| 1. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
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Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: A pilot study
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 9:3, s. 168-174
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Tidskriftsartikel (refereegranskat)abstract
- Background: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. Aims:The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.Methods:A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions. Results:Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations ”with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test – retest values for all but one question exceeded 0.70.Conclusions:The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.
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| 2. |
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| 3. |
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| 4. |
- Persson, Hans, et al.
(författare)
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Fine root dynamics in a Norway spruce forest (Picea abies (L.) Karst) in eastern Sweden
- 2010
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Ingår i: Plant and Soil. - : Springer Science and Business Media LLC. - 0032-079X .- 1573-5036. ; 330, s. 329-344
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Tidskriftsartikel (refereegranskat)abstract
- The annual dynamics of live and dead fine roots for trees and the field layer species and live/dead ratios were investigated at a coniferous fern forest (Picea abies L. Karts) in Sweden. Our methods of estimating the average amount of fine roots involved the periodic sampling of fine roots in sequential cores on four sampling occasions. The highest live/dead ratio was found in the upper part of the humus layer for both tree and field-layer species and decreased with depth. Most tree fine roots on the four sampling occasions were found in the mineral soil horizon, where 86, 81, 85 and 89% of < 1 mm and 89, 88, 89 and 92% of < 2 mm diameter of the total amounts of live fine roots in the soil profile were found. The mean amounts of live fine roots of tree species for the total soil profile on the four sampling occasions was 317, 150, 139 and 248 g m(-2) for < 1 mm and 410, 225, 224 and 351 g m(-2) for < 2 mm diameter fine roots. The related amount of dead fine roots was 226, 321, 176 and 299 g m(-2) and 294, 424, 282 and 381 g m(-2), respectively. Average amounts of live and dead fine-roots and live/dead ratios from other Picea abies forest ecosystems were within the range of our estimates. The production of fine roots, < 1 and < 2 mm in diameter, estimated from the annual increments in live fine roots, was 207 and 303 g m(-2). The related accumulation of dead fine roots was 257 and 345 g m(-2), The turnover rate of tree fine roots < 1 mm in diameter in the total soil profile amounted to 0.7 yr(-1) for live and 0.8 yr(-1) for dead fine roots. The related turnover rates for tree fine roots < 2 mm were 0.4 yr(-1) and 0.7 yr(-1). Our data, although based on minimum estimates of the annual fluxes of live and dead fine roots, suggests a carbon flow to the forest soil from dead fine-roots even more substantial than from the needle litter fall. Fine-root data from several Picea abies forest ecosystems, suggest high turnover rates of both live and dead tree fine-roots.
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| 5. |
- Persson, Lena, 1951-, et al.
(författare)
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A new model for dealing with patients who frequently arrive spontaneously at hospital emergency departments requiring health care : a pilot study
- 2014
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Ingår i: International Journal of Nursing & Clinical Practices. ; 1, s. 103-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients who repeatedly seek care directly at hospital based somatic emergencydepartments take up a large proportion of health care resources, at the same time they appear to experience low satisfaction with the care they receive. The purposes of this pilot study were to describe: I) the development of a team model for taking care of frequent visitors to a somatic hospital based ED; II) Eventual changes, over six months, in costs and patients’ health care utilization related to pilot testing the model and III), the team’s experiences of implementing the model.Methods: A mixed method convergent parallel design was used.Results: The development of the model began as a top-down process and later on into a bottom-up approach once the inter-professional team became involved. The new model functioned as a support for all 12 patients included in the study and collectively their visits decreased by a total of 73 visits (55%).Conclusion: The inference quality description is that a management induced project may be accepted and actively applied when those involved experience freedom to structure the project. Increased communication between different professionals within the hospital and between different caregivers such as ED, primary health care and community social- and health-care, increases the possibility for the patients to be cared for in a sustainable and non-fragmented way.
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| 6. |
- Persson, Lena, 1951-, et al.
(författare)
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A new model for dealing with patients who frequently arrive spontaneously at hospital emergency departments requiring health care : A pilot study
- 2014
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Ingår i: International Journal of Nursing & Clinical Practices. - : Graphyonline Publications PVT, Ltd.. - 2394-4978. ; 1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients who repeatedly seek care directly at hospital based somatic emergency departments take up a large proportion of health care resources, at the same time they appear to experience low satisfaction with the care they receive. The purposes of this pilot study were to describe: I) the development of a team model for taking care of frequent visitors to a somatic hospital based ED; II) Eventual changes, over six months, in costs and patients’ health care utilization related to pilot testing the model and III), the team’s experiences of implementing the model.Methods: A mixed method convergent parallel design was used.Results: The development of the model began as a top-down process and later on into a bottom-up approach once the inter-professional team became involved. The new model functioned as a support for all 12 patients included in the study and collectively their visits decreased by a total of 73 visits (55%).Conclusion: The inference quality description is that a management induced project may be accepted and actively applied when those involved experience freedom to structure the project. Increased communication between different professionals within the hospital and between different caregivers such as ED, primary health care and community social- and health-care, increases the possibility for the patients to be cared for in a sustainable and non-fragmented way.
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| 7. |
- Pettersson, Anna, 1979-, et al.
(författare)
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Assessing patients’ perceived bother from the gastrointestinal side effects of radiotherapy for localized prostate cancer : initial questionnaire development and validation
- 2014
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 53:3, s. 368-377
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe present study reports on the development and first steps of validation of the Gastrointestinal Side Effects Questionnaire (GISEQ), a measure of patient-reported gastrointestinal symptoms following local radiotherapy to the prostate. The questionnaire design provides a novel approach of assessment of side effects of prostate radiotherapy, by enabling measurement of patient-perceived change in symptoms.Material and methodsThe eight-item GISEQ was administered to 130 prostate cancer patients referred to radiotherapy. Patients completed the GISEQ at four, eight and 15 weeks after start of radiotherapy. The psychometric properties including validity, reliability, responsiveness and feasibility were evaluated. The EORTC QLQ-C30 and QLQ-PR25 were chosen as comparative measures.ResultsExpert opinion supported content validity. For concurrent validity, correlation between the GISEQ and matching items in the EORTC questionnaires was moderate but significant (r > 0.41, p < 0.001). The responsiveness was adequate, indicated by changes in GISEQ scores over time corresponding to the effects of radiation. Internal consistency was satisfactory (overall Cronbach's α> 0.70). Sensitivity and specificity for items diarrhea, constipation and blood in stools ranged from 50% to 100% and from 68% to 100%, respectively. All items had a floor effect above 15%. The response rates ranged from 85% to 92% and missing items was < 0.8%, indicating good feasibility.ConclusionsThe GISEQ showed satisfactory internal consistency and adequate content validity, concurrent validity and responsiveness. It is brief, easy to use and can be quickly evaluated, making it useful not only for research but possibly also for clinical settings. Modification of response scale and extension of items are potential improvements. Further work is needed to strengthen the psychometric qualities of the GISEQ and to evaluate its clinical use and potential effects of response shift and recall bias.
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| 8. |
- Pettersson, Anna, 1979-
(författare)
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Diet and Gastrointestinal Symptoms in Patients with Prostate Cancer Treated with Radiotherapy
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective The main objective of this thesis was to explore the effects of diet on gastrointestinal symptoms in prostate cancer patients treated with local curative radiotherapy, by evaluating dietary intake prior to treatment (Study I), the psychometric properties of a new questionnaire on patient-reported gastrointestinal side effects (Study II), and the effect of a dietary intervention on acute and long-term gastrointestinal symptoms up to 2 years after radiotherapy completion (Study III-IV).Methods A total of 130 men with localized prostate cancer referred to dose-escalated radiotherapy (ED2 87-102 Gy, α/β=3 Gy) were recruited to a dietary intervention trial. Patients were randomized to receive either standard care plus the dietary intervention of a fibre- and lactose-restricted diet (intervention group, IG; n=64) or standard care alone (standard care group, SCG; n=66). Data on gastrointestinal symptoms and dietary intake were collected pre-treatment and at seven time points during a follow-up period of 26 months.Results Prior to treatment, grain products and milk products were major sources of energy. Unbalanced fatty acid intake and low intake of selenium were observed (Study I). Validation of the Gastrointestinal Side Effects Questionnaire (GISEQ) revealed satisfactory internal consistency, moderate concurrent validity and adequate responsiveness (Study II). There were no significant effects of the intervention on acute or long-term gastrointestinal symptoms, but a tendency towards lower prevalence and severity of bloating and diarrhoea in the IG compared to the SCG during radiotherapy. Gastrointestinal symptoms were predominantly mild, and the frequency of clinically relevant symptoms was merely a few percent. Dietary adherence in the IG was initially good, but tended to decline beyond 12 months post-radiotherapy (Study III-IV).Conclusions A fibre- and lactose-restricted diet was not superior to the habitual diet in reducing gastrointestinal symptoms in patients undergoing high-dose, small-volume radiotherapy for localized prostate cancer. The GISEQ enables assessment of patient-perceived change in symptoms, but further work is needed to strengthen its psychometric qualities. It is suggested that continued research in this area target patient categories referred to irradiation of larger pelvic volumes with a higher risk of gastrointestinal symptoms, and that dietary interventions incorporate established strategies to enhance adherence and effectiveness.
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| 9. |
- Pettersson, Anna, et al.
(författare)
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Effects of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life : A randomized controlled trial in prostate cancer patients undergoing radiotherapy
- 2012
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 103:3, s. 333-340
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:To study the effect of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life (HRQOL) in prostate cancer patients referred to radiotherapy.Materials and methods:A total of 130 patients were randomly assigned to one of two groups: an intervention group (IG, n = 64), instructed to reduce their intake of insoluble dietary fibres and lactose, a standard care group (SC, n = 66), instructed to continue their normal diet. Gastrointestinal side effects and other aspects of HRQOL were evaluated from baseline up to 2 months after completed radiotherapy, using the EORTC QLQ-C30 and QLQ-PR25 and the study-specific Gastrointestinal Side Effects Questionnaire (GISEQ). A scale indicating adherence to dietary instructions was developed from a Food Frequency Questionnaire (FFQ), with lower scores representing better compliance. Descriptive and inferential statistical analyses were conducted.Results:There was an interaction effect between randomization and time in the FFQ Scores (p < 0.001), indicating that both groups followed their assigned dietary instructions. The dietary intervention had no effect on gastrointestinal side effects or other aspects of HRQOL. During radiotherapy, the percentage of patients with bowel symptoms and bloated abdomen was lower in IG compared to SC, but the between-group differences were not statistically significant. During radiotherapy, the percentage of patients with bowel symptoms, urinary symptoms, pain, fatigue and diminished physical and role functioning increased in both groups.Conclusions: The dietary intervention had no effect on gastrointestinal side effects or other aspects of HRQOL. The tendency towards lower prevalence of bowel symptoms in IG may indicate some positive effect of the dietary intervention, but methodological refinements, clearer results and longer follow-up are needed before the value of diet change can be established with certainty.
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| 10. |
- Pettersson, Anna, et al.
(författare)
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Effects of a dietary intervention on gastrointestinal symptoms after prostate cancer radiotherapy : Long-term results from a randomized controlled trial
- 2014
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 113:2, s. 240-247
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE:To evaluate the long-term effects of dietary intervention on gastrointestinal symptoms after highly dose-escalated radiotherapy for localized prostate cancer, using boost with protons or high-dose-rate brachytherapy.MATERIALS AND METHODS:Patients were randomized to an intervention group (n=64) advised to reduce insoluble dietary fiber and lactose intake, or to a standard care group (n=66) advised to continue their usual diet. Gastrointestinal symptoms, other domains of health-related quality of life (HRQOL), and dietary intake were evaluated for ⩽24months post-radiotherapy with the European Organization for Research and Treatment of Cancer quality-of-life questionnaires QLQ-C30 and QLQ-PR25, Gastrointestinal Side Effects Questionnaire, and Food Frequency Questionnaire. The effect of the intervention on gastrointestinal symptoms was evaluated using generalized estimating equations.RESULTS:Dietary intervention had no obvious effect on long-term gastrointestinal symptoms or HRQOL. The intervention group markedly reduced their dietary fiber and lactose intake during radiotherapy, but adherence tended to decline over time. The vast majority of long-term gastrointestinal symptoms were reported as 'a little', with a noticeable difference from pre-treatment only for unintentional stool leakage, limitations on daily activities, and mucus discharge.CONCLUSION:Long-term gastrointestinal symptoms were predominantly mild, and dietary intervention was not superior to a usual diet in preventing these symptoms.
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| 11. |
- Salmelin, A., et al.
(författare)
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Fetal monitoring with computerized ST analysis during labor : A systematic review and meta-analysis
- 2013
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - Hoboken, USA : Wiley. - 0001-6349 .- 1600-0412. ; 92:1, s. 28-39
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Tidskriftsartikel (refereegranskat)abstract
- Background. Computerized ST analysis of fetal electrocardiography (ECG) combined with cardiotochography (CTG) has been introduced for intrapartum monitoring and is the prevailing method when ST analysis (STAN®) is used. Objective. To assess the evidence that computerized ST analysis during labor reduces the incidence of fetal metabolic acidosis, hypoxic ischemic encephalopathy, cesarean section, instrumental vaginal delivery or the number of instances where fetal scalp blood sampling is used as compared with CTG only. Methods. Search of PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL and CRD databases. Selection criteria. CTG only compared with CTG + computerized ST analysis. Data collection and analysis. Studies were assessed using pre-designed templates. Meta-analyses of included randomized controlled trials were performed using a random effects model. Results. Risk ratio for cord metabolic acidosis with STAN® was 0.96 [95% confidence interval (CI) 0.49-1.88]. Risk ratio for cesarean sections or instrumental vaginal deliveries for fetal distress was 0.93 (95%CI 0.80-1.08) and for fetal scalp blood sampling 0.55 (95%CI 0.40-0.76). Encephalopathy cases were not assessed due to their low incidence. Conclusions. There is not enough scientific evidence to conclude that computerized ST analysis reduces the incidence of metabolic acidosis. Cesarean sections and instrumental vaginal deliveries due to fetal distress or other indications are the same, regardless of method, but STAN® reduces the number of instances which require scalp blood sampling. © 2012 The Authors © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
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| 12. |
- Sjögren, Ingela, 1968-
(författare)
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To be or not to be American : Statehood and Peoplehood in Native American Self-identification during the Self-determination era
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As colonized peoples Native Americans have had a complicated relationship to the United States. They have faced the question of whether they should demand tribal independence or embrace American citizenship. During the early 1970s, when radical ethnic and political movements occupied center stage in the United States, and in 1992, when the 500 year anniversary of Columbus discovery of America was celebrated, the issue of Indian American identification was actualized. The various possible ways in which Native Americans could identify in relation to the United States made their identification often seem contradictory. The same group and even the same individual could identify as both part of and apart from the United States. Likewise, the same event could trigger different identifications in relation to the United States. How can this be explained?In this thesis I offer an explanation of Indian American identification that combines the perspectives of world view and historical context. Native Americans have related to two different world views, a Western world view which imagines a world made up of states, and a "traditional" Indian world view which imagines a world made up of peoples placed on their lands by the Creator. Different ways of understanding the world impacted how Native Americans understood "America," as USA or Indian ancestral homelands. Different world views provided different images of Native American relationship to the United States. These images could be put forward or be actualized in different contexts. The historical context influenced which images were most commonly chosen. During the 1970s, given the period's generally revolutionary discourse, more separatist images were prominent. In 1992, when a government-to-government relationship between tribal and federal governments was firmly established, Indians chose a more inclusive relationship to the Untied States.
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| 13. |
- Svedberg, Petra, 1973-, et al.
(författare)
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Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - Malden, USA : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 203-208
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Tidskriftsartikel (refereegranskat)abstract
- The patients’ sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of ‘The 25-item Sex after MI Knowledge Test’ in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients’ National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test–retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test–retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.
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| 14. |
- Thylefors, Ingela, et al.
(författare)
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The more, the better?: Exploring vertical and horizontal leadership in cross-professional health care teams
- 2014
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Ingår i: Leadership in Health Services. - : Emerald Group Publishing Ltd.. - 1751-1879 .- 0952-6862. ; 27:2, s. 135-149
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This paper seeks to explore vertical and horizontal leadership and the relationship of the form of leadership to effectiveness in Swedish cross-professional health care teams. Design/methodology/approach: Questionnaire data were collected from a sample of 47 teams and observation data from a sub-sample of 38 teams. Data on leadership were condensed to indices: directive and participative leadership (vertical leadership) and functional influence and self-regulation (horizontal leadership). Effectiveness was estimated using five measures: team climate, self-assessed effectiveness, teamwork organisation, assessments of results from a simulated case conference (case quality) and manager-rated effectiveness. Findings: Positive relationships were found between leadership and effectiveness with one exception: case quality was negatively associated with vertical leadership though positively to functional influence. When controlled for team climate the correlations between self-assessed effectiveness and leadership disappeared. However, it remained between vertical leadership and the assessment of teamwork organisation. The results suggest that hierarchical and horizontal/shared leadership are complementary forms. Research limitations/implications: The small number of teams together with the problem of causality in this cross-sectional study are the main limitations. Practical implications: One implication for practice is the need for clarification of how leadership and influence should be distributed from a contingency perspective. Originality/value: This study takes both horizontal and vertical leadership into account compared with previous studies often focusing on one facet. In addition, cross-professional health care teams with their special characteristics are underrepresented within research on team leadership. © Emerald Group Publishing Limited.
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