| 1. |
- Hildingsson, Ingegerd, et al.
(author)
-
Fathers experiences of support during pregnancy and the first year following childbirth - Findings from a Swedish regional survey
- 2011
-
In: Journal of Men's Health. - : IMR Press. - 1875-6867 .- 1875-6859. ; 8:4, s. 258-266
-
Journal article (peer-reviewed)abstract
- Background: Support during pregnancy is mainly directed towards pregnant women, although parenthood is viewed as a joint project by society and by parents themselves. Research has shown that fathers often feel excluded by health care professionals. The aim of the present study was to describe personal and professional sources of support used by prospective and new fathers and to study factors associated with fathers having no support from anyone in mid-pregnancy. Methods: This was a prospective longitudinal study of 655 new fathers living in a northern part of Sweden who completed four questionnaires. Results: The majority of fathers reported having good personal support at most time points, but 18% reported that they did not have support from anyone, when asked in mid-pregnancy. A logistic regression analysis showed that the following factors were associated with not receiving support from anyone: having previous children (odds ratio (OR) = 3.4; 95% confidence interval (CI) = 1.7-7.0, P <0.001), expectations from the midwife to attend antenatal visits (OR = 1.9; 95% CI = 1.1-3.4, P <0.05), not attending parent education classes (OR = 2.3; 95% CI = 1.1-4.8, P <0.05), not feeling involved by the prenatal midwife (OR = 1.9; 95% CI = 1.1-3.3, P <0.05), and not being offered the opportunity to attend fathers' groups (OR = 3.5; 95% CI = 1.1-12.3, P <0.05). Conclusion: Although personal support seemed satisfying for the majority of fathers, those with no support from close family/friends also lacked support from midwives as well in terms of the organization of care.
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| 2. |
- Jong, Miek C, 1968-, et al.
(author)
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P02.128. The effects of guided imagery on preoperative anxiety and pain management in patients undergoing Laparoscopic Cholecystectomy in a multi-centre RCT study
- 2012
-
In: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012. BMC Complementary and Alternative Medicine 2012, 12(Suppl 1): P184 (12 June 2012). - : BioMed Central. ; , s. 184-
-
Conference paper (peer-reviewed)abstract
- PurposeLaparoscopic Cholecystectomy (LC) is common practicein treatment of symptomatic gall stones. LC is often associatedwith preoperative anxiety and stress which maynegatively impact postoperative pain perception andrecovery from surgery. The aim of the present study wasto investigate whether a “non-pharmacological” interventionwith guided imagery can reduce preoperative anxiety,postoperative pain perception and medication comparedto standard care in patients undergoing LC.MethodsIn a pragmatic multi-centre randomized controlled study140 patients were randomized to a Guided Imagery (GI)group or control group. The GI group was provided witha CD to practice guided imagery once a day, 7 days priorto surgery. Patients in the control group received standardcare instructions only. Primary outcome measurement wasthe use of postoperative analgesics. Secondary outcomeparameters were preoperative anxiety levels using theAmsterdam Preoperative Anxiety and Information Scale(APAIS), postoperative pain perception (VAS-scale), generalpatient satisfaction (PSQ) and safety (adverse events)with treatment.Results95 out of 140 randomized patients completed the study,43 in the GI and 52 in the control group. The major reasonsfor dropping out were acute LCs or cancellation ofLC. Both groups were highly comparable with respect todemographic data. The majority was female (GI: 77%,Control: 75%). Postoperative morphine use was not significantlydifferent between the GI (15.8±18.5 mg) andcontrol group (12.5±13.6 mg, p=0.34). No significant differenceswere observed in anxiety and postoperative VASscores. Twenty-three percent of patients did exercises1-3 times, 65% 4-7 times and 12% >7 times. Within GIgroup analysis showed significantly less postoperativemorphine use upon better compliance to GI exercises(p=0.02).ConclusionIt is not as simple as replacing a pill with a CD. GuidedImagery seems to reduce postoperative pain medicationonce compliance to imagery exercises is achieved.
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| 3. |
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| 4. |
- Karlström, Annika, et al.
(author)
-
Postoperative pain after cesarean birth affects breastfeeding and infant care
- 2007
-
In: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 36:5, s. 430-440
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To study women's experience of postoperative pain and pain relief after cesarean birth and factors associated with pain assessment and the birth experience. DESIGN: Descriptive patient survey. Data were collected through a questionnaire. The outcome variables were assessments of pain using a Visual Analog Scale and women's birth experience measured on a seven-point Likert scale. SETTING: Central Swedish county hospital, maternity unit. PATIENTS/PARTICIPANTS: The sample consisted of 60 women undergoing cesarean birth. RESULTS: Women reported high levels of experienced pain during the first 24 hours. Seventy-eight percent of the women scored greater than or equal to 4 on the Visual Analog Scale, which can be seen as inadequately treated pain. There was no difference between elective and emergency cesarean births in the levels of pain. In spite of high levels of pain, women were pleased with the pain relief. The risk of a negative birth experience was 80% higher for women undergoing an emergency cesarean birth compared with elective cesarean birth. Postoperative pain negatively affected breastfeeding and infant care. CONCLUSIONS: There is a need for individual and adequate pain treatment for women undergoing cesarean birth, as high levels of pain interfere with early infant care and breastfeeding.
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| 5. |
- Karlström, Annika, et al.
(author)
-
Women's postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesareansection
- 2010
-
In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 19:9-10, s. 1326-1334
-
Journal article (peer-reviewed)abstract
- Aim.The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.Background.Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.Design.Comparative patient survey.Methods.Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.Results.The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.Conclusions.Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.Relevance to clinical practice.The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.
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| 6. |
- Langenes, Veronica, et al.
(author)
-
Expression of the chemokine decoy receptor D6 is decreased in colon adenocarcinomas.
- 2013
-
In: Cancer immunology, immunotherapy : CII. - : Springer Science and Business Media LLC. - 1432-0851 .- 0340-7004. ; 62:11, s. 1687-1695
-
Journal article (peer-reviewed)abstract
- Recruitment of immune cells to tumors is a complex process crucial for both inflammation-driven tumor progression and specific anti-tumor cytotoxicity. Chemokines control the directed migration of immune cells, and their actions are partly controlled by nonsignaling chemokine decoy receptors. The role of the receptors such as D6, Duffy antigen receptor for chemokines and ChemoCentryx chemokine receptor in immunity to tumors is still unclear. Using real-time PCR, we detected significantly decreased expression of D6 mRNA in colon tumors compared to unaffected mucosa. D6 protein was expressed by lymphatic endothelium and mononuclear cells in the colon lamina propria and detected by immunohistochemistry in two out of six tissue samples containing high D6 mRNA levels, whereas no staining was observed in any tissue samples expressing low mRNA levels. When examining the density of lymphatic vessels in colon tumors, we detected a marked increase in vessels identified by the lymphatic endothelial marker Lyve-1, excluding passive regulation of D6 due to decreased lymphatic vessel density. In parallel, the Treg-recruiting chemokine CCL22, which is sequestered by D6, was threefold increased in tumor tissue. Furthermore, we could show that low D6 expression correlated to more invasive tumors and that tumor location influences D6 expression, which is lower in the more distal parts of the colon. The data support that regulation of D6 by colon tumors results in altered levels of proinflammatory CC chemokines, thereby shaping the local chemokine network to favor tumor survival. This may have implications for the design of future immunotherapy for colon cancer.
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| 7. |
- Olsson, Helén, 1961-, et al.
(author)
-
Decreased risk for violence in patients admitted to forensic care, measured with the HCR-20
- 2013
-
In: Archives of Psychiatric Nursing. - : Saunders Elsevier. - 0883-9417 .- 1532-8228. ; 27:4, s. 191-197
-
Journal article (peer-reviewed)abstract
- AIM: The aim of this study was to explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the clinical (C) and risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.METHODS: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.RESULTS: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.CONCLUSION: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.
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| 8. |
- Sjöling, Mats, 1968-, et al.
(author)
-
Auricular acupuncture versus sham acupuncture in the treatment of women suffering from insomnia
- 2008
-
In: Journal of Alternative and Complementary Medicine. - : Mary Ann Liebert Inc Publishers. - 1075-5535 .- 1557-7708. ; 14:1, s. 39-46
-
Journal article (peer-reviewed)abstract
- Background: Improvement in sleep parameters in relation to acupuncture treatment is often found and referredto as being a positive side-effect in the treatment of other illnesses. There is a lack of randomized studies,which primarily study the direct effect of acupuncture on sleep.Objectives: To investigate whether or not auricular acupuncture has an effect on sleep parameters amongpeople with insomnia.Design: A single-blind, randomized pilot study where the treatment group received auricular acupuncturetreatment (AAT) on active points and the control group received AAT on sham points during a 6-week treatmentperiod.Setting: Participants were recruited from the psychiatric outpatient clinics in the geographical area connectedto a local hospital in central Sweden.Subjects: In all, 28 women were included in the study, with 14 in each group. Their mean and median agewas 53 years.Outcome Measures: Sleep parameters were obtained by using the Karolinska Sleep Diary.Results: No statistically significant differences were observed between the groups relating to parameters associatedwith the definition of insomnia. The treatment group experienced that it was easier to wake up in themorning compared with the control group (repeated-measures analysis of variance, p 0.04). Both groupsshowed a statistically significant recovery in subjective sleep parameters during the study period (weeks 1–6)compared with baseline values (week 0).Conclusions: Only modest evidence was found supporting the hypothesis that AAT may have an effect oninsomnia. Least improvements were found in total sleep time and number of awakenings, 2 parameters directlyassociated with the definition of insomnia. AAT may have a role in the treatment of insomnia, especially incombination with other treatments such as cognitive behavioral therapy. This study provides an example of how to perform studies using alternative therapies for sleep disorders.
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| 9. |
- Sjöling, Mats, 1968-, et al.
(author)
-
Effectiveness of motivational interviewing and physical activity on prescription on leisure exercise time in subjects suffering from mild to moderate hypertension
- 2011
-
In: BMC Research Notes. - : BioMed Central. - 1756-0500. ; 4
-
Journal article (peer-reviewed)abstract
- Background: Physical inactivity is considered to be the strongest individual risk factor for poor health in Sweden. It has been shown that increased physical activity can reduce hypertension and the risk of developing cardiovascular diseases. The objective of the present pilot study was to investigate whether a combination of Motivational Interviewing (MI) and Physical Activity on Prescription (PAP) would increase leisure exercise time and subsequently improve health-related variables.Methods: This pilot study was of a repeated measures design, with a 15 months intervention in 31 patients with mild to moderate hypertension. Primary outcome parameter was leisure exercise time and secondary outcome parameters were changes in blood pressure, Body Mass Index (BMI), waist circumference, lipid status, glycosylated haemoglobin (HbA1c) and maximal oxygen uptake (VO2 max). Assessments of the outcome parameters were made at baseline and after 3, 9 and 15 months.Results: Leisure exercise time improved significantly from < 60 min/week at baseline to a mean activity level of 300 ( 165) minutes/week at 15 months follow up. Furthermore, statistically significant improvements (p < 0.05) were observed in systolic (-14,5 8.3 mmHg) and diastolic blood pressure (-5,1 5.8 mmHg), heart rate (-4.9 8.7 beats/min, weight (-1.2 3.4 kg) BMI -0.6 1.2 kg/m2), waist circumference (-3.5 4.1 cm) as well as in VO2 max(2.94 3.8 ml/kg and 0.23, 0.34 lit/min) upon intervention as compared to baseline.Conclusions: A 15 month intervention period with MI, in combination with PAP, significantly increased leisure exercise time and improved health-related variables in hypertensive patients. This outcome warrants further research to investigate the efficacy of MI and PAP in the treatment of mild to moderate hypertension.
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| 10. |
- Sjöling, Mats, 1968-
(author)
-
Experiences of abandonment and anonymity among arthroplastic surgery patients in the perioperative period : some issues concerning communication, pain and suffering
- 2005
-
Doctoral thesis (other academic/artistic)abstract
- Det övergripande syftet med avhandlingsarbetet är att illustrera och belysa upplevelsen av att vara patient med behov av ledprotes, avseende aspekterna kommunikation, smärtupplevelse, lidande och tillfredsställelse med vård och behandling. Under väntetiden för ledprotesoperation upplever deltagarna i studierna lidande i olika former, tillika att vården är otillgänglig och onåbar i ett ansiktslöst system (I). Att få information om sin sjukdom vad man kan/får/ska göra är nästan omöjligt. Kontakten med sjukvården är svår att upprätta och det är mestadels patientens ansvar att söka information om vad som händer (II). Den bristfälliga kommunikationen som deltagarna i delstudie I upplever, leder till att de känner sig missförstådda och nedvärderade av sjukvårdssystemet, och därmed befinner sig i en ständig kamp för att få sitt vårdbehov bekräftat. Under deltagarnas vandring i sjukvårdssystemet förändras deras negativa uppfattning om vården till att bli mer positiv när en reell kommunikation och personlig kontakt etablerats (IIV). Fynden i arbetena (I-IV) tolkas inom ramen för Katie Erikssons och Lennart Fredrikssons beskrivningar av lidande och det vårdande samtalet. En del deltagare i studierna har av egen kraft, eller till följd av personliga egenskaper uppnått insikter om sig själva och försonats med sitt lidande, på så sätt har de kunnat bibehålla eller uppnå mening i sin tillvaro. Av egen kraft, eller med hjälp av anhöriga kan individerna få sitt lidande bekräftat och därmed möjligheten att kunna lida ut och försonas med sig själv och den förändrade tillvaron. Så länge som sjukvården upplevs som ett ansiktslöst system finns det deltagare i avhandlingen som inte klarar av att ta itu med sitt lidande. Under patientens vandring i sjukvårdssystemet blir det uppenbart att systemet får ett ansikte först när deltagarna kan relatera till vården i form av en reell person. Vården får inte ett ansikte så länge som patienten upplever sig dåligt bemött utan detta sker när det med Fredrikssons termer uppstår ett vårdande samtal. Under väntetiden för operation finns det relativt få tillfällen där ett vårdande samtal har möjlighet att uppstå. Möjligheten för detta är dock större när patienten väl är inlagd på sjukhuset för att bli opererad, vilket återspeglas i den höga grad av tillfredsställelse med vården som uttrycks i delstudie II-IV. Patienterna är tillfredsställda med vård och behandling, trots att de har upplevt postoperativ smärta i en hög grad. I delstudie III var det 68% (n=40) och i delstudie IV 83.5% (n=50) som hade upplevt smärtor motsvarande ≥ 4 på Visuell Analog Skala (VAS). Under sjukhusvistelsen upplever sig patienten bekräftad och synlig i systemet. Synligheten är ömsesidig då även vården (systemet) får ett ansikte på patienten. I ett vårdande samtal uppstår en känsla av tillit och när detta sker vågar patienten och vårdaren kommunicera på ett öppet sätt där de båda är närvarande i situationen
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| 11. |
- Sjöling, Mats, 1968-, et al.
(author)
-
Is tactile massage (touch massage) a treatment option for primary insomnia?
- 2010
-
Conference paper (peer-reviewed)abstract
- The primary objective of the present trial was to study if tactile massage (TM) was equivalent to nurse led sleep counseling (SC) in the treatment of primary insomnia. In the randomized controlled design in total 30 women (aged 18-65 years) was allocated to one of three groups; TM, SC or a control group. Treatment with TM was administered twice a week for six weeks, SC once a week for six weeks. Subjective sleep quality (Karolinska sleep diary) during was assessed during baseline (week 0) until week 6.and at subsequent follow up at week 7, and 13. Objective sleep quality (Polysomnography) and parameters of subjective health (SF-36, Shirom-Melamed Burnout Questionnaire) and several physiological markers of stress (Cortisol, HbA1c, Blood Pressure) was assessed at baseline and subsequent follow up. Data analysis shall be analyzed with R-ANOVA methodology. Data collection will be completed by April 2010 and preliminary findings will be presented at ICCMR 2010. Primary insomnia a d other sleep disorders are a major public health problem worldwide. Sleep has an important role in the balance act between health and disease. Insufficient sleep and restitution is acknowledged as a factor contributing cardiovascular disease and lethal injury. Tactile stimulation stimulates the release of hormones, for example oxytocin which is important for the circadian homeostasis, and also related to the parasympathetic nervous system. Treatment of sleep disorders with Cognitive Behavioural Therapy (CBT), is so far the only long-term evidence based treatment for primary insomnia. Within regular health care there is no sustainable treatment for people with primary insomnia, hypnotic drugs only has short term effects and several side effects. CBT shows promising results but the availability of therapists are scarce. Nurse led SC or/and TM may have a role in the treatment of people with sleep disorders through its low-tech/low-cost design and an absence of side effects
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| 12. |
- Sjöling, Mats, et al.
(author)
-
Patient satisfaction with postoperative pain management despite experiencing high levels of pain
- 1998
-
In: European Nurse. - 1358-8621. ; 3:4, s. 264-273
-
Journal article (peer-reviewed)abstract
- .European Nurse 3(4): 264-273. The survey was conducted at a Swedish county hospital. Fifty-nine patients undergoing orthopaedic surgery (hip and knee arthroplasty) participated. In structured interviews, the patients answered questions about preoperative information, general satisfaction with nursing care and on assessment of their postoperative pain. On the fourth day after surgery, they were asked to estimate their experienced level of postoperative pain on the Visual Analogue Scale (VAS). The results reveal that approximately 70% of the patients undergoing surgery for knee arthroplasty (KA) had experienced pain corresponding to at least >/=4 on the VAS. This was very different from the study hypothesis, which was that fewer than half the patients would experience pain of >/=4 on VAS. Patients undergoing KA experienced significantly more pain postoperatively than patients undergoing hip arthroplasty (HA) (p = 0.001). Of HA patients, 46% experienced pain of 2:4 on the VAS; this was also slightly more than the study hypothesis. Forty-nine percent of patients had received information about pain and pain treatment on admission to hospital. Patients who had received information had a slight tendency to experience higher levels of pain, on movement (p = 0.077). In spite of high levels of experienced pain among a large number of the patients, they were generally satisfied with their pain management and the nursing care and the personal approach of the hospital staff. The ethics committee at the University of Umea approved the study.
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| 13. |
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| 14. |
- Sjöling, Mats, et al.
(author)
-
Patientens upplevelse av postoperativ smärtlindring. : information preoperativt, bemötande av personal
- 1997
-
Reports (other academic/artistic)abstract
- Denna studie är genomförd på ortopedkliniken vid Sundsvalls Sjukhus. Femtionio patienter som ge-nomgått planerad ledplastik deltog (höft, knä). I strukturerade intervjuer har patienterna fått svara på frågor om de informerats om smärtlindring före operation, allmän tillfredsställelse med vården och omhändertagandet av deras smärtor efter operation. Det visade sig att ca 70% av de patienter som opererat in knäprotes, har upplevt postoperativa smärtor motsvarande 4 (minst 4) på VAS. Detta var betydligt mer än utgångshypotesen, vilken var att mindre än hälften skulle uppleva smärtor motsva-rande 4 på VAS. Knäpatienterna hade signifikant mer smärtor postoperativt än de som fått en höft-protes inope- rerad (p= 0.001). Av dessa upplevde ca 50% smärtor 4 på VAS, även det en högre in-cidens än hypotesen. Visst samband ses mellan upplevelse av höga smärtnivåer preoperativt och post-operativt. Av patienterna som deltog i studien hade endast hälften fått information om smär-ta/smärtlindring före operation. De som fått information hade en viss tendens till att uppleva rörelse-smärtor i högre grad postoperativt (p=0.077).
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| 15. |
- Sjöling, Mats, 1968-, et al.
(author)
-
Skydiving culture and its relation to injury risks and injury reporting
- 2010
-
Conference paper (peer-reviewed)abstract
- This article explores some aspects of the Swedish skydiving culture and its relation to injury risks and injury reporting. The reference frame emerging from the analyses encompasses experiences of joy, passion and playfulness; and of injury, suffering and death. For the individual the risk of injury is viewed as an integrated element of the recreational activity, counterbalanced by its recreational value. From the findings we suggest that Swedish skydiving culture on an organisational level is carried by the local club; not the national association. Though the association has far-reaching powers over the clubs, skydiving culture at the local drop zone and formal and informal hierarchical structures among skydivers are what really decide how rules are enforced, and if incidents and injuries are reported.
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| 16. |
- Sjöling, Mats, et al.
(author)
-
Skydiving culture and its relation to injury risks and injury reporting
-
Other publication (pop. science, debate, etc.)abstract
- This article explores some aspects of the Swedish skydiving culture and its relation to injury risks and injury reporting. Seventeen skydivers were interviewed and the transcripts were analyzed with latent and manifest content analyses. The reference frame emerging from the narratives encompasses experiences of joy, passion and playfulness; and of injury, suffering and death. The risk of injury is viewed as an integrated element of the recreational activity, counterbalanced by its recreational value. From the text analysis we suggest that Swedish skydiving culture is carried by the local club; not the national association. Though the Swedish Parachute Association has far-reaching powers over the clubs, our findings imply that skydiving culture at the local drop zone and formal and informal hierarchical structures among skydivers are what really decide how rules are enforced, and if incidents and injuries are reported.
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| 17. |
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| 18. |
- Sjöling, Mats, 1968-, et al.
(author)
-
Tactile massage and nurse led sleep counseling in the treatment of primary insomnia
- 2010
-
Conference paper (peer-reviewed)abstract
- The primary objective of the present trial was to study if tactile massage (TM) was equivalent to nurse led sleep counseling (SC) in the treatment of primary insomnia. In the randomized controlled design in total 30 women (aged 18-65 years) was allocated to one of three groups; TM, SC or a control group. Treatment with TM was administered twice a week for six weeks, SC once a week for six weeks. Subjective sleep quality (Karolinska sleep diary) during was assessed during baseline (week 0) until week 6.and at subsequent follow up at week 7, and 13. Objective sleep quality (Polysomnography) and parameters of subjective health (SF-36, Shirom-Melamed Burnout Questionnaire) and several physiological markers of stress (Cortisol, HbA1c, Blood Pressure) was assessed at baseline and subsequent follow up. Data analysis shall be analyzed with R-ANOVA methodology. Data collection will be completed by April 2010 and preliminary findings will be presented at ICCMR 2010. Primary insomnia a d other sleep disorders are a major public health problem worldwide. Sleep has an important role in the balance act between health and disease. Insufficient sleep and restitution is acknowledged as a factor contributing cardiovascular disease and lethal injury. Tactile stimulation stimulates the release of hormones, for example oxytocin which is important for the circadian homeostasis, and also related to the parasympathetic nervous system. Treatment of sleep disorders with Cognitive Behavioural Therapy (CBT), is so far the only long-term evidence based treatment for primary insomnia. Within regular health care there is no sustainable treatment for people with primary insomnia, hypnotic drugs only has short term effects and several side effects. CBT shows promising results but the availability of therapists are scarce. Nurse led SC or/and TM may have a role in the treatment of people with sleep disorders through its low-tech/low-cost design and an absence of side effects.
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| 19. |
- Sjöling, Mats, et al.
(author)
-
The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management.
- 2003
-
In: Patient Education and Counseling. - 0738-3991 .- 1873-5134. ; 51:2, s. 169-176
-
Journal article (peer-reviewed)abstract
- The primary objective of this study was to test whether specific information given prior to surgery can help patients obtain better pain relief after total knee arthroplasty (TKA). Secondary objectives were to study the impact of preoperative information on state and trait anxiety, satisfaction with pain management and satisfaction with nursing care. The study was an intervention study with two groups of equal size (n ¼ 30). The intervention group was given specific information while the control group received routine information. Pain assessments were made preoperatively and every 3 h for the first three postoperative days, using the visual analogue scale (VAS). The results of this study suggest that information does influence the experience of pain after surgery and related psychological factors. The postoperative pain declined more rapidly for patients in the treatment group, the degree of preoperative state anxiety was lower and they were more satisfied with the postoperative pain management.
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| 20. |
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| 21. |
- Sjöling, Mats, et al.
(author)
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Waiting for surgery; living a life on hold : A continuous struggle against a faceless system
- 2005
-
In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 42:5, s. 539-547
-
Journal article (peer-reviewed)abstract
- This interpretive-phenomenological study examined the lived experience of being on the waiting list for arthroplastic surgery of the knee or hip and its impact on daily life. The interviews reveal that respondents experience suffering from different points of view; illness-, caring- and life- suffering. Suffering leads to a struggle in order to have their caring needs met and the struggle is often fruitless - against a faceless enemy - "the system". No one is there to answer their plea or to address the frustration that then arises and, in combination with their present life situation, this may lead to a disrupted self-image. Finding or creating meaning in suffering appears to be a crucial issue in the struggling process. Respondents who are able to preserve or create meaning in life may find it easier to accept the waiting times and wait for their turn in the queue. They are able to reformulate their life-world and live a full life, in spite of severe pain and disability.
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| 22. |
- Sjöling, Mats, et al.
(author)
-
What information do patients waiting for and undergoing arthroplastic surgery want? Their side of the story
- 2006
-
In: Journal of Orthopaedic Nursing. - : Elsevier BV. - 1361-3111 .- 1873-4839. ; 10:1, s. 5-14
-
Journal article (peer-reviewed)abstract
- This nurse-led focus-group study investigated information needs of patients waiting for arthroplastic surgery – how did they obtain the information and advice they needed? The content analysis of the interview transcripts revealed two main categories – ways of obtaining information and advice and what is needed – what patients want. In the picture emerging from the findings, it is evident that the content of the information that is given does not solely determine whether the respondents’ information needs are met. The way the information is given and whether the respondent is confirmed as a human being and taken seriously by the staff, is believed to be more important in the mutual process of communicating information. On a concrete level, respondents ask for information and advice on what they can do to manage their present life situation while waiting for surgery; this includes pain management, advice on self-training and contact with physiotherapists. They want to know “when” surgery will be performed and to be given opportunities to ask questions. This study serves as another piece in the puzzle investigating patients’ information needs. Implications for nursing are discussed, together with suggestions for future areas of research.
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| 23. |
- Thureborn, Petter
(author)
-
Microbial Ecosystem Functions Along the Steep Oxygen Gradient of the Landsort Deep, Baltic Sea
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Through complex metabolic interactions aquatic microbial life is essential as a driver of ecosystem functions and hence a prerequisite for sustaining plant and animal life in the sea and on Earth. Despite its ecological importance, information on the complexity of microbial functions and how these are related to environmental conditions is limited. Due to climate change and eutrophication, marine areas facing oxygen depletion are increasing and predicted to continue to do so in the future. Vertically steep oxygen gradients are particularly pronounced in the Baltic Sea. In this thesis, therefore, the ecosystem functions of microbial communities were investigated, using metagenomics, to understand how they were distributed along the steep oxygen gradient at the Landsort Deep, the deepest point of the Baltic Sea. Furthermore, microbial communities from the Landsort Deep transect were compared to microbial communities of other marine environments to establish whether the environment at this site resulted in a characteristic community. To reveal what microbial community functions and taxa were active in the anoxic sediment a metatranscriptomic approach was used. Results showed a marked effect of the coupled environmental parameters dissolved oxygen, salinity and temperature on distribution of taxa and particularly community functions. Microbial communities showed functional capacities consistent with a copiotrophic life-style dependent on organic material sinking through the water column. The eutrophic condition with high organic load was further reflected in the metatranscriptome of the anoxic sediment community, which indicated active carbon mineralisation through anaerobic heterotrophic-autotrophic community synergism. New putative linkages between nitrogen and- sulphur metabolisms were identified at anoxic depths. Furthermore, viable Cyanobacteria in the anoxic sediment was evident from the transcript analyses as another reflection of marine snow. High abundance and expression of integron integrases were identified as a characteristic feature of the Landsort Deep communities, and may provide these communities with a mechanism for short-term-adaptation to environmental change. In summary, this thesis clearly documents what impact eutrophication and oxygen depletion have on microbial community functions. Furthermore, it specifically advances the mechanistic insight into microbial processes in anoxic deep-water sediment at both genomic and transcriptional level. Given the predicted progress of oxygen depletion in marine and brackish environments, this work advances information necessary to estimate effects on marine and in particular brackish ecosystem functions where anoxic conditions prevail.
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| 24. |
- Westman, Anton, et al.
(author)
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The SKYNET data: Demography and injury reporting in Swedish skydiving
- 2010
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In: Accident Analysis and Prevention. - London, United Kingdom : Elevier Science. - 0001-4575 .- 1879-2057. ; 42:2, s. 778-783
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Journal article (peer-reviewed)abstract
- Background: The Swedish Parachute Association (SFF) national registry of skydiving injuries is one of the few trauma databases available for research on sport parachuting. The usefulness of this compulsory reporting system may benefit from a description of its base population and an evaluation of its sensitivity and specificity. Methods: Cross-sectional analysis based on data collected through a web-based questionnaire (SKYNET), from all persons renewing a Swedish skydiving license 2008(n=1049). Sensitivity was measured as the proportion of injury events fulfilling the reporting criterion(injury event requiring care of a physician) that were actually reported, by comparing the injury events reported to the SFF during the skydiving seasons 2006 and 2007 with the injury events retrospectively reported to the webbased questionnaire for the same time period. Specificity was measured as the proportion of false positives in relation to the defined reporting criterion for the same time period. Self-stated bone fractures, shoulder dislocations and cruciate ligament injuries were labeled as non-minor injuries. Factors affecting the likelihood of reporting were evaluated using logistic regression. Results: The response rate was 100%. The overall sensitivity of the reporting system 2006/2007 was 0.37(95% confidence interval(CI) 0.24-0.51). With self-stated non-minor injuries as the target for reporting, the sensitivity was 0.67(95% CI 0.43-46 0.85). No significant effect on reporting was found for gender, age, license level, years in the sport, total number of jumps or club affiliation. The specificity was 0.91(95% CI 0.83-0.95). Descriptive statistics of the Swedish skydiving population show several gender differences. Conclusions: The low sensitivity will yield false low incidence calculations, but as there is no evidence for differential underreporting, risk comparisons related to the candidate predictor variables appear reasonably valid. The false positive reporting warrants assortment of incoming data and a clarification of the reporting criteria. Attitudes to reporting may be of value to study, to understand the drivers and constraints for achieving a more complete notification of skydiving injuries.
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| 25. |
- Westman, Anton, 1972-, et al.
(author)
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Validity of injury reporting among active Swedish skydivers
- 2009
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Other publication (other academic/artistic)abstract
- Objective: Evaluation of a national compulsory reporting system for skydiving injuries.Design: Self-report survey.Setting: The Swedish Parachute Association (SFF).Subjects: All persons renewing a Swedish skydiving license 2008 (n=1049).Main outcome measures: Sensitivity was measured as the proportion of injury events fulfilling the reporting criterion that were actually reported; Specificity was measured as the proportion of false positives in relation to the defined gold standard. Self-stated bone fractures, shoulder dislocations and cruciate ligament injuries were labeled as non-minor injuries.Results: The response rate was 100%. The overall sensitivity of the reporting system 2006/2007 was 0.37 (95% confidence interval (CI) 0.24-0.51). With selfstated non-minor injuries as the target for reporting, the sensitivity was 0.67 (95% CI 0.43-0.85). No significant effect on reporting was found for gender, age, license level, years in the sport, total number of jumps or club affiliation. The specificity was 0.91 (95% CI 0.83-0.95).Conclusions: The low sensitivity will yield false low incidence calculations, but risk comparisons related to the candidate predictor variables appear reasonably valid. The false positive reporting warrants assortment of incoming data and a clarification of the reporting criterions. We propose the addition of “hospitalization Yes/No” in future reporting and endorse coordinating skydiving data collection in the Nordic countries. Further studies on attitudes to reporting are necessary to understand the drivers and constraints for achieving a more complete notification of skydiving injuries.
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