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| 3. |
- Hommel, Ami, et al.
(författare)
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Öka satsningarna på forskning i omvårdnad
- 2017
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Ingår i: Dagens Medicin. - 1104-7488. ; :19 januari
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Långsiktiga satsningar för välfärdsforskning är bra, men för att nå ända fram och minimera hälsoklyftorna är det nödvändigt att även forskning inom omvårdnad prioriteras, skriver tio debattörer.
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| 4. |
- Hommel, Ami, et al.
(författare)
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Öka satsningarna på forskning i omvårdnad
- 2017
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Ingår i: Dagens medicin. - 1104-7488. ; :19 januari
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Långsiktiga satsningar för välfärdsforskning är bra, men för att nå ända fram och minimera hälsoklyftorna är det nödvändigt att även forskning inom omvårdnad prioriteras, skriver tio debattörer.
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| 5. |
- Afua Quaye, Angela, et al.
(författare)
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Children's active participation in decision‐making processesduring hospitalisation : An observational study
- 2019
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Ingår i: Journal of cilinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 28:23¨24, s. 4525-4537
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: The aim was to explore and describe the child's active participationin daily healthcare practice at children's hospital units in Sweden.Objectives: (a) Identify everyday situations in medical and nursing care that illustratechildren's active participation in decision‐making, (b) identify various ways of activeparticipation, actual and optimal in situations involving decision‐making and (c) explorefactors in nursing and medical care that influence children's active participation indecision‐making.Background: Despite active participation being a fundamental right for children, theyare not always involved in decision‐making processes during their health care. Therestill remains uncertainty on how to support children to actively participate in decisionsconcerning their health care.Design: A qualitative study with overt, nonparticipant observations fulfilling theCOREQ checklist criteria.Methods: Observations of interactions between children aged 2 and 17 years withboth acute and chronic conditions, their parents, and healthcare professionals wereconducted at three paediatric hospitals in Sweden. The Scale of Degrees of SelfDetermination was used to grade identified situations. The scale describes five levelsof active participation, with level one being the least and level five being the mostactive level of participation. Normative judgements were also made.Results: Children's active participation was assessed as being generally at levels fourand five. Children demonstrated both verbal and nonverbal ways of communicationduring decision‐making. Findings indicated that children's, parents' and healthcareprofessional's actions influenced children's active participation in decision‐makingprocesses involving healthcare.Conclusions: Healthcare professionals specialised in paediatrics need to embrace botha child perspective and a child's perspective, plan care incorporating key elements of achild‐centred care approach, to ensure children's active participation at a level of theirchoosing.
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- Almblad, Ann-Charlotte, 1965-
(författare)
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Early Detection and Treatment for Children : Experiences and outcome of implementation at a pediatric hospital
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Early recognition of severely ill children is necessary to prevent serious adverse events and unexpected death. To promote patient safety the Early Detection and Treatment Program for Children (EDT-C) was developed at a University Children’s Hospital in Sweden. This program consists of validated tools for communication and teamwork combined with the Pediatric Early Warning Score (PEWS) and guidelines for recommended actions. Ward specific guidelines were developed and EDT-C instructors were trained. The aims were to describe healthcare professionals’ experience of caring for acutely, severely ill children (Study I) and to evaluate the implementation of EDT-C (Study II, III, IV). The Promoting Action on Research Implementation in Health Services (PARiHS) framework guided both implementation and the research study.Before introducing the EDT-C, focus group interviews were performed to explore healthcare professionals’ experience of caring for acutely, severely ill children. A context assessment, using the Alberta Context Tool (ACT) was also conducted. After implementation, a retrospective review of the electronic patient records (EPR) to assess adherence to guidelines were carried out. Instructors’ and healthcare professionals’ experiences from the implementation of EDT-C were gathered through individual interviews. To evaluate the introduction of EDT-C in relation to admission and stay at intensive care a retrospective before-after study using EPR data was performed. Interviews were analyzed using qualitative content analysis and descriptive statistical methods were utilized for quantitative data.The caring for acutely severely ill children was described as being in a multifaceted area of tension with paradoxical elements where contradictory emotions emerged. According to documentation, children at a very high risk of clinical deterioration according to PEWS were identified. Adherence to actions prescribed in guidelines varied. Healthcare professionals and instructors described EDT-C as suitable for clinical practice and that it created a more structured way of working. It was furthermore described that PEWS measurement had become routine practice at the hospital.EDT-C can lead to increased knowledge about early detection of deterioration, strengthen the healthcare in their profession, optimize treatment and teamwork and thereby has potential to increase patient safety for children treated in hospitals.
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| 7. |
- Astermark, Cathrine, et al.
(författare)
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Health-related quality of life in children with Type 1 diabetes : an RCT of hospital-based care and hospital-based home care at diagnosis
- 2017
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Ingår i: International Diabetes Nursing. - : Taylor & Francis. - 2057-3316 .- 2057-3324. ; 14:2-3, s. 90-95
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Tidskriftsartikel (refereegranskat)abstract
- Introduktion: När ett barn får diagnosen typ 1 diabetes betyder det omfattande ändringar i livsstilen för hela familjen. Det finns begränsad kunskap avseende den påverkan som den initiala vården har för barn och föräldrar. Syftet var att jämföra barns diabetesspecifika hälsorelaterade livskvalitet (HRQOL) i sjukhusbaserad vård och sjukhusbaserad hemsjukvård (HBHC), 12 respektive 24 månader efter debuten av typ 1 diabetes. Syftet var också att jämföra barnens och föräldrarnas beskrivning av barnens diabetesspecifika HRQOL efter 12 och 24 månader oavsett vårdform. Metod: Undersökningen genomfördes vid ett universitetssjukhus i Sverige och hade en randomiserad kontrollerad design för att utvärdera sjukhusbaserad vård och HBHC, med hänvisning till specialist vård i en hemmiljö. Barn i åldern 5-16 år och deras föräldrar besvarade enkäten PedsQLTM 3.0 Diabetes Module, 12 månader och 24 månader efter debuten av sjukdomen. Resultat: Resultatet visade ingen skillnad avseende barnens diabetes-specifika HRQOL. Däremot, 12 månader efter diagnos, upplevde barnen och deras föräldrar som fått HBHC mer oro jämfört med de som hade fått sjukhusbaserad vård vid diagnosen (p=0,012). Oaktat vilken vårdform som erbjudits rapporterade barnen mer obehag av sjukdomen jämfört med vad deras föräldrar upplevde att barnen kände (p=0.017). Konklusion: Sammanfattningsvis så indikerar resultatet att både sjukhusbaserad vård och HBHC erbjuder jämförbara resultat gällande barnens diabetes-specifika HRQOL. Dock verkar en vårdmodell mer lik vård i hemmet innebära större påfrestning för vissa familjer. Dessa familjer behöver bli identifierade och rutinerna behöver vara mer flexibla för att kunna möta dessa familjers behov.
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| 8. |
- Biru, Mulatu, et al.
(författare)
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Caregiver-reported antiretroviral therapy non-adherence during the first week and after a month of treatment initiation among children diagnosed with HIV in Ethiopia
- 2017
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Ingår i: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. - : Informa UK Limited. - 0954-0121. ; 29:4, s. 436-440
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Tidskriftsartikel (refereegranskat)abstract
- To achieve optimal virologic suppression for children undergoing antiretroviral therapy (ART), adherence must be excellent. This is defined as taking more than 95% of their prescribed doses. To our knowledge, no study in Ethiopia has evaluated the level of treatment adherence at the beginning of the child's treatment. Our aim was therefore to evaluate caregiver-reported ART non-adherence among children and any predictors for this during the early course of treatment. We conducted a prospective cohort study of 306 children with HIV in eight health facilities in Ethiopia who were registered at ART clinics between 20 December 2014 and 20 April 2015. The adherence rate reported by caregivers during the first week and after a month of treatment initiation was 92.8% and 93.8%, respectively. Our findings highlight important predictors of non-adherence. Children whose caregivers were not undergoing HIV treatment and care themselves were less likely to be non-adherent during the first week of treatment (aOR = 0.17, 95% CI: 0.04, 0.71) and the children whose caregivers did not use a medication reminder after one month of treatment initiation (aOR = 5.21, 95% CI: 2.23, 12.16) were more likely to miss the prescribed dose. Moreover, after one month of the treatment initiation, those receiving protease inhibitor (LPV/r) or ABC-based treatment regimens were more likely to be non-adherent (aOR = 12.32, 95% CI: 3.25, 46.67). To promote treatment adherence during ART initiation in children, particular emphasis needs to be placed on a baseline treatment regimen and ways to issue reminders about the child's medication to both the health care system and caregivers. Further, large scale studies using a combination of adherence measuring methods upon treatment initiation are needed to better define the magnitude and predictors of ART non-adherence in resource-limited settings.
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| 9. |
- Biru, Mulatu, et al.
(författare)
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Rates and predictors of attrition among children on antiretroviral therapy in Ethiopia : A prospective cohort study
- 2018
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Attrition from antiretroviral therapy (ART) programmes is a critical challenge among children receiving care in resource-limited settings. Our objective was to determine the rates and predictors of attrition among children on ART in Ethiopia. Methods Between December 2014 and September 2016, we conducted a prospective cohort study in eight health facilities in Ethiopia. Eligibility criteria included age 3 months–14 years; being on ART for not more than a month. Outcome was attrition due to death and/or loss to follow-up. Predictor variables were child clinical and socio-demographic characteristics, and caregiver socio-demographic characteristics. We used Cox Regression analyses to examine the association between predictors and outcome. Results Of 309 children, 304 were included, 52% were male. Their median age was 9 years (Inter-quartile range, IQR, 6–12). At ART initiation, their median CD4 was 362 cells/mm3 (IQR 231–499); and 74.3% had WHO stage 1 or 2 disease. During 287.7 person-years of observation (PYO), 24 attritions were recorded, yielding an attrition rate of 8.3 per 100 PYO (95% CI 5.4–12.1). Of these, six children were reported dead, leading to a mortality rate of 2.1 per 100 PYO (95% CI 0.8–4.3). Eighteen were lost to follow-up (LTFU) leading to LTFU rate of 6.26 per 100 PYO (95% CI: 3.83–9.70). The majority, 14 (58%) of attrition occurred during the first six months of treatment. Age below three years [aHR] = 5.14 (95% CI: 2.07–12.96), rural residence (aHR = 3.97, 95% CI: 1.34–11.78) and baseline Hgb in g/dl < 10 g/dl [aHR] = 5.68 (95% CI: 2.03–6.23) predicted higher risk of attrition. Baseline Hgb < 10 g/dl (aHR = 16.63, 95% CI: 1.64–168.4) and WHO stage III or IV (aHR = 12.25, 95% CI: 1.26–119.05) predicted the death of the child. Higher attrition was documented among children of both biological parents alive and biologically related close family caregivers. Conclusion Younger children, those from rural areas, and children with anaemia were at higher risk of attrition, especially during the early months of treatment, and therefore should be prioritized during treatment follow-up. Further studies should examine underlying reasons for higher attrition.
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| 10. |
- Biru, Mulatu, et al.
(författare)
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Surviving Overwhelming Challenges: Family Caregivers' Lived Experience of Caring for a Child Diagnosed with HIV and Enrolled in Antiretroviral Treatment in Ethiopia.
- 2015
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Ingår i: Issues in Comprehensive Pediatric Nursing. - : Informa UK Limited. - 0146-0862 .- 1521-043X. ; 38:4, s. 99-282
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Tidskriftsartikel (refereegranskat)abstract
- Family caregivers play a critical role in caring for children living with HIV, however, there is little knowledge about their experiences. The aim of this study was to illuminate the family caregivers' lived experiences of caring for a child when he or she has been diagnosed with HIV and enrolled to antiretroviral treatment. Qualitative interviews with 21 family caregivers of 21 children diagnosed with HIV were analyzed using an inductive design with a hermeneutic phenomenological approach. The caregivers' experience were articulated in 5 subthemes under the main theme of "Surviving overwhelming challenges": "Committed care-giving," "Breaking the family life," "Caring burdens," "Confronting conflicts," and "Living with worry." Despite the difficult situation the family caregivers experienced with extensive worry, caring burdens, and disrupted family and social networks, they were committed caregivers. They were empowered by their belief in God but also by their strong belief in the child's treatment and support from healthcare workers. The healthcare system needs to consider possible ways to support the family caregivers during child's HIV diagnosis and treatment initiation as part of a continuum of care.
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