction was used for multiple statistical comparisons. The mothers of children with DS ('DS mothers') had significantly lower, less favourable scores than did the fathers of DS children ('DS fathers') in the Vitality (p < 0.0005) domain. Further, DS mothers spent significantly more time in caring for their child with DS than did the DS fathers (p < 0.0001). DS mothers also had lower scores than the mothers of the control group in the Vitality (p < 0.001) and Mental Health (p < 0.001) domains. DS fathers and control fathers differed significantly in the Mental Health domain (p < 0.002), but not otherwise. In conclusion, DS mothers showed poorer health than their spouses and the control mothers. No differences similar to those found between the DS mothers and DS fathers were observed between control mothers and control fathers.
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| 19. |
- Hedov, Gerth, et al.
(författare)
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Self-perceived health in Swedish parents of children with Down's syndrome
- 2000
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Ingår i: Quality of Life Research. - 0962-9343 .- 1573-2649. ; 9:4, s. 415-422
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Tidskriftsartikel (refereegranskat)abstract
- In this comparative study, self-perceived health was investigated in 165 parents of 86 children with Down's syndrome (DS), using the Swedish version of the SF-36 questionnaire. Questionnaires were mailed to parents of children with DS in a defined Swedish population. The results were compared with those in a randomised control group of parents from the Swedish SF-36 norm population. Mothers and fathers replied separately. Student's t-test with the Bonferroni correction was used for multiple statistical comparisons. The mothers of children with DS ('DS mothers') had significantly lower, less favourable scores than did the fathers of DS children ('DS fathers') in the Vitality (p < 0.0005) domain. Further, DS mothers spent significantly more time in caring for their child with DS than did the DS fathers (p < 0.0001). DS mothers also had lower scores than the mothers of the control group in the Vitality (p < 0.001) and Mental Health (p < 0.001) domains. DS fathers and control fathers differed significantly in the Mental Health domain (p < 0.002), but not otherwise. In conclusion, DS mothers showed poorer health than their spouses and the control mothers. No differences similar to those found between the DS mothers and DS fathers were observed between control mothers and control fathers.
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| 20. |
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| 21. |
- Hedov, Gerth, et al.
(författare)
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Sickness abscense in Swedish parents of children with Down's syndrome : relation to self-perceived health, stress and sense of coherence.
- 2006
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Ingår i: Journal of Intellectual Disability Research. - : Wiley. - 0964-2633 .- 1365-2788. ; 50:7, s. 546-552
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Tidskriftsartikel (refereegranskat)abstract
- Background The aims of present study were to study sickness absence among Swedish parents of children with Down's syndrome (DS) and to compare their rates of absence with those of control parents. Sickness absence data for 165 DS parents were compared with those for 174 control parents; all data were for the period 1997-2000. Sickness absence rates were also related to parental self-perceived health, stress and sense of coherence. Methods The self-administrated measures of parental self-perceived health, stress and sense of coherence were compared with the number of days of sickness absence. Results In about two-thirds of the parents in both the study and the control group, no days of sickness absence were registered. Six of the DS parents had remarkably large numbers of days of sickness absence (more than 100 per year). None of the control parents had such high sickness absence rates. It is speculated that there is a small group (less than 5%) of parents who are more vulnerable to the birth of a child with DS. Apart from these six DS parents, sickness absence was not more frequent among the DS parents than among the control parents. DS parents stayed at home to care for their sick DS child three times more often than control parents did for their non-disabled child. DS fathers took greater responsibility in the care of their temporarily sick child and stayed at home to care for the child even more often than control mothers did. DS parents with sickness periods experienced small deterioration in self-perceived health, significantly higher stress and decreased sense of coherence in comparison with parents without sickness periods. Conclusion There was a great similarity in sick leave rates due to one's own sickness between DS and control parents, but a small group of DS parents (< 5%) may be more vulnerable. DS fathers stayed at home to care for their sick DS child remarkably often.
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| 22. |
- Hedov, Gerth, et al.
(författare)
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Sickness absence in Swedish parents of children with Down's syndrome : relation to self-perceived health, stress and sense of coherence
- 2006
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Ingår i: Journal of Intellectual Disability Research. - 0964-2633 .- 1365-2788. ; 50:7, s. 546-552
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aims of present study were to study sickness absence among Swedish parents of children with Down's syndrome (DS) and to compare their rates of absence with those of control parents. Sickness absence data for 165 DS parents were compared with those for 174 control parents; all data were for the period 1997-2000. Sickness absence rates were also related to parental self-perceived health, stress and sense of coherence. METHODS: The self-administrated measures of parental self-perceived health, stress and sense of coherence were compared with the number of days of sickness absence. RESULTS: In about two-thirds of the parents in both the study and the control group, no days of sickness absence were registered. Six of the DS parents had remarkably large numbers of days of sickness absence (more than 100 per year). None of the control parents had such high sickness absence rates. It is speculated that there is a small group (less than 5%) of parents who are more vulnerable to the birth of a child with DS. Apart from these six DS parents, sickness absence was not more frequent among the DS parents than among the control parents. DS parents stayed at home to care for their sick DS child three times more often than control parents did for their non-disabled child. DS fathers took greater responsibility in the care of their temporarily sick child and stayed at home to care for the child even more often than control mothers did. DS parents with sickness periods experienced small deterioration in self-perceived health, significantly higher stress and decreased sense of coherence in comparison with parents without sickness periods. CONCLUSIONS: There was a great similarity in sick leave rates due to one's own sickness between DS and control parents, but a small group of DS parents (<5%) may be more vulnerable. DS fathers stayed at home to care for their sick DS child remarkably often.
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| 23. |
- Hedov, Gerth, et al.
(författare)
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Swedish parents of children with Down's syndrome : parental stress and sense of coherence in relation to employment rate and time spent in child care
- 2002
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 16:4, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- Becoming parents of a child with Down's syndrome (DS) challenges the adjustment ability in parenthood. Individuals with higher sense of coherence (SOC) are supposed to manage stressors better than those with lower SOC. The aims of this study were to investigate parental self-perceived stress, SOC, frequency of gainful employment and amount of time spent on child care in Swedish DS parents (165 parents; 86 mothers, 79 fathers) and to compare those with control parents of healthy children (169 parents; 87 mothers, 82 fathers). The mean age of the children was 4.7 years. Parents responded to questionnaires separately including Hymovich's Parent Perception Inventory as stress measurement and Antonovsky's short version of the Orientation to Life. No differences concerning total employment rate were observed, but the DS mothers were more often employed part-time than control mothers. The DS parents did not spend more time on child care than the control parents and they did not differ in mean SOC score, but the DS parents perceived greater stress. The differences in stress, particularly between the DS and control mothers, were related to time-demanding areas. Parents with high SOC scores experienced significantly less self-perceived stress.
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| 24. |
- Hedov, Gerth, et al.
(författare)
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Swedish parents of children with Down's syndrome : Parental stress and sense of coherence in relation to employment rate and time spent in child care
- 2002
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 16:4, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- Becoming parents of a child with Down's syndrome (DS) challenges the adjustment ability in parenthood. Individuals with higher sense of coherence (SOC) are supposed to manage stressors better than those with lower SOC. The aims of this study were to investigate parental self-perceived stress, SOC, frequency of gainful employment and amount of time spent on child care in Swedish DS parents (165 parents, 86 mothers, 79 fathers) and to compare those with control parents of healthy children (169 parents, 87 mothers, 82 fathers). The mean age of the children was 4.7 years. Parents responded to questionnaires separately including Hymovich's Parent Perception Inventory as stress measurement and Antonovsky's short version of the Orientation to Life. No differences concerning total employment rate were observed, but the DS mothers were more often employed part-time than control mothers. The DS parents did not spend more time on child care than the control parents and they did not differ in mean SOC score, but the DS parents perceived greater stress. The differences in stress, particularly between the DS and control mothers, were related to time-demanding areas. Parents with high SOC scores experienced significantly less self-perceived stress.
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| 25. |
- Hedov, Gerth, et al.
(författare)
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Swedish parents of children with Down's syndrome
- 2002
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 16:4, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- Becoming parents of a child with Down's syndrome (DS) challenges the adjustment ability in parenthood. Individuals with higher sense of coherence (SOC) are supposed to manage stressors better than those with lower SOC. The aims of this study were to investigate parental self-perceived stress, SOC, frequency of gainful employment and amount of time spent on child care in Swedish DS parents (165 parents; 86 mothers, 79 fathers) and to compare those with control parents of healthy children (169 parents; 87 mothers, 82 fathers). The mean age of the children was 4.7 years. Parents responded to questionnaires separately including Hymovich's Parent Perception Inventory as stress measurement and Antonovsky's short version of the Orientation to Life. No differences concerning total employment rate were observed, but the DS mothers were more often employed part-time than control mothers. The DS parents did not spend more time on child care than the control parents and they did not differ in mean SOC score, but the DS parents perceived greater stress. The differences in stress, particularly between the DS and control mothers, were related to time-demanding areas. Parents with high SOC scores experienced significantly less self-perceived stress.
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| 26. |
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| 27. |
- Karlsson, Agneta, et al.
(författare)
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Teenagers with type 1 diabetes : A phenomenological study of the transition towards autonomy in self-management
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 45:4, s. 562-570
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Tidskriftsartikel (refereegranskat)abstract
- Background: Becoming autonomous is an important aspect of teenagers' psychosocial development, and this is especially true of teenagers with type 1 diabetes. Previous studies exploring the everyday problems of teenagers with diabetes have focused on adherence to self-care management, how self-determination affects metabolic control, and the perception of social support. Objective: The aim of the study was to elucidate lived experiences, focusing on the transition towards autonomy in diabetes self-management among teenagers with type 1 diabetes. Design and method: Data were collected using interviews, and a qualitative phenomenological approach was chosen for the analysis. Participants: Thirty-two teenagers (18 females and 14 males) were interviewed about their individual experiences of self-management of diabetes. Findings: The lived experiences of the transition towards autonomy in self-management were characterized by the overriding theme "hovering between individual actions and support of others". The findings indicate that individual selfreliance and confirmation of others are helpful in the transition process. Growth through individual self-reliance was viewed as a developmental process of making one's own decisions; psychological maturity enabled increased responsibility and freedom; motivation was related to wellbeing and how well the diabetes could be managed. The theme "confirmation of others" showed that parental encouragement increased the certainty of teenagers' standpoints; peers! acceptance of diabetes facilitated incorporation of daily self-management activities; support from the diabetes team strengthened teenagers' self-esteem. Conclusion: In striving for autonomy, teenagers needed distance from others, but still to retain the support of others. A stable foundation for self-management includes having the knowledge required to practice diabetes management and handle different situations.
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| 28. |
- Leksell, Janeth, 1955-
(författare)
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Diabetes-Related Blindness : Studies of Self-Management, Power, Empowerment and Health
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Individuals with diabetes and blindness meet problems in daily life that are related to both conditions. The aim was to study diabetes self-management, burden of diabetes, power, sense of coherence (SOC) and health among individuals with diabetes-related blindness. The aim was further to determine psychometric properties of a diabetes empowerment scale (DES) and to use it in the evaluation of an empowerment programme. The participants were 39 blind diabetic and non-diabetic individuals and 21 diabetic individuals with threat of blindness. A convenience sample of 195 diabetic patients completed DES and 9 blind diabetic individuals participated in the empowerment programme. Two reference groups from the Swed-qual population studies were also included. Data were collected by questionnaires, interviews and by scrutinizing medical records. Quantitative data were analyzed with parametric and non-parametric methods and qualitative data with content analysis. Blind diabetic individuals expressed more problems with self-management than did those with threat of blindness. In some health domains, blind diabetic individuals perceived significantly poorer health than did non-diabetic blind individuals. There were though individual differences in how blind individuals perceived their health as well as how burdensome they experienced their self-management. Individuals with power and strong SOC felt less burden and perceived better health when compared to those with weak SOC or non-power. The diabetes empowerment scale showed acceptable validity and reliability and was used, along with qualitative interviews, to evaluate the effect of the empowerment programme. Evaluation of the programme showed that the participants had improved knowledge and awareness of self-management. The programme seems suitable for blind individuals and creates an inspiring learning climate enhancing empowerment. It is concluded that blind individuals have problems in their diabetes self-management and perceive poor health but the experience of power is a factor of importance for health and an empowerment education programme may enhance power.
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| 29. |
- Leksell, Janeth, et al.
(författare)
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Experiences of an educational programme for individuals with blindness caused by diabetes
- 2006
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Ingår i: European Diabetes Nursing. - : Informa UK Limited. - 1551-7853 .- 1551-7861. ; 3:2, s. 86-91
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Tidskriftsartikel (refereegranskat)abstract
- Background:Individuals with blindness caused by diabetes face problems in their daily life that are related to both conditions. Hopefully some of these problems can be solved and simplified through a suitable educational programme.Aims: The aim of this study was to evaluate whether the educational programme 'I'm the boss' is suitable for blind individuals with diabetes, and to discover whether and how the programme inspired the participants in developing self-management skills.Methods: An ophthalmologic centre and two medical centres in a well-defined geographic area were screened for blind individuals with diabetes, resulting in the participation of nine individuals in the educational programme. The programme consisted of six three-hour-long weekly sessions based on empowerment and problem-based learning. Empowerment was measured using the Swedish version of the diabetes empowerment scale (Swe-DES-23). After completion of the programme, the participants were interviewed (focus group and individual interviews). The interviews were analysed using qualitative content analysis.Findings: The evaluation of the educational programme showed that almost half the participants improved their diabetes empowerment in the subscales ‘self-awareness’ and ‘ability to manage stress’. The qualitative data corresponded well with the quantitative data in terms of increasing participants' self-efficacy and knowledge. The learning process was experienced as flexible and the content as stimulating and creative.Conclusion: It is concluded that the programme seems suitable for blind individuals with diabetes, and in collaboration with others allows space for innovation and self-realisation
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| 30. |
- Leksell, J.K., et al.
(författare)
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Power and self-perceived health in blind diabetic and nondiabetic individuals
- 2001
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 34:4, s. 511-519
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Tidskriftsartikel (refereegranskat)abstract
- Aims. The aims of this study were: (1) to explore perceptions of power in blind individuals and relate presence or absence of power to self-perceived health and (2) to compare self-perceived health in blind individuals with that of the general population. Background. The theoretical framework of this study was Barrett's Power theory, which is based on The Rogerian nursing theory. Power is defined as being aware of what one is choosing to do, feeling free to doing it, and do it intentionally. Methods. Thirty-nine blind subjects at three adjacent ophthalmology centres agreed to participate in the study. Of those 23 had become blind because of late complications of diabetes. Power was explored during semi-structured interviews and self-perceived health was measured with the Swedish health-related quality of life questionnaire. Data on socio-economic, rehabilitative and diabetes-related variables were also collected. Findings. Power was experienced by 19 of the 39 respondents and was more frequently found in nondiabetic subjects than in diabetic subjects. Those experiencing power reported a better emotional and general health compared with individuals lacking power. The perception of having power was not significantly related to any other of the studied variables. When compared with age- and gender-matched controls from the general population, nondiabetic blind subjects scored higher in positive feelings and lower in physical functioning. In contrast diabetic subjects experienced poorer general health, less satisfaction with physical health and more negative feelings, but they reported that they did not experience limitation as a result of these emotions. Conclusion. One way of improving health in diabetic blind individuals could be to increase the subject's perception of power.
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| 31. |
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| 32. |
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| 33. |
- Leksell, Janeth, et al.
(författare)
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Psychometric properties of the Swedish Diabetes Empowerment Scale
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:2, s. 247-252
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Tidskriftsartikel (refereegranskat)abstract
- This study was conducted to determine the psychometric properties of the Swedish version of the Diabetes Empowerment Scale (Swe-DES-23). Research design and methods: A convenience sample of 195 patients with type 1 and type 2 diabetes completed the Swe-DES-23 questionnaire. To establish discriminant validity, Swe-DES subscales were compared with the Semantic Differential in Diabetes scale (SDD) and a general health scale (EVGFP). Construct validity was tested using factor analyses. To determine unidimensionality of the subscales, inter-item correlations were calculated. Internal consistency was tested by the use of the Crohnbach-α coefficient. Results: The factor analysis resulted in four factors (empowerment subscales) with eigenvalues >1.0, explaining 60% of the variance. The four empowerment subscales: goal achievement, self-awareness, stress management and readiness to change showed Crohnbach-α values ranging from 0.68 to 0.91. Patients with good self-reported health and low burden of diabetes scored significantly higher on almost all empowerment subscales. Only weak correlations were found between metabolic control and the empowerment subscales. Conclusions: The SWE-DES-23 scale had acceptable validity and reliability and, thus, could be a suitable tool in evaluating empowerment-based education programmes. Further testing is needed to shorten the questionnaire.
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| 34. |
- Leksell, Janeth, et al.
(författare)
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Self-perceived health and self-care among diabetic subjects with defective vision : A comparison between subjects with threat of blindness and blind subjects
- 2005
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Ingår i: Journal of diabetes and its complications. - : Elsevier BV. - 1056-8727 .- 1873-460X. ; 19:1, s. 54-59
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare self-perceived health among diabetic patients who experienced threat of blindness with those who had already gone blind. Another aim was to explore different aspects of self-care in relation to self-perceived health among the subjects. Twenty-one diabetic patients under threat of becoming blind and 23 with diabetes-related blindness agreed to participate in the study. The participants were compared with an age- and gender-matched nondiabetic reference group. Self-perceived health was measured using the 63-item Swedish Health-Related Quality of Life Survey (SWED-QUAL) questionnaire. Data on diabetes-related variables were collected from the patient's hospital records. An interview guide was created for measuring dimensions of self-care. Patients with threat of becoming blind showed better self-perceived health than blind patients, but no differences were found in comparison with the Swedish reference group. Blind patients scored lower in 6 of the 13 health domains and they reported more problems with diabetes self-care than patients with threat of becoming blind. One of the 13 health domains, role limitations due to physical health, seemed to be associated with impaired self-care although only a partial understanding could be demonstrated. The results show that blind patients need specific support to cope well with different self-care situations. A great challenge in future research in diabetes is to implement education programs suitable especially for patients who have gone blind because of diabetes. © 2005 Elsevier Inc. All rights reserved.
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| 35. |
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| 36. |
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| 37. |
- Lindholm Olinder, Anna, 1960-
(författare)
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Self-management of diabetes in adolescents using insulin pumps
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Insulin pump treatment (CSII) is considered the most physiological way to imitate the healthy body’s insulin profile in adolescents with diabetes. However, despite the use of CSII, achieving the recommended disease control is difficult for adolescents. The aim of this thesis was to explore aspects of self-management of diabetes in adolescents using insulin pumps in order to describe conditions contributing to the recommended disease control. Three methods of bolusing (normal, dual-wave and square-wave) in connection with pasta meals were tested in a crossover study among 15 adolescents with diabetes to assess whether one method was superior in managing glucose levels. A cross-sectional study among 90 adolescents being treated with CSII was conducted to investigate the management of CSII, including the administration of bolus doses. Two qualitative interview studies, based on the grounded theory method, were performed to gain insight into the processes involved in taking bolus doses and to investigate reasons for missed bolus doses and strategies for avoiding missing them. Twelve adolescents, four parents and one diabetes specialist nurse were interviewed. No method of bolusing was found to be superior in managing the glucose levels after these meals. The post-prandial glucose peaks were <10 mmol/L, in 48% of the cases, regardless of bolus methods. This indicates that adolescents can be encouraged to individually test which bolus method gives them the most normal post-prandial glucose levels. The cross-sectional study showed that adolescents were satisfied with CSII, but that 38% had missed more than 15% of the bolus doses the day under study. The frequency of bolus doses correlated with the disease control. Findings from the interview study revealed the need to clarify the responsibility for diabetes self-management in continuous negotiation between adolescents and parents to avoid insulin omission. The main reason for missed boluses was lost focus, and the strategies for remembering them were agreements involving reminders. The thesis describes that individual dose testing, clarification of responsibility and agreements involving reminders are conditions contributing to the recommended disease control. The thesis also describes that lost focus and a lack of responsibility can lead to insulin omission and be a hindrance to achieving disease control.
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| 38. |
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| 39. |
- Löfmark, Anna, et al.
(författare)
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Competence of newly-graduated nurses : a comparison of the perceptions of qualified nurses and students
- 2006
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 53:6, s. 721-728
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper reports a study that compares opinions of final year nursing students, rating their own competence, with the opinions of experienced nurses on the competence of newly-graduated nurses. BACKGROUND: The transition of nursing preparation into higher education is regarded as positive, although it has led to differences in opinion about the competence of newly-graduated nurses and their readiness to enter the nursing profession. There are studies showing that newly-graduated nurses perceive themselves as holistically focused, professional practitioners, while other nurses are concerned that newly-graduated nurses do not have necessary skills. METHODS: A convenience sample of 106 nursing students in the final week of their course and 136 nurses who had experience of supervising nursing students completed a questionnaire. The data were collected in 2002. RESULTS: Own competence, in the form of ability to perform nursing care, was rated by nursing students to be good or strongly developed in most of the investigated areas of nursing care. Experienced nurses also estimated newly-graduated nurses' competence to be good or strongly developed, although to a lesser extent. Nurses qualified within the previous 5 years rated newly-graduated nurses' competence to be higher in comparison with those with less recent education. CONCLUSIONS: Further studies are needed to broaden our understanding of why some areas of nursing care, such as ethical awareness, were rated very highly, while others, like informing and teaching of co-workers and planning and prioritizing interventions had the lowest rating.
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| 40. |
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| 41. |
- Löfmark, A, et al.
(författare)
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Facilitating and obstructing factors for development of learning in clinical practice - a student perspective.
- 2001
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Ingår i: Journal of Advanced Nursing. - 0309-2402 .- 1365-2648. ; 34:1, s. 43-50
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Tidskriftsartikel (refereegranskat)abstract
- Aim of the study. The aim of this study was to provide information on what the student nurses found facilitating and obstructing for their learning during clinical practice. Background. Earlier studies of experiences of learning in clinical practice have shown that factors as the possibilities of variations of experiences, the culture of the workplace, and communication between the educational institution and health care facilities are of importance. Less is known about the opportunities which students are given in order to practise the skills that the), will be expected to perform as new graduate nurses. Methods. The experiences of 47 degree student nurses from two colleges in Sweden were gathered in weekly diaries during their final period of clinical practice. A content analysis technique was used to analyse their diaries. Results. The students emphasized responsibility and independence, opportunities to practise different tasks, and receiving feedback as facilitating factors. Other perceived promoting factors included perceptions of control of the situation and understanding of the 'total picture'. Examples of obstructing factors were the nurses as supervisors not relying on the students, supervision that lacked continuity and lack of opportunities to practise. Perception of their own insufficiency and low self-reliance were drawbacks for some students. Conclusions. Recommended proposals are presented to lecturers and supervising staff concerning organizational and educational changes, and changes of attitudes for elucidating the students' experiences of different facilitating and obstructing factors. Changes may contribute to making easier the students' transition into the nursing profession.
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| 42. |
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| 43. |
- Löfmark, Anna, et al.
(författare)
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Student nurses' ability to perform pain assessment.
- 2003
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Ingår i: Nurse Education in Practice. - 1471-5953 .- 1873-5223. ; 3:3, s. 133-43
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate student nurses' ability to handle a pain assessment situation. A systematic way of working based on knowledge within the area is emphasised in nursing education today. The performance of 32 student nurses at a university college in Sweden took place in an arranged assessment situation that closely simulated clinical practice. The conversation between the student and the patient (a voluntary patient) was videotaped and analysed with content analysis according to predetermined components of pain assessment. The results showed that one-third of the students had performed adequately based on the requirements for pain assessment in the curriculum for nursing education. Two-thirds of the group did not handle the situation systematically and also showed a lack of knowledge of pain assessment, and among these was a group of students whose performance was inadequate. The results indicate that during their education it is very important for student nurses to obtain experience and guidance in how to work systematically and to have their knowledge and skills in pain assessment evaluated.
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