| 1. |
- Emmesjö, Lina
(författare)
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Within an integrated home health care model : Registered nurses’, physicians’, patients’ and their next of kin’s perspectives
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many older patients receive health care from several different healthcare organizations, which may lead uncertainty about the responsibility for their healthcare needs. Integrated care has been argued to aid the healthcare system by addressing the challenge of the complex care needs of older patients with multiple health problems. Previous research has stated that integrated care models often have been developed with a focus on a single diagnosis, which risks overlooking the extensive and complex care needs of older patients. Prior research has also expressed the need to deepen knowledge about how integrated care models influence health care professionals, patients and their next of kin. Moreover, it is important to understand how the COVID-19 pandemic affected integrated care models which may expand knowledge about integrated home health care in crisis situations.The overall aim is to study expectations, perceptions and experiences of integrated home health care through the perspective of registered nurses, physicians, patients and their next of kin.Inductive qualitative designs where data was collected through interviews and field notes in the setting of the mobile integrated care model with a home health care physician (MICM) with registered nurses, physicians and patients and next of kin. Analysis was conducted using qualitative content analysis, phenomenography, and thematic analysis.The emphasis on person-centered care in the MICM was evident in the perceptions of the healthcare professionals about the patients and their next of kin, whom they viewed as persons, not simply recipients of health care. Differences were found in the health care provided in the MICM and in comparison, to other healthcare organizations which did not align with the person-centered care ethics. However, providing health care to patients in their own home benefited the provision of person-centered care – the value base of the MICM. The MICM was created with the goal of implementing individually tailored and coherent health care with increased continuity. The healthcare professionals viewed individual medical healthcare plans as co-created with each patient, and yet no patient could recall participating in this co-creation. The coherency of the MICM was regarded as having been improved by teamwork between the registered nurse and the home healthcare physician. Collaborations with other healthcare professionals rarely occurred and should be improved in the future. Participants reported varying experiences of continuity in the MICM, which influenced the possibility of building relationships. Providing continuity with a home healthcare physician for patients is therefore preferable. The work described in this thesis was conducted during the COVID-19 pandemic. The thesis provides unique insights into an integrated care model during a crisis situation, which the healthcare system may face in similar or different ways in the future. The MICM was upheld as the best way to work in home health care, especially as patients and their next of kin regarded the model as making their daily lives easier.
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| 2. |
- Wising, Jenny, et al.
(författare)
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Certified Registered Nurse Anaesthetists’ and Critical Care Registered Nurses’ perception of knowledge/power in teamwork with Anaesthesiologists in Sweden : a mixed-method study
- 2024
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Efficient teamwork is crucial to provide optimal health care. This paper focuses on teamwork between Anaesthesiologists (ANES), Certified Registered Nurse Anaesthetists’ (CRNA) and Critical Care Registered Nurses (CCRN) working in challenging environments such as the intensive care unit (ICU) and the operating room (OR). Conflicts are common between physicians and nurses, negatively impacting teamwork. Social hierarchies based on professional status and power inequalities between nurses and physicians plays a vital role in influencing teamwork. Foucault was a famous thinker especially known for his reasoning regarding power/knowledge. A Foucauldian perspective was therefore incorporated into this paper and the overall aim was to explore CCRN/CRNA perception of knowledge/power in teamwork with ANES.Methods A mixed-method approach was applied in this study. Data was collected using a web-based questionnaire containing both closed-end and open-ended questions. A total of 289 CCRNs and CRNAs completed the questionnaire. Data analysis was then conducted through five stages as outlined by Onwuebugzie and Teddlie; analysing quantitative data in SPSS 27.0 and qualitative data with a directed content analysis, finally merging data together in ATLAS.ti v.23.Results The result reveals a dissonance between quantitative and qualitative data; quantitative data indicates a well-functioning interdisciplinary teamwork between CCRN/CRNA and ANES - qualitative data highlights that there are several barriers and inequalities between the two groups. Medicine was perceived as superior to nursing, which was reinforced by both social and organisational structures at the ICU and OR.Conclusion Unconscious rules underlying current power structures in the ICU and OR works in favour of the ANES and biomedical paradigm, supporting medical knowledge. To achieve a more equal power distribution between CCRN/CRNAs and ANES, the structural hierarchies between nursing and medicine needs to be addressed. A more equal power balance between the two disciplines can improve teamwork and thereby reduce patient mortality and improve patient outcomes.
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| 3. |
- Ahlstrand, Inger, et al.
(författare)
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Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study
- 2022
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
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| 4. |
- Alvarado-Vazquez, Perla Abigail, et al.
(författare)
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Circulating mast cell progenitors increase in frequency during natural birch pollen exposure in allergic asthma patients
- 2023
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 78:11, s. 2959-2968
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mast cells (MCs) develop from a rare population of peripheral blood circulating MC progenitors (MCps). Here, we investigated whether the frequency of circulating MCps is altered in asthma patients sensitized to birch pollen during pollen season, compared to out of season.Methods: Asthma patients were examined during birch pollen season in late April to early June (May), and out of season in November–January. Spirometry measurements, asthma and allergy-related symptoms, asthma control questionnaire (ACQ), and asthma control test (ACT) scores were assessed at both time points. The MCp frequency was determined by flow cytometry in ficoll-separated blood samples from patients with positive birch pollen-specific IgE, and analyzed in relation to basic and disease parameters.Results: The frequency of MCps per liter of blood was higher in May than in November (p = .004), particularly in women (p = .009). Patients that reported moderate to severe asthma symptoms (<.0001), nose or eye symptoms (p = .02; p = .01), or reduced asthma control (higher ACQ, p = .01) had higher MCp frequency in May than those that did not report this. These associations remained significant after adjusting for sex and BMI. The change in asthma control to a lower ACT score in May correlated with an increase in MCp frequency in May (p = .006, rho = 0.46).Conclusions: The data suggest that the frequency of MCps increases in symptomatic patients with allergic asthma. Our results unravel a link between asthma symptoms and circulating MCps, and bring new insight into the impact of natural allergen exposure on the expansion of MCs.
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| 5. |
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| 6. |
- Bouwmeester Stjernetun, Björn, doktorand, 1983-, et al.
(författare)
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Effects of an age suit simulation on nursing students’ perspectives on providing care to older persons - an education intervention study
- 2024
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Ingår i: Educational gerontology. - : Taylor & Francis Group. - 0360-1277 .- 1521-0472. ; 50:3, s. 240-253
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Tidskriftsartikel (refereegranskat)abstract
- Nursing students are important future health care providers to the growing number of older persons in society. However, two barriers are their common ageist attitudes and lack of interest in geriatrics. This is a concern in light of the global demand for nurses and a challenge that need to be addressed in nurse education. Age suit simulation has been shown to affect the attitudes of students toward older persons, but the important context of home is often missing from studies. Accordingly, the present study employed a quantitative approach with the goal of investigating the effects of aging simulation with an age suit in a home context as a part of experiential learning among second-year nursing students. The age simulation allowed the students to experience both specific and common health problems from the patient’s point of view in a controlled environment and a relevant context: the home. Data were collected using a questionnaire in a quasi-experimental pretest – posttest design with a control group. Results showed that the intervention had a positive effect on various aspects of the nursing students’ perspectives on caring for older persons. Work experience was associated with more positive attitudes. The control group was more negative toward geriatrics as a career choice than the intervention group. In conclusion, age suit simulation can be an innovative part of nurse education because it raises awareness and understanding of the health challenges of older persons, which are important in combating ageism among future nurses.
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| 7. |
- Bouwmeester Stjernetun, Björn, doktorand, 1983-, et al.
(författare)
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”It´s like walking in a bubble”, nursing students´ perspectives on age suit simulation in a home environment – group interviews from reflection seminars
- 2024
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOlder persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults.MethodsA qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis.ResultsThe analysis generated three main themes; “It’s like walking in a bubble”, “An eye opener” and “Concerns about ageing and the current structure of geriatric care”. The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability.ConclusionsAge suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons.
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| 8. |
- Emmesjö, Lina, et al.
(författare)
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Home health care professionals’ experiences of working in integrated teams during the COVID-19 pandemic : a qualitative thematic study
- 2022
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Ingår i: BMC Primary Care. - : BioMed Central (BMC). - 2731-4553. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Since COVID-19 emerged, over 514 million COVID-19 cases and 6 million COVID-19-related deaths have been reported worldwide. Older persons receiving home health care often have co-morbidities that require advanced medical care, and are at risk of becoming severely ill or dying from COVID-19. In Sweden, over 10,000 COVID-19-related deaths have been reported among persons receiving municipal home health and social care. Home health care professionals have been working with the patients most at risk if infected. Most research has focused on the experiences of professionals in hospitals and assistant nurses in a home care setting. It is therefore valuable to study the experiences of the registered nurses and physicians working in home health care during the COVID-19 pandemic to learn lessons to inform future work.Method: A thematic qualitative study design using a semi-structured interview guide.Results: The health care professionals experienced being forced into changed ways of working, which disrupted building and maintaining relationships with other health care professionals, and interrupted home health care. The health care professionals described being forced into digital and phone communication instead of in-person meetings, which negatively influenced the quality of care. The COVID-19 pandemic brought worry about illness for the health care professionals, including worrying about infecting patients, co-workers, and themselves, as well as worry about upholding the provision of health care because of increasing sick leave. The health care professionals felt powerless in the face of their patients’ declining health. They also faced worry and guilt from the patients’ next of kin.Conclusion: Home health care professionals have faced the COVID-19 pandemic while working across organizational borders, caring for older patients who have been isolated during the pandemic and trying to prevent declining health and feelings of isolation. Due to the forced use of digital and phone communication instead of in-person visits, the home health care professionals experienced a reduction in the patients’ quality of care and difficulty maintaining good communication between the professions.
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| 9. |
- Emmesjö, Lina, et al.
(författare)
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Patients’ and next of kin’s expectations and experiences of a mobile integrated care model with a home health care physician : a qualitative thematic study
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The organizational principle of remaining at home has offset care from the hospital to the home of the older person where care from formal and informal caregivers is needed. Globally, formal care is often organized to handle singular and sporadic health problems, leading to the need for several health care providers. The need for an integrated care model was therefore recognized by health care authorities in one county in Sweden, who created a cross-organisational integrated care model to meet these challenges. The Mobile integrated care model with a home health care physician (MICM) is a collaboration between regional and municipal health care. Descriptions of patients’ and next of kin’s experiences of integrated care is however lacking, motivating exploration.Method: A qualitative thematic study. Data collection was done before the patients met the MICM physician, and again six months later.Results: The participants expected a sense of relief when admitted to MICM, and hoped for shared responsibility, building a personal contact and continuity but experienced lack of information about what MICM was. At the follow-up interview, participants described having an easier daily life. The increased access to the health care personnel (HCP) allowed participants to let go of responsibility, and created a sense of safety through the personalised contact and continuity. However, some felt ignored and that the personnel teamed up against the patient. The MICM structure was experienced as hierarchical, which influenced the possibility to participate. However, the home visits opened up the possibility for shared decision making.Conclusion: Participants had an expectation of receiving safe and coherent health care, to share responsibility, personal contact and continuity. After six months, the participants expressed that MICM had provided an easier daily life. The direct access to HCP reduced their responsibility and they had created a personalised contact with the HCP and that the individual HCP mattered to them, which could be perceived as in line with the goals in the shift to local health care. The MICM was experienced as a hierarchic structure with impact on participation, indicating that all dimensions of person-centred care were not fulfilled.
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| 10. |
- Ernsth Bravell, Marie, et al.
(författare)
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Motor functioning differentially predicts mortality in men and women
- 2017
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 72, s. 6-11
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionResearch indicates gender differences in functional performance at advanced ages, but little is known about their impact on longevity for men and women.ObjectiveTo derive a set of motor function factors from a battery of functional performance measures and examine their associations with mortality, incorporating possible gender interactions.MethodAnalyses were performed on the longitudinal Swedish Adoption/Twin Study of Aging (SATSA) including twenty-four assessments of motor function up to six times over a 19-year period. Three motor factors were derived from several factor analyses; fine motor, balance/upper strength, and flexibility. A latent growth curve model was used to capture longitudinal age changes in the motor factors and generated estimates of intercept at age 70 (I), rates of change before (S1) and after age 70 (S2) for each factor. Cox regression models were used to determine how gender in interaction with the motor factors was related to mortality.ResultsFemales demonstrated lower functional performance in all motor functions relative to men. Cox regression survival analyses demonstrated that both balance/upper strength, and fine motor function were significantly related to mortality. Gender specific analyses revealed that this was true for women only. For men, none of the motor factors were related to mortality.ConclusionWomen demonstrated more difficulties in all functioning facets, and only among women were motor functioning (balance/upper strength and fine motor function) associated with mortality. These results provide evidence for the importance of considering motor functioning, and foremost observed gender differences when planning for individualized treatment and rehabilitation.
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| 11. |
- Gamgam Leanderz, Åsa, et al.
(författare)
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Parental-couple separation during the transition to parenthood
- 2021
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 8:5, s. 2622-2636
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate factors associated with parental separation during the parenthood transition.DESIGN: Prospective, longitudinal and explorative.METHODS: This is a quantitative longitudinal study of N784 subjects throughout the pregnancy journey with multivariate regression analysis of survey data derived from three validated measurement scales; the Sense of Coherence scale, the Multidimensional Scale of Perceived Social Support and the Perceived Quality of the Dyadic Relationship scale conducted 2014-2016.RESULTS: N17 participants separated at 2 years. Parental separation was significantly greater for those women and partners with low or changing sense of coherence, perceived social support and perceived quality of the parental-couple relationship indexes. Partners with a change in sense of coherence (p: .003) and perceived quality of the parental-couple relationship (p: .020) between 1 week and 2 years were at greater risk for separation. Attending professional preparatory support with a partner for women (p: .013) and attending the "Inspirational Lecture" for partners (p: .046) were, to a lesser extent, associated with a risk of parental separation.
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| 12. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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En utbildnings-intervention med simulering i äldredräkt i Skaraborgs Hälsoteknikcentrum för ökad insikt och förståelse för att åldras och leva med åldersrelaterade hälsoproblem
- 2021
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Ingår i: DAL-21 Det akademiska lärarskapet. - Skövde : Högskolan i Skövde. - 9789198366785 ; , s. 30-31
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Konferensbidrag (refereegranskat)abstract
- Världshälsoorganisationen, [1] belyser utmaningen att ge en vård som stödjer ett hälsosamt åldrande. Ett centralt hinder är den höga förekomsten av negativa attityder gentemot åldrandet, äldre personer och vård av äldre, särskilt bland vårdpersonal [2-4]. Vidare påvisas att sjuksköterskestudenter kan bära på negativa attityder till att vårda äldre och därför inte ser arbete inom äldrevård som ett önskvärt och framtida arbetsfält [5, 6]. Otillräcklig forskning avseende ålderism tillsammans med bristande utbildning inom området äldre, det normala åldrandet samt åldrandets hälsoproblem beskrivs som en bidragande faktor till ålderism [4]. Trots att interventioner kontinuerligt genomförs för att ändra attityder och minska ålderism i vården kvarstår dessa i betydande omfattning [3]. Det finns således ett behov av att skapa innovativa lösningar som bidrar till en ökad och hållbar förståelse för åldrandet, äldre och åldersrelaterade hälsoproblem. Detta adresseras i en ny utbildningsintervention med simulering i äldredräkt som utformats och genomförs i Skaraborgs Hälsoteknikcentrum (SHC), Högskolan i Skövde. Forskning [7] lyfter fram att simulering i utbildning, särskilt genom användande av utrustning som äldredräkt, är en framgångsrik väg att ändra studenters attityder gentemot äldre. Simulering i SHC ger även möjlighet att testa hälso- och välfärdsteknik vilket ytterligare kan inverka positivt på uppfattningar om dess nytta vid implementering av teknik i vården [8].Pågående utbildningsmoment i utbildning till sjuksköterska och distriktssköterskaUnder läsåret 2019-2020 har grupper av studerande inom omvårdnad deltagit i simulering i SHC. Vid denna simulering har äldredräkt använts för att återspegla upplevelsen av normalt åldrande och vanligt förekommande hälsoproblem. De studerande tilldelas en personas och genomför olika scenarier i SHC. I samband med detta besvaras enkät [9], före simulering samt efter simulering för att ta del av synen på åldrandet och att vårda äldre samt eventuell förändring efter genomgången simulering. Efter simuleringen reflekterar studenterna i grupp över upplevelsen av simuleringen, åldrandet och den vård som ges. Reflektionerna relateras sedan till centrala begrepp i omvårdnad samt sjuksköterskans kärnkompetenser. Vidare reflekterar de studerande över hur simuleringen påverkat deras insikt och förståelse samt hur det kommer att visa sig i den vård som ges.ForskningsprojektUtbildningsinterventionen beforskas som en del i ett longitudinellt projekt med övergripande syfte att studera hur en utbildningsintervention med simulering i äldredräkt inverkar på insikt och förståelse för åldrandet, att vara äldre och att leva med åldersrelaterade hälsoproblem i kontexten samt vård av äldre personer. Vidare är syftet att longitudinellt studera studenters syn på åldrandet, äldre och att vårda äldre personer. De hittills genomförda simuleringarna visar tecken på att studenters insikt och förståelse avseende åldrandet, att åldras och att leva med åldersrelaterade hälsoproblem förändras på ett positivt sätt. Det finns därför ett behov av att systematiskt utvärdera effekten och nyttan av den intervention som nu genomförs i SHC. Externa medel söktes hos Familjen Kamprads stiftelse och 3,5 miljoner erhölls för att genomföra projektet och att anställa en doktorand.Referenser1. WHO, Integrated care for older people (ICOPE) implementation framework: guidance for systems and services. 2019, Geneva: World Health Organization.2. Wyman, M.F., S. Shiovitz-Ezra, and J. Bengel, Ageism in the Health Care System: Providers, Patients, and Systems, in Contemporary Perspectives on Ageism, L. Ayalon and C. Tesch-Römer, Editors. 2018, Springer International Publishing: Cham. p. 193-212.3. Burnes, D., et al., Interventions to Reduce Ageism Against Older Adults: A Systematic Review and Meta-Analysis.American Journal of Public Health, 2019. 109(8): p. e1-e9.4. Wilson, D.M., et al., A critical review of published research literature reviews on nursing and healthcare ageism. Journal of Clinical Nursing, 2017. 26(23-24): p. 3881-3892.5. Szadowska-Szlachetka, Z., et al., Attitudes of students of nursing major towards people of geriatric age. Polish Journal of Public Health, 2019. 129(3): p. 95.6. Naughton, C., K.L. O’Shea, and N. Hayes, Incentivising a career in older adult nursing: The views of student nurses. International Journal of Older People Nursing, 2019. 14(4): p. e12256.7. Giner Perot, J., et al., Aging-simulation experience: impact on health professionals’ social representations. BMC Geriatrics, 2020. 20(1): p. 14.8. Frennert, S. and K. Baudin, The concept of welfare technology in Swedish municipal eldercare. Disability and Rehabilitation, 2019: p. 1-8.9. Burbank, P.M., G.J. Burkholder, and J. Dugas, Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses. Applied Nursing Research, 2018. 43: p. 98-104
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| 13. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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A prospective cross-sectional study of child healthcare competence among nurses within primary healthcare in Sweden
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Child-centered care is based on the fact that children are individuals with their own rights. Since January 2020, The United Nations Convention on the Rights of the Child (CRC) is law in Sweden. Children's meeting with professionals is important because it becomes the children's impression of healthcare that may reflect the children's future image of and feelings about the whole healthcare system. This prospective cross-sectional study aimed to explore child healthcare competence among nurses within primary healthcare. Data were collected through a web-based questionnaire among 101 primary healthcare district nurses, specialist nurses, and registered nurses. The study was compliant with the STROBE checklist. The results showed that the nurses have a good ability to apply child-centered care during children's visits to primary healthcare. To further implement a child-centered approach in primary healthcare, nurses need to have access to workplace educational opportunities continually, to enhance their child competence throughout their nursing careers.
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| 14. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Cognitive trajectories in relation to hospitalization among older Swedish adults
- 2018
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 74, s. 9-14
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionResearch indicate that cognitive impairment might be related to hospitalization, but little is known about these effects over time.ObjectiveTo assess cognitive change before and after hospitalization among older adults in a population-based longitudinal study with up to 25 years of follow-up.MethodA longitudinal study on 828 community living men and women aged 50–86 from the Swedish Adoption/Twin Study of Ageing (SATSA) were linked to The Swedish National Inpatient Register. Up to 8 assessments of cognitive performance (general cognitive ability, verbal, spatial/fluid, memory, and processing speed) from 1986 to 2010 were available. Latent growth curve modelling was used to assess the association between cognitive performance and hospitalization including spline models to analyse cognitive trajectories pre- and post-hospitalization.ResultsA total of 735 persons (89%) had at least one hospital admission during the follow-up. Mean age at first hospitalization was 70.2 (±9.3) years. Persons who were hospitalized exhibited a lower mean level of cognitive performance in general ability, processing speed and spatial/fluid ability compared with those who were not hospitalized. The two-slope models revealed steeper cognitive decline before hospitalization than after among those with at least one hospitalization event, as compared to non-hospitalized persons who showed steeper cognitive decline after the centering age of 70 years.ConclusionsPersons being hospitalized in late life have lower cognitive performance across all assessed domains. The results indicate that the main decline occurs before the hospitalization, and not after. This might indicate that when you get treatment you also benefit cognitively.
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| 15. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Elderly living in institutions and their visits to acute care - Patterns; needs och habits?.
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Every year 1.4 million visits are made to acute care or hospital in Sweden. Elderly makes about one third of these visits and many of them are considered to be unnecessary. Little is known about the patterns of hospitalization and visits to acute care among elderly living in institutions.Objective: The aim of this study is to longitudinally describe patterns of hospitalization and visits to the acute care among elderly living in institutions.Method: SHADES is a longitudinal study including 423 elderly (mean age of 84.8 years, ± 7.27, 71% females) living in institutions in Sweden. Participants were examined every six months during three years. One-hundred thirty individuals participated in all the six in-person testings.Results: At baseline 16 % of the respondents had visited the acute care at least once and around a fourth had been hospitalized the last six months. The most common reasons for visits to acute care were falls and infections. The reasons for hospitalization were mostly complications after falls (n=25) and circulatory diseases (n=24). About one third (n=48) of those who participated at all six IPTs visited the acute care in the hospital at least once during the study and nearly half (n=60) was hospitalized at least once during the study period.Discussion and Conclusion: Hospitalization and visits to acute care are common among persons living in institutions. The next step is to analyze the longitudinal trajectories of visits to the acute care and hospitalization in this group of elderly living in institutions. For the presentation analyzes will also be performed with the aim to examine which factors (e.g. diseases, drugs, function in daily life, social network factors) that relate to visits to the acute care and hospitalization. The results will provide important knowledge that can be used to prevent unnecessary hospitalization in order to provide continuity in the institutional care for the elderly and to save costs.
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| 16. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Factors associated with hospitalization risk among community living middle aged and older persons : Results from the Swedish Adoption/Twin Study of Aging (SATSA)
- 2016
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 66, s. 102-108
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46–103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR = 1.02, p < 0.001) and more support from relatives (HR = 1.09, p = 0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR = 0.75, p = 0.033) and widow/widower (HR = 0.69, p < 0.001)) and support from friends (HR = 0.93, p = 0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization.
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| 17. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Factors associated with increased hospitalisation risk among nursing home residents in Sweden : a prospective study with a three-year follow-up
- 2016
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Ingår i: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 11:2, s. 130-139
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHospitalisation of nursing home residents might lead to deteriorating health.AimTo evaluate physical and psychological factors associated with hospitalisation risk among nursing home residents.DesignProspective study with three years of follow-up.MethodsFour hundred and twenty-nine Swedish nursing home residents, ages 65–101 years, from 11 nursing homes in three municipalities were followed during three years. The participants' physical and psychological status was assessed at baseline. A Cox proportional hazards model was used to evaluate factors associated with hospitalisation risk using STATA.ResultsOf the 429 participants, 196 (45.7%) were hospitalised at least once during the three-year follow-up period, and 109 (25.4%) during the first six months of the study. The most common causes of hospitalisation were cardiovascular diseases or complications due to falls. A Cox regression model showed that residents who have had previous falls (P < 0.001), are malnourished (P < 0.001), use a greater number of drugs (P < 0.001) and have more diseases (P < 0.001), are at an increased risk of hospitalisation.ConclusionNursing home residents are frequently hospitalised, often due to falls or cardiovascular diseases. Study results underscore the relationships between malnutrition, previous falls, greater numbers of drugs and diseases and higher risk of hospitalisation.Implications for practicePreventive interventions aimed at malnutrition and falls at the nursing home could potentially reduce the number of hospitalisations. With improved education and support to nurses concerning risk assessment at the nursing homes, it may be possible to reduce the numbers of avoidable hospitalisation among nursing home residents and in the long run improve quality of life and reduce suffering.
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| 18. |
- Hallgren, Jenny, et al.
(författare)
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Health- and social care in the last year of life among older adults in Sweden
- 2020
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Ingår i: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of life among persons living in ordinary housing or in assisted living facilities. METHODS: A retrospective study examining health- and social care utilization during their last year of life, using a subsample from the Swedish twin registries individually linked to several Swedish national quality registries (NQR). Persons that died during 2008-2009 and 2011-2012 (n = 1518) were selected. RESULTS: Mean age at death was 85.9 ± 7.3 (range 65.1-109.0). Among the 1518 participants (women n = 888, 58.5%), of which 741 (49%) were living in assisted living facilities and 1061 (69.9%) had at least one hospitalization during last year of life. The most common causes of death were cardiovascular disease (43.8%) and tumors (15.3%). A multivariable logistic regression revealed that living in ordinary housing, younger age and higher numbers of NQR's increased the likelihood of hospitalization. CONCLUSIONS: Persons in their last year of life consumed high amount of health- and social care although 12% did not receive any home care. Married persons received less home care than never married. Persons living in ordinary housing had higher numbers of hospitalizations compared to participants in assisted living facilities. Older persons and persons registered in fewer NQR's were less hospitalized.
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| 19. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Implementing a person centred collaborative health care model : A qualitative study on patient experiences
- 2021
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 59
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Tidskriftsartikel (refereegranskat)abstract
- Background: Collaborative Health Care (CHC) is a unique model in which ambulance services, home health care, hospital care and the national telephone helpline for healthcare in Sweden – Swedish health care direct (SHD1177) collaborate to provide the fastest possible health care for inhabitants living in eleven municipalities in western region of Sweden. Aim: To explore how patients experience and perceive health care received in the CHC. Method: Qualitative descriptive study using open-ended individual telephone interviews with fifteen community dwelling persons with experiences of care throughthe model CHC were conducted. Results: Two main categories and six subcategories were identified. The category “Thoughts of time in regard to acute health care” include “CHC leads to shorter waiting time for health care”, “Knowledge about the staff working hours” and “To alert or not alert”. The category “Thoughts on unplanned health care from CHC” involved “Receiving health care in my home”, ”Coordination from SHD1177 surprises” and “Accessibility of health care values higher than continuity”. Conclusion: Integrated health care models such as CHC are time saving and highly appreciated by community dwelling persons. The benefits of provision of coherent health care like in CHC, addresses the need to implement innovative integrated healthcare models in today's health care.
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| 20. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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In Hospital We Trust : Experiences of older peoples' decision to seek hospital care
- 2015
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Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 36:4, s. 306-311
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.
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| 21. |
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| 22. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Older persons´ arguments for seeking hospital care while receiving home health care
- 2014
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Hospitalization among older persons is not unusual and can lead to serious consequences such as iatrogenic conditions. Although the majority of the hospitalizations are necessary, there are probably a substantial number of hospitalizations that could be avoided. Many of those persons that are hospitalized are living at home, and are entitled for home health care, meaning that they can receive basic as well as advanced medical care in their own home. Little is known about older persons’ perceptions about seeking hospital care despite having home health care.Aim: To explore older persons’ reasoning for seeking hospital care.Method: Twenty-two older persons (age 66-93, 73 % females) living in southern Sweden, receiving home health care and having experiences of hospitalization, were interviewed about their health care experiences. The data was analyzed using qualitative content analysis.Results: Preliminary results indicate that the older persons’ emotions, past experiences and perceptions of health care resources influenced transitions to hospital. The results are illustrated by three categories: Home health care design; Specific medical condition; and Superior care at hospital. Conclusion: Understanding about older persons’ arguments for seeking care at hospital may have implication for how the homecare staff encounters individual’s perceived needs. Further, fulfillment of perceived health needs may reduce avoidable hospitalization and consequently improve quality of life.
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| 23. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Risk factors for hospital readmission among Swedish older adults
- 2018
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Ingår i: European Geriatric Medicine. - : Springer. - 1878-7649 .- 1878-7657. ; 9:5, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Hospital readmissions of older persons are common and often associated with complex health problems. The objectives were to analyze risk factors for readmission within 30 days from hospital discharge.MethodsA prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/ Twin Study of Aging (SATSA) was conducted. During 9 years of follow-up, information on hospitalizations, readmissions and associated diagnoses were obtained from national registers. Logistic regression models controlling for age and sex were conducted to analyze risk factors for readmissions.ResultsOf the 772 participants, [mean age 69.7 (±11.1), 84 (63%)] were hospitalized and among these 208 (43%) had one or several readmissions within 30 days during the follow-up period. Most of the readmissions (57%) occurred within the frst week; mean days from hospital discharge to readmission was 7.9 (±6.2). The most common causes of admission and readmission were cardiovascular diseases and tumors. Only 8% of the readmissions were regarded as avoidable admissions. In a multivariate logistic regression, falling within the last 12 months (OR 0.57, p=0.039) and being a male (OR 1.84, p=0.006) increased the risk of readmission.ConclusionsMost older persons that are readmitted return to hospital within the frst week after discharge. Experiencing a fall was a particular risk factor of readmission. Preventive actions should preferably take place already at the hospital to reduce the numbers of readmission. Still, it should be remembered that most readmissions were considered to be necessary.
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| 24. |
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| 25. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Trajectories of motor function and cognition in relation to hospitalization
- 2017
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Konferensbidrag (refereegranskat)abstract
- Background: Hospitalization among older people is common and associated with adverse outcomes. However, knowledge about long-term effects on motor functions and cognitive abilities in relation to hospitalization is scarce. In order to explore development of motor functions and cognition after hospitalization, a longitudinal study among middle-aged and older adults with up to 25 years of follow-up was conducted.Methods: Overall, 828 participants from the Swedish Adoption/Twin Study of Ageing (SATSA) were linked to the Swedish National Inpatient Register, which contains information on participants’ hospital admissions. Up to 8 assessments of cognitive performance and 7 assessments of motor functions i.e. fine motor, balance/upper strength, and flexibility, from 1986 to 2010 were available. Latent growth curve modelling was used to assess the association between hospitalization and subsequent motor function and cognitive performance.Results: A total of 735 (89 %) persons had at least one hospital admission during the follow-up. The mean age at first hospitalization was 70.2 (± 9.3) years. Persons who were hospitalized exhibited a lower mean level of cognitive performance in all domains and in motor functions compared with those who were not hospitalized. A significantly steeper decline was observed in motor function abilities as well as in processing speed, spatial/fluid, and general cognitive ability performance of hospitalized participants. These patterns remained even after comorbidities and dementia prevalence were controlled for.Discussion: We are the first to show that hospitalization is associated with steeper decline in both motor function and cognitive abilities across more than two decades of post-hospitalization follow-up.
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| 26. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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‘Who will do it if I don’t?’ : Nurse anaesthetists’ experiences of working in the intensive care unit during the COVID-19 pandemic
- 2022
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Ingår i: Australian Critical Care. - : Elsevier. - 1036-7314 .- 1878-1721. ; 35:1, s. 52-58
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the COVID-19 pandemic, the workload on the intensive care unit (ICU) increased nationally in Sweden as well as globally. Certified registered nurse anaesthetics (CRNAs) in Sweden were transferred at short notice to work with seriously ill patients with COVID-19 in the ICU, which is not part of the CRNAs’ specialist area. However, limited research has shed light on healthcare professionals’ experiences of the pandemic.Objectives: This study illuminates CRNAs’ experiences of working in the ICU during the COVID-19 pandemic.Methods: This study used a qualitative method with an inductive approach to interview nurse anaesthetists’ who worked in the ICU during the COVID-19 pandemic.Findings: The participants experienced ambivalent feelings towards their work in the ICU. They also lacked information, which created feelings of uncertainty and resulted in expectations that did not correspond to the reality. They described that due to an inadequate introduction, they could only provide “sufficient” care, which in many cases caused ethical stress. Not being able to get to know their new colleagues well enough to create effective cooperation created frustration. Even though the participants experienced the work in the ICU as demanding and challenging, overall, they enjoyed their time in the ICU and were treated well by their colleagues.Conclusions: While CRNAs cannot replace intensive care nurses (ICNs), they are a useful resource in the ICU in the care of patients with COVID-19. Healthcare workers who are allocated from their ordinary units to the ICU need adequate information and support from their work managers to be able to provide the best possible care and to stay healthy themselves.
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| 27. |
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| 28. |
- Hovlin, Lina, et al.
(författare)
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Mutual trust is a prerequisite for nurses’ sense of safety and work satisfaction – Mobile Integrated Care Model : A qualitative interview study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- An increasing number of older persons have complex health care needs. This, along with the organizational principle of remaining at home, emphasizes the need to develop collaborations among organizations caring for older persons. A health care model developed in Sweden, the Mobile Integrated Care Model aims to promote work in teams across organizations. The aim of the study was to describe nurses’ experiences in working and providing health care in the Mobile Integrated Care Model in the home with home health care physicians. Semi-structured interviews were conducted with 18 nurses and analyzed through qualitative content analysis. The method was compliant with the COREQ checklist. A mutually trusting collaboration with physicians, which formed person-centered care, created work satisfaction for the nurses. Working within the Mobile Integrated Care Model was negatively impacted by being employed by different organizations, lack of time to provide health care, and physicians’ person-centered work abilities.
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| 29. |
- Hovlin, Lina, et al.
(författare)
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The role of the home health care physician in mobile integrated care : a qualitative phenomenograpic study
- 2022
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing older population, along with the organizational principle of remaining at home, has moved health care from institutions into the older person’s home, where several health care providers facilitate care. The Mobile Integrated Care Model strives to provide cost-efficient, coherent, person-centered health care in the home. In the integrated care team, where the home health care physician is the medical authority, several health care professions work across organizational borders. Therefore, the aim of this study was to describe Home Health Care Physicians perceptions of working and providing health care in the Mobile Integrated Care Model, as well as perceptions of participating in and forming health care.Methods: A phenomenographic qualitative study design, with semi-structured interviews using an interview guide.Results: Working within Mobile Integrated Care Model was a different way of working as a physician. The physicians’ role was to support the patient by making safe medical decisions. Physicians described themselves as a piece in the team puzzle, where the professional knowledge of others was crucial to give quality health care. Being in the patients’ homes was expressed as adding a unique dimension in the provision of health care, and the physicians learned more about the patients by meeting them in their homes than at an institution. This aided the physicians in respecting patient autonomy in medical decision making, even though the physicians sometimes disregarded patient autonomy in favor of their own medical experience. There was a divided view on next of kin participation among the home health care physicians, ranging from always including to total absence of involving next of kin in decision making.Conclusions: The home health care physicians described the Mobile Integrated Care Model as the best way to work, but there was still a need for additional resources and structure when working in different organizations. The need for full-time employment, additional time or hours, more equipment, access to each other’s medical records, and additional collaboration with other health care providers were expressed, which could contribute to increased work satisfaction and facilitate further development of person-centered care in the Mobile Integrated Care Model.
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| 30. |
- Johansson, Linda, 1978-, et al.
(författare)
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Using aggregated data from Swedish national quality registries as tools to describe health conditions of older adults with complex needs
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33:5, s. 1297-1306
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Tidskriftsartikel (refereegranskat)abstract
- Background: Combining National Quality Registries (NQRs) with existing National Health Registries (NHRs) might make it possible to get a wider picture of older adults health situation. The aim was to examine the feasibility of aggregating data across different NQRs and existing NHRs to explore the possibility to investigate trajectories and patterns of disease and care, specifically for the most ill older adults. Method: A Swedish twin population (N = 44,816) was linked to nine NQRs and four NHRs. A descriptive mixed-method study was performed. A manifest content analysis identified which health parameters were collected from each NQR. Factor analysis identified patterns in representation across NQRs. Two case studies illustrated individual trajectories of care by using NQRs and NHRs. Results: About 36% of the population was registered in one or more NQRs. NQRs included 1849 variables that were sorted into 13 categories with extensive overlap across the NQRs. Health and function variables were identified, but few social or cognitive variables. Even though most individuals demonstrated unique patterns of multi-morbidities, factor analysis identified three clusters of representation in the NQRs with sufficient sample sizes for future investigations. The two cases illustrated the possibility of following patterns of disease and trajectories of care. Conclusions: NQRs seem to be a significant source for collecting data about a population that may be underrepresented in most research on aging because of their age and poor health. However, NQRs are primarily disease related, and further development of the registries to maximize coverage and utility is needed.
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| 31. |
- Karlsson, Ida K., et al.
(författare)
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Genetic influences on body mass index across Adulthood and late-life
- 2018
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Ingår i: Innovation in Aging. - : Oxford University Press. - 2399-5300. ; 2:suppl_1, s. 620-620
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Tidskriftsartikel (refereegranskat)abstract
- Although genetic factors significantly contribute to variation in body-mass index (BMI), the effects appear to differ with age. To investigate this, we applied polygenic methods to longitudinal data from the Swedish Twin Registry where BMI was available for age categories ranging from 20–35 to above 80. Using GCTA, a polygenic method to estimate heritability, we showed that heritability explains around 20% of the variability in BMI across age categories. However, a polygenic risk score based on the largest GWAS of BMI (PRSBMI) explained 4–6% of the variation in BMI before 65, but less than 0.5% after age 65. This indicates that while there is substantial heritability of BMI across adulthood and late-life, the genetic variants identified in GWAS mainly predict BMI before age 65. Hence, more work is warranted studying the genetics of BMI in late-life, to better understand its biology and what distinguishes it from BMI earlier in adulthood.
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| 32. |
- Larsson, Margaretha, Lektor, et al.
(författare)
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Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden : a multicentre repeated cross-sectional study
- 2024
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 14:4, s. e080995-e080995
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.DesignThe study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors.SettingStudents at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers. Participants Of 2283 students, 851 (37.3%) participated.ResultsThe students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11.ConclusionsThe association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students’ health and well-being in the long run.
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| 33. |
- Leonardsen, Ann-Chatrin Linqvist, et al.
(författare)
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Nursing students’ attitudes towards the use of digital technology in the healthcare of older adults- a cross-sectional study in Norway and Sweden
- 2023
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Implementation of digital technology has been suggested as a potential solution to future healthcare challenges. Healthcare personnel’s attitudes are important in the acceptance and implementation of digital technologies. Aim: The aims of this study were to (1) translate and validate two different questionnaires to Norwegian and Swedish respectively, and then (2) use these to examine nursing students’ attitudes towards digital technology in healthcare, as well as their attitudes towards older adults’ abilities to use digital technology. Design: Cross-sectional. Methods: A web-based questionnaire was distributed in first year nursing students in a Norwegian and a Swedish university college, respectively. The questionnaire consisted of the short form of the ‘Information Technology Attitude Scales for Health (ITASH)’ and the ‘Attitudes Towards Older Adults Using Digital technology (ATOAUT-11)’ questionnaire. The questionnaires were translated and validated in both countries. Frequencies, Student’s t-test, and one-way ANOVA were used to analyze the data. Results: In total 236 students responded to the questionnaire in the period September 2022 to April 2023. Students mainly reported positive attitudes towards digital technology use in general. They most agreed with the items ‘Using digital technology devices makes my communication with other health professionals faster’, ‘The sort of information I can get from the digital technology devices helps me give better care to patient’, and ‘Digital technology skills are becoming more and more necessary for healthcare professionals’. However, they reported more negative attitudes towards older adults using digital technology. They most agreed with the items ‘One needs a lot of patience to explain to an older adult how to use digital technologies’, ‘It’s hard to explain to older adults how to use digital technology’, ‘Using digital technology is harder for most older adults’, and ‘Most older adults fear using digital technology because they fear of being scammed or cheated’. Conclusion: The ITASH and the ATOAUT-11 is appropriate for use in a Norwegian and Swedish setting. Even if nursing students are positive to digital technology in healthcare in general, they are sceptical to older adults using digital technology. This may impact on their attitudes to using digital technology in the healthcare of older adults. These aspects need emphasis when revising nursing education curricula focusing on developing technological competencies in nursing, and gaining knowledge regarding older adults’ use of digital technology.
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| 34. |
- Mendez-Enriquez, Erika, et al.
(författare)
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IgE cross-linking induces activation of human and mouse mast cell progenitors
- 2022
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 149:4, s. 1458-1463
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Tidskriftsartikel (refereegranskat)abstract
- Background: The concept of innate and adaptive effector cells that are repleted by maturing inert progenitor cell populations is changing. Mast cells develop from rare mast cell progenitors populating peripheral tissues at homeostatic conditions, or as a result of induced recruitment during inflammatory conditions.Objective: Because FceRI-expressing mast cell progenitors are the dominating mast cell type during acute allergic lung inflammation in vivo, we hypothesized that they are activated by IgE cross-linking.Methods: Mouse peritoneal and human peripheral blood cells were sensitized and stimulated with antigen, or stimulated with anti-IgE, and the mast cell progenitor population analyzed for signs of activation by flow cytometry. Isolated peritoneal mast cell progenitors were studied before and after anti-IgE stimulation at single-cell level by time-lapse fluorescence microscopy. Lung mast cell progenitors were analyzed for their ability to produce IL-13 by intracellular flow cytometry in a mouse model of ovalbumin-induced allergic airway inflammation.Results: Sensitized mouse peritoneal mast cell progenitors demonstrate increased levels of phosphorylation of tyrosines on intracellular proteins (total tyrosine phosphorylation), and spleen tyrosine kinase (Syk) phosphorylation after antigen exposure. Anti-IgE induced cell surface-associated lysomal-associated membrane protein-1 (LAMP-1) in naive mast cell progenitors, and prompted loss of fluorescence signal and altered morphology of isolated cells loaded with lysotracker. In human mast cell progenitors, anti-IgE increased total tyrosine phosphorylation, cell surface-associated LAMP-1, and CD63. Lung mast cell progenitors from mice with ovalbumin-induced allergic airway inflammation produce IL-13.Conclusions: Mast cell progenitors become activated by IgE cross-linking and may contribute to the pathology associated with acute allergic airway inflammation.
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| 35. |
- Mendez-Enriquez, Erika, et al.
(författare)
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Mast cell-derived serotonin enhances methacholine-induced airway hyperresponsiveness in house dust mite-induced experimental asthma
- 2021
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:7, s. 2057-2069
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Airway hyperresponsiveness (AHR) is a feature of asthma in which airways are hyperreactive to stimuli causing extensive airway narrowing. Methacholineprovocations assess AHR in asthma patients mainly by direct stimulationofsmooth muscle cells. Using in vivo mouse models, mast cells have been implicated in AHR,but the mechanism behind has remained unknown.METHODS: Cpa3Cre/+ mice, which lack mast cells, were used to assess the role of mast cells inhouse dust mite (HDM)-induced experimental asthma. Effects of methacholine in presence or absence of ketanserin were assessed on lung function, andin lung mast cells in vitro. Airway inflammation, mast cell accumulation and activation, smooth muscle proliferation,HDM-induced bronchoconstriction were evaluated.RESULTS: Repeated intranasal HDM sensitization induced allergic airway inflammation associated with accumulation and activation of lung mast cells. Lack of mast cells, absence of activating Fc-receptors, or antagonizingserotonin (5-HT)2A receptors abolishedHDM-induced trachea contractions.HDM-sensitized mice lacking mast cells had diminished lung-associated 5-HT levels, reduced AHR and methacholine-induced airway contraction, while blocking 5-HT2A receptors in wild types eliminated AHR, implying that mast cells contribute to AHR by releasing 5-HT. Primary mouse and human lung mast cells express muscarinic M3 receptors. Mouse lung mast cells store 5-HT intracellularly, and methacholine induces release of 5-HT from lung-derived mouse mast cells and Ca2+ flux in human LAD-2 mast cells.CONCLUSIONS: Methacholineactivates mast cells to release 5-HT, which by acting on 5-HT2A receptors enhances bronchoconstriction and AHR. Thus, M3-directed asthma treatments like tiotropium may also act by targeting mast cells.
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| 36. |
- Salomonsson, Maya, et al.
(författare)
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Circulating mast cell progenitors correlate with reduced lung function in allergic asthma
- 2019
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 49:6, s. 874-882
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStudies using mouse models have revealed that mast cell progenitors are recruited from the blood circulation to the lung during acute allergic airway inflammation. The discovery of a corresponding human mast cell progenitor population in the blood has enabled to study the relation of circulating mast cell progenitors in clinical settings.ObjectivesTo explore the possible association between the frequency of mast cell progenitors in the blood circulation and allergic asthma, we assessed the relation of this recently identified cell population with asthma outcomes and inflammatory mediators in allergic asthmatic patients and controls.MethodsBlood samples were obtained, and spirometry was performed on 38 well‐controlled allergic asthmatic patients and 29 controls. The frequency of blood mast cell progenitors, total serum IgE and 180 inflammation‐ and immune‐related plasma proteins were quantified.ResultsAllergic asthmatic patients and controls had a similar mean frequency of blood mast cell progenitors, but the frequency was higher in allergic asthmatic patients with reduced FEV1 and PEF (% of predicted) as well as in women. The level of fibroblast growth factor 21 (FGF‐21) correlated positively with the frequency of mast cell progenitors, independent of age and gender, and negatively with lung function. The expression of FcεRI on mast cell progenitors was higher in allergic asthmatic patients and correlated positively with the level of total IgE in the controls but not in the asthmatic patients.ConclusionElevated levels of circulating mast cell progenitors are related to reduced lung function, female gender and high levels of FGF‐21 in young adults with allergic asthma.
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- Snögren, Maria, et al.
(författare)
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Hearing-impaired and deaf individuals' perceptions of primary healthcare in Sweden : A mixed-methods study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:2
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Tidskriftsartikel (refereegranskat)abstract
- People with impaired hearing or deafness often perceive communication barriers when and participating in their daily lives, such as when contacting primary healthcare, leading to a risk of them using emergency services for less urgent conditions. Therefore, the aim of the present study was to describe the perceptions of individuals with hearing impairments and deafness in relation to the treatment and communication they received from primary healthcare professionals. The study employed a mixed-methods design, and the data comprised questionnaire responses from 101 individuals with hearing impairments or deafness, including 11 open-ended questions, analyzed with conventional content analysis. The study was evaluated using the COREQ checklist and the GRAMMS guidelines to further improve the transparency of the research. The results indicate that healthcare professionals who are responsive, considerate, and respectful regarding communication were perceived among people with hearing impairments or deafness to be professionals. The ideal healthcare encounter for people with hearing impairments or deafness would be where the healthcare professionals could perform sign language, which would allow the healthcare professional to communicate freely. Healthcare professionals need more knowledge about how they can best meet, care for, and communicate with individuals with hearing impairments or deafness.
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- Åberg, Cecilia, 1976-
(författare)
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Striving for meaning in a diminishing world : Older persons’ experiences of reflective STRENGTH-giving dialogues including a digital tool
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Reflective STRENGTH-Giving Dialogue (STRENGTH) method was developed, grounded in a lifeworld perspective, with a focus on identifying and meeting older persons’ needs for the promotion of health and well-being. In this thesis, STRENGTH, including the digital tool SelfSTRENGTH, was tested in the context of community-dwelling older persons living with long-term health problems.The overall aim was to describe how life with long-term health problems is experienced and influenced by the Reflective STRENGTH-Giving Dialogue intervention, including the SelfSTRENGTH app, by community-dwelling older persons.The research was conducted based on a reflective lifeworld approach, through qualitative and quantitative method studies. Three of the studies had a qualitative, descriptive, and inductive design based on individual interviews and reflection notes with the older persons in the intervention group (Papers I–III). Analysis was conducted using phenomenology (Papers I–II), and phenomenography (Paper III). One study had a quasi-experimental pretest-posttest no-treatment control group design (Paper IV), and was analyzed using nonparametric paired statistics. Altogether, 60 older persons in the fourth age participated in the studies.The finding showed, according to self-reports, that STRENGTH immediately and significantly reduced the impact of health problems on daily life, and increased well-being after each single dialogue. The content and outcome of the dialogues are affected by intersubjectivity, which is influenced by the healthcare professional (HCP) and the older person’s ability, as well as the relationship between them. STRENGTH dialogues that have an existential dimension are described as a starting point to provide a “push” toward joy and meaning. When the understanding of an older person’s holistic situation, including the past, present, and future, is tactfully and sensitively challenged with reflection and an emphasis on possibilities, the dialogues support joy and meaning in life. Dialogues of this nature have been lacking, as older persons may choose not to have that conversation with their family or HCPs, and HCPs may not attend to the older person’s existential needs and concerns. It is important when living in the feeling of a diminishing world for older persons to be involved in decisions that concern their lives and care, and to engage in life projects that improve well-being. This is made possible through the dialogues and use of the SelfSTRENGTH app. However, use of the app is hindered by resistance to digital technology and the occurrence of health problems.To foster healthy ageing, HCPs need increased knowledge and favorable conditions for caring conversations and provision of digital support that older persons with long-term health problems need for participation in a digital society.
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