| 1. |
- Lindmark, Ulrika, 1965-, et al.
(author)
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Health-promoting factors in higher education for a sustainable working life : protocol for a multicenter longitudinal study
- 2020
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In: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 20:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.
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| 2. |
- Sundler, Annelie Johansson, 1973-, et al.
(author)
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Incidents reported by nurse anesthetists in the operating room
- 2018
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In: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 32:6, s. 699-705
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Journal article (peer-reviewed)abstract
- The quality of health care and patient safety in the operating room is a major concern for nurse anaesthetists. However, few studies have focused on the experiences of nurse anaesthetists’ and their contributions to safety in this setting. Therefore, this study aims to explore the content and frequency of incidents reported by nurse anaesthetists in the operating room and the risks involved in these incidents. A retrospective study with a descriptive design was conduct. Data were gathered concerning 220 incidents reported by nurse anaesthetists from 2012 to 2015 in operating rooms at a middle-sized hospital in Sweden. These were analysed with a method for qualitative and quantitative content analysis. The findings are presented in five categories: communication and teamwork; routines and guidelines; patient care; nurses’ work environment; devices, materials and technologies. In 184 (73%) of the incidents, there was either a risk of harm or there was an actual harm to patients or nurses. Of all incidents only 23 (10%) had harmed patients or nurses. Few of these incidents involved patient harm (n = 6), while a greater number involved harm to nurses (n = 17). The findings reveal lack of communication and interprofessional teamwork as the two most common areas for the reported incidents, followed by problems related to lack of compliance with guidelines and routines. The findings suggest that strategies are needed to improve these areas. Patient safety reporting systems may be important to identify risk in preventing patients and health care professionals from being harmed. In addition, the findings indicate that the nurses sought to prevent harm to patients rather than to themselves. Consequently, increased attention to the work environments of nurses, and most likely other professionals, in the operating room may be needed to prevent health care professionals from being harmed.
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| 3. |
- Hedén, Lena E, et al.
(author)
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Children's self-reports of fear and pain levels during needle procedures
- 2020
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In: Nursing Open. - : Wiley. - 2054-1058. ; 7:1, s. 376-382
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Journal article (peer-reviewed)abstract
- AimThe objective was to determine the levels of and potential relationships between, procedure‐related fear and pain in children.DesignClinical based cross‐sectional.MethodsNinety children aged between 7–18 years were included consecutively and self‐reported levels of pain and fear on a 0–100 mm visual analogue scales (VAS) when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anaesthesia.ResultsThe needle‐related fear level was reported to be as high as the needle‐related pain level (mean VAS: 14 mm and 12 mm, respectively, N = 90). With fear as the dependent variable, age and pain were significantly associated and explained 16% of the variance. With pain as the dependent variable, fear was significantly associated and explained 11% of the variance. A post hoc analysis indicated that younger children reported their fear levels to be higher than their pain levels.
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| 4. |
- Hedén, Lena E, et al.
(author)
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Do children's self-reports differ from the proxy reports of fear levels during needle procedures in children with cancer?
- 2019
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Conference paper (peer-reviewed)abstract
- IntroductionNeedle procedures in relation to cancer disease and treatment are often experienced as frightening and painful for children. To assess fear a proxy report by nurses or parents are often clinically used.ObjectiveTo investigate fear levels experienced by children in connection with needle procedures and use findings to optimise the recurring needle process.Aim The aim was to determine if child self-report and proxy report of needle fear levels are in agreement.MethodsData was collected during 90 needle insertions in children 7 to 18 years of age, included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anaesthesia. Fear in connection with the needle procedure was independently assessed on a 100 mm Visual Analogue Scale (VAS) with anchors at the extreme ends (no fear - worst possible fear) by the child, nurse and parent and investigated with one-way ANOVA within subjects and post hoc with Bonferroni correction.ResultsThe reported fear level differed between children’s self-reports (VAS mean 14 mm), nurse ratings (VAS mean 21 mm), and parents ratings (VAS mean 21 mm) during a needle insertion in a subcutaneously implanted port (F(2, 178)= 6.211, p=0.002). Post hoc tests revealed differences between (i) children’s self-reports and nurses reports (p=0.017) and (ii) children’s self-reports vs. parents reports (p=0.006) but showed no differences between nurses reports and parents reports (p=1).ConclusionNurses and parents significantly overestimated the child’s fear level of the needle procedure. Therefore children, as far as possible, should be (i) more actively involved as partners throughout the needle procedures and (ii) encouraged to self-report their fear level in connection with needle procedures for improved analysis and treatment.
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| 5. |
- Hedén, Lena E., et al.
(author)
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Effect of morphine in needle procedures in children with cancer
- 2011
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In: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 15:10, s. 1056-1060
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Journal article (peer-reviewed)abstract
- Background: The aim was to investigate whether children experience less fear, distress, and/or pain when they receive oral morphine vs. placebo before a needle is inserted in a subcutaneously implanted intravenous port when combined with topical anesthesia. Method: Fifty children 1-18 years of age who were treated in a pediatric oncology and hematology setting were included consecutively when undergoing routine needle insertion into an intravenous port. All children were subjected to one needle insertion following topical anesthetic (EMLA) application in this randomized, triple-blind, placebo-controlled study comparing orally administered morphine (n = 26) 0.25 mg/kg body weight with placebo (n = 24). The patients' fear, distress, and pain were reported by parents, nurses and the children themselves (if >= 7 years of age) on 0-100 mm Visual Analogue Scales. In addition, observational methods were used to measure distress and procedure pain. Results: No differences between the morphine and the placebo group were found with respect to age, weight, height, physical status, sex, weeks from diagnosis, or weeks from latest needle insertion. According to, parents, nurses, and children, oral morphine at a dose of 0.25 mg/kg body weight did not reduce fear, distress or pain compared with placebo. Conclusion: We could not reject the null hypothesis that there is no difference between the oral morphine and placebo groups assuming an effect size of 15 mm on VAS. Therefore it seems that oral morphine at 0.25 mg/kg does not give any additional reduction of fear, distress or pain compared with placebo when combined with topical anesthesia in pediatric patients undergoing subcutaneous port needle insertion, and would not be expected to be of any advantage for similar procedures such as venipuncture and venous cannulation when topical anesthesia is used.
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| 6. |
- Hedén, Lena E, et al.
(author)
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Effects of the Intervention "reflective STRENGTH-Giving Dialogues" for Older Adults Living with Long-Term Pain : A Pilot Study
- 2020
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In: Journal of Aging Research. - : Hindawi Publishing Corporation. - 2090-2204 .- 2090-2212. ; 2020
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Journal article (peer-reviewed)abstract
- Background. Long-term musculoskeletal pain is a major, often undertreated, disabling health problem among an increasing number of older adults. Reflective STRENGTH-giving dialogues (STRENGTH) may be a tool to support older adults living with long-term pain. The main aim of this pilot study was to investigate the immediate and longitudinal effect of the intervention STRENGTH on levels of pain, wellbeing, occurrence of depression symptoms, and sense of coherence (SOC) among community-dwelling older adults suffering from musculoskeletal pain compared to a control group. Methods. The study was semiexperimental with an intervention group and a control group. The effect of a single STRENGTH intervention was reported on the Numeric Rating Scale (NRS) regarding pain and wellbeing. To evaluate the longitudinal effect of STRENGTH, using the Brief Pain Inventory-Short Form (BPI-SF), the Geriatric Depression Scale-20 (GDS-20), SOC-13 at baseline (T1), and six months after the intervention/no intervention (T2), a total of 30 older adults, aged 72 to 97 years (Mdn 86 years), were included consecutively and fulfilled the intervention series (n = 18) or untreated controls (n = 12). Results. The intervention with STRENGTH decreases pain (NRS 6 Mdn versus NRS 4 Mdn, p<0.001) and increases wellbeing (NRS 7 Mdn versus NRS 8 Mdn, p<0.001). After a six-month study period with STRENGTH, no longitudinal effect difference was found compared to baseline. Compared to the control group, there was an increasing trend between decreased pain level and increased SOC level for STRENGTH intervention. Conclusions. This pilot study supports STRENGTH's effect as a pain-alleviating model that provides a decrease in pain levels and an increase of wellbeing in older adults with long-term pain. STRENGTH dialogues could be a useful intervention to provide individually holistic care in older adults living with long-term pain.
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| 7. |
- Israelsson-Skogsberg, Åsa, 1968-, et al.
(author)
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'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation
- 2018
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In: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 22:1, s. 6-18
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Journal article (peer-reviewed)abstract
- Developments in medical technology and treatment have increased the survival rates of children with serious illnesses or injuries, including those receiving home mechanical ventilation, which is a small but growing group. The aim of this study was to explore everyday life experiences of children and young people living with home mechanical ventilation (HMV). Data were obtained through interviews with nine participants. The interviews were supported by photovoice methodology: photographs taken by the participants before or during the interviews were used to facilitate conversation. Interview data were analyzed using qualitative content analysis. The findings revealed that everyday life on a ventilator can be described as including power but simultaneously as characterized by vulnerability to the outside world, comparable to balancing on a tightrope. Various types of technology, both information and communication technology (ICT) and vital medical technology, enabled the participants to engage with the world around them. This study contributes knowledge about the experiences of children and young people with HMV, who depict their lives as good and valuable. The study also underscores, when designing plans and home support, it is necessary to take a sensible approach to personal experiences of what a good life is and what resources are needed to attain and maintain health.
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| 8. |
- Kamsvåg, Tove, 1986-, et al.
(author)
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Ibuprofen in needle procedures in children with cancer : A feasibility and pilot study
- 2021
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:2, s. 704-710
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Journal article (peer-reviewed)abstract
- AIM: To investigate the feasibility, and perform a pilot study, of a randomised clinical trial, investigating whether children experience less pain, fear and/or distress when they receive oral ibuprofen vs placebo before a needle is inserted in a subcutaneously implanted intravenous port.METHODS: Twenty-three children were included consecutively and randomised to either oral ibuprofen (n = 12) 7.5 mg/kg body weight or placebo (n = 11). The child's pain, fear and distress were reported by parents, nurses and the children (if ≥7 years of age). Feasibility criteria were defined as (a) ≥4 children included/month, (b) ≥80% of eligible patients agreed to participate, (c) >90% treated according to protocol, (d) <5% missing data, (e) s-cortisol samples analysed in ≥90% of the children.RESULTS: All feasibility criteria were met except recruitment and consent. Parents, nurses and children reported no trend of benefit of oral ibuprofen with regard to pain, fear and distress compared with placebo.CONCLUSION: The study failed to meet important feasibility criteria and was closed due to low recruitment rate and absence of trend of effect. From this data, we cannot state that ibuprofen is not helpful in needle procedures but that it seems unlikely.
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| 9. |
- Kleye, Ida, 1984-, et al.
(author)
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Children's communication of emotional cues and concerns during a preoperative needle procedure
- 2022
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In: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 105:6, s. 1518-1523
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Journal article (peer-reviewed)abstract
- ObjectiveThis study explores children’s expressions of emotional cues and concerns during needle procedures, nurses’ responses and findings in relation to children’s age and sex.MethodsTwenty-six children aged 6–12 years were video recorded during a preoperative needle procedure. Emotional communication was analyzed using Verona Coding Definitions of Emotional Sequences.ResultsA total of 111 cues or concerns were identified in the observed needle procedures, with a distribution of 77 cues and 34 concerns. A majority of children (85%) expressed emotional cues through non-verbal communication. No differences between child age or sex related to expressed emotion were found. The child elicited the communicated emotion in 98% of sequences. Nurses' responses were coded as not providing space for communication in 75% of sequences.ConclusionChildren are capable of expressing their emotional distress, primarily non-verbally, during needle procedures. A child showing less overt expressions during a needle procedure does not necessarily experience less fear or pain. The nurses’ communication focused on practical information during the needle procedure, with less attention to the child’s distress.Practice implicationsNurses need to develop strategies to be aware of emotions the child communicates before, during and after a needle procedure.
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| 10. |
- Kleye, Ida, 1984-, et al.
(author)
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Children's individual voices are required for adequate management of fear and pain during hospital care and treatment
- 2021
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In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:2, s. 530-537
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Journal article (peer-reviewed)abstract
- Background: Children often report both fear and pain in conjunction with clinical care and treatment. Interventions developed in the field have still not been sufficient to prevent and relieve children’s fear and pain. More knowledge, from children’s own perspectives, is needed about how they deal with their experiences.Aim: To explore child-identified strategies that children use to manage fear and pain during needle-related medical procedures in hospital.Methods: Interviews with children, age 4–12 years, with experience of hospital care were analysed qualitatively using content analysis.Results: Children have self-identified strategies for dealing with fear and pain during hospital care and treatment. The strategies vary depending on examination or treatment and on how the child felt at that particular day. Children describe what they can do themselves, how adults can empower them and support from surroundings as strategies that give them a choice and a voice. Children wished to have influence, decide when and how information should be given, scream out loud or squeeze something hard, to deal with fear and pain. The results also show that children tried to be brave, gain control and think positively. Something nice to look at and opportunities to play with others also contributed.Conclusions: Strategies vary between children and are used differently on different occasions. Healthcare professionals pose a threat to the child’s needs and ability to use their strategies due to lack of knowledge of the child’s chosen strategies.
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