| 1. |
|
|
| 2. |
|
|
| 3. |
- Wilde, B., et al.
(författare)
-
Quality of care from a patient perspective : A grounded theory study
- 1992
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 7:2, s. 113-120
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to develop a theoretical understanding of quality of care from a patient perspective, using a grounded theory approach. Thirty-five interviews were conducted with a sample of 20 adult hospitalized patients (mean age: 60 years) in a clinic for infectious diseases. Data were analysed according to the constant comparative method. A model was formulated according to which quality of care can be understood in the light of two conditions, the resource structure of the care organization and the patient's preferences. The resource structure of the care organization consists of person-related and physical- and administrative environmental qualities. The patient's preferences have a rational and a human aspect. Within this framework, patients' perceptions of quality of care may be considered from four dimensions: the medical-technical competence of the caregivers; the physical-technical conditions of the care organization; the degree of identity-orientation in the attitudes and actions of the caregivers and the socio-cultural atmosphere of the care organization. The model is discussed in relation to existing theories in the field.
|
|
| 4. |
- Wilde, B., et al.
(författare)
-
Quality of care from the patient's perspective : Development of a patient centered questionnaire based on a grounded theory model
- 1994
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 8:1, s. 39-48
-
Tidskriftsartikel (refereegranskat)abstract
- In a previous study (Wilde et al. 1993), we developed a model of quality of care from a patient perspective using a grounded theory approach. The aim of the present study was to derive an instrument from this model. A questionnaire, Quality from Patients' Perspective (QPP), was developed which consisted of 56 items. Each item was evaluated in two ways by the respondent; assessment of perceived reality and evaluation of subjective importance (Likert scales). A personal quality of care index was computed on the basis of the relationship between these two scores. The QPP was tested on two samples, patients with infectious diseases (n = 147, mean age: 60 years) and nursing students (n = 103, mean age: 27 years). Patient's scores were factor analysed (principal factoring with oblique rotation) and 17 factors were extracted. Subgroups of patients were compared and correlations were computed between factor scores and self-rated health and well-being. Students also responded to a short form of the QPP (41 items) and personality scales. Correlations between these sets of variables were computed. The QPP was discussed in relation to existing scales.
|
|
| 5. |
- Wilde-Larsson, Bodil, et al.
(författare)
-
Begreppet vårdkvalitet
- 1994
-
Ingår i: I G. Udén (Red.), Kvalitets-säkring inom omvårdnad: Olika perspektiv (sid 37-46). - Lund : Studentlitteratur. ; , s. 37-46
-
Bokkapitel (refereegranskat)
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Hall-Lord, M-L., et al.
(författare)
-
Elderly patients' experiences of pain and distress in intensive care : A grounded theory study
- 1994
-
Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 10:2, s. 133-141
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to develop a theoretical understanding of elderly patients' experiences of pain and distress in intensive care, using a grounded theory approach. 18 patients, 7 women and 11 men, were interviewed and observed in an intensive care unit (ICU). Their average age was 76.5, varying from 70–85. A model was generated from data, according to which elderly patients' experiences of pain and distress in intensive care can be described as four interrelated aspects: a sensory, an intellectual, an emotional, and an existential dimension. 16 categories form the four dimensions. The categories, in turn, are grounded in a number of interview and observational data. The sensory dimension is formed by the categories physical pain, physical discomfort, fatigue, and breathing problems, and the intellectual dimension by the categories not knowing, difficulty in expressing oneself/not being understood and confused perception of reality. The categories in the emotional dimension are worry, fear, resignation, bitterness, anger/irritation and dependency. Finally, the existential dimension is formed by the categories despair, threat to life and death acceptance. The categories within the four dimensions may be separate, but often they interact and influence each other in various ways. The model is discussed in relation to existing models and definitions of pain, where the intellectual and existential dimensions in particular have not been emphasized in a similar way.
|
|
| 11. |
|
|
| 12. |
- Johansson, I., et al.
(författare)
-
Evaluation of the prognostic value of the Health Assessment Form among patients clinically ready for discharge
- 1994
-
Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 2:2, s. 77-85
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to identify patterns of physical, psychological, and social conditions that may be of prognostic value when it comes to assessing continued care of patients clinically ready for discharge; a related aim was to evaluate instruments used for this identification, especially a Swedish version of the health assessment form. The sample consisted of 53 consecutive patients (mean age 82.8 years, SD = 6.6 years) All patients came from their own homes and were admitted to surgical and orthopaedic departments. Interviews were carried out on the day the patients were assessed as medically ready for discharge, and a second time 1 month later. The health assessment form measured the persons' social and environmental situation, health history, and functional health status, and another instrument measured the persons' sense of coherence. Few significant differences in functional health status were noted between persons who could return to their homes (n =25) and persons who were referred to institutions after discharge (n = 17). However, the persons being referred to institutions showed less favourable scores within the areas of mood, sense of coherence, and worries about their home accommodation situation. When another sub-group was included (patients who died between the interview occasions; n = 8), significant differences were also noted in the health functions breathing, digestion, elimination, and body movement. Sense of coherence had a significant prognostic value for the continued care after discharge irrespective of whether the deceased patients were included or not.
|
|
| 13. |
- Larsson, Gerry, et al.
(författare)
-
A Stress Reduction Program Led by Health Care Personnel : Effects on health and well-being
- 1991
-
Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 1:2, s. 90-93
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to evaluate a stress control program which can be led by nurses. The program consisted of 10 three hour sessions conducted weekly. The meetings were devoted to theoretical lectures, discussions about personal stress experiences, and relaxation training. Participants read written material and practiced relaxation between sessions. Subjects in an intervention group showed significant changes in the following variables: fewer perceived daily hassles; more positive self-esteem; improved problem-focused coping capacity; improved eating and exercise habits; fewer self-reported psychological symptoms; improved subjective health status and well-being; lowered level of diastolic blood pressure; reduced waist-hip ratio; and an increase in actions taken against stressors. The results were discussed as promising but it was noted that the program seemed to attract a select group; women with academic training.
|
|
| 14. |
- Larsson, Gerry, et al.
(författare)
-
Appraisal and coping processes immediately before ejection : A study of Australian and Swedish pilots
- 1990
-
Ingår i: Military Psychology. - : Routledge. - 0899-5605 .- 1532-7876. ; 2, s. 63-78
-
Tidskriftsartikel (refereegranskat)abstract
- This study focuses on appraisal and coping processes among military pilots during ejection episodes. A total of 49 ejection episodes were reported by 24 pilots from the Royal Australian Air Force (RAAF) and 24 pilots from the Swedish Air Force (SAF). Two clusters of coping strategies were identified- instrumental self-management and emotional self-management-and both forms of coping were clearly related to effective problem solving. The emotional self-management strategies suggest an effective block of disturbing thoughts and emotions. Good performance was associated with challenge appraisals and considerable use of instrumental self-management. Poor performance was associated with appraising the episodes as irrelevant or threatening. Ejections caused by technical malfunctions were handled more effectively psychologically than were ejections caused by human errors. Only minor differences were found between the Australian and Swedish samples.
|
|
| 15. |
- Larsson, Gerry, et al.
(författare)
-
Contributions of stress theory to the understanding of helping
- 1991
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 5:2, s. 79-85
-
Tidskriftsartikel (refereegranskat)abstract
- The paper is theoretical, patient centred, and focuses on the two following questions: (1) In what way might a stress theoretical approach further our understanding of how helping can affect somatic and psychological processes in patients, and (2) in what way might stress theory offer action oriented guidelines for those who offer help ? A stress model is outlined involving relationships between a patient's cognitive appraisal of a given care situation, his or her coping efforts, and emotional and physiological reactions. Several conditions, related to the patient and to the care giving situation, which might influence the patient's appraisal process are discussed. Possible short- and long-term effects of helping in the somatic and psychological domains are presented. Two examples of common care situations are analysed to show how stress theory may offer helpers an action oriented tool. The concept of participatory caring, implying not only patient involvement but actual power sharing between patients and health professionals, is discussed.
|
|
| 16. |
|
|
| 17. |
- Larsson, Gerry, et al.
(författare)
-
Daughters helping their elderly mothers : Impact of early attachment, daughter's trait anxiety, and helping interaction characteristics
- 1994
-
Ingår i: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397 .- 0907-2055. ; 3:3, s. 167-172
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to explore the relationships between early attachment between mother and daughter, the adult daughter's general anxiety level, and characteristics of the helping interaction between the adult daughter and her elderly mother on the one hand and the quality of this help on the other. One sample consisted of 46 Swedish women (mean age: 55 years) who acted as informal caregivers for their elderly mothers. A second sample consisted of 106 Swedish female nursing students (mean age: 27 years). The participants rated the quality of the practical, physical and psychosocial help they gave their elderly mothers (imagined helping activities in a predefined situation among the nursing students). Subjects also rated their mother's degree of caring and overprotection in childhood, their own trait anxiety, and various characteristics of their helping interactions. A high degree of motherly caring and a low degree of motherly overprotection in childhood covaried with a lower level of trait anxiety in the adult daughters. These conditions, in turn, covaried with mutual friendliness during the helping interactions. All these conditions covaried with high-quality psychosocial support. The quality of practical help and physical caring covaried with friendliness during the helping interactions only.
|
|
| 18. |
- Larsson, Gerry
(författare)
-
Emotionally supportive counselling for health care personnel led by social welfare officers : effects on well-being
- 1993
-
Ingår i: Scandinavian Journal of Social Welfare. - : Wiley. - 0907-2055. ; 2:1, s. 43-46
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evalute an emotionally supportive counselling program for health care personnel that can be led by social welfare officers. The program consisted of 1-hour sessions conducted every second week for 7 months. The meetings were devoted to talks about personal stress experiences related to patients and their relatives. Nurses and nursing aides (n= 51) in counselling groups showed significant changes in a favourable direction on the following variables: fewer perceived daily hassles; fewer self-reported physical and psychological symptoms; and improved subjective well-being. No effects were noted on sense of coherence and subjective physical health status. Interviews with program participants, the group leaders (social welfare officers), and their supervisor (a psychotherapist) indicated how the counselling program may be affected by the personality and competence of the group leader, the working conditions of the wards in general and the attitudes of the head nurse in particular. The results were discussed as promising.
|
|
| 19. |
|
|
| 20. |
- Larsson, Gerry
(författare)
-
Health inequalities in Europe
- 1991
-
Ingår i: WHO, Challenges for health promotion. - Toronto, Canada : World Health Organization.
-
Bokkapitel (refereegranskat)
|
|
| 21. |
- Larsson, Gerry
(författare)
-
Hjälp till hjälparna
- 1991
-
Ingår i: Människor och olyckor. - Stockholm : Folk och försvar. - 9186862022 ; , s. 69-75
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
- Larsson, Gerry, et al.
(författare)
-
Linen in the hospital bed : Effects on patients' well-being
- 1991
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 16:8, s. 1004-1008
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to determine if using linen in hospital beds affects patients' well-being An experimental group consisting of 52 patients (mean age 64 4 years) at a medical ward used linen in the bottom sheet, the protective sheet, the pillow-case and the patient gown for 4 weeks A control group consisting of 40 patients (mean age 67 5 years) at the same ward was observed for 4 weeks using the conventional material (cotton, cotton/polyester) Marginal positive effects on patients' well-being were noted when linen was used It was discussed that the relative importance of the bed material to patients' well-being may be low, compared to medical treatment, nursing, etc Given the high cost of linen, about 15 times more than the conventional material, it was suggested that the health care system should refrain from large-scale use of linen in hospital beds
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
- Larsson, Gerry, et al.
(författare)
-
Patient-nurse interactions : relationships between person characteristics, empathy, content of communication, and patients' emotional reactions
- 1990
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 4:3, s. 129-135
-
Tidskriftsartikel (refereegranskat)abstract
- Relationships between antecedent person variables (sex and age), empathic understanding, content of communication, and patients' emotional reactions were studied in 3200 patient-assistant nurse dyadic interactions. The sample consisted of 32 psychiatric patients (20 males and 12 females, mean age: 61 years) and eight female assistant nurses at a nursing-home in Sweden. Four assistant nurses were younger (25 years old or less) and four were older (45 years old or more). All interactions were regular morning meetings at which the patient's activity plans for the day were discussed. These meetings were held in each patient's private room, and lasted for about 15 min. High empathic understanding on part of the helper covaried with more communication of "everyday character" and communication dealing with "personal and emotional qualities", with less communication dealing with "facts and practical issues", and with a more cheerful emotional state among the patients during the encounters. Male patients were more cheerful during encounters with younger assistant nurses while female patients were more cheerful when interacting with older assistant nurses. Helpers with higher scores on empathic understanding seemed to have a higher awareness of relational history.
|
|
| 28. |
- Larsson, Gerry, et al.
(författare)
-
Personality development in nursing education : A Swedish study
- 1993
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 7:2, s. 79-83
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to explore personality development during nursing education. The sample consisted of 122 Swedish nursing students. Ninety-three per cent of the students were female and the mean age at the beginning of the nursing education (which lasts for two years) was 27.6 years. Personality inventories were administered at the beginning and end of the education. The post-education assessment rendered several statistically significant differences of means. Compared with the pre-education assessment, the nursing students reported a more positive profession-oriented self-perception at the end of the education, a stronger ideal, real, and mirror identity, a reduced trait anxiety, stronger needs for achievement, exhibition, autonomy, dominance, and nurturance, and a weaker abasement need. The practical significance of the results was discussed.
|
|
| 29. |
- Larsson, Gerry
(författare)
-
Preventing health problems among the elderly
- 1992
-
Ingår i: Health policy development for disadvantaged groups. - Oslo : Scandinavian University Press. ; , s. 59-76
-
Bokkapitel (refereegranskat)
|
|
| 30. |
|
|
| 31. |
|
|
| 32. |
- Larsson, Gerry, et al.
(författare)
-
Relaxation training as an integral part of caring activities for cancer patients : Effects on well-being
- 1992
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 6:3, s. 179-185
-
Tidskriftsartikel (refereegranskat)abstract
- The purposes of this study were twofold. The first was to investigate if relaxation training conducted by nurses as an integral part of their caring activities affected breast cancer patients' experiences of radiotherapy sessions as well as their general wellbeing. Second was to evaluate a pedagogical model for large scale application of relaxation training as an integral part of caring. The sample consisted of 64 consecutive outpatients with breast cancer at a Swedish oncology clinic, receiving their first radiotherapy treatment course following surgery. Every second patient was assigned to an experimental group (n= 32, mean age: 59.5 years) and every other second patient was assigned to a control group (n= 32, mean age: 60.0 years). The programme resulted in the following general effects: fewer perceived daily hassles and a more cheeful overall mood state. The following treatment situation specific effects were noted: programme participants appraised the treatment sessions as successively more benign-positive and less threatening. They also reported more perceived muscular tensions during treatment sessions. Most goals concerning the routinization of the pedagogical model were reached.
|
|
| 33. |
- Larsson, Gerry, et al.
(författare)
-
Routinization of stress control programs in organizations : A study of Swedish teachers
- 1990
-
Ingår i: Health Promotion International. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 5:4, s. 269-278
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to design and evaluate a stress control programme which can be carried out by employees in work organizations without direct assistance from specialists. The target group was Swedish high school teachers. Using a two-step model, so called health teams at six high schools were trained by a specialist. A health team is usually comprised of three to five voluntarily recruited persons, generally a school nurse and a few teachers. After this training, the health teams arranged voluntary circles with their colleagues at their respective schools. A treatment group of teachers (n = 56) followed the programme. Programme participants learned relaxation, discussed various aspects of stress, and were equipped with target group adapted training materials. The circles met five to eight times at 2–3 week intervals, 1–3 h per session; all sessions were held during the subjects' spare time. Compared with a control group of teachers (n = 33), the programme participants reported significantly different mean responses in the following respects at a post-training assessment: (i) fewer perceived stressors in the work situation; (ii) more use of emotion-focused coping strategies such as distancing, positive reappraisal, seeking social-emotional support, and self-control, (iii) improved health behaviour (drinking, exercise, nutrition, relaxation and smoking); (iv) fewer physical and emotional stress reactions; (v) a more cheerful overall mood state and a higher sense of well-being and work satisfaction; (vi) less work-related ill health; (vii) a lower intensity of reaction in response to daily hassles; and (viii) an increase in actions taken against stressors-individually and collectively-at work and in the private situation. It was suggested that routinization of stress control programmes in work organizations requires the following: the presence of goal-oriented and entrepreneurial intraorganizational change agents to lead the programmes, the presence of a specialist to train and supervise the local change agents, the availability of comprehensive and target group adapted (raining aids, and formal implementation of the programme in the organizational structure.
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
- Lindberg, G., et al.
(författare)
-
Serum lipids and mood in working men and women in Sweden
- 1994
-
Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 48, s. 360-363
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVE--To explore the link between serum cholesterol and suicide by investigating the relation between serum lipids and depressive symptoms. DESIGN--This was a cross sectional study of the relation between serum cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides on the one hand and depressive symptoms as expressed in a questionnaire on the other. SETTING--An organisational development programme in industry with assistance from occupational health care. PARTICIPANTS--A total of 644 male and 261 female employees (mainly white-collar workers) participated. MAIN RESULTS--Total cholesterol and LDL cholesterol values were lower in those men who, sometimes, often, or very often, had experienced low mood or glumness during the past month compared with those who had not. Serum triglyceride concentrations did not differ between the groups. In women, however, the serum triglyceride value, but not the total cholesterol or LDL cholesterol, was lower in those who reported low mood, depression, or anxiety during the past six months. CONCLUSIONS--Decreasing appetite as a consequence of depression in men would probably lead to both decreasing cholesterol and triglyceride concentrations. Thus, these data indicate the presence of some other explanation for the relation between the level of LDL cholesterol and depressive symptoms in men.
|
|
| 37. |
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
- Starrin, B., et al.
(författare)
-
A review and critique of psychological approaches to the burn-out phenomenon
- 1990
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 4:2, s. 83-91
-
Tidskriftsartikel (refereegranskat)abstract
- In the 70s the concept burn-out appeared in psychological literature on the helping professions. The concept has since then been ascribed several meanings, and critical voices have been raised against the lack of clarity and consensus in the definitions. The aim of this article was to critically examine the thinking on the concept of burn-out. The helping professionals--nurses, welfare officers, psychologists, medical doctors, etc.--have expanded rapidly since the 60s. It is stated that the issues on which burn-out researchers focus deserve the attention of social scientists in general. The major limitation in the literature on burn-out is that there is little analysis of the role of society and social conditions in producing the phenomenon. It is suggested that sociological analyses may have a contribution to make here.
|
|
| 42. |
- Starrin, B., et al.
(författare)
-
Community types, socio-economic structure, and IHD-mortality : A contextual analysis based on Swedish aggregate data
- 1993
-
Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 36:2, s. 1569-1578
-
Tidskriftsartikel (refereegranskat)abstract
- The importance of social and economic conditions for people's health has been receiving more and more attention during the past 10 years. The question that is raised in this study is if the link between socio-economic factors in society, seen in the more composite sense, and cardiovascular mortality are dependent on different socio-geographical contexts? Two contextual situations are used; one concerns the dimension which places the analysis in an urban-rural context and the other, the dimension placing it in a context which describes people's forms of work.The study is based on aggregated data on the social and economic conditions for men in the municipalities in Sweden for the period 1983–1987.The results show that the link between various dimensions of the socio-economic structure and IHD rates is more pronounced in the urban and white-collar community types than in rural and blue-collar communities. In the community type where the links are more pronounced the IHD rate is lower and in the type where the links are less pronounced the IHD rate is higher.The results are discussed in relation to different theoretical perspectives.
|
|
| 43. |
|
|
| 44. |
|
|
| 45. |
- Starrin, B., et al.
(författare)
-
Structural Changes, Ill Health, and Mortality in Sweden, 1963-1983 : A Macroaggregated Study
- 1990
-
Ingår i: International Journal of Health Services. - 0020-7314 .- 1541-4469. ; 20:1, s. 27-42
-
Tidskriftsartikel (refereegranskat)abstract
- An exploratory time series analysis was performed on selected indicators of structural change, health behavior, and ill health in Sweden in the years 1963-1983. Both synchronic (nonlagged) and asynchronic (lagged) analyses were made. The synchronic analysis of variations in the suicide rate reveals two main contributory factors: level of employment and overtime work. For cardiovascular mortality in men, the synchronic and the two-year time lagged analyses reveal that the sale of alcohol and, to a certain extent, the length of the period of unemployment play a major role. In an analysis with a three-year time lag, only one significant factor for both men and women is revealed, namely the level of employment. In the synchronic analysis of cirrhosis mortality in men, the sale of alcohol plays a dominant role. The results of the synchronic analysis of the variations in sick leave show a similar pattern for both men and women. In both cases, the sale of alcohol is positively associated and the proportion of unemployed industrial workers negatively associated with sick leave. The results give rise to a number of questions. For example, how should these findings be interpreted and how should they be related to existing knowledge about the links between business cycles and changes in the health of the population? The answers to such questions are of importance both from a scientific viewpoint and with regard to health policy. We argue that the answers require further studies of the characteristics of the periods in the business cycle and of how these periods affect people's lives, living conditions, and behavioral patterns in general.
|
|
