| 1. |
|
|
| 2. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
-
Assessment of nutritional status using biochemical and anthropometric variables in a nutritional intervention study of women with hip fracture
- 2001
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 20:3, s. 217-223
-
Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: The aim of this study of women with hip fracture was to describe nutritional status with biochemical markers and anthropometric variables, and to evaluate the effect of nutritional intervention with the intention of increasing protein and energy intake.Methods: The first consecutive 44 women were included, and used as controls. The next 44 were matched for age, fracture and mental state. Anthropometric variables, IGF-I, hormones and serum albumin were collected 4–6 days (baseline), 1 and 3 months after surgery. Twenty-four women filled out a 7-day food record.Results: At baseline, one fourth had BMI <20 kg/m2and subnormal triceps skinfold thickness. Baseline serum albumin, IGF-I and growth hormone levels were low, probably as an acute response to trauma. Women with BMI <20 kg/m2had lower IGF-I levels compared to those with higher BMI. At 3 months, one-third of both groups were protein and energy malnourished. The intervention group obtained higher daily energy percentage from fat but none of the groups reached their calculated energy need.Conclusions: Using biochemical markers in the acute postoperative situation to assess nutritional status is not recommended. The intervention had no impact on anthropometric or biochemical variables.
|
|
| 3. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
-
Förebygg undernäring!
- 2002
-
Ingår i: Äldre i centrum. - 1401-5110. ; 3, s. 16-17
-
Tidskriftsartikel (populärvet., debatt m.m.)
|
|
| 4. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
-
Nutritional state and functional capacity among elderly Swedish people with acute hip fracture
- 2000
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 14:4, s. 268-274
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to describe characteristics in a group of elderly men and women with hip fracture, regarding presumed risk factors, such as nutritional state and functional capacity. A total of 142 men and women aged 75 years or more were consecutively included on admittance to the hospital. Anthropometry and body composition were measured 4-6 days after the fracture. Data on functional status, activities of daily living and living arrangements at the time of the fracture were collected. The women and men had a body mass index (BMI) of 22.3 ▒ 3.7 kg/m2 and 21.7 ▒ 2.1 kg/m2, respectively. Of the whole group, 71% had a BMI < 24 kg/m2 and 25% a BMI < 20.0 kg/m2. Forty-five percent of the patients needed daily home help, and a majority of them were mentally impaired (p < 0.0001). Women with a trochanteric hip fracture were shorter, had lower body weight, lower lean body mass and lower arm muscle circumference (AMC) than the cervical fracture group (p < 0.05). Fewer women with a trochanteric fracture and fewer women with mental impairment took walks outside before the fracture, (p = 0.023 and p = 0.002, respectively). Characteristics found in the group were low BMI, low muscle mass as indicated by low lean body mass and mental impairment. It seems important to evaluate such factors when developing post-operative care plans aimed at avoiding further deterioration. Extra frail sub-groups of patients, such as people who are mentally impaired, women with trochanteric fracture and women with high dependency concerning ADL functions were identified.
|
|
| 5. |
- Bachrach-Lindström, Margareta, et al.
(författare)
-
Nutritional status and functional capacity after femoral neck fractures : a prospective randomized one-year follow-up study
- 2000
-
Ingår i: Aging. - 1945-4589. ; 12:5, s. 366-374
-
Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.
|
|
| 6. |
- Bringman, S, et al.
(författare)
-
Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study
- 2001
-
Ingår i: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques. - 1051-7200 .- 2331-2254. ; 11:5, s. 322-326
-
Tidskriftsartikel (refereegranskat)abstract
- Laparoscopic hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to gain the initial working space in totally extraperitoneal endoscopic (TEP) hernioplasty, but this increases its cost. Forty-four men with bilateral, primary or recurrent inguinal hernias were randomized to undergo TEP with or without dissection balloon, There were two conversions to transabdominal preperitoneal hernioplasty, or open herniorrhaphy, in the group with balloon and four in the group without balloon. There was no difference in the postoperative morbidity or operation time between the two groups, and there were no major complications in either group. The recurrence rate was 4.3% in the group with the balloon and 7.1% in the group without the balloon. There were no statistically significant differences between the groups, Although our study population is too small to detect small differences between the groups, it seems that the use of a dissection balloon is not beneficial in a bilateral TEP.
|
|
| 7. |
|
|
| 8. |
- Christensson, Lennart, 1952-, et al.
(författare)
-
Attitudes of nursing staff towards nutritional nursing care
- 2003
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 17:3, s. 223-231
-
Tidskriftsartikel (refereegranskat)abstract
- Fulfilling nutritional requirements in residents with eating problems can be a challenge for both the person in need of help and for the caregiver. In helping and supporting these residents, a positive attitude is assumed to be as important as practical skill. The aim of this study was to test the hypothesis that nutritional education and implementation of a nutritional programme would change the attitudes towards nutritional nursing care among nursing staff with daily experience of serving food and helping residents in municipal care. The study was carried out as a before and after experimental design. An attitude scale, staff attitudes to nutritional nursing care (SANN scale), was developed and used. The response on the scale gives a total SANN-score and scores in five underlying dimensions: self ability, individualization, importance of food, assessment and secured food intake. Nursing staff at eight different residential units (n = 176) responded to the attitude scale and, of these, staff at three of the units entered the study as the experimental group. After responding to the attitude scale, nutritional education was introduced and a nutritional programme was implemented in the experimental units. One year later, attitudes were measured a second time (n = 192). Of these, 151 had also responded on the first occasion. Education and implementation of a nutritional programme did not significantly change attitudes. Overall, nursing staff responded with positive attitudes towards nutritional nursing care. Most of the positive attitudes concerned items within the dimension importance of food. In contrast, items within self ability showed the lowest number of staff with positive attitudes.
|
|
| 9. |
- Christensson, Lennart, 1952-, et al.
(författare)
-
Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care
- 2002
-
Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 56:9, s. 810-818
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA) with regard to validity using a combination of anthropometric and serum-protein measurements as standard criteria to assess protein-energy malnutrition (PEM).Design: Cross-sectional study with consecutive selection of residents aged 65 y.Setting: A municipality in the south of Sweden.Subjects: During a year, starting in October 1996, 148 females and 113 males, aged 65-104 y of age, newly admitted to special types of housing for the elderly, were included in the study.Results: According to SGA, 53% were assessed as malnourished or moderately malnourished on admission. The corresponding figure from MNA was 79% malnourished or at risk of malnutrition. Both tools indicated that anthropometric values and serum proteins were significantly lower in residents classified as being malnourished (P<0.05). Sensitivity in detecting PEM was in SGA 0.93 and in MNA 0.96 and specificity was 0.61 and 0.26, respectively. Using regression analysis, weight index and serum albumin were the best objective nutritional parameters in predicting the SGA- and MNA classifications. Item 'muscle wasting' in SGA and 'self-experienced health status' in MNA showed most predictive power concerning the odds of being assessed as malnourished.Conclusions: SGA was shown to be the more useful tool in detecting residents with established malnutrition and MNA in detecting residents who need preventive nutritional measures.
|
|
| 10. |
- Christensson, Lennart, 1952-, et al.
(författare)
-
Individually adjusted meals for older people with protein-energy malnutrition : a single-case study
- 2001
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 10:4, s. 491-502
-
Tidskriftsartikel (refereegranskat)abstract
- • The objective of this study was to investigate the effect of a 3-month intervention programme consisting of meals based on individual nutritional requirements in residents assessed as protein-energy malnourished on admission to a municipal care Institution.• Using a single-case design, 11 malnourished residents were given individual care aimed at fulfilling their personal requirements for energy intake during a period of 12 weeks. The residents were selected from a sample of 261 newly admitted older adults of whom 87 were assessed to be malnourished on admission. Nutritional status, including anthropometric and biochemical variables and functional capacities were assessed before, during, and after the intervention. Energy intake was recorded every day. Body weight, and serum concentration of albumin and transthyretin were measured every other week.• During a 3-month period, the mean value of energy intake reached the calculated energy requirement in 10 residents. Eight residents increased in weight, triceps skin-fold thickness, and transthyretin concentration. Nine residents increased in arm muscle circumference, and 10 showed increased serum albumin concentration and functional capacity.• We conclude that nursing care based on individual nutritional requirements, resources, and desires improves nutritional status and functional capacity in a group of malnourished residents.
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
- Flensner, Gullvi, 1945-, et al.
(författare)
-
Lived experience of MS-related fatigue : a phenomenological interview study
- 2003
-
Ingår i: International Journal of Nursing Studies. - London : Pergamon. - 0020-7489 .- 1873-491X. ; 40:7, s. 707-17
-
Tidskriftsartikel (refereegranskat)abstract
- Fatigue is a major problem among individuals diagnosed with multiple sclerosis (MS), but its meaning in daily living is unclear. The aim was to describe MS-related fatigue as lived by a group of individuals diagnosed with MS. Interviews with nine individuals were analysed from a phenomenological perspective. MAIN FINDINGS: MS-related fatigue is living with a time-consuming and all absorbing phenomenon, involving the body and the whole human being. Fatigue is commonly non-constructively perceived and expressed in terms of energy loss, emotional afflictions, dependency and restrictions of life in general, however, it is also constructively perceived and involves a desire to accept life and strive for a better situation. CONCLUSION: MS-related fatigue is a comprehensive phenomenon and its relationship with self-care requires further investigation.
|
|
| 19. |
- Foldemo, Annica, 1953-, et al.
(författare)
-
Needs in outpatients with schizophrenia, assessed by the patients themselves and their parents and staff
- 2004
-
Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 39:5, s. 381-385
-
Tidskriftsartikel (refereegranskat)abstract
- Background:There has been a change in psychiatric care from a hospital-oriented care system to an outpatient-centred system, which has underlined the importance of support alternatives.Methods:The sample was drawn from outpatients with schizophrenia at an outpatient clinic in 2001. We used structured interviews when interviewing outpatients, parents and staff. The interview with the patient included the patient’s needs, global function, clinical global impression and insight. Both parents and staff were interviewed about the patient’s needs.Results:The mean value of GAF was 56 ± 10, CGI 4 ± 1 and 89% of the patients had full insight into their illness. The patients rated the total score of the severity of needs at a mean of 7 ± 4, while the parents’ and staff’s rating was 9 ± 5. The needs ranking between patients and parents and patients and staff showed a correlation of rho = 0.65 (p < 0.01) and parents and staff rho =0.95 (p < 0.01). The parents rated more problems involving physical health and money than the patients.Conclusion:When planning mental health in the future, it is important to assess the views of the patients, the parents and the staff from a multiple perspective.
|
|
| 20. |
- Fägerskiöld, Astrid, 1942-, et al.
(författare)
-
Expectations of the child health nurse in Sweden : two perspectives
- 2003
-
Ingår i: International Nursing Review. - : Wiley. - 0020-8132 .- 1466-7657. ; 50:2, s. 119-128
-
Tidskriftsartikel (refereegranskat)abstract
- Background: the child health service exists to support and stimulate parents in order to reduce stress and to encourage an advantageous development of the preschool child.Aim: To explore and describe similarities and differences in expectations of the child health nurse, from the perspective of the recently delivered first-time mother, as compared to an expression of what the child health nurse believed mothers of infants expected of them. The data consisted of 15 interviews with child health nurses and 20 interviews with first-time mothers. Thematic content analysis resulted in seven categories of expectations. The child health nurse was expected to be someone to approach, who could assess the child's development and give immunizations and to be a supporter, counsellor, safety provider and a parent group organizer with knowledge. Similarities between the mothers’ and the nurses’ statements occurred more frequently than differences, which is suggested to depend on the Swedish tradition among new mothers of visiting the child health clinic. The mothers expected participation in parent groups to a higher degree than the nurses thought they did. Child health nurses who fulfil the mothers’ expectations appear to require a good relationship with the mother in order to find out what she desires, which the allocation of sufficient time for regular meetings, will facilitate. Moreover, the nurse requires knowledge about children's requirements and the transition to motherhood as well as the father's important role.
|
|
| 21. |
- Fägerskiöld, Astrid M., et al.
(författare)
-
Maternal expectations of the child health nurse
- 2001
-
Ingår i: Nursing and Health Sciences. - : Wiley. - 1441-0745 .- 1442-2018. ; 3:3, s. 139-147
-
Tidskriftsartikel (refereegranskat)abstract
- The main aim of this study was to identify what first-time mothers in Sweden expected of Child Health Nurses. A further aim was to investigate what help and support was received by the new mothers and whether they felt that anything was missing. Twenty new mothers were interviewed according to grounded theory and the data were analyzed by the constant comparative method. It was found that first-time mothers expected Child Health Nurses to have faith in a new mother's own strength and to be accessible, approachable and knowledgeable, providing advice and support. New mothers indicated that they had experienced most of these characteristics, especially accessibility and approachability, but some felt that there were deficiencies (e.g. a lack of continued interest in their own bodies and health, as well as a lack of support when they ceased to breast-feed). The Child Health Service was taken for granted by new mothers. First-time mothers indicated that they appreciated the service, particularly those mothers who did not have a good social network. However, some of the new mothers expressed negative feelings regarding the Child Health Service provided.
|
|
| 22. |
- Fägerskiöld, Astrid M., et al.
(författare)
-
What child health nurses believe mothers with infants expect of them
- 2000
-
Ingår i: Nursing and Health Sciences. - : Wiley. - 1441-0745 .- 1442-2018. ; 2:2, s. 83-91
-
Tidskriftsartikel (refereegranskat)abstract
- The aims were to identify what the child health nurse believed was expected of her by women who had recently become mothers, primipara and multipara, to investigate which problems the nurse found most difficult to deal with and to analyse why they were difficult. The grounded theory method was employed for conducting interviews with 15 nurses. The data analysis showed that the nurses thought mothers expected care of the infant and the family from the nurse, comprising support, advice and child health assessments. What the nurses found most difficult to deal with were obstacles to interaction with mothers such as motherhood problems, hidden, social and organisational problems. They wanted to have a positive interaction with mothers to be able to fulfil the task of supporting parents and identifying risks to the child's healthy upbringing. This task places great demands on nurses' competence and knowledge about the child and family.
|
|
| 23. |
- Fägerskiöld, Astrid, 1942-, et al.
(författare)
-
The view of the child health nurse among mothers
- 2003
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 17:2, s. 160-168
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this exploratory study was to investigate mothers' experiences of their encounters with the child health (CH) nurse. A cross-sectional design was used for the study, based on data from 140 mothers gathered by the critical incident technique. The analysis was accomplished by a thematic content analysis, using inductive reasoning in three steps. Symbolic interactionism was used as a frame of reference. The results suggest that the central factor in the encounter between mother and nurse is that they are able to share the realm of motherhood, meaning that the nurse is open and willing to share all types of emotions, experiences and attitudes related to being a mother. Given this basis, other important factors are the supply of sound advice and practical interventions, and that the nurse is reassuring and accessible. The majority of the participating mothers had experienced CH nurses who had provided them with valuable support during troublesome incidents. However, there were also several dissatisfied mothers who had expected support but thought they received insulting treatment instead. The mothers and the nurses have varying experiences and background and therefore different perspectives, which may lead to difficulties in understanding each other. Knowledge about the important factors, that affect the mother–nurse encounter, can be used to strengthen the nurses' positive behaviours and facilitate understanding of how disappointed mothers have experienced their health care encounters.
|
|
| 24. |
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
- Hollman, Gunilla, 1953-, et al.
(författare)
-
Familial hypercholesterolaemia and quality of life in family members
- 2003
-
Ingår i: Preventive Medicine. - 0091-7435 .- 1096-0260. ; 36:5, s. 569-574
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundAwareness of genetic disease in the family may influence quality of life. The purpose of this study was to describe quality of life among nonaffected members of families with familial hypercholesterolaemia. All were aware of the risk for coronary heart disease. Their quality of life was compared with a reference group and with the patients with familial hypercholesterolesterolaemia themselves.MethodsNames of family members (n = 129) were given by the patients with familial hypercholesterolaemia. A randomly selected reference group (n = 1485) and patients with familial hypercholesterolaemia (n = 185) were included for comparison. They all completed the questionnaire Quality of Life Index, the Hospital Anxiety and Depression Scale, and the Mastery Scale measuring coping. Family members and patients with familial hypercholesterolaemia also completed a questionnaire on health and lipids.ResultsFamily members were more satisfied with family life, mean 22.1 ± 3.5 (SD), and psychological/spiritual life, 22.9 ± 4.0, than the reference group, 21.4 ± 4.3 and 21.1 ± 4.8, respectively; this was particularly expressed among partners, P < 0.05. Of family members, 91% were anxious about the patient with familial hypercholesterolaemia developing coronary heart disease.ConclusionsFamily members have as good a quality of life as members of the reference group, but they were anxious about the patient with familial hypercholesterolaemia developing coronary heart disease.
|
|
| 28. |
|
|
| 29. |
|
|
| 30. |
|
|
| 31. |
|
|
| 32. |
|
|
| 33. |
- Hollman, Gunilla, 1953-, et al.
(författare)
-
Quality of life in patients with familial hypercholesterolaemia
- 2002
-
Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 251:4, s. 331-337
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives. The primary aim of this study was to analyse quality of life in adult patients with familial hypercholesterolaemia (FH), a genetic disorder with increased risk of coronary heart disease (CHD). Secondary aims were to find explanatory factors for quality of life and anxiety.Design. A descriptive cross-sectional design was used.Setting. Outpatients from lipid clinics at two university hospitals in Sweden were included. Patients with heterozygous FH and a randomly selected control group participated by filling out questionnaires.Subjects. Two hundred and eighty patients with heterozygous FH above 18 years of age were asked, and 212 of whom 185 were free of overt CHD, participated. Of a control group of 2980 persons 1485 were included for comparison.Methods. We used Likert-type questionnaires: the Quality of Life Index (QLI) consisting of four subscales, the Hospital Anxiety and Depression Scale (HAD), the Mastery Scale measuring coping and a questionnaire on health and lipids constructed for FH patients.Results. Patients with FH were significantly more satisfied with overall quality of life 21.8 ± 0.3 (SEM) vs. controls 21.1 ± 0.1 and this was also the case in three of four subscales, all differences P < 0.05. Anxiety about getting CHD was expressed amongst 86% of the patients with FH.Conclusions. Quality of life amongst patients with FH was at least as good as in controls but they were worried about getting CHD.
|
|
| 34. |
|
|
| 35. |
- Hollman, Gunilla, 1953-, et al.
(författare)
-
The meaning of quality of life among patients with familial hypercholesterolemia
- 2004
-
Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 19:4, s. 243-250
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Living with a genetic predisposition to disease may influence quality of life. The presence of premature disease can lead to an increased focus on family history and genetic predisposition.Objective: The purpose of this study was to describe quality of life in patients with the genetic disease, familial hypercholesterolemia, who are at an increased risk of premature coronary heart disease.Methods: Interviews from 12 adult patients with FH were analyzed using constant comparative analysis. The findings of this qualitative study revealed that for patients, quality of life was equated with harmony in life, the core category. Attaining harmony in life presumes satisfaction and togetherness. Cognizance of the threat of coronary heart disease and impending mortality is balanced by the support of togetherness and satisfaction that builds harmony in life.Conclusion: When caring for patients with familial hypercholesterolemia, it is important to meet each patient on his or her own level, and to support balance and their choices for maintaining or regaining harmony in life.
|
|
| 36. |
- Junestedt, Christian, et al.
(författare)
-
Karakterisering av utsläpp. Jämförelse av olika utsläpp till vatten
- 2003
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I tidigare studier av utsläpp till vatten har fokus legat på lakvatten från kommunala avfallsupplag (Öman m.fl. 2000a ). Syftet med undersökningarna var dels att ta fram och utveckla en metodik för bedömning av lakvatten och dels att utreda vilka typer av kemiska föreningar ett lakvatten normalt innehåller. För att erhålla något slags referensmaterial till de föreningar och ämnen som analyserats i lakvattnen och de halter som mätts upp tidigare startades detta projekt. I projektet har ett antal dagvatten från sorteringsytor provtagits och analyserats tillsammans med ett dagvatten från en avisningsyta vid en flygplats. Dessutom har tre behandlade lakvatten ingått i studien tillsammans med ett grundvatten, ett utgående renat avloppsvatten och ett normalt belastat recipientvatten i närheten av en större stad. Samtliga vattentyper har provtagits och analyserats med hjälp av en tidigare framtagen metodik för bedömning av lakvatten (Öman m.fl. 2000a). Rapporten innehåller data för koncentrationer av ett 100-tal föreningar för de flesta vattnen. Resultaten av studien pekar på att dagvattnen från sorteringsytor tillhör den typ av vatten som innehåller de högsta koncentrationerna av miljöstörande föreningar som lipofila organiska föreningar och tungmetaller. En stor del av föreningarna finns bundna till partiklar i vattnet. Dagvatten från sorteringsytor i Sverige står dock för endast uppskattningsvis 2 % av de totala lakvattenflödet på 12 miljoner kubikmeter Tre grupper av föreningar har visat sig förekomma oftare än andra i stort sett i samtliga vattentyper. Dessa är bromerade flamskyddsmedel, tennorganiska föreningar och nonyl- och oktylfenoletoxilater. I studien har det dessutom framkommit att en stor del av de närvarande lipofila organiska föreningarna och metallerna i en lakvattendamm koncentreras i ytfilmen. Ytfilmen utgör därför en potentiell transportväg för miljöstörande föreningar. Dessutom har det inom projektet visats att både avloppsvatten och lakvatten innehåller kemiska föreningar som kan ha en hormonell effekt.
|
|
| 37. |
- Lindgren, Margareta, 1951-, et al.
(författare)
-
A risk assessment scale for the prediction of pressure sore development : reliability and validity
- 2002
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 38:2, s. 190-199
-
Tidskriftsartikel (refereegranskat)abstract
- Background. The ability to assess the risk of a patient developing pressure sores is a major issue in pressure sore prevention. Risk assessment scales should be valid, reliable and easy to use in clinical practice.Aim. To develop further a risk assessment scale, for predicting pressure sore development and, in addition, to present the validity and reliability of this scale.Methods. The risk assessment pressure sore (RAPS) scale, includes 12 variables, five from the re-modified Norton scale, three from the Braden scale and three from other research results. Five hundred and thirty patients without pressure sores on admission were included in the study and assessed over a maximum period of 12 weeks. Internal consistency was examined by item analysis and equivalence by interrater reliability. To estimate equivalence, 10 pairs of nurses assessed a total of 116 patients. The underlying dimensions of the scale were examined by factor analysis. The predictive validity was examined by determination of sensitivity, specificity and predictive value.Results. Two variables were excluded as a result of low item–item and item–total correlations. The average percentage of agreement and the intraclass correlation between raters were 70% and 0·83, respectively. The factor analysis gave three factors, with a total variance explained of 65·1%. Sensitivity, specificity and predictive value were high among patients at medical and infection wards.Conclusions. The RAPS scale is a reliable scale for predicting pressure sore development. The validity is especially good for patients undergoing treatment in medical wards and wards for infectious diseases. This indicates that the RAPS scale may be useful in clinical practice for these groups of patients. For patients undergoing surgical treatment, further analysis will be performed.
|
|
| 38. |
- Lindgren, Margareta, 1951-, et al.
(författare)
-
Immobility – a major risk factor for development of pressure ulcers among adult hospitalized patients : a prospective study
- 2004
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 18:1, s. 57-64
-
Tidskriftsartikel (refereegranskat)abstract
- Objective : To identify risk factors associated with pressure ulcer development among adult hospitalized medical and surgical patients.Design : A prospective comparative study including 530 adult patients from medical and surgical wards. Registered Nurses made the data collection on admission and once a week for up to 12 weeks. The risk assessment scale used was the Risk Assessment Pressure Sore (RAPS) scale, including the following variables; general physical condition, activity, mobility, moisture, food intake, fluid intake, sensory perception, friction and shear, body temperature and serum albumin.Results : Sixty-two (11.7%) patients developed 85 pressure ulcers. The most common pressure ulcer was that of nonblanchable erythema. Patients who developed pressure ulcers were significantly older, hospitalized for a longer time, had lower scores on the total RAPS scale, had lower weight and lower diastolic blood pressure than nonpressure ulcer patients did. In the multiple logistic regression analyses using variables included in the RAPS scale immobility emerged as a strong risk factor. When adding remaining significant variables in the analyses, mobility, time of hospitalization, age, surgical treatment and weight were found to be risk factors for pressure ulcer development.Conclusion : It is confirmed that immobility is a risk factor of major importance for pressure ulcer development among adult hospitalized patients. The results also indicate that the RAPS scale may be useful for prediction of pressure ulcer development in clinical practice.
|
|
| 39. |
- Lindgren, Margareta, 1951-, et al.
(författare)
-
Pressure sore prevalence within a public health services area
- 2000
-
Ingår i: International Journal of Nursing Practice. - : Wiley. - 1322-7114 .- 1440-172X. ; 6:6, s. 333-337
-
Tidskriftsartikel (refereegranskat)abstract
- Pressure sores are a great problem for patients, staff and society. The aim of this study was to examine the prevalence, treatment and prevention of pressure sores in a public health service area in Sweden. Criteria used for pressure sore assessment were persistent discoloration, epithelial damage and damage to the full thickness of the skin, without or with a cavity. The data were collected during 2 weeks in April 1995 from 1173 inpatients. The pressure-sore prevalence rate was 3.75%; 44 patients had a total of 68 sores. Men were as prone to developing pressure sores as women. The most frequently reported preventive measures were antidecubitus mattresses and turning schedules. Relief from pressure and occlusive dressings were the most common treatment measures. There was no statistical difference in pressure-sore prevalence when compared with a similar study from 1980. Patients were, however, older in 1995.
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
- Söderhamn, O, et al.
(författare)
-
Ability for self-care among home dwelling elderly people in a health district in Sweden
- 2000
-
Ingår i: International Journal of Nursing Studies. - 0020-7489 .- 1873-491X. ; 37:4, s. 361-368
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the ability for self-care among home dwelling elderly in the community in a health district in western Sweden. Two self-report instruments plus a number of self-care related questions were distributed by mail to an age stratified random sample and finally completed by a total of 125 subjects. Bivariate and multivariate statistical methods were used in the analyses. The results showed that self-care ability and self-care agency decreased for respondents 75 + years of age. Self-care ability was predicted by three productive means for self-care and four risk factors.
|
|
| 43. |
- Widar, Marita, 1943-, et al.
(författare)
-
Coping with long-term pain after a stroke.
- 2004
-
Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 0885-3924 .- 1873-6513. ; 27:3, s. 215-225
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this qualitative study was to describe pain, coping strategies, and experienced outcome of coping with long-term pain conditions after a stroke. Forty-three participants were interviewed: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain, and 10 with tension-type headache. Analysis of the data was by content analysis. Pain-related problems described were incomprehensibility regarding the pain, disturbed sleep, fatigue, diminished capacity, mood changes, and stress in relationships. Different coping strategies were used; the most common were making the pain comprehensible, planning of activities, taking medications, communicating, and distractions. Changing body position, making comparison, and enduring the pain were common in central or nociceptive pain, rest and relaxation in tension-type headache. Communicating their pain gave a feeling of perplexity and resignation. Satisfaction was reported in the cases of consideration shown by others. Pain after a stroke requires specialized knowledge in order to understand the patient's experiences and to enhance coping.
|
|
| 44. |
- Widar, Marita, 1943-, et al.
(författare)
-
Health-related quality of life in persons with long-term pain after a stroke.
- 2004
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 13:4, s. 497-505
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: No study has, to our knowledge, previously been published on health-related quality of life (HRQoL) in a group suffering from long-term pain after a stroke. AIM: The aim of the present study was to describe HRQoL in persons with long-term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status. DESIGN: This study has a design combining qualitative and quantitative methods. METHODS: Forty three participants suffering from long-term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self-report questionnaires, SF-36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used. RESULTS: The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF-36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF-36. The men had more decreased vitality than the women. CONCLUSION: The results show, that the participants in this study have a lower HRQoL due to their long-term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care. RELEVANCE TO CLINICAL PRACTICE: Awareness and understanding of the patients' perceptions and transitions with regard to their life situation and suffering from long-term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.
|
|
| 45. |
- Widar, Marita, 1943-
(författare)
-
Living with Long-Term Pain after a Stroke
- 2003
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this thesis was to classify and describe long-term pain two years after a stroke and to describe the experiences of pain, and the consequences it has on the persons’ lives. The studies were conducted from a multidimensional perspective on pain, combining quantitative and qualitative methods. Three types of long-term pain were classified and described among the 43 participants included, aged 33-82 years. These were central post-stroke pain, nociceptive, mainly shoulder pain, and tension-type headache. Pain onset, within one to six months in most of the cases was after discharge from the hospital. Continuous pain or pain almost every day was reported by nearly two-thirds. The pain was mostly described as troublesome, annoying and tiring in all pain groups. The rating of pain intensity revealed individual differences among the participants within the pain groups. In addition to long-term pain, the participants suffered several impairments and nearly half of them were dependent on others, and two-thirds on assistive devices. Several coping strategies were described, most often problem-focused. Their health-related quality of life was decreased, mostly related to their long-term pain and physical impairments. Their experiences of caring revealed the need of improvements in knowledge about longterm pain, attention and understanding among the professionals, and continuity in the contacts.
|
|
| 46. |
- Wilhelmsson, Susan, et al.
(författare)
-
Opinions about district nurses prescribing
- 2001
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 15:4, s. 326-330
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the opinions of district nurses (DNs) and general practitioners (GPs) about nurse prescribing in Sweden in order to elucidate similarities and differences, and relate different opinions to background and psychosocial working factors. In a questionnaire about psychosocial working conditions, seven statements about DNs prescribing were included. The questionnaire was sent to 554 DNs and 566 GPs with a participant rate of 83%. On all items as well as on the total score DNs rated more positively compared with GPs. Amongst the DNs a positive opinion was related to a traditional primary care organization, age < 50, good social support at work, and high workload. A positive opinion amongst GPs was associated with working in a traditional primary care organization, being male GP, and a good social support at work. In a multiple regression analysis, occupation and organization were independently associated with the total score. The result shows a strong professional solidarity amongst GPs and seems to be based on concern about the profession rather than patient care.
|
|
| 47. |
- Wissing, Ulla, 1945-, et al.
(författare)
-
A follow-up study of ulcer healing, nutrition, and life-situation in elderly patients with leg ulcer
- 2001
-
Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 5:1, s. 37-42
-
Tidskriftsartikel (refereegranskat)abstract
- This study was undertaken in order to follow up ulcer healing, ulcer recurrence, nutritional status and life-situation in elderly patients with leg ulcers. Of 70 patients assessed previously in 1996, 43 (61%) were still alive in 2000 and, of these, 38 (88%) participated in the follow-up. Rate of healing, recurrence and amputation were obtained from medical records and interviews with the patients. The Mini Nutritional Assessment (MNA) was used to assess their nutritional status and the Philadelphia Geriatric Center Multilevel Assessment Instrument was used for assessment of their life-situation. Nineteen patients (50%), mean age 82+/-4.6 years, had healed ulcers. Two (5%) patients, mean age 86+/-2.8, had required amputation and had no ulceration after surgery. Seventeen patients (45%), mean age 80.3+/-6 years, had open ulcers, six had their original ulcers still unhealed, and 11 had open recurrent ulcers. Decreased mean MNA scores, as well as decreased mean scores in ADL and mobility, were seen over time in patients with open ulcers but not in those who were healed. Patients with healed ulcers had significantly higher mean scores in social interaction than those with open ulcers and significantly increased mean scores in environmental quality over time. The results indicate that nutrition and the life-situation might be related to leg ulcer healing. The nutritional situation and the whole life-situation should be observed and taken into consideration when care is planned. Additional research is needed to increase the understanding of the relationship between nutrition, life-situation and ulcer healing.
|
|
| 48. |
- Wissing, Ulla, 1945-, et al.
(författare)
-
Can individualised nutritional support improve healing in therapy-resistant leg ulcers?
- 2002
-
Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 11:1, s. 15-20
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study investigated whether an individually designed programme of nutritional support can improve healing in otherwise therapy-resistant venous leg ulcers. METHOD: Six primary health-care patients, aged between 79 and 93 years, with venous ulcers that had been open for one year or more (range: 1.5-8 years) were recruited into the study. The patients were asked to follow an individualised diet plan which included the use of liquid dietary supplements. Ulcer area, anthropometric and biochemical variables, and energy and nutrient intake were assessed before intervention and then regularly for nine months.RESULTS: At nine months ulcer healing had occurred in two patients, of whom one had had ulcers on both legs. In a third patient the ulceration on one leg had healed and that on the other leg had almost healed. In a fourth patient, the ulcer area reduced by approximately 90%.CONCLUSION: The use of nutritional support might have assisted the wound healing in these patients. Although the relationship between nutritional supplementation and wound healing is not well defined, an appropriate nutritional plan is recommended if undernourishment is suspected and leg ulcers are not healing.
|
|
| 49. |
- Wissing, Ulla, 1945-, et al.
(författare)
-
Life situation and function in elderly people with and without leg ulcers
- 2002
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 16:1, s. 59-65
-
Tidskriftsartikel (refereegranskat)abstract
- The majority of elderly patients with leg ulcers live at home and receive treatment for their ulcers within the primary health care system. Little is known about the patients' ability or behaviour in the life situation and how well they manage their daily life at home. The Philadelphia Geriatric Center Multilevel Assessment Instrument (PGC MAI) was used to assess and compare the life situation in 70 patients (mean age 79 +/- 6.5 years) with leg ulcers and in 74 elderly persons (mean age 80 +/- 5.7 years) without leg ulcers. The patients with leg ulcers had significantly lower mean values in the domains of physical health, activity of daily living (ADL), cognition, time use and social behaviour, personal adjustment and environmental quality than those without ulcers. Sixty-three percent of the patients reported ulcer-related pain, and all of them were dependent on health care personnel for dressing changes. This may indicate that the life situation among elderly persons with leg ulcers is not so good as compared with that of elderly persons without ulcers and that patients with leg ulcers are more vulnerable than elderly people of the same age.
|
|
| 50. |
- Wissing, Ulla, 1945-, et al.
(författare)
-
Meal patterns and meal quality in patients with leg ulcers
- 2000
-
Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 13:1, s. 3-12
-
Tidskriftsartikel (refereegranskat)abstract
- Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers.Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes.Results Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients.Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.
|
|
