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- Lundin Gurné, Frida, et al.
(författare)
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Striving to be in close proximity to the patient: An interpretive descriptive study of nursing practice from the perspectives of clinically experienced registered nurses
- 2021
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 28:2
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: ‘A practice pervaded by comprehensive responsibility’, ‘A practice that recognises a patient's unique needs’, ‘A practice based on multifaceted knowledge’ and ‘A practice that mediates between traditional values and changing demands’. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice.
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| 4. |
- Acuña Mora, Mariela, 1990, et al.
(författare)
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The longitudinal association between patient empowerment and patient-reported outcomes: What is the direction of effect?
- 2022
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:11
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Tidskriftsartikel (refereegranskat)abstract
- Theoretical literature and cross-sectional studies suggest empowerment is associated with other patient-reported outcomes (PROs). However, it is not known if patient empowerment is leading to improvements in other PROs or vice versa.The present study aimed to examine the direction of effects between patient empowerment and PROs in young persons with congenital heart disease (CHD).As part of the STEPSTONES-CHD trial, adolescents with CHD from seven pediatric cardiology centers in Sweden were included in a longitudinal observational study (n = 132). Data were collected when patients were 16 (T0), 17 (T1) and 18 ½ years old (T2). The Gothenburg Young Persons Empowerment Scale (GYPES) was used to measure patient empowerment. Random intercepts cross-lagged panel models between patient empowerment and PROs (communication skills; patient-reported health; quality of life; and transition readiness) were undertaken.We found a significant cross-lagged effect of transition readiness over patient empowerment between T1 and T2, signifying that a higher level of transition readiness predicted a higher level of patient empowerment. No other significant cross-lagged relationships were found.Feeling confident before the transition to adult care is necessary before young persons with CHD can feel in control to manage their health and their lives. Clinicians interested in improving patient empowerment during the transitional period should consider targeting transition readiness.
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| 5. |
- Acuña Mora, Mariela, 1990, et al.
(författare)
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The Scope of Research on Transfer and Transition in Young Persons With Chronic Conditions
- 2019
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Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X .- 1879-1972. ; 65:5, s. 581-589
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To determine the amount, type, and evidence level of published literature on transfer and/or transition of young people with chronic conditions (CCs) and to describe the characteristics of such studies. Methods Databases including PubMed, CINAHL, Web of Science, and Scopus were searched for publications in English, French, Spanish, Dutch, or Swedish. Included publications were related to transfer and/or transition of young persons (10–25 years) with a CC. Grey literature was excluded. Region and country where the study was performed, type of study design, study population (i.e., type of CC, sample size, group), and data collection methods were extracted from the studies. Results We included 952 publications for data analysis, of which 790 were quantitative, 128 qualitative, and 34 multimethods or mixed methods studies. Only seven studies were experimental designs, and the majority (n = 341) were categorized as expert opinion or narrative reviews. Endocrinology and neurology were the most common medical specialties involved in the studies, and young persons were the most represented group, while health-care providers were involved the least. Conclusions The majority of publications are categorized at the lowest evidence level. Furthermore, evidence is limited to a certain group of medical specialties.
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- Bratt, Ewa-Lena, 1970, et al.
(författare)
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Effectiveness of the STEPSTONES Transition Program for Adolescents With Congenital Heart Disease : A Randomized Controlled Trial
- 2023
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Ingår i: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adolescents with congenital heart disease transition from childhood to adulthood and transfer from pediatric-oriented to adult-oriented care. High-level empirical evidence on the effectiveness of transitional care is scarce. This study investigated the empowering effect (primary outcome) of a structured person-centered transition program for adolescents with congenital heart disease and studied its effectiveness on transition readiness, patient-reported health, quality of life, health behaviors, disease-related knowledge, and parental outcomes e.g., parental uncertainty, readiness for transition as perceived by the parents (secondary outcomes). Methods: The STEPSTONES-trial comprised a hybrid experimental design whereby a randomized controlled trial was embedded in a longitudinal observational study. The trial was conducted in seven centers in Sweden. Two centers were allocated to the randomized controlled trial-arm, randomizing participants to intervention or control group. The other five centers were intervention-naïve centers and served as contamination check control group. Outcomes were measured at the age of 16 years (baseline), 17 years, and 18.5 years. Results: The change in empowerment from 16 years to 18.5 years differed significantly between the intervention group and control group (mean difference = 3.44; 95% confidence interval = 0.27–6.65; p = .036) in favor of intervention group. For the secondary outcomes, significant differences in change over time were found in parental involvement (p = .008), disease-related knowledge (p = .0002), and satisfaction with physical appearance (p = .039). No differences in primary or secondary outcomes were detected between the control group and contamination check control group, indicating that there was no contamination in the control group. Discussion: The STEPSTONES transition program was effective in increasing patient empowerment, reducing parental involvement, improving satisfaction with physical appearance, and increasing disease-related knowledge. © 2023 Society for Adolescent Health and Medicine
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- Grahn, Oskar, et al.
(författare)
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Postoperative non-steroidal anti-inflammatory drug use and oncological outcomes of rectal cancer
- 2021
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Ingår i: BJS open. - : Oxford University Press (OUP). - 2474-9842. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are known to suppress the inflammatory response after surgery and are often used for pain control. This study aimed to investigate NSAID use after radical surgical resection for rectal cancer and long-term oncological outcomes. Methods: A cohort of patients who underwent anterior resection for rectal cancer between 2007 and 2013 in 15 hospitals in Sweden was investigated retrospectively. Data were obtained from the Swedish Colorectal Cancer Registry and medical records; follow-up was undertaken until July 2019. Patients who received NSAID treatment for at least 2 days after surgery were compared with controls who did not, and the primary outcome was recurrence-free survival. Cox regression modelling with confounder adjustment, propensity score matching, and an instrumental variables approach were used; missing data were handled by multiple imputation. Results: The cohort included 1341 patients, 362 (27.0 per cent) of whom received NSAIDs after operation. In analyses using conventional regression and propensity score matching, there was no significant association between postoperative NSAID use and recurrence-free survival (adjusted hazard ratio (HR) 1.02, 0.79 to 1.33). The instrumental variables approach, including individual hospital as the instrumental variable and clinicopathological variables as co-variables, suggested a potential improvement in the NSAID group (HR 0.61, 0.38 to 0.99). Conclusion: Conventional modelling did not demonstrate an association between postoperative NSAID use and recurrence-free survival in patients with rectal cancer, although an instrumental variables approach suggested a potential benefit.
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- Karlström, Petter, et al.
(författare)
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CALL in the zone of proximal development : novelty effects and teacher guidance
- 2013
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Ingår i: Computer Assisted Language Learning. - : Informa UK Limited. - 0958-8221 .- 1744-3210. ; 26:5, s. 412-429
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Tidskriftsartikel (refereegranskat)abstract
- Digital tools are not always used in the manner their designers had in mind. Therefore, it is not enough to assume that learning through CALL tools occurs in intended ways, if at all. We have studied the use of an enhanced word processor for writing essays in Swedish as a second language. The word processor contained natural language processing technology to display linguistic information such as part of speech while students wrote their texts. We investigated how students' real classroom activity when using the tool corresponded to that which was planned by their teacher. Our contribution is on two levels: (1) a real-world analysis of occasionally problematic technology and (2) an elaboration on research methodology for conducting classroom studies within the sociocultural perspective. Our findings show that use of the tool varied greatly between sessions and that paying close attention to the near-future proficiencies of students is paramount. It is therefore important to account for novelty effects in CALL and to provide guidance to teachers concerning the use of such tools in their pedagogical context. We also suggest further elaborations of sociocultural theory and method in order to capture learners' classroom activities.
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| 10. |
- Lindström, Eva, et al.
(författare)
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Schizofreni - läkemedelsbehandling, patientens delaktighet och vårdens organisation : En systematisk litteraturöversikt
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Schizofreni är i de flesta fall en kronisk och invalidiserande psykisk sjukdom. Antipsykotiska läkemedel (neuroleptika) är namnet på den grupp läkemedel som är avsedd att lindra de psykotiska symtomen som uppstår vid schizofreni. Antipsykotiska läkemedel kan indelas i första generationens antipsykotika och andra generationens antipsykotika. Denna litteraturöversikt kompletterar SBU:s systematiska översikt från år 1997 med en granskning av andra generationens antipsykotika. I översikten ingår också ett kapitel om den kunskap man idag har om hur personer med schizofreni upplever sin medverkan och sin delaktighet i behandling och vård. Dessutom ingår ett kapitel där man undersökt värdet av integrerade vårdformer för personer med olika psykiatriska tillstånd där huvuddelen av dem har schizofreni.
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