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1.
  • Berg, Linda, 1961, et al. (författare)
  • Characterisation of Cancer Support and Rehabilitation Programmes: A Swedish Multiple Case Study
  • 2014
  • Ingår i: The open nursing journal. - : Bentham Science Publishers Ltd.. - 1874-4346. ; 8, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Cancer support and rehabilitation are suggested to be an integral part of cancer care strategies. This study focuses on comparativeness of cancer support and rehabilitation programmes. The aim of this study was to analyse available cancer support and rehabilitation programmes in Sweden presented as complementary to cancer rehabilitation at cancer clinics. A multiple case study design was chosen in order to inquire the small number of existing supportive and rehabilitative cancer programmes. Based on the structures, processes and outcomes of the nine included programmes, three types of cancer support and rehabilitation programmes were identified: multimodal rehabilitation, comprehensive cancer support and art therapy. Cancer support and rehabilitation programmes offer a variety of activities and therapies which are highly valuable and relevant for people with cancer. The typology of cancer support and rehabilitation programmes and comparability between programmes need further inquiry.
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2.
  • Flink, Maria, et al. (författare)
  • Measuring care transitions in Sweden : validation of the care transitions measure
  • 2018
  • Ingår i: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 30:4, s. 291-297
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To translate and assess the validity and reliability of the original American Care Transitions Measure, both the 15-item and the shortened 3-item versions, in a sample of people in transition from hospital to home within Sweden.Design: Translation of survey items, evaluation of psychometric properties.Setting: Ten surgical and medical wards at five hospitals in Sweden.Participants: Patients discharged from surgical and medical wards.Main outcome measure: Psychometric properties of the Swedish versions of the 15-item (CTM-15) and the 3-item (CTM-3) Care Transition Measure.Results: We compared the fit of nine models among a sample of 194 Swedish patients. Cronbach's alpha was 0.946 for CTM-15 and 0.74 for CTM-3. The model indices for CTM-15 and CTM-3 were strongly indicative of inferior goodness-of-fit between the hypothesized one-factor model and the sample data. A multidimensional three-factor model revealed a better fit compared with CTM-15 and CTM-3 one factor models. The one-factor solution, representing 4 items (CTM-4), showed an acceptable fit of the data, and was far superior to the one-factor CTM-15 and CTM-3 and the three-factor multidimensional models. The Cronbach's alpha for CTM-4 was 0.85.Conclusions: CTM-15 with multidimensional three-factor model was a better model than both CTM-15 and CTM-3 one-factor models. CTM-4 is a valid and reliable measure of care transfer among patients in medical and surgical wards in Sweden. It seems the Swedish CTM is best represented by the short Swedish version (CTM-4) unidimensional construct.
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3.
  • Hanan, El Malla, et al. (författare)
  • Adherence to medication : A nation-wide study from the Children's Cancer Hospital, Egypt
  • 2013
  • Ingår i: World journal of psychiatry. - : Baishideng Publishing Group Inc.. - 2220-3206. ; 22, s. 62-62
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt.METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read the questions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo (February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows (SAS Institute Inc., Cary, NC, United States).RESULTS: Two hundred and eighty-one (90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment (181/281, 64%). Sixty-eight percent (123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance (111/123, 90%) and inadequate information (100/123, 81%). In the adherent group, 20% of the parents (n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123 (7%) for both their child's doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment (116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child's life (70%) (P = 0.005) and worry that their child would die if they discontinued the treatment (81%) (P < 0.0001).CONCLUSION: Non-adherence to medical regimen is common among children diagnosed with cancer in Egypt, the main reasons being child resistance and inadequate information.
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4.
  • Bergius, Anki, et al. (författare)
  • Stödverksamhet för barn som förlorat en förälder : En litteraturstudie
  • 2004
  • Ingår i: Vård i Norden. - : SAGE Publications. - 0107-4083 .- 1890-4238. ; 24:4, s. 41-44
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • The aim with this literature review was to describe content, objectives, design, and outcomes of support groups for parentally bereaved children three to twelve years of age. In a support group with children in similar situation the children's thoughts, experiences and feelings will be normalised through different activities. Pedagogical methods include creative activities of different kinds, e.g. painting, writing letters and poems, reading stories, play and games. The purposes of the methods are to accept and understand the reality of the loss, to understand and work through the grieving, to enhance family communication, and to keep the memory of the death and go on living. Organisation and structure are described in relation to development levels and ages of children and youths. Outcomes of groups are characterized by clinical observations and a dearth of evaluative studies. All bereaved children should have the opportunity to participate in a support group when a parent, sibling or other relative dies. Well developed services for bereaved children should be a matter of health care policy and quality.
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5.
  • Björkdahl, Ann, 1959-, et al. (författare)
  • Decline in cognitive function due to diffuse axonal injury does not necessarily imply a corresponding decline in ability to perform activities
  • 2016
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:10, s. 1006-1015
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The study explored the direction of change (decline vs. improvement) after diffuse axonal injury (DAI) in the domains of the ICF: body structure, body function, and activity.Methods: Thirteen patients with DAI were assessed by using diffusion tensor imaging (DTI) to measure body structure, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) to measure body function, and the Assessment of Motor and Process Skills (AMPS) to measure activity. The DTI, BNIS, and AMPS were applied at the acute phase (A1), and at 6 and 12 months post-injury (A2 and A3). Visual and statistical analyses were conducted to explore time-dependent changes in the ICF domains.Results: Improvements were observed for most patients in all ICF domains from injury until six months. Thereafter, the results diverged, with half of the subjects showing a decline in DTI and BNIS scores between A2–A3, and all but one of the patients exhibiting identical or better A2–A3 AMPS process skill scores.Conclusions: From 6 to 12 months post-injury, some patients underwent an ongoing degenerative process, causing a decline in cognitive function. The same decline was not observed in the activity measure, which might be explained by the use of compensatory strategies.Implications for rehabilitationIn rehabilitation it is essential to be aware that in some cases with TBI, an ongoing degenerative process in the white matter can be expected, causing an adverse late effect on cognitive function.The cognitive decline, caused by DAI, does not necessarily mean a concurrent decrease in activity performance, possibly explained by the use of compensatory strategies. This suggests that, after the post-acute phase, rehabilitation offering strategy training may be beneficial to enhance every-day functioning.Strategy use requires awareness, which imply the need to assess level of awareness in order to guide rehabilitation.
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6.
  • Dussel, Veronica, et al. (författare)
  • Looking beyond where children die : Determinants and effects of planning a child's location of death.
  • 2009
  • Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 0885-3924 .- 1873-6513. ; 37:1, s. 33-43
  • Tidskriftsartikel (refereegranskat)abstract
    • While dying at home may be the choice of many, where people die may be less important than argued. We examined factors associated with parental planning of a child's location of death (LOD) and its effects on patterns of care and parent's experience. In a cross-sectional study of 140 parents who lost a child to cancer at one of two tertiary-level U.S. pediatric hospitals, 88 (63%) planned the child's LOD and 97% accomplished their plan. After adjusting for disease and family characteristics, families whose primary oncologist clearly explained treatment options during the child's end of life and who had home care involved were more likely to plan LOD. Planning LOD was associated with more home deaths (72% vs. 8% among those who did not plan, P<0.001) and fewer hospital admissions (54% vs. 98%, P<0.001). Parents who planned were more likely to feel very prepared for the child's end of life (33% vs. 12%, P=0.007) and very comfortable with LOD (84% vs. 40%, P<0.001), and less likely to have preferred a different LOD (2% vs. 46%, P<0.001). Among the 73 nonhome deaths, planning was associated with more deaths occurring in the ward than in the intensive care unit or other hospital (92% vs. 33%, P<0.001), and fewer children being intubated (21% vs. 48%, P=0.029). Comprehensive physician communication and home care involvement increase the likelihood of planning a child's LOD. Opportunity to plan LOD is associated with outcomes consistent with high-quality palliative care, even among nonhome deaths, and thus may represent a more relevant outcome than actual LOD.
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7.
  • Eilegård Wallin, Alexandra, 1975-, et al. (författare)
  • Psychological health in siblings who lost a brother or sister to cancer 2 to 9 years earlier.
  • 2013
  • Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 22:3, s. 683-691
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The objective of this study was to assess long-term psychological distress in siblings who lost a brother or sister to cancer 2 to 9 years earlier, as compared with a control group of non-bereaved siblings from the general population.METHODS: During 2009, we conducted a nationwide follow-up study in Sweden by using an anonymous study-specific questionnaire. Siblings who had lost a brother or sister to cancer between the years 2000 and 2007 and also a control group of non-bereaved siblings from the general population were invited to participate. The Hospital Anxiety and Depression Scale (HADS) was used to measure psychological distress, and to test for differences in the ordinal outcome responses between the groups, we used Wilcoxon-Mann-Whitney rank-sum test.RESULTS: Among the bereaved siblings, 174/240 (73%) participated and 219/293 (75%) among the non-bereaved. Self-assessed low self-esteem (p = 0.002), difficulties falling asleep (p = 0.005), and low level of personal maturity (p = 0.007) at follow-up were more prevalent among bereaved siblings. However, anxiety (p = 0.298) and depression (p = 0.946), according to HADS, were similar.CONCLUSION: Bereaved siblings are at increased risk of low self-esteem, low level of personal maturity and difficulties falling asleep as compared with non-bereaved peers. Yet, the bereaved were not more likely to report anxiety or depression.
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8.
  • Elmberg, Johan, et al. (författare)
  • Potential disease transmission from wild geese and swans to livestock, poultry and humans : a review of the scientific literature from a One Health perspective
  • 2017
  • Ingår i: Infection Ecology & Epidemiology. - : Taylor & Francis. - 2000-8686 .- 2000-8686. ; 7:1, s. 1-21
  • Tidskriftsartikel (refereegranskat)abstract
    • There are more herbivorous waterfowl (swans and geese) close to humans, livestock and poultry than ever before. This creates widespread conflict with agriculture and other human interests, but also debate about the role of swans and geese as potential vectors of disease of relevance for human and animal health. Using a One Health perspective, we provide the first comprehensive review of the scientific literature about the most relevant viral, bacterial, and unicellular pathogens occurring in wild geese and swans. Research thus far suggests that these birds may play a role in transmission of avian influenza virus, Salmonella, Campylobacter, and antibiotic resistance. On the other hand, at present there is no evidence that geese and swans play a role in transmission of Newcastle disease, duck plague, West Nile virus, Vibrio, Yersinia, Clostridium, Chlamydophila, and Borrelia. Finally, based on present knowledge it is not possible to say if geese and swans play a role in transmission of Escherichia coli, Pasteurella, Helicobacter, Brachyspira, Cryptosporidium, Giardia, and Microsporidia. This is largely due to changes in classification and taxonomy, rapid development of identification methods and lack of knowledge about host specificity. Previous research tends to overrate the role of geese and swans as disease vectors; we do not find any evidence that they are significant transmitters to humans or livestock of any of the pathogens considered in this review. Nevertheless, it is wise to keep poultry and livestock separated from small volume waters used by many wild waterfowl, but there is no need to discourage livestock grazing in nature reserves or pastures where geese and swans are present. Under some circumstances it is warranted to discourage swans and geese from using wastewater ponds, drinking water reservoirs, and public beaches. Intensified screening of swans and geese for AIV, West Nile virus and anatid herpesvirus is warranted.
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9.
  • Elmberg, Johan, et al. (författare)
  • Sprider gäss och svanar smittsamma sjukdomar?
  • 2018
  • Ingår i: Fakta för förvaltare: gäss och svanar. - Stockholm : Naturvårdsverket. - 9789162087937 ; , s. 49-65
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • INLEDNING• Gäss och svanar förekommer idag i större antal nära fler människor än någonsin tidigare, i Sverige och i övriga Västeuropa.• De ökande antalen leder ibland till problem och konflikter. På jordbruksmark kan gäss och svanar orsaka kostsamma skador på oskördade grödor. Hårt bete kan också påverka naturlig växtlighet och då bli ett naturvårdsproblem.• Gäss och svanar är vegetarianer och äter enbart blad, stjälkar, frön och rotdelar från växter, både på land och i vatten.• Bete på växande grödor kan också skapa intressekonflikter i områden där gäss samlas i stora antal, till exempel vid skyddade och restaurerade våtmarker.• Samtidigt bidrar gässen med många ekosystemtjänster, bland andra i form av naturupplevelser, jakt och kött.GÄSS OCH SVANAR SOM SMITTSPRIDARE• Många smittämnen är kända hos vilda gäss och svanar. Det handlar om virus, bakterier och encelliga parasiter.• En del av dessa smittämnen har förmåga att infektera också andra fågelarter och ibland däggdjur.• Gäss och svanar är rörliga och uppträder ofta nära människor och i jordbrukslandskapet. Därför misstänks de ibland för att sprida sjukdomar till människor och våra tamdjur.SMITTSPRIDNING TILL MÄNNISKOR OCH TAMDJUR• En genomgång av forskningen inom detta fält visar att gäss och svanar ytterst sällan utgör en hälsorisk för människor, men något oftare för tamdjur och då främst fjäderfän.• I vissa fall tycks gäss och svanar kunna bidra till spridning av följande sjukdomar till tamdjur eller människa: fågelinfluensavirus, campylobacter, salmonella (gäller främst smitta till fjäderfä) och antibiotikaresistenta bakterier. I samtliga fall är dock andra smittkällor än gäss och svanar betydligt vanligare.• Forskningen har däremot inte funnit några belägg för att gäss och svanar sprider till exempel Newcastle-virus, West Nile virus, botulism, papegojsjuka eller borrelia till tamdjur eller människa.• För några smittämnen, till exempel E. coli och cryptosporidier, är det fortfarande oklart om gäss och svanar alls har någon betydelse för spridning till tamdjur eller människa.• Klimatförändringar och en allt bättre förståelse för de olika smittämnenas variation i förekomst och farlighet gör det viktigt att vi fortsätter att övervaka dem samt har beredskap för att omvärdera deras betydelse.• Att tamboskap och gäss betar sida vid sida har inga kända risker från smittsynpunkt, inte heller på strandängar.• Trots slutsatserna om en relativt låg smittorisk kan det vara klokt att iaktta försiktighetsåtgärder vid djurhållning, till exempel att förse tamdjur med rent vatten och att hålla fjäderfä avskilda från vilda gäss och svanar. För människans del kan man minska riskerna genom att sätta upp nät för att hindra fåglarna att ta sig upp på badstränder. Om man badar i sjöar där det vistas mycket gäss eller svanar är detklokt att tvätta sig efter badet och att undvika kallsupar.
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10.
  • Falk, Hanna, 1977, et al. (författare)
  • Differences in Symptom Distress Based on Gender and Palliative Care Designation Among Hospitalized Patients.
  • 2016
  • Ingår i: Journal of Nursing Scholarship. - : Wiley. - 1527-6546 .- 1547-5069. ; 48:6, s. 569-576
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To explore patient-reported symptom distress in relation to documentation of symptoms and palliative care designation in hospital inpatients.DESIGN: This cross-sectional study analyzed data from 710 inpatients at two large hospitals in Sweden using the Edmonton Symptom Assessment Scale and the Memorial Symptom Assessment Scale. Chart reviews focused on nurses' and physicians' symptom documentation and palliative turning point.METHODS: Descriptive statistics were calculated for all variables and provided summaries about the sample. Patients were grouped according to gender, age, palliative care designation, and symptom documentation. The t test and chi-square test were used to calculate whether symptom distress varied between groups. A two-way analysis of variance was conducted for multiple comparisons to explore the impact of gender and age on mean symptom distress.FINDINGS: Females reported higher levels of symptom distress than did males related to pain, fatigue, and nausea. When comparing symptom distress between males and females with documentation pertaining to symptoms, there were significant differences implying that females had to report higher levels of symptom distress than males in order to have their symptoms documented.CONCLUSIONS: Females need to report higher levels of symptom distress than do males for healthcare professionals to identify and document their symptoms. It can be hypothesized that females are not receiving the same attention and symptom alleviation as men. If so, this highlights a serious inequality in care that requires further exploration.CLINICAL RELEVANCE: Considering that common reasons why people seek health care are troublesome symptoms of illness, and that the clinical and demographic characteristics of inpatients are changing towards more advanced ages with serious illnesses, inadequate symptom assessment and management are a serious threat to the care quality.
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