| 1. |
- Bergman, Lina, et al.
(författare)
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Registered nurses' experiences of working in the intensive care unit during the COVID-19 pandemic
- 2021
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Ingår i: Nursing in Critical Care. - : John Wiley & Sons. - 1362-1017 .- 1478-5153. ; 26:6, s. 467-475
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDuring the pandemic, increased numbers of patients requiring intensive care unit (ICU) admission required an increase in ICU capacity, including ICU staffing with competence to care for critically ill patients. Consequently, nurses from acute care areas were called in to staff the ICU along with experienced intensive care nurses.Aims and objectivesTo describe Swedish registered nurses' experiences of caring for patients with COVID-19 in ICUs during the pandemic.DesignMixed method survey design.MethodsAn online questionnaire was distributed through social media to registered nurses who had been working in the ICU during the COVID-19 outbreak. Data were collected for 1 week (May 2020) and analysed using content analysis and descriptive statistics.ResultsOf the 282 nurses who participated, the majority were ICU nurses (n = 151; 54%). Half of the nurses specialized in ICU reported that they were responsible for the ICU care of three or more patients during the pandemic (n = 75; 50%). Among non-intensive care nurses, only 19% received introduction to the COVID-19 ICU (n = 26). The analysis of data regarding nurses' experiences resulted in three categories: tumbling into chaos, diminished nursing care, and transition into pandemic ICU care. Participants described how patient safety and care quality were compromised, and that nursing care was severely deprioritized during the pandemic. The situation of not being able to provide nursing care resulted in ethical stress. Furthermore, an increased workload and worsened work environment affected nurses' health and well-being.ConclusionsThe findings from the present study indicate that nurses perceived that patient safety and quality of care were compromised during the pandemic. This resulted in ethical stress among nurses, which may have affected their physical and psychosocial well-being.Relevance to clinical practiceThe COVID-19 pandemic had a severe impact on nurses' work environment, which could result in burnout and staff turnover.
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| 2. |
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| 3. |
- Malmborg, Julia, 1988-, et al.
(författare)
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Risk Factors for Persistence and Development of Frequent Musculoskeletal Pain in Adolescent Athletes
- 2020
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl 1, s. 206-206
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity has a positive impact on health, but adolescent athletes often report musculoskeletal pain (MP) which is negative in the aspect of sustaining physical activity over time. There is a lack of longitudinal assessments of MP and potential risk factors, such as timing of physical maturation, in adolescent athletes.Objectives:To identify risk factors associated with the persistence or development of frequent MP at a 2-year follow-up in adolescent sport school students.Methods:Fourteen-year-old sport school students (n=233) were invited to participate in this 2-year longitudinal study. Self-reports of MP was assessed as frequency, distribution, and intensity, and health status by EQ-5D. Physical maturation was calculated by the Mirwald equation (height, weight, and sitting height) (1), and categorized as early (>1 year), average (±1 year), or late (<–1 year). Students were grouped at baseline and follow-up into infrequent (never to monthly) or frequent (weekly to daily) MP groups. Logistic regression analysis was used to study associations between frequent MP at follow-up and baseline variables.Results:131 students (79 boys and 52 girls) were included in the study. Development or persistence of frequent MP at follow-up (n=61) was associated with being a girl, late physical maturation (only boys were categorized as late), non-contact sports participation, frequent MP at baseline, and reporting ≥2 MP sites at baseline. Students with a better health status at baseline were less likely to belong to the frequent MP group at follow-up (Table).Conclusion:Frequent MP is common in sport school students. MP in young athletes may become a future health problem and there is a need for recognition and interventions by coaches and health services to prevent MP from becoming persistent.References:[1]Mirwald, R. L., Baxter-Jones, A. D., Bailey, D. A., & Beunen, G. P. (2002). An assessment of maturity from anthropometric measurements.Med Sci Sports Exerc, 34(4), 689-694.Table.Associations between background variables at baseline and frequent MP at follow-up based on crude logistic regression analysis controlling each variable for sex.Baseline variablesModelInfrequent MP vs. Frequent MPOR(95% CI; p-value)SexBoys1.00Girls2.76(1.34–5.68; p<0.01)Physical maturationAverage (±1 year)1.00Early (>1 year)0.41(0.05–3.65; p=0.42)Late (<–1 year)3.83(1.13–12.95; p=0.03)Sport categoriesContact1.00Non-contact5.16(2.07–12.88; p<0.001)MP groupsInfrequent1.00Frequent2.74(1.31–5.72; p<0.01)MP intensity last week (NRS 0–10, best to worst)1.15(0.98–1.35; p=0.10)Number of MP sites01.0012.32(0.71–7.58; p=0.16)≥22.87(1.32–6.25; p<0.01)EQ-5D (0.00–1.00, worst to best)0.03(0.001–0.58; p=0.02)Disclosure of Interests:None declared
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| 4. |
- Malmborg, Julia S., 1988-, et al.
(författare)
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Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up
- 2022
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Ingår i: Bmc Sports Science Medicine and Rehabilitation. - London : Springer Science and Business Media LLC. - 2052-1847. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance. Methods Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never-monthly) or frequent (weekly-almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex. Results A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146-13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001-11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033-12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026-12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011-34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength. Conclusions Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent.
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| 5. |
- Spinord, Linda, 1973-
(författare)
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Multimodal rehabilitation for patients with chronic pain in northern Sweden, focusing on gender and age
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to study outcomes and experiences of multimodal rehabilitation programmes (MMRP) for patients with chronic pain in northern Sweden, focusing on gender and age. This thesis is based on four studies that used both quantitative and qualitative methods. The quantitative studies (I-III) investigated patient-reported outcome measures (PROM) from the Swedish Quality Registry for Pain Rehabilitation (SQRP) collected during 2011-2016 at two specialist clinics in northern Sweden. Adults aged 18-65 years were included, n=436 (356 women and 83 men), divided into three age groups (18-30, 31-45 and 46-65 years of age). Data from the two programmes at three measurement occasions were used, at the start of MMRP, immediately after MMRP and at one-year follow-up. Descriptive and multivariate statistics were used in Studies I-III.The analyses were performed separately for women, men and three different age groups. In Study I, the analysis was performed in two steps: in the first step the two patient populations in the two MMRPs were analysed separately and in the next step, the patients in the two programmes were analysed together. In Studies (II-III), the patient in the programmes were analysed together. In Study IV, a qualitative design was used to explore how patients with chronic pain experienced staying at a residency during participation in MMRP. In Study IV, a grounded theory method with emergent design was used for data collection and analysis. Individual semi-structured interviews with 12 patients (8 women and 4 men) with experiences of MMRP were conducted.In Study I, patients improved regardless of the design of the MMRP in terms of pain intensity, emotional functioning, activity and physical functioning at the one-year follow-up. For both programmes, the women were found to improve in more variables than the men did.In Study II, all subgroups (men, women and age groups) improved in terms of pain intensity and emotional functioning immediately after MMRP. The results revealed that the men showed greater short-term improvements than the women did. The women improved in more variables at one-year follow-up than the men did. The youngest age group was found to have greater positive effects of MMRP in terms of pain intensity and emotional functioning, immediately after MMRP and at one-year follow-up, than the other two age groups.In Study III, a number of interacting factors influenced whether patients participating in MMRP ended up on full-time sick leave at one-year follow-up, or not. Sick leave at start was an important factor for all subgroups. For women at start, low physical functioning, low health-related quality of life, low work importance and low affective distress were related to full-time sick leave at one-year follow-up. The results showed that unemployed men who reported widespread pain were related to full-time sick leave at one-year follow-up. The 31-45 years age group, which reported high pain intensity, low emotional functioning and low activity and physical functioning, was related to full-time sick leave at one-year follow-up. Those in the 46-65 years age group with low education, low work importance, low belief in recovery and long duration of pain were found to be related to full-time sick leave at one-year follow-up.In Study IV, the analysis resulted in a core category “Finding my self-worth”, consisting of the four categories: “Space for myself”, “Mirroring myself”, “I am of value” and “Dealing with returning to everyday life”. The results showed that the patients who stayed at a residency during MMRP were more likely to be released from the obligations of chores in their everyday life at home. This created space and time for reflection and interaction with others. The patients’ participation in MMRP while staying at a residency contributed to experiences of awareness of their own value and the significance of taking care of themselves and changing their behaviour after returning home.In conclusion, the results showed that MMRP seems to be an effective method of treating patients with chronic pain, in terms of reduced pain, improved emotional functioning, activity and physical functioning and health. The results also revealed that men seemed to need more support after MMRP to sustain the effects of MMRP while woman were more likely to sustain the positive effects at one-year follow-up. Full-time sick leave for patients with chronic pain at one-year follow-up can be affected by a number of interacting factors and these factors differ for women, men and different age groups. The opportunity to be released from everyday obligations, enjoy time for reflection and interaction with others can contribute to personal awareness which facilitates the implementation of changes at home following MMRP.
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| 6. |
- Söderström Malmborg, Julia, 1988-
(författare)
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Pain and health in adolescents and young adults – pieces of a puzzle
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Musculoskeletal pain is a burden for the individual and for society, and it has a negative impact on overall health. The biological, psychological, and social factors that govern pain and health form a complex puzzle to put together. Musculoskeletal pain conditions may be alleviated by physical activity, but a too high level of physical activity may also increase the risk of pain. Youth athletes may be especially vulnerable to developing pain due to factors related to training load and physical maturity. Being physically active and maintaining a healthy diet is associated with better health, but if carried out to excess these health behaviours may become unhealthy. Our understanding of musculoskeletal pain and health in adolescents and young adults needs to be developed, both in individuals involved in sports and exercise and in the general population.Aim: The overall aim was to study musculoskeletal pain and its relationship to various health-related factors in adolescents and young adults enrolled in sport or general education programmes.Methods: Study I was a cross-sectional study on university students (aged 19–29) from an exercise science programme (n = 118) and a business programme (n = 89), assessing health status, physical activity, and orthorexia nervosa (an exaggerated fixation on healthy food). Study II was a cross-sectional study (n = 178), and Study III a 2-year longitudinal (n = 131) study on sport school students (aged 14 at baseline), assessing musculoskeletal pain, health status, physical maturity, and sports performance. Study IV was a 3-year longitudinal study on students from a general upper secondary school (n = 256, aged 16 at baseline), assessing chronic musculoskeletal pain, health status, physical activity, sleep, stress, anxiety, and depression.Results: In Study I, compared to business students, exercise science students reported more pain, but better general health. A high level of physical activity in combination with orthorexia nervosa was most prevalent in men from the exercise science programme. In Studies II and III, pain was common in sport school students. At baseline, boys with constant pain were not as physically mature as boys with infrequent pain. Students with constant pain reported a worse health status than students with infrequent pain. At follow-up, frequent pain, frequent pain in two or more body regions, and a worse health status at baseline were identified as risk factors for having frequent pain at follow-up in girls. For boys, late physical maturation at baseline was a risk factor. Involvement in non-contact sports was also an identified risk factor over time in both sexes. Pain was associated with a worse sports performance in boys at both baseline and follow-up. In Study IV, chronic musculoskeletal pain was common in students from a general upper secondary school. A worse health status, severe sleeping problems, anxiety, and chronic musculoskeletal pain at baseline were associated with reporting chronic musculoskeletal pain at follow-up.Conclusions: Pain was prevalent, and also persistent, in adolescents and young adults, irrespective of attending sport or general education programmes. Pain is a biopsychosocial phenomenon and must be treated as such. Pain should be frequently monitored, and treatment should be introduced early on to prevent pain from becoming persistent.
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| 7. |
- Tingsvik, Catarina, et al.
(författare)
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Long-term impact of COVID-19 on nursing and care delivery : A national survey among anaesthetic and critical care nurses
- 2024
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Ingår i: Australian Critical Care. - : Elsevier. - 1036-7314 .- 1878-1721.
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Tidskriftsartikel (refereegranskat)abstract
- Background: The coronavirus disease 2019 (COVID-19) pandemic has put an exceptional strain on intensive care delivery and has significantly impacted nursing practice in the intensive care unit, consequently affecting nurses' working environment and health. Little is known about the long-term impact on the nursing workforce and care delivery in intensive care and anaesthetic departments.Aim/objective: This cross-sectional study aimed to describe the long-term impact of the COVID-19 pandemic on the nursing profession and nursing care from the perspectives of anaesthetic and critical care nurses.Methods: In this study, an online questionnaire with open- and close-ended questions was distributed to registered nurses working in anaesthesia and intensive care between February 8 and March 7, 2022. The data were analysed using content analysis and descriptive statistics.Results: Of the 514 registered nurses who responded to the questionnaire, 256 (50%) worked in anaesthesia care and 215 (42%) in intensive care. The long-term impact of COVID-19 was expressed in three categories: nursing care on hold, insights and experiences forming a new professional identity, and the impact of organisational conditions on the profession. Critical care nurses considered nursing care comparable to that before the COVID-19 pandemic. Nurse anaesthetics experienced changes in nursing tasks and activities compared to that before the COVID-19 pandemic.Conclusions: Nursing care is still influenced by the pandemic due to the lack of resources and persistent high workload and needs to be reclaimed and prioritised. Re-establishing high-quality nursing care is a shared responsibility of the organisation and nursing profession, and the organisation needs to create prerequisites for this. Furthermore, nurses' views and insights into their profession developed both positively and negatively during the pandemic, which must be further considered, including the profession's values.
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