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| 2. |
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| 3. |
- Larsson, Gerry, et al.
(författare)
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Quality of care : Relationships between the perceptions of elderly home care users and their caregivers
- 1998
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Ingår i: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397 .- 0907-2055. ; 7:3, s. 252-258
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the relationship between elderly home care users', and their caregivers', perceptions of the quality of care. The sample consisted of 151 matched elderly home care user-caregiver pairs in a Swedish municipality. The elderly home care users were interviewed and their caregivers filled in questionnaires using an established, theory-based instrument. Results showed that the elderly home care users evaluated most care components more favourably than their caregivers. On ratings of the various care components' subjective importance to the caretaker, the caregivers consistently scored higher than the elderly home care users. Within the subset of elderly home care users who received help at least twice a day, there were greater similarities between caregivers and caretakers. The results are related to comparable research and discussed in terms of caregivers' needs to legitimize their professional identity and actions.
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| 4. |
- Larsson, Gerry, et al.
(författare)
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Refinement of the questionnaire 'quality of care from the patient's perspective' using structural equation modelling
- 1998
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712 .- 0000-0000. ; 12:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- In 1994, the questionnaire 'Quality of Care from the Patient's Perspective' (QPP) was developed using a conventional factor analytical approach (Wilde et al. 1994). The items and conceptual framework of this questionnaire were derived from a theoretical model, which, in turn, was developed from qualitative patient interviews, using a grounded theory method of analysis (Wilde et al. 1993). The aims of this study were to develop further the dimensionality of the QPP using structural equation modelling combined with advances in factor analysis modelling, and to refine the instrument. This comparatively new methodology extracts more information out of questionnaire data and is considered to be superior to traditional scaling methods. The sample consisted of 611 somatic inpatients from four departments at a Swedish hospital. Data collected with the QPP were explored with the new tool tracing the dimensions postulated in the theoretical model underlying the QPP. A nested factor model was developed fulfilling statistical criteria for adjustment between model and data. The model consists of a general factor and 16 subordinate factors. Most of the original QPP scales were reproduced with the new statistical technique. However, some content changes were made which appear to bring the QPP scales closer to patients' meaning representations of the area. Some changes were also made to the response format, changes which appear to strengthen the psychometric properties of the instrument. The refined QPP will hopefully contribute to a more differentiated picture of quality of care when applied in the field. All scales, items, and response formats of the revised QPP are presented in an appendix.
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| 5. |
- Larsson, Gerry, et al.
(författare)
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Sörmlandskuppen : kartläggning av vårdkvalitet vid syncentralen vid Mälarsjukhuset i Eskilstuna 1998
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning gjordes 1998 vid syncentralen, Mälarsjukhuset i Eskilstuna, av patienternas och personalens upplevelse av vårdens kvalitet. Personalens upplevelser av psykosocial arbetsmiljö och av egna stressrelaterade symptom kartlades också. Deltagare var 115 patienter (55 % svarsfrekvens) och 8 anställda (100 % svarsfrekvens). Flertalet patienter, liksom personalen, är tillfredsställda med huvuddelen av vården. Många, såväl patienter som personal, är mindre tillfredsställda med att patienterna inte kan delta i beslut om rehabilitering, att kontinuiteten i habilitering/rehabilitering brister, och att de inte får information om övriga tillgängliga habiliterings/rehabiliteringsresurser. Ett åtgärdsförslag presenteras.
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| 6. |
- Larsson, Gerry, et al.
(författare)
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Sörmlandskuppen : kartläggning av vårdkvalitet vid ortopedtekniska avdelningen Aktiv ortopedteknik Sörmland AB, vid Mälarsjukhuset i Eskilstuna 1998
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning gjordes 1998 vid ortopedtekniska avdelningen Aktiv ortopedteknik Södermanland AB, vid Mälarsjukhuset i Eskilstuna, av patienternas och personalens upplevelse av vårdens kvalitet. Personalens upplevelser av psykosocial arbetsmiljö och av egna stressrelaterade symptom kartlades också. Deltagarna var 115 patienter (57 % svarsfrekvens) och 7 anställda (54 % svarsfrekvens). Flertalet patienter, liksom personalen, är tillfredsställda med huvuddelen av vården. Många av såväl patienter som personal är dock mindre tillfredsställda med väntetiden, med att telefonframkomligheten är för låg och med att inte personalen har efterfrågat hur hjälpmedlet fungerat. Ett åtgärdsförslag presenteras som handlar om uppläggningen av enskilda patienters habilitering/rehabilitering.
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| 7. |
- Larsson, Gerry, et al.
(författare)
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Sörmlandskuppen : kartläggning av vårdkvalitet vid hörcentralen och pedagogiska hörselvården vid Mälarsjukhuset i Eskilstuna 1998
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning gjordes 1998 vid hörcentralen och pedagogiska hörselvården vid Mälarsjukhuset i Eskilstuna av patienternas och personalens upplevelse av vårdens kvalitet. Personalens upplevelser av den psykosociala arbetsmiljön och av egna stressrelaterade symptom kartlades också. Deltagarna var 152 patienter (64 % svarsfrekvens) och 19 anställda (100 % svarsfrekvens). Flertalet patienter, liksom personalen, är tillfredsställda med huvuddelen av vården. Många, såväl patienter som personal, är mindre tillfredsställda med telefonframkomligheten. Väntetiden för fortsatt hjälp efter det inledande hörseltestet är för lång. Ett åtgärdsförslag presenteras som handlar om uppläggningen av enskilda patienters habilitering/rehabilitering.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
- Larsson, Gerry, et al.
(författare)
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Är patienten nöjd?
- 1995
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Ingår i: Läkartidningen, 92, 1587-1590. ; 92, s. 1587-1590
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Tidskriftsartikel (refereegranskat)
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| 14. |
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| 15. |
- Wilde, B., et al.
(författare)
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Quality of care from the elderly person's perspective : Subjective importance and perceived reality
- 1995
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Ingår i: Aging. - 1945-4589. ; 7:2, s. 140-149
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to carry out a theoretically-based survey of elderly persons' perceptions of quality of care, in terms of their evaluations of actual care conditions, as well as the subjective importance they ascribe to these. The sample consisted of 428 elderly (> or = 60 years) persons, in four different care environments: a geriatric department (N = 51); persons receiving home nursing (N = 111); nursing homes (N = 111); and service homes (N = 154) in two Swedish cities. Data were collected by way of personal interviews, structured from the questionnaire, Quality from the Patients' Perspective (QPP). The QPP is theory-based and consists of 40 items covering 17 factors. Each item was evaluated in two ways by the respondent: assessment of perceived reality, and evaluation of subjective importance (Likert scales). The results show that personal characteristics, such as age, sex, and self-rated health, had a limited effect on reports of what were regarded as highly important care characteristics, as well as on ratings of actual care conditions. Psychological well-being was strongly related to perceived reality ratings: a favorable well-being covaried with favorable ratings and vice versa. Considerable differences were noted in both types of ratings when the four types of care environments were compared. On the subjective importance scales, persons living in service homes reported lower scores, particularly on the scales designed to measure the medical-technical competence of the caregivers. On the perceived reality scales, the participants in service homes and the geriatric department scored lower.
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| 16. |
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| 17. |
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| 18. |
- Wilde Larsson, B., et al.
(författare)
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Patients' perceptions of quality of care, self-rated functional ability, and health one year after total knee arthroplasty : a follow-up of forty-one patients
- 1999
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Ingår i: Journal of Orthopaedic Nursing. - 1361-3111 .- 1873-4839. ; 3:1, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the relationships between two care conditions of patients reveiving total knee arthroplastic surgery: firstly, patients' perceptions of the quality of care and their length of stay in hospital; secondly different indicators of health outcomes — self-rated functional ability and health. The sample consisted of 41 patients (median age 71 years) undergoing total knee arthroplastic surgery during 1995 at the Central Hospital of Karlstad, Sweden. Data were collected from the medical records and by means of telephone interviews and a postal questionnaire. Results show that functional ability (walking ability and need of walking aids) covaried with favourable patient perceptions of the quality of care. Favourable functional ability was also associated with a low need of walking aids before surgery. Self-rated health I year after surgery was not related to any of the measured care conditions or the need of walking aids before surgery.
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| 19. |
- Wilde Larsson, B., et al.
(författare)
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Patients' views on quality of care : Do they merely reflect their sense of coherence
- 1999
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 30:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore the relationship between patients’ perceptions of the quality of care and their sense of coherence. The sample consisted of 782 Swedish in-patients at a gynaecological, a medical, an orthopaedic, and a surgical department. The median age was 59 years and 55% of the patients were women. Data were collected using the Quality from the Patient’s Perspective (QPP) Questionnaire and the Sense of Coherence Questionnaire. The QPP consists of 61 items designed to measure the following four quality dimensions: the medical-technical competence and the degree of identity-orientation in the actions of the caregivers, the physical-technical conditions and the socio-cultural atmosphere of the care organization. Each question is posed in two different ways in the QPP; one measures perceived reality of the item in question and one the subjective importance the patient ascribes to it. Results showed that patients’ ratings of perceived reality covaried systematically with their sense of coherence. This was particularly the case on questions rated by experts to be more abstract and emotionally loaded. Patients’ ratings of the subjective importance of the items were weakly related to their sense of coherence. The results are discussed in terms of negative affectivity and culturally shared ideals regarding quality of care.
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| 20. |
- Wilde Larsson, B., et al.
(författare)
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Patients' views on quality of care : A comparison of men and women
- 1999
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 7:3, s. 133-139
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Tidskriftsartikel (refereegranskat)abstract
- Aim This study set out to explore gender differences among medical and surgical acute care inpatients regarding their perceptions of actual care conditions as well as their evaluation of the subjective importance of various care conditions.Background Firstly, the literature reports inconsistent findings regarding male and female patients’ views on care. Secondly, the instruments used in most previous research are not derived from a patient perspective.Methods The sample consisted of 831 patients (48% were women and 52% were men) at two Swedish hospitals. Data were collected using the questionnaire ‘Quality from the Patient’s Perspective’.Findings Male and female patients tended to evaluate the actual care received similarly. However, women tend to assign the different care aspects higher subjective importance.Conclusion More research is needed to illuminate the reasons why men and women hold these different values. Until these issues are better understood, there is no valid basis on a group (gender) level to give specific practical recommendations to nursing managers.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Andersson, Inger S
(författare)
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Utveckling av metoder för mätning av vårdkvalitet : Med inriktning mot omvårdnad
- 1995
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present thesis has its roots in the need to measure and evaluate quality of care, especially in times when resources allocated to health- and medical care are being limited. This is of concern for many groups in society, but perhaps mOst of all for patients, hospital staff and politicians.The main purpose of the thesis was to develop methods for measuring quality of care within nursing.The thesis has been organised in three main parts, the first of which deals with the principal concepts in this research,in addition to research and develop- ment in existing instruments for measuring quality of care. The second part contains the empirical study and its results. Finally, the third part deals with the development of variables for methods of measurement based on the empirical study: it also looks ahead, at visions and viewpoints governing future research and development work.Data collection was carried out by means of a thematic interview, and by measuring attitudes to quality of care on a modified attitude scale based on Osgood's semantic differential. The interview group comprised 128 people; 25 patients and 25 staff members at a local hospital, 25 patients and 27 staff members at a health centre, and 26 county council politicians. The interview material was analysed inductively using qualitative and quantitative content analysis. On analysing the three themes which dealt with the interviewees' perception of health, quality of life as a result of care received, the quality of selfcare as well as care goals, literature studies were added which dealt with the above-mentioned phenomena.The result of the interview study, and the literature studies included in the analysis phase, can be stated in brief, that the main focus in the perception of quality of care held by the patients, the staff and the politicians was on 1) the quality of the staff, with an emphasis on the characteristics and skills of the staff, 2) quality in implementing care, involving care measures of an affective nature and the quality of the patient- staff relationship, and 3) the patient-related quality of results, consisting of such changes in the patient's health status as a cure or a change in health; cognitively oriented results like better knowledge about one's condition; wellbeing as a result of care; satisfaction with the care and treatment provided, and with the staff.The result of the attitudes survey was that politicians were the most positive towards the quality of the care provided, while the personal at the health centre were the least positive. Of the various professional categories interviewed, physicians were the most positive. Other staff comprising paramedical groups were the least positive.Further groups of variables have been generated from the data collected and from the literature studies in order to extend the evaluation of the quality of nursing care. All of the variable groups developed in the present thesis have been named and grouped together in a system called the KISAAL system, after the initials of the author. The different groups of variables can be related to each other to facilitate a total assessment of the quality of nursing care, and its management.
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| 26. |
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| 27. |
- Edvardsson, B., et al.
(författare)
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Internal service quality and the psychosocial work environment : An empirical analysis of conceptual interrelatedness
- 1997
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Ingår i: Service Industries Journal. - : Informa UK Limited. - 0264-2069 .- 1743-9507. ; 17:2, s. 252-263
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Tidskriftsartikel (refereegranskat)abstract
- There is a need to integrate service quality concepts withconcepts from other research fields, such as the psychosocialwork environment, to help us better understand and create abasis for quality control in services. The main aim of this paperis to explore empirically the relationships between thepsychosocial work environment and internal service qualily. Weuse concepts and measures derived from psychosocial workenvironment theory and service quality theory respectively. Datawere collected from 555 employees in a Swedish computerservice company using questions from a Stress Profile as well as from a Quality Profile. All 52 items from the Stress Projile and20 items from the Quality Profile were entered into a factoranalysis. The main result of the study is not the exact outcome ofthe factor analysis per se, but rather the point that questionsderived from two different research fields appear to measuredifferent mental representations of work conditions. Clearly,interdependence exists between the psyclzosocial workenvironment and internal quality. It is quite concmon to ncap adrestructure service processes in order to improve internal qualityin an attempt to solve quality problems created by organisationalchanges. We suggest that it should be equally inportant to takenieasures to increase work satisfaction by improvingpsychosocial work conditions
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Hall-Lord, M-L., et al.
(författare)
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Chronic pain and distress among elderly in the community : Comparison of patients' experiences and enrolled nurses' assessments
- 1999
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Ingår i: Journal of Nursing Management. - 0966-0429 .- 1365-2834. ; 7:1, s. 45-54
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study compared elderly patients' reported experiences of pain and distress with enrolled nurses' assessments and related potential differences to patient and enrolled nurse characteristics.BACKGROUND: Many elderly suffer from chronic pain but few studies have focused on this group of patients.METHODS: Data were collected through personal interviews with 38 patients and questionnaires completed by 38 enrolled nurses.FINDINGS: Enrolled nurses underestimated patients' experiences of physical pain, physical discomfort, breathing problems, resignation, and dependency. Pain and distress were overestimated by enrolled nurses who had lower scores on three of the five personality scales used. In contrast, enrolled nurses who had higher scores on these personality scales tended to underestimate the patients' pain and distress.CONCLUSIONS: There is a need to develop staff training programmes in order to optimize the care for elderly patients with chronic pain in the community.
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| 32. |
- Hall-Lord, M-L., et al.
(författare)
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Chronic pain and distress in older people : A cluster analysis
- 1999
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 5:2, s. 78-85
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Tidskriftsartikel (refereegranskat)abstract
- Chronic pain represents a major health problem among older people. The aims of the present study were to: (i) identify various profiles of pain and distress experiences among older patients; and (ii) compare whether background variables, sense of coherence, functional ability and experiences of interventions aimed at reducing pain and distress varied among the patient profiles. Interviews were carried out with 42 older patients. A cluster analysis yielded three clusters, each representing a different profile of patients. Case illustrations are provided for each profile. There were no differences between the clusters, regarding intensity and duration of pain. One profile, with subjects of advanced age, showed a decreased functional ability and favourable scores in most of the categories of pain and distress. Another profile of patients showed favourable mean scores in all categories. The third cluster of patients showed unfavourable scores in most categories of pain and distress. There appears to be a need to treat the three groups of patients in different ways in the caring situation.
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| 33. |
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| 34. |
- Hall-Lord, M-L., et al.
(författare)
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Postoperative experiences of pain and distress in the elderly patients : An explorative study
- 1999
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 11, s. 73-82
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore postoperative experiences of pain and distress in elderly patients, as well as interventions aimed at reducing these conditions, on three occasions. The study group was composed of 100 patients who had undergone elective surgery in two orthopedic and two general surgical units. Of the 50 patients in the orthopedic units, 26 had undergone hip arthroplasty and 24 knee arthroplasty: of the 50 patients in the general surgical units, 23 had had breast cancer surgery, and 27 abdominal surgery. The patients were interviewed, using a structured interview format, on three occasions; at the ward on the first and second day after surgery, and by telephone about ten days after discharge from hospital. Within both the sensory and the emotional dimensions, logistic regression analyses showed that the dependent variables of pain and distress were significantly related above all to type of surgery and sense of coherence (SOC). In a cluster analysis, three meaningful clusters of patients were obtained. The patients in the different profiles showed variations in their experiences of pain and distress. The 12 patients with the least favorable scores had weaker SOC than the patients in the other profiles. It is concluded that type of surgery and psychological factors influenced patients' experiences of pain and distress after undergoing surgery. These experiences should be reduced by identifying risk patients, and improving assistance and support in the nursing ward, and also when patients have returned home.
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| 35. |
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| 36. |
- Johansson, Eva, et al.
(författare)
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A model for understanding stress and daily experiences among soldiers in peacekeeping operations
- 1998
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Ingår i: International Peacekeeping. - : Informa UK Limited. - 1353-3312 .- 1743-906X. ; 5:3, s. 124-141
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Tidskriftsartikel (refereegranskat)abstract
- This article is based on research that aimed to develop a deeper theoretical understanding of the UN peacekeeping soldiers’ experiences of their daily service, from their own perspective, using a grounded theory approach. Study participants were Swedish UN peacekeeping personnel who served in former Yugoslavia from Autumn 1993 to Autumn 1995. A model was developed, according to which UN peacekeeping soldiers’ experiences of their daily service are formed by the dynamic interplay between external influencing factors and internal peacekeeping force factors. The external factors comprise: the service environment including the parties to a dispute, the media and the soldier's private social network. Most of the soldiers’ responses concerning the environment were about low‐intensity stress and fear of losing control of their aggressiveness. The internal peacekeeping force factors include the recruitment principles, the preparatory training, leadership issues and personal characteristics of the individual soldiers. The model indicates that internal factors can be modified in ways that might make it possible to reduce the impact of the external factors. The generalizability of the model needs to be evaluated in future studies involving different kinds of peacekeeping missions.
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| 37. |
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| 38. |
- Kallenberg, K., et al.
(författare)
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Den svåra konsten att mäta hälsa
- 1999
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Ingår i: Psykologtidningen. - 0280-9702. ; 45:3, s. 4-7
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Tidskriftsartikel (refereegranskat)
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| 39. |
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| 40. |
- Kallenberg, K., et al.
(författare)
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View of life and health
- 1997
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Ingår i: Archive for the Psychology of Religion/ Archiv für Religionspsychologie. - 0084-6724 .- 1573-6121. ; 22:1, s. 237-249
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Tidskriftsartikel (refereegranskat)
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| 41. |
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| 42. |
- Larsson, Gerry, et al.
(författare)
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Conditions affecting experiences of the quality of psychological debriefings : Preliminary findings from a grounded theory study
- 1999
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Ingår i: International Journal of Emergency Mental Health. - 1522-4821. ; 1:2, s. 91-97
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to develop a theoretical understanding of conditions and mechanisms affecting experiences of the quality of emotional debriefings, using a grounded theory approach. Twenty interviews were conducted with experienced male debriefing leaders and participants in the Stockholm fire brigade and the Swedish armored United Nations battalions serving in Bosnia. Data were analyzed according to the constant comparative method. A model was formulated according to which the quality of debriefings is formed by the dynamic interplay between group and debriefing leader characteristics. The key group and debriefing leader quality is security. Furthermore, individual group member resourcefulness and vulnerability, together with the degree of knowledge and support from the management of the organization, also affect experiences of the quality of debriefings. The model is discussed in relation to existing thoughts on potentially favorable mechanisms.
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| 43. |
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| 44. |
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| 45. |
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| 46. |
- Larsson, Gerry, et al.
(författare)
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Dimensional analysis of sense of coherence using structural equation modelling
- 1999
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Ingår i: European Journal of Personality. - 0890-2070 .- 1099-0984. ; 13:1, s. 51-61
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Tidskriftsartikel (refereegranskat)abstract
- The sense of coherence (SOC) concept has been criticized on conceptual and psychometric grounds. The aim of this study was to develop the concept using structural equation modelling. The short 13-item version of the SOC questionnaire was used and data were collected from two different samples. Each sample consisted of about 2000 individuals, selected to be representative of the Swedish population. A model with a general factor and two subordinate specific factors yielded a satisfactory solution in both samples. The two factors were labelled Social Comprehension and Commitment and Unpleasant Emotions and Inner Tension respectively. It was concluded that the 13-item SOC scale could to a cel rain degree be regarded as a measure of negative affectivity and that the suggested model makes the SOC concept move theoretically coherent.
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| 47. |
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| 49. |
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| 50. |
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