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1.
  • Jakobsson, Malin, 1971-, et al. (author)
  • Adolescents' lived experience of sleeping difficulties
  • 2020
  • In: Journal of Sleep Research.
  • Conference paper (peer-reviewed)abstract
    • Objectives/Introduction: Sleeping difficulties, including insufficient sleep, trouble falling asleep, waking up at night, or sleep that does not leave an individual rested, are increasingly prevalent among adolescents and have negative consequences for their’ health, well‐being, and education. It is of utmost importance to research adolescents’ sleep. A range of studies with different methodological perspectives are needed to inform and understand adolescents’ sleep. To date, there are few studies in sleep research that take a qualitative approach. Therefore, it is important to illuminate adolescents’ own experience of sleeping difficulties to acquire broader knowledge and the necessary evidence in order to provide preventive care interventions.Methods: The data were obtained from narrative interviews with 16 adolescents aged 14–15 in a Swedish city and were analyzed using the phenomenological hermeneutic method.Results: Four themes that illustrate the meaning of adolescents experience of sleeping difficulties emerged: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates what being an adolescent with sleeping difficulties means; it is a challenge to go through the night; cope with the next day; and to harbor a panorama of emotions that emerge during the night, such as frustration, annoyance, concern, dejection, sadness, and fear. These emotions arise when the adolescent is unable to unwind and has concerns that grow during the night. The adolescent experience a feeling of being trapped in circumstances, all of which are incompatible with getting a good night's sleep.Conclusions: In order to understand adolescents’ sleeping difficulties, a comprehensive understanding of the context in which the adolescents live is needed. Adolescents need to navigate and find balance in relation to circumstances that may affect their sleep and that are often beyond their control, such as norms and values in society, in social media, in school, and in family and friend groups. By genuinely listening to the adolescents’ narratives about their sleeping difficulties and the context in which they interact will parents, professional caregivers, and researchers increase their understanding.
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2.
  • Jakobsson, Malin, 1971-, et al. (author)
  • En obarmhärtigt lång väntan på att somna
  • 2021
  • In: Skolhälsan. - : Riksföreningen för skolsköterskor. - 0284-284X. ; :1
  • Journal article (pop. science, debate, etc.)abstract
    • En vanlig uppfattning i samhället är att ungdomar som sover för lite är slarviga med rutiner och att skärmarna tar deras tid. Men är problematiken så enkel? Hur är det egentligen att ha sömnsvårigheter? En ny studie från Högskolan Borås ger en inblick i ungdomars egna upplevelser.
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3.
  • Jakobsson, Malin, 1971-, et al. (author)
  • "I Want to Sleep, but I Can't" : Adolescents' Lived Experience of Sleeping Difficulties
  • 2022
  • In: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 38:5, s. 449-458
  • Journal article (peer-reviewed)abstract
    • Sleeping difficulties are increasingly prevalent among adolescents and have negative consequences for their health, well-being, and education. The aim of this study was to illuminate the meanings of adolescents' lived experiences of sleeping difficulties. The data were obtained from narrative interviews with 16 adolescents aged 14-15 in a Swedish city and were analyzed using the phenomenological hermeneutic method. The findings revealed four themes: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates that being an adolescent with sleeping difficulties means it is challenging to go through the night and to cope the next day. It also means a feeling of being trapped by circumstances. As the adolescents' lived experiences become apparent, the possibility for parents, school nurses, and other professional caregivers to support adolescents' sleep increases.
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4.
  • Daniel, Maria, et al. (author)
  • Effect of Myocardial Infarction With Nonobstructive Coronary Arteries on Physical Capacity and Quality-of-Life
  • 2017
  • In: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 120:3, s. 341-346
  • Journal article (peer-reviewed)abstract
    • Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA), including Takotsubo syndrome (TS), are considered to have a better survival compared with those with coronary heart disease (CHD). Studies of patients with MINOCA measuring physical and mental function including matched control groups are lacking. The aim of this study was to determine the physical capacity and quality of life in patients with MINOCA. One-hundred patients with MINOCA along with TS (25%) were investigated from 2007 to 2011. A bicycle exercise stress test was performed 6 weeks after hospitalization and QoL was investigated by the Short Form Survey 36 at 3 months' follow-up. Both a healthy and a CHD group that were age and gender matched were used as controls. The MINOCA group had a lower physical capacity (139 ± 42 W) compared with the healthy control group (167 ± 53 W, p <0.001) but better than the CHD control group (124 ± 39 W, p = 0.023). Patients with MINOCA had lower physical and mental component summary scores compared with the healthy controls (p <0.001) and lower mental component summary (p = 0.012), mental health (p = 0.016), and vitality (p = 0.008) scores compared with the CHD controls. In conclusion, the findings of this first study on exercise capacity and QoL in patients with MINOCA showed both physical and mental distress from 6 weeks to 3 months after the acute event similar to CHD controls and in some perspectives even lower scores especially in the mental component of QoL.
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6.
  • Nero, Daniella, et al. (author)
  • Personality Traits in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries.
  • 2019
  • In: The American journal of medicine. - : Elsevier BV. - 1555-7162 .- 0002-9343. ; 132:3, s. 374-381
  • Journal article (peer-reviewed)abstract
    • The purpose of this study was to describe type A behavior pattern and trait anger in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and compare them with patients with coronary heart disease and healthy controls. Type A behavior pattern and anger have been linked to coronary heart disease in previous studies. This is the first study to assess type A behavior pattern and trait anger in MINOCA patients.One hundred MINOCA patients, consecutively recruited during 2007-2011 at 5 coronary care units in Stockholm, were matched for sex and age to 100 coronary heart disease patients and 100 healthy controls. All participants completed the Bortner Rating Scale to quantify type A behavior pattern and the Spielberger Trait Anger Scale to quantify anger 3 months after the acute event.MINOCA patients' Bortner Rating Scale score was 70.9 ± 10.8 (mean ± SD) and Spielberger Trait Anger Scale score was 14 (12-17) (median; interquartile range). Coronary heart disease patients' Bortner Rating Scale score was 70.5 ± 10.2 and Spielberger Trait Anger Scale score was 14 (12-17). Healthy controls' Bortner Rating Scale score was 71.9 ± 9.1 and Spielberger Trait Anger Scale score was 13 (11-16).We found no significant differences in Bortner Rating Scale score and Spielberger Trait Anger Scale score among MINOCA, coronary heart disease patients, and healthy controls, regardless of whether total scores, subscales, or cutoffs were used to classify type A behavior pattern and trait anger. However, we cannot exclude the existence of an occasional episode of anger or mental stress in relation to the coronary event. This is the first study to assess type A behavior pattern and trait anger in patients with MINOCA, and future studies need to confirm the current findings before any firm conclusions can be made.
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7.
  • Pusa, Susanna, 1982- (author)
  • Vägen mot implementering av familjecentrerad omvårdnad
  • 2019
  • Doctoral thesis (other academic/artistic)abstract
    • Bakgrund: När människor är inkluderade i varandras liv påverkar en förändring av livssituationen hos en person även de övriga personerna som står den nära. Det innebär att när en person drabbas av ohälsa eller sjukdom påverkas även personens familj. Familjens upplevelse av den situation som uppstår i samband med ohälsa kan dessutom negativt påverka familjemedlemmarnas medvetenhet om familjens tillgängliga styrkor och resurser, vilket i sin tur kan påverka familjers kamp för att återfå och bibehålla hälsa. Traditionellt sett har vården fokuserat på att erbjuda stöd på personnivå, och främst då till patienter. De senaste decennierna har dock en tendens uppmärksammats till ökad förståelse för att hela familjen behöver inkluderas i omvårdnaden. Att anamma ett familjecentrerat förhållningssätt – det vill säga, att se och möta familjen som en enhet och som ett system – har visat sig ha flera fördelar utifrån såväl patient- och familje- som sjuksköterskeperspektiv. Detta har medfört en efterfrågan på forskning om hur familjecentrerad omvårdnad kan läras ut och implementeras i den kliniska hälso- och sjukvården.Syfte: Det övergripande syftet med avhandlingen är att belysa erfarenheter av stöd från distriktssköterskor/sjuksköterskor till familjer i ordinärt boende, samt att utvärdera implementering av familjecentrerade samtal.Metod: Avhandlingen inkluderar tre studier med kvalitativ design och en studie med mixad-metod design. I delstudie I samlades data in genom tio fokusgruppintervjuer med 36 distriktssköterskor och analyserades sedan med en fenomenologisk hermeneutisk metod. Datainsamlingen för delstudie II bestod av ljudinspelade familjecentrerade samtal med sju familjer, samt sju avslutande brev riktade till familjerna som distriktssköterskorna/sjuksköterskorna skrev efter samtalen med familjerna. Familjesamtalen och breven analyserades med hjälp av kvalitativ innehållsanalys. I delstudie III analyserades individuella intervjuer med 21 distriktssköterskor/sjuksköterskor med kvalitativ innehållsanalys. Mixad metod användes i delstudie IV, där kvantitativa data från instrumentet Families’ Importance in Nursing Care – Nurses’ Attitudes (FINC-NA) integrerades med kvalitativa data från individuella intervjuer med 14 distriktssköterskor/sjuksköterskor.Resultat: Resultatet visar att distriktssköterskor/sjuksköterskor strävar efter att stödja familjer (I, IV) och att familjecentrerad omvårdnad i form av familjecentrerade samtal kan vara ett sätt att stöda familjer att dela med sig av sina upplevelser och känslor både inom familjen och med distriktssköterskan/ sjuksköterskan (II, IV). Det upplevda stödet från såväl familjen som distriktssköterskan/sjuksköterskan ansågs värdefullt för att bättre hantera situationen och framtiden (II). Distriktssköterskorna/sjuksköterskorna uppfattade den webbaserade utbildningen i familjecentrerad omvårdnad inklusive familjecentrerade samtal som överlag funktionell och välanpassad (III). Utbildningen med den påföljande implementeringen beskrevs bidra till ett förändrat förhållningssätt hos dem, där de tänkte och arbetade mer inkluderande och stödjande gentemot familjer, även när de inte utförde familjecentrerade samtal enligt den tänkta strukturen (III, IV). Utvärderingen av implementeringen av de familjecentrerade samtalen visade att införandet av familjecentrerade samtal fortgick även om de inte hade implementerats fullt ut som avsett. Acceptans och lämplighet utvärderades överlag positivt, dock framkom personliga, sociala och organisatoriska hinder, vilka påverkade genomförandet, användningen och metodtroheten (IV).Konklusion: Stöd från distriktssköterskor/sjuksköterskor till familjer är en omvårdnadshandling som förutsätter medveten omsorg i ett aktivt möte med familjen, där varje enskild person, men även familjen som enhet, behöver beaktas. Detta stöd för familjers hälsa kan ske genom familjecentrerad omvårdnad. En webbaserad utbildning för distriktssköterskor/sjuksköterskor i familjecentrerad omvårdnad och familjecentrerade samtal utgör ett adekvat steg i processen att implementera detta arbetssätt i den kliniska verksamheten. Sammanfattningsvis bidrar avhandlingen till kunskap om hur stödjande familjecentrerade samtal kan implementeras i klinisk verksamhet och vilka aspekter som kan påverka detta.
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8.
  • Siegbahn, Anna, et al. (author)
  • Rules for priming and inhibition of glycosaminoglycan biosynthesis; probing the beta 4GalT7 active site
  • 2014
  • In: Chemical Science. - : Royal Society of Chemistry (RSC). - 2041-6520 .- 2041-6539. ; 5:9, s. 3501-3508
  • Journal article (peer-reviewed)abstract
    • beta-1,4-Gatactosyltransferase 7 (beta 4GalT7) is an essential enzyme in the biosynthesis of glycosaminoglycan (GAG) chains of proteoglycans (PGs). Mammalian cells produce PGs, which are involved in biological processes such as cell growth and differentiation. The PGs consist of a core protein, with one or several GAG chains attached. Both the structure of the PGs and the GAG chains, and the expression of the enzymes involved in their biosynthesis and degradation, vary between normal cells and tumor cells. The biosynthesis of GAG chains is initiated by xylosylation of a serine residue of the core protein, followed by galactosylation by beta 4GalT7. The biosynthesis can also be initiated by exogenously added beta-D-xylopyranosides with hydrophobic aglycons, which thus can act as acceptor substrates for beta 4GalT7. To determine the structural requirements for beta 4GalT7 activity, we have cloned and expressed the enzyme and designed a focused library of 2-naphthyl beta-D-xylopyranosides with modifications of the xylose moiety. Based on enzymatic studies, that is galactosylation and its inhibition, conformational analysis and molecular modeling using the crystal structure, we propose that the binding pocket of beta 4GalT7 is very narrow, with a precise set of important hydrogen bonds. Xylose appears to be the optimal acceptor substrate for galactosylation by beta 4GalT7. However, we show that modifications of the xylose moiety of the beta-D-xylopyranosides can render inhibitors of galactosylation. Such compounds will be valuable tools for the exploration of GAG and PG biosynthesis and a starting point for development of anti-tumor agents.
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9.
  • Sundin, Karin, et al. (author)
  • Suffering from care as expressed in the narratives of former patients in somatic wards
  • 2000
  • In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 14:1, s. 16-22
  • Journal article (peer-reviewed)abstract
    • To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.
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10.
  • Valan, Lotha (author)
  • Föräldrars användning av Internet för rådgivning avseende sina friska barns hälsa och utveckling och dess inverkan på Barnhälsovårdens konsultativa arbete : En studie i Svensk Barnhälsovård
  • 2020
  • Licentiate thesis (other academic/artistic)abstract
    • Att bli förälder är en livsomvälvande händelse som kan vara både glädjande och skrämmande. Som förälder ansvarar man för en annan människa där man i vissa fall behöver ny information, kunskap och råd för att leva upp till de nya kraven som en förändrad familjesituation kräver. Förmågan att tillgodogöra sig information, kunskap och råd kan relateras till begreppet hälsolitteracitet som berör hur personer förstår och tillgodogör sig hälsorelaterad information. Den svenska barnhälsovårdens mål är att främja barns hälsa och utveckling och förebygga ohälsa hos barn, samt stödja föräldrar i föräldrarollen. Barnhälsovårdens sjuksköterskor följer barnets hälsa och utveckling till dess att barnet fyller fem år och är en viktig del i stöttningen av föräldrarna. De flesta av dagens föräldrar är födda i den digitala generationen och Internet är en naturlig källa till information och ökad kunskap. Föräldrarnas hälsolitteracitet kan inverka på hur internetinformationen påverkar dem och deras agerande för att möta barnens behov. I nuläget är litet känt om hur informationsöverflödet från digitala källor som Internet används av föräldrar och i interaktionen med barnhälsovården. Denna licentiatavhandlings syfte är att generera ökad kunskap om hur föräldrar använder Internet för hälsorelaterad information relaterat till deras 0–6 åriga friska barn och hur detta kan påverka dem själva samt om och i så fall, hur detta inverkar på barnavårdssjuksköterskans konsultativa arbete. I licentiatavhandlingen ingår två delstudier: Delstudie I genomfördes som en kvalitativ intervjustudie med sjuksköterskor (n=20) verksamma inom Barnhälsovården. Syftet var att beskriva deras erfarenheter och uppfattningar om föräldrars internetanvändning. I resultatet framkom tre kategorier som belyste syftet: Det framkom att ”Internet underlättar vård samt tillgång och tillgänglighet av vård och vårdinformation”, vidare att ” Internet gör yrkesutövande mer komplext” samt till sist uttrycktes det ”Ett behov av förändrad yrkesroll för barnhälsovårdssjuksköterskan”. I delstudie II genomfördes en enkätundersökning med föräldrar (n=687) som hade barn inskrivna på barnhälsovården inom en region i norra Sverige. Syftet var att beskriva föräldrars internetanvändning för råd eller information relaterat till hälsa och barns utveckling för deras friska barn samt hur informationen användes i kontakten med Barnhälsovården. Nästan alla föräldrar (n=686), uppfattade att Internet är en bra informationskälla för råd och information om barns hälsa och utveckling, men de uttryckte osäkerhet inför mängden av information samt kring den egna förmågan att söka, sortera och värdera funnen information. I resultatet sågs också att många föräldrar 81,7% (n = 561) önskade ha stöd och vägledning av sin barnhälsovårdssjuksköterska avseende internetinformation och webbsidor. Licentiatavhandlingens resultat visar att föräldrar har ett behov av stöd och att barnhälsovårdens sjuksköterskor genom den uppbyggda relationen dem emellan både kan vägleda och ge råd för att stödja föräldrar. Genom att stödja föräldrar på detta sätt kan barnhälsovården bidra till att öka föräldrars hälsolitteracitet och därmed även deras hälsokompetens. Barnhälsovårdens medarbetare behöver kompetensutveckling och verktyg för att kunna stödja föräldrar mot större hälsolitteracitet och därigenom även en högre hälsokompetens. Det ses som viktigt att utveckla fler kvalitetssäkrade digitala verktyg som komplement till dagens Barnhälsovård baserad på personliga möten. Verktygen skulle kunna bestå i att stötta föräldrar till att söka och värdera information från evidensbaserade källor, samt att införliva chatt och videokonferensmöjligheter mellan föräldrar och barnhälsovårdssjuksköterskorna också inom offentlig sjukvård.
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11.
  • Andersson, Susanne, et al. (author)
  • Introduction
  • 2012
  • In: Promoting innovation. - Stockholm : Vinnova. - 9789186517717 ; , s. 9-19
  • Book chapter (peer-reviewed)
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12.
  • Appelkvist, Jenny (author)
  • Professionsföretagare : I skärningspunkten mellan småföretagande, profession och genus
  • 2016
  • Doctoral thesis (other academic/artistic)abstract
    • Den här avhandlingen handlar om kvinnors företagande i en profession stadd i förändring. Flera professioner i Sverige, men också internationellt, präglas av en ökad andel kvinnor men även av de strukturella omvandlingar som under 1900-talet lett från ett industri- till ett tjänstesamhälle. Ett ökat småföretagande är en annan förändring som uppkommit under senare år.I föreliggande studie beskrivs och analyseras kvinnors företagande inom en profession utifrån vad som sker i skärningspunkten mellan företagande, profession och genus. Ett tydligt exempel i Sverige på en profession stadd i förändring är veterinärprofessionen som de senaste 50 åren genomgått en rad förändringar. Den teoretiska referensramen består av en kombination av teorier om småföretagande, profession och genus. Det empiriska materialet består av intervjuer med samtliga veterinärer som är företagare och kvinnor i Östergötland. I avhandlingen myntas begreppet professionsföretagare med avsikt att synliggöra samspelet mellan företagande och profession. Studiens resultat visar att professionen i många fall prioriteras framför företagandet. Professionsföretagarna gör genus på skilda sätt i olika dimensioner och på olika nivåer. Det är stabilitet i hur genus görs på generell nivå medan genus på specifik nivå görs på ett sätt som i vissa dimensioner utmanar genussystemet. Även om stabilitet är dominerande visar studien exempel på att professionsföretagande skapar förutsättningar för vissa glipor i genussystemets mönster.
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13.
  • Barremo, Ann-Sofi, et al. (author)
  • Personers upplevelse av att leva med kronisk hjärtsvikt : Systematisk litteraturstudie
  • 2008
  • In: Vård i Norden. - : SAGE Publications. - 0107-4083 .- 1890-4238. ; 28:3, s. 34-38
  • Journal article (peer-reviewed)abstract
    • Background: Heart failure is a clinical syndrome where the heart is no longer able to maintain adequate blood circulation to the tissue. Many suffer from symptoms difficult to handle such as dyspnoea, fatigue, and physical weakness.Aim: The purpose of the study was to investigate peoples’ experiences of living with congestive heart failure.Method: A systematic literature review was used. Relevant articles were found in the Medline and Cinahl databases. The articles were examined, classified and critically appraised. Twenty articles were included. A qualitative content analysis was used to organize the results.Results: The results are described in three main categories: losses, protecting independences and readjustment. The category ‘losses’ details physical, emotional and social changes that people experience as losses caused by the debilitating symptoms of heart failure. The category ‘protecting independences’ shows the different ways in which people try to keep control over their lives. The category ‘readjustment’ presents how people try to seek a new ‘wholeness’ in life after the changes heart failure have caused by using acceptance, adaptation and finding new meanings.Conclusion: Living with congestive heart failure can be experienced as a synopsis of the «suffering human being» on a continuum, a time axle; from falling ill to seeking a new meaning in life.
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16.
  • Berglund, Karin, 1967- (author)
  • Jakten på Entreprenörer : Om öppningar och låsningar i entreprenörskapsdiskursen
  • 2007
  • Doctoral thesis (other academic/artistic)abstract
    • Entrepreneurs are expected to play a crucial role in times of unemployment and economical regression. A “hunt for entrepreneurs” can thus be said to be occurring as they appear to be people who can save nations, societies, and companies in troublesome situations. The project Diversity in Entrepreneurship (DiE) aimed to introduce a broad view of entrepreneurship in a regional context. Three development areas are emphasized that are strategically important to transforming a traditional industrial community into an entrepreneurial region: paying attention to the spirit of enterprise among underrepresented groups; stimulating entrepreneurship among young people; and considering the importance of culture in stimulating a diverse and entrepreneurial society.An equality discourse is introduced through DiE that – emphasising social and mundane occurrences - stands in contrast to the historically rooted enterprise discourse that proffers companies as productive apparatus, where a few competent people – often men – have been, and still are, in charge. In the equality discourse, all people in the region make a difference, not merely a few. The encounter of the two discourses has resulted in confusion, and thus conflicts and collisions; but also in new possibilities.A new perspective of entrepreneurship and regional development is developed where conflicts are put forward as constructive. That the two discourses met on the same regional scene is therefore seen as positive as many people have been made aware of the social, political, and economic contradictions which restrain some groups in society from creating a (working) life. Hence, the contradictions have enabled the inhabitants to see themselves, and others, as entrepreneurs in regional development processes. Openings have thus emerged to view entrepreneurship from a broader perspective that includes people, to create practices through which a more diverse working life is becoming discernible.
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17.
  • Berglund, Sofia, et al. (author)
  • Granulocyte transfusions could benefit patients with severe oral mucositis after allogeneic hematopoietic stem cell transplantation
  • 2019
  • In: Vox Sanguinis. - : Wiley-Blackwell. - 0042-9007 .- 1423-0410. ; 114:7, s. 769-777
  • Journal article (peer-reviewed)abstract
    • Background and objectives Mucositis is a common complication after allogeneic hematopoietic stem cell transplantation (HSCT), and is caused by a combination of conditioning-induced mucosal damage and severe neutropenia. The symptoms include oral and abdominal pain, inability to swallow food and fluids, and severe diarrhoea. Severe mucositis is associated with increased risk of Graft-versus-Host disease and infection. Granulocyte transfusions (GCX) could be a treatment option, and our objective was to study its feasibility and potential benefits. Material and methods This retrospective, single-centre study included 30 patients receiving GCX because of severe oral mucositis after HSCT during 2005-2017. Clinical outcome, response to GCX, change in opiate administration and adverse events were studied. Results Twenty-seven patients received GCX from donors pre-treated with steroids and G-CSF, and three from donors pre-treated with steroids only. Overall response was 83% (24/29 evaluable patients). Fifteen patients reached a complete response. In 14 of 24 responders, a reduction of the administration of opiate pain relief was seen. In eight patients this reduction was >= 50% of the dose. Adverse events (AEs) were reported in 14 cases, and were mild to moderate, and well manageable with symptomatic treatment. No life-threatening or fatal AEs were recorded. Conclusions These results indicate that GCX could be a safe and effective treatment for oral mucositis after HSCT with the potential to reduce the necessity of opiate analgesic treatment in this disorder. No severe AEs were seen in this study, but the risk for severe pulmonary AEs after GCX needs to be considered.
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18.
  • Björk, Jonas, et al. (author)
  • Prospects for improved glomerular filtration rate estimation based on creatinine—results from a transnational multicentre study
  • 2020
  • In: Clinical Kidney Journal. - : Oxford University Press (OUP). - 2048-8505 .- 2048-8513. ; 13:4, s. 674-683
  • Journal article (peer-reviewed)abstract
    • Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved.MethodsIn a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation.Results7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%.ConclusionsNone of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.
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19.
  • Bruce, Elisabeth, 1973-, et al. (author)
  • A translation into Swedish and psychometric analysis of the Icelandic instrument “ICE-Family Perceived Support Questionnaire”, and parents’ estimations of support to families from nurses
  • Other publication (other academic/artistic)abstract
    • Aims and objectives. Testing the psychometric properties, reliability, and validity of a cross-cultural translation into Swedish of the Icelandic instrument “ICE-Family Perceived Support Questionnaire” and, furthermore, reporting estimations of support given by nurses to families in a sample of parents of children with congenital heart defects. Background. Parents of children with congenital heart (CHD) defects often experience greater psychosocial morbidity than parents of children with other medical conditions. In order to design and evaluate interventions with family-centered support, a suitable instrument for measuring family members’ perceived support is required for the Swedish context.Design. A translation and psychometric testing of the instrument ICE-FPSQ.Methods. A sample of 97 parents, including both fathers and mothers, of children with CHD selected in year 2012. A translation of the ICE-FPSQ into Swedish was done, and reliability and validity were tested for the Swedish version.Results. Parents scored low on perceived family support from nurses on the ICE-FPSQ scale. The Swedish version of the ICE-FPSQ was found to be reliable and valid in this context. Reliability was tested by analyzing internal consistency through Cronbach’s α for the entire scale and the two subscales. Test-retest was performed by calculating intra-class correlation, and the results showed satisfactory scale stability over time. The results from the validity test illustrated an acceptable model fit of the Swedish version.Conclusion. This study, by psychometrically testing an instrument for Swedish conditions, has provided an instrument for measuring families’ experience of cognitive and emotional support from nurses to families in Sweden. Additionally, the present study found while testing this instrument that nurses at four pediatric cardiac outpatient clinics only sparingly offered family-centered care to the parents.Relevance to clinical practice. The Swedish version of ICE-FPSQ can be considered useful to measure the effects of family-centered support interventions in the future. 
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20.
  • Bruce, Elisabeth, 1973- (author)
  • Erfarenheter av stöd bland föräldrar till barn med medfödda hjärtfel
  • 2014
  • Doctoral thesis (other academic/artistic)abstract
    • Bakgrund. Antalet överlevande barn som diagnostiserats med medfött hjärtfel (CHD) har ökat markant de senaste 15 åren, vilket har bidragit till en växande grupp av barn och familjer som behöver specialiserat stöd, eftersom familjelivet påverkas och begränsas av CHD. Studier har visat att föräldrar till barn med CHD har en ökad risk för psykosocial sjuklighet i jämförelse med föräldrar till barn med andra sjukdomar eller föräldrar till friska barn. Få studier har belyst föräldrars erfarenheter av stöd när de har barn med CHD. Därför fokuseras denna avhandling på föräldrarnas perspektiv av fenomenet stöd, för att öka förståelsen för vad stöd innebär för föräldrar till barn med CHD.Syfte. Avhandlingens syfte är att belysa innebörder i den levda erfarenheten av stöd, hos föräldrar till barn med CHD samt att till svensk kontext anpassa och validera ett familjecentrerat instrument för föräldrars skattning av stöd till hela familjen från sjuksköterskor.Metoder. Avhandling består av fyra delstudier. I tre av dessa (I, II, III) genomfördes datainsamlingen genom narrativa intervjuer, som tolkades genom fenomenologisk hermeneutisk tolkningsmetod. I den fjärde delstudien gjordes en översättning och psykometrisk testning av det isländska instrumentet ICE-FPSQ till svensk kontext. Dessutom beskrevs föräldrars skattning av uppfattat stöd från sjuksköterskor till familjer som har barn med CHD.Resultat. Fynden från delstudie I visade att innebörder i den levda erfarenheten av stöd hos föräldrar till tonåringar med CHD var stöd för att själva kunna vara stödjande för sin familj, men också för andra personer i tonåringens omgivning. Delstudie II visade att innebörder i den levda erfarenheten av stöd för mödrar till yngre barn med CHD var att få stöd så att de själva kunde hantera sin egen oro och sitt familjeliv. Delstudie III visade att innebörder i den levda erfarenheten av stöd för fäder till yngre barn med CHD var önskan att få stöd genom delande relationer med familjen och att bli involverad i vården av sitt barn. Den fjärde delstudien (IV) visade att den svenska versionen av instrumentet ICE-FPSQ var valid och reliabel i svensk kontext. Föräldrarnas skattningar av uppfattat familjecentrerat stöd till familjen från sjuksköterskor visade sig vara lågt.Slutsats. En övergripande slutsats från de tre första delstudierna pekar mot att innebörder i stöd för föräldrarna är stöd genom att ha goda, interaktiva relationer med vårdpersonalen, bli mött som en hel familj med unika och individuella behov samt inkluderade i vårdprocessen för att kunna stödja varandra inom familjen. Dessa fynd pekar mot familjecentrerad pediatrisk omvårdnad som sannolikt är lämplig för att, på ett mångfacetterat sätt, möta varje familjs behov av att bli bemött som en unik helhet. Det Isländska instrumentet ICE-FPSQ är designad utifrån teorin om familjecentrerad omvårdnad. I delstudie IV visade resultaten på acceptabla psykometriska egenskaper för den svenska versionen av instrumentet. Fynden visade även att föräldrarna inte skattade höga nivåer av familjecentrerat stöd från sjuksköterskor.
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21.
  • Bruce, Elisabeth, et al. (author)
  • Experience of support for parents of adolescents with heart defects : supported to be supportive
  • 2012
  • In: Journal of Pediatric Nursing. - : WB Saunders. - 0882-5963 .- 1532-8449. ; 27:4, s. 366-374
  • Journal article (peer-reviewed)abstract
    • The purpose of this study was to illuminate the meanings of the lived experience of support for parents of adolescents with heart defects. Narrative interviews were conducted with four mothers and two fathers of adolescents with heart defects. Interviews were interpreted using a phenomenological-hermeneutic method. The interpretation revealed that parents, themselves, attempt to be very supportive. They support their adolescent children, the rest of their families, the staffs of their children's schools, and others around their children. The sense of gratification and contentment that parents receive from fulfilling supportive functions is, in turn, influenced by the support that they, themselves, receive from care providers.
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22.
  • Bruce, Elisabeth, 1973-, et al. (author)
  • Fathers' experiences when having a child with heart defects
  • Other publication (other academic/artistic)abstract
    • The purpose of the study was to illuminate the meanings of the lived experiences of support as disclosed by fathers of children with CHD. Narrative interviews were conducted individually with five fathers of children diagnosed with a CHD. A phenomenological-hermeneutic method was used to interpret the verbatim transcribed narrative interviews. The meanings of the lived experiences of support for the fathers were identified in two themes and illustrate the fathers’ feelings of being supported when being in a shared relationship with others. A third theme illustrates the situation when support is absent. Our findings pointed to that support for fathers of children with a CHD might be best promoted by the philosophy of family-centered care.
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23.
  • Bruce, Elisabeth, et al. (author)
  • Mothers' lived experiences of support when living with young children with congenital heart defects
  • 2014
  • In: Journal for specialists in pediatric nursing. - : Wiley-Blackwell. - 1744-6155 .- 1539-0136. ; 19:1, s. 54-67
  • Journal article (peer-reviewed)abstract
    • PURPOSE: The purpose of this study was to illuminate the meanings of support as disclosed by mothers of children with congenital heart defects (CHD).DESIGN AND METHOD: Narrative interviews were conducted with 10 mothers of children with CHD. A phenomenological-hermeneutic method was used for interpretation of the transcribed interviews.RESULTS: The comprehensive understanding of mothers' lived experiences of support emerged as the experiences of receiving good support, receiving "poor support," and absence of support.PRACTICE IMPLICATIONS: Mothers receiving person-centered and family-centered care feel more supported and are more likely to adapt to the stresses of parenting a child with CHD.
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24.
  • Bruce, Elisabeth, et al. (author)
  • Pediatric nurses' perception of support for families with children with congenital heart defects
  • 2018
  • In: Clinical Nursing Research. - Thousand oaks : Sage Publications. - 1054-7738 .- 1552-3799. ; 27:8, s. 950-966
  • Journal article (peer-reviewed)abstract
    • The purpose of this study was to illuminate pediatric nurses' (PNs) perceptions of support for families with a child with a congenital heart defect. The study used a qualitative design with narrative interviews with eight PNs in Northern Sweden, and the interview data were analyzed with content analysis. The analysis revealed that the nurses perceive that letting the parents be involved in their child's care is of great importance in supporting the families. Although they have a paternalistic attitude to the families, they also stated that nurses should inform the parents about the care of the child, create a good relationship with the family, and build trust among all parties involved.
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25.
  • Bruce, Elisabeth, et al. (author)
  • Support for Fathers of Children With Heart Defects
  • 2016
  • In: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 25:3, s. 254-272
  • Journal article (peer-reviewed)abstract
    • The purpose of the study was to illuminate the meanings of the lived experiences of support as disclosed by fathers of children with congenital heart defect (CHD). Narrative interviews were conducted individually with five fathers of children diagnosed with CHD. A phenomenological-hermeneutic method was used to interpret the verbatim transcribed narrative interviews. The meanings of the lived experiences of support for the fathers were identified in two themes and illustrate the fathers' feelings of being supported when being in a mutual relationship with others. A third theme illustrates the situation when support is absent. Our findings indicate that support for fathers of children with CHD might be best promoted by the philosophy of family-centered care.
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26.
  • Bruce, Elisabeth, et al. (author)
  • Translation and Testing of the Swedish Version of Iceland-Family Perceived Support Questionnaire With Parents of Children With Congenital Heart Defects
  • 2016
  • In: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 22:3, s. 298-320
  • Journal article (peer-reviewed)abstract
    • There is a need for a suitable instrument for the Swedish context that could measure family members’ perceptions of cognitive and emotional support received from nurses. The purpose of this study was to translate and test the psychometric properties of the Swedish version of the Iceland-Family Perceived Support Questionnaire (ICE-FPSQ) and, further, to report perceptions of support from nurses by family members of children with congenital heart defects (CHDs). A sample of 97 parents of children with CHD, living in Sweden, completed the Swedish translation of ICE-FPSQ. The Swedish version of ICE-FPSQ was found to be reliable and valid in this context. Parents scored perceived family support provided by nurses working in pediatric outpatient clinics as low, which suggests that nurses in these outpatient contexts in Sweden offered family nursing only sparingly.
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27.
  • Bruce, Elisabeth, et al. (author)
  • 'walking in their shoes' : experiences of support in pediatric cardiac care
  • 2024
  • In: Pediatric Nursing. - : Jannetti Publications. - 0097-9805. ; 50:2, s. 84-96
  • Journal article (peer-reviewed)abstract
    • Purpose: The purpose of this study was to illuminate experiences of obtainingsupport among male adolescents with congenital heart disease and their mothers,and nurses’ experiences of providing support within pediatric nursing care.Methods: This descriptive qualitative study used an inductive approach. Datawere collected from interviews with six participants: two adolescents with congenital heart defects-mother dyads, and two nurses at a pediatric cardiac outpatient clinic in Sweden. Data were analyzed through content analysis.Results: Results are divided into three domains: desired support, lacking support,and undesirable support. Within these three respective domains, support is furtherillustrated from three categories of perspectives: adolescents, mothers, and nurses.Conclusions: Study findings show adolescents and their mothers desire support,such as family-system nursing. Nurses strive to provide support in the form ofinformative care like the approach based on the philosophy of pediatric familycentered care.Implications: When highlighting experiences of support from different perspectives, it is important for the provided support to be adapted to families’ needs.
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28.
  • Bäckström, Britt (author)
  • En tillvaro av utanförskap : En longitudinell studie om att vara i medelåldern och närstående till en person som insjuknat i stroke
  • 2010
  • Doctoral thesis (other academic/artistic)abstract
    • Ett övergripande syfte med avhandling var att belysa den levda erfarenheten av att vara i medelåldern och närstående till en person som insjuknat i stroke för första gången och studera de närståendes erfarenheter av förändringen över tid under det första året efter utskrivning till hemmet, samt att belysa innebörden av medelålders makars levda erfarenhet av relationen till en partner som insjuknat i stroke; under det första året. Avhandlingen omfattar 4 delstudier (I-IV) som sammantaget utgör en longitudinell studie. Tio närstående (40 - 64 år) till personer insjuknade i stroke (förstagångs insjuknande) med förväntat hjälpbehov överstigande 6 månader, inkluderades konsekutivt i studien och följdes under ett år efter utskrivning till hemmet. Narrativa intervjuer utfördes en månad (I, n=10), sex månader (II, n=9) och ett år (III, n=9) efter utskrivning till hemmet. Bland de närstående i delstudie I-III fanns fyra kvinnliga makar (gifta; n=2, sambo; n=2) som utgjorde deltagarna i delstudie IV. För att analysera data användes en fenomenologisk hermeneutisk tolkningsmetod (I, IV) och kvalitativ innehållsanalys (II, III). Avhandlingen visar på att vara i medelåldern och närstående till en person som insjuknat i stroke, efter utskrivningen till hemmet, innebär att gå igenom en förändringsprocess i olika steg. Upplevelsen var att en månad efter utskrivningen kämpa för att inte tappa fotfästet i en otrygg livssituation, där de upplevde ett främlingskap inför situationen, sig själv och personen som insjuknat i stroke. Ändå svarade de närstående oreflekterat an ett krav på ansvar och omsorg (I, IV). Efter sex månader visade de närstående på en kamp för att integrera förändringarna orsakade av stroke till det dagliga livet, förlika sig med förlusterna och att hitta balans och en ny normalitet (II). Makarna förde en kamp för att återfå känslan av samhörighet med sin partner och hitta tillbaka till sin egen identitet som maka, vilket bara var möjligt i frånvaro av en vårdarroll (II, IV). Efter ett år tvingades de närstående att erkänna, lära sig hantera och förlika sig med förändringarna orsakade av strokeinsjuknandet (III). Makarna fick lämna en ‛bild‛ av hur deras partner en gång varit. En trygg relation i samvaro och jämlikhet med en känsla av ‛vi‛ förändrades och blev främmande och ojämlik och ersattes med en känsla av ‛jag‛ och ‛du‛. För att härda ut måste makarna omvärdera relationen till sin partner och målen i livet. Även om partnern fortfarande var i livet visade makarna en sorg och ett lidande beroende på förlusten av den relation de en gång haft till personen som insjuknat i stroke (IV). Avhandlingen visar även att de närstående inte upplevde sig varit sedda och bekräftade av den professionella vårdpersonalen i sin egen situation som närstående. Vårdens fokus upplevdes hela tiden enbart vara den sjuke och främst de fysiska förändringarna hos personen med stroke. De närståendes upplevelse var av oförståelse för innebörden av de kognitiva och emotionella förändringarna hos den sjuke (I, II, III). De närstående gav så småningom också upp sin strävan att bli bekräftade vilket innebar att bära på ett lidande som inte blev synliggjort (III). En annan del av förändringsprocessen var att de närstående gick ifrån självförnekelse med fokus på den som insjuknat och nuet (I), till en medvetenhet om att ta egna behov i beaktande (II) och att även fokusera på eget välbefinnande för att orka i en framtid (III). Avhandlingen visar att de medelålders närstående går igenom en transitionsprocess, där upplevelser av förluster, förändringar, lidande och sorg finns relaterat till; dåtid, nutid och framtid. De närståendes upplevelse av oförståelse och brist på känsla av bekräftelse i deras livssituation under året efter utskrivningen till hemmet, kan leda till en känsla av ensamhet och övergivenhet både inom de närstående själva, men också i förhållande till andra och världen utanför.
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29.
  • Bäckström, Britt, 1952-, et al. (author)
  • The experience of being a middle-aged close relative of a person who has suffered a stroke : six months after discharge from a rehabilitation clinic
  • 2010
  • In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 24:1, s. 116-124
  • Journal article (peer-reviewed)abstract
    • The experience of being a middle-aged close relative of a person who has suffered a stroke - six months after discharge from a rehabilitation clinicBeing a close relative brings with it a large number of consequences, with the life situation changing over time. The aim of this study was to illuminate the experiences of being a middle-aged close relative of a person who has suffered a stroke 6 months after being discharged from a medical rehabilitation clinic. Narrative interviews were conducted with nine middle-aged close relatives and analysed using a content analysis with a latent approach. The analysis revealed that being close to someone who had suffered a stroke 6 months after discharge meant; a struggling for control and a renewal of family life in the shadow of suffering and hope. The middle-aged close relatives began to perceive the changed reality. They were struggling to take on something new, become reconciled and find a balance in their family life. Their ability to work, relief from caring concerns and having support and togetherness with others seemed to be essential for the close relatives in their efforts to manage their life situation and maintain their well-being. Having reached the 'halfway point' in their lives and still with half of their life in front of them created worries. They felt dejected about their changed relationships and roles, experience a sense of loss of shared child responsibilities, a negative impact on their marital relationships and sexual satisfaction. They felt trapped in a caring role and they worried about how to endure in the future. The middle-aged close relatives' experiences were of being alone and neglected, in an arduous and complex life situation filled with loss and grief. The findings highlights that health professionals need to see and listen to the close relatives' experiences of transition in order to provide appropriate support adjusted to their varying needs during a time of renewal.
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30.
  • Bäckström, Britt, et al. (author)
  • The experience of being a middle-aged close relative of a person who has suffered a stroke, 1 year after discharge from a rehabilitation clinic: A qualitative study
  • 2009
  • In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 46:11, s. 1475-1484
  • Journal article (peer-reviewed)abstract
    • Background Living in close emotional and physical proximity to a person who has suffered a stroke may alter almost every aspect of daily living and will inevitably impact family life. Age seems to be a factor in the experiences of stroke sufferers’ close relatives after the stroke. Objectives This study aimed to illuminate the experience of being a middle-aged close relative of a person who has suffered a stroke; 1 year after the stroke sufferer's discharge from a rehabilitation clinic. Participants Nine middle-aged close relatives of persons with a confirmed diagnosis of a first-time stroke were consecutively included in the study and interviewed. Methods The narrative interviews were audio-taped, transcribed verbatim and analyzed using a thematic content analysis. The study was part of a longitudinal study. Results Four themes emerged from the data, intertwined and in conflict with one another. A turning point was reached, and the inevitability of an altered future became self-evident, so much so that the middle-aged close relatives felt forced to accept and become reconciled to a changed way of living, even if feelings of grief from loss were still present. The middle-aged close relatives’ process of coming to awareness and recognition of their own needs was part of a complex interplay of emotions, in which they learned to leave feelings of shame and guilt behind. They experienced movement from self-denial to self-recognition in their search for their own well-being and the recovery of their strength for a functioning family life. Even if they experienced a greater sense of freedom, they still face living life within limits. A significant challenge appears to be the effects of the personality changes among the person with a stroke, and the resulting sense of being an outsider. Relatives struggled with health care providers for visibility and confirmation. Their experiences were ones of standing alone, outside a closing door to the rehabilitation. Their ability to work, the benefits of functioning home care, and support from their family helped them through these challenges. Conclusion This study highlights the middle-aged relatives’ realization that they will live an inevitability altered future. Individually, the stroke sufferer's relatives need support in their relationships within the family for emotional confirmation and to help them recognize and verbalize their needs without feeling guilt; gaining these supportive factors may help the relatives to recover their sense of well-being and give strength for a future, properly functioning family life.
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31.
  • Bäckström, Britt, 1952-, et al. (author)
  • The experience of being a middle-aged close relative of a person who has suffered a stroke - six months after discharge from a rehabilitation clinic
  • 2009
  • Conference paper (other academic/artistic)abstract
    • Being a close relative brings with it a large number of consequences, with the life situation changing over time. The aim of this study was to illuminate the experiences of being a middle-aged close relative of a person who has suffered a stroke six months after being discharged from a medical rehabilitation clinic. Narrative interviews were conducted with nine middle-aged close relatives and analyzed using a content analysis with a latent approach. The analysis revealed that being close to someone who had suffered a stroke six months after discharge meant; a struggling for control and a renewal of family life in the shadow of suffering and hope. The middle-aged close relatives began to perceive the changed reality. They were struggling to take on something new, become reconciled and find a balance in their family life. Their ability to work, relief from caring concerns and having support and togetherness with others seemed to be essential for the close relatives in their efforts to manage their life situation and maintain their well-being. Having reached the ‘halfway point’ in their lives and still with half of their life in front of them created worries. They felt dejected about their changed relationships and roles, experience a sense of loss of shared child responsibilities, a negative impact on their marital relationships and sexual satisfaction. They felt trapped in a caring role and they worried about how to endure in the future. The middle-aged close relatives’ experiences were of being alone and neglected, in an arduous and complex life situation filled with loss and grief. The findings highlights that health professionals need to see and listen to the close relatives’ experiences of transition in order to provide appropriate support adjusted to their varying needs during a time of renewal.
  •  
32.
  • Bäckström, Britt, et al. (author)
  • The meaning of being a middle-aged close relative of a person who has suffered a stroke, 1 month after discharge from a rehabilitation clinic
  • 2007
  • In: Nursing Inquiry. - : Wiley-Blackwell Publishing Inc.. - 1320-7881 .- 1440-1800. ; 14:3, s. 243-254
  • Journal article (peer-reviewed)abstract
    • The sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle‐aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged over 18 and under 65. A phenomenological‐hermeneutic interpretation of the narratives was then conducted. Three intimately intertwined themes emerged during the analysis: ‘being called to mission’, ‘feeling lost and set adrift’ and ‘struggling to keep going’. The middle‐aged close relatives felt unreflectively duty bound. There was a struggle with suffering and enduring the process of coping with life and overcoming a feeling of helplessness. Life turned out to be a struggle with overwhelming feelings. They felt alienated in a restricted life situation, disconnected from themselves and others, and from a world that supports feelings of being lost and set adrift (i.e. feeling homeless). Strength was found in moments when the situation improved, in being related to oneself and others, and when feelings of normality were regained.
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33.
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34.
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35.
  • Bäckström, Britt, et al. (author)
  • The meaning of middle-aged female spouses' lived experience of the relationship with a partner who has suffered a stroke, during the first year postdischarge
  • 2010
  • In: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 17:3, s. 257-268
  • Journal article (peer-reviewed)abstract
    • Stroke consequences present a great long-term challenge to the spouses of the stroke sufferer. A longitudinal study with a phenomenological hermeneutic approach was used to illuminate the meanings of middle-aged female spouses' lived experience of their relationship with a partner who has suffered a stroke, during the first year postdischarge. Four middle-aged female spouses of stroke sufferers participated in the study. Narrative interviews were conducted 1, 6 and 12 month postdischarge (total of 12 interviews), audio-taped and transcribed verbatim to a text and interpreted by a phenomenological hermeneutic method inspired by Ricoeur. The findings showed a process over time during which spouses come to know, recognize and acknowledge the residual changes in their partners' cognitive and emotional conditions and the impact on their relationship. Spouses showed grief due to the loss of the marital relationship they once had and anxiety that they would not be able to continue in an undesired relationship in the future. Even if the partner is still alive, there is a loss to grieve and to be understood, an important meaning of the transition process in the relationship during the first year after the partner's discharge.
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36.
  • Delanaye, Pierre, et al. (author)
  • Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil, and Africa
  • 2022
  • In: Nephrology, Dialysis and Transplantation. - : Oxford University Press. - 0931-0509 .- 1460-2385. ; 38:1, s. 106-118
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: A new Chronic Kidney Disease Epidemiology equation without race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared to the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts.METHODS: Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France, (n = 4429, including 964 Black Europeans), from Brazil (n = 100), and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or Black Europeans was performed.RESULTS: In White Europeans (n = 9496), both the EKFC and LMREV equations outperformed CKD-EPIAS (bias of -0.6 and -3.2, respectively versus 5.0 mL/min/1.73m², and accuracy within 30% of 86.9 and 87.4, respectively versus 80.9%). In Black Europeans and Black Africans, the best performance was observed with the EKFC equation using a specific Q-value ( = concentration of serum creatinine in healthy males and females). These results were confirmed in matched analyses, which showed that serum creatinine concentrations were different in White Europeans, Black Europeans, and Black Africans for the same measured GFR, age, sex and body mass index. Creatinine differences were more relevant in males.CONCLUSION: In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated, population-specific Q-values presents the best performance in the whole age range in the European and African populations included in this study.
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37.
  • Delanaye, Pierre, et al. (author)
  • Performance of creatinine-based equations to estimate glomerular filtration rate with a methodology adapted to the context of drug dosage adjustment
  • 2022
  • In: British Journal of Clinical Pharmacology. - : Wiley-Blackwell Publishing Inc.. - 0306-5251 .- 1365-2125. ; 88:5, s. 2118-2127
  • Journal article (peer-reviewed)abstract
    • AIM: The Cockcroft-Gault (CG) creatinine-based equation is still used to estimate glomerular filtration rate (eGFR) for drug dosage adjustment. Incorrect eGFR may lead to hazardous over- or underdosing METHODS: In a cross-sectional analysis, CG was validated against measured GFR (mGFR) in 14,804 participants and compared with the Modification-of-Diet-in-Renal-Diseases (MDRD), Chronic-Kidney-Disease-Epidemiology (CKD-EPI), Lund-Malmö-Revised (LMR), and European-Kidney-Function-Consortium (EKFC) equations. Validation focused on bias, imprecision, and accuracy (percentage of estimates within ±30% of mGFR, P30), overall and stratified for mGFR, age, and body mass index at mGFR <60 mL/min, as well as classification in mGFR stages.RESULTS: The CG equation performed worse than the other equations, overall and in mGFR, age and BMI subgroups in terms of bias (systematic overestimation), imprecision and accuracy except for patients ≥65 years where bias and P30 were similar to MDRD and CKD-EPI, but worse than LMR and EKFC. In subjects with mGFR<60 mL/min and at BMI [18.5-25[kg/m2 , all equations performed similarly and for BMI<18.5kg/m2 CG and LMR had the best results though all equations had poor P30-accuracy. At BMI≥25kg/m2 the bias of the CG increased with increasing BMI (+17.2mL/min at BMI≥40kg/m2 ). The four more recent equations also classified mGFR stages better than CG.CONCLUSIONS: The CG equation showed poor ability to estimate GFR overall and in analyses stratified for GFR, age, and BMI. CG was inferior to correctly classify the patients in the mGFR staging compared to more recent creatinine-based equations.
  •  
38.
  • Dorell, Åsa, et al. (author)
  • Becoming visible : Experiences from families participating in Family Health Conversations at residential homes for older people
  • 2016
  • In: Geriatric Nursing. - : Elsevier BV. - 0197-4572 .- 1528-3984. ; 37:4, s. 260-265
  • Journal article (peer-reviewed)abstract
    • Having a sick family member living at a residential home for older people can be difficult for families, who as a result often suffer from feelings of forsakenness and powerlessness. In response, the purpose of this study was to illuminate family members' experiences with participating in Family Health Conversations at residential homes for older persons 6 months after concluding the conversation series. Twenty-two family members who participated in the conversations later took part in group interviews, the texts of which were analyzed according to qualitative content analysis. Findings showed that participating in Family Health Conversations mediated consolation, since within such a liberating communicative interaction, family members for the first time felt visible as persons with individual significance. Family members reported a positive experience involving both being open to each other and speaking and listening to each other in a new, structured way. As a result, families were able to discover their family members' problems and suffering, as well as to identify their family's resources and strengths.
  •  
39.
  • Dorell, Åsa, et al. (author)
  • Experiences With Family Health Conversations at Residential Homes for Older People
  • 2016
  • In: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 25:5, s. 560-582
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to highlight family members' experiences of participating in Family Health Conversation (FamHC), based on families in which a family member was living in a residential home for older people. A total of 10 families and 22 family members participated in evaluating family interviews 1 month after participating in FamHC. The interviews were analyzed by qualitative content analysis. The main finding was being a part of FamHC increased family members' insights, understanding, and communication within the family. Getting confirmation from nurses was essential to cope with the new life situation, which also meant that they felt comfortable to partly hand over the responsibility for the older person who moved to the residential home. By being open and expressing their feelings, a bad conscience could be relieved. These findings showed that FamHC could be helpful for family members in adapting to this novel situation.
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40.
  • Dorell, Åsa, et al. (author)
  • Expressed emotions and experiences from relatives regarding having a family member living in a nursing home for older people
  • 2019
  • In: SAGE Open Medicine. - : SAGE Open. - 2050-3121. ; 7
  • Journal article (peer-reviewed)abstract
    • Objectives: The purpose of this study was to describe the topics relatives with a family member in a nursing home for older persons choose to talk about and focus on when participating in a nurse-led “Family Health Conversations” intervention. Family Health Conversations consisted of a series of three nurse-led conversations with each family, with a 2-week interval between meetings.Methods: The Family Health Conversations meetings were tape-recorded and analyzed using qualitative content methods. The participants were relatives of family members living in a nursing home for older persons in a municipality in Sweden.Results: The findings showed how the relatives talked about their suffering and difficulties concerning the new situation. The relatives talked about frustration and sadness together in a new way, with a focus on how to manage the future. They also wished that they had been offered an opportunity to talk about this with nurses earlier in the illness trajectory.Conclusion: The relatives had a significant need to talk about their experiences together within the family and together with the nurses. Nurses have an especially important task in supporting relatives having a family member living in a nursing home.
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41.
  • Dorell, Åsa, et al. (author)
  • Family Health Conversations have positive outcomes on families : A mixed method study
  • 2017
  • In: Open Nursing Journal. - : Bentham Open. - 1874-4346. ; :11, s. 14-25
  • Journal article (peer-reviewed)abstract
    • Background: A Family Systems Nursing intervention, “Family Health Conversations” (FamHC) was conducted in order to strengthen the health of families having relatives at residential home for older people. Having a family member living in a residential home affects the entire family and can be hard to handle. Family members require encouraging and open communication support from nurse during and after relocation to a residential home.Objectives: The aims of this study were to evaluate the responses to and effects of the Family Health Conversations in families with a member living at a residential home for older people and to integrate the empirical results with a theoretical assumption upon which the intervention was based.Methods: A mixed method research design was used. The Swedish Health-Related Quality of Life Survey and the Family Hardiness Index were administered before and 6 months after the intervention. Qualitative data was collected by semi-structured interviews with each family 6 months post-intervention. The sample included families of residents, a total of 10 families comprising 22 family members.Result: Main finding was that FamHCs helped family members process their feelings about having a member living at a residential home and made it easier for them to deal with their own situations. FamHCs helped to ease their consciences, improve their emotional well-being, and change their beliefs about their own insufficiency and guilt. Seeing problems from a different perspective facilitated the families’ thinking in a new way.Conclusion: These findings showed that FamHC can be an important type of intervention to improve family functioning and enhance the emotional well-being.
  •  
42.
  • Dorell, Åsa, et al. (author)
  • Nurses' perspective of conducting family conversation
  • 2016
  • In: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 11
  • Journal article (peer-reviewed)abstract
    • INTRODUCTION: Nurses are in a prime position to manage to support families that have a family member living in a residential home for older people. Nurses' attitudes about meeting patients' family members vary. Studies describe that some nurses consider family members as a burden. But some nurses consider family members a resource and think it is important to establish good relationships with them.AIM: The aim of this study was to describe how registered nurses (RNs) experienced to participate in and conduct the intervention Family Health Conversations (FamHCs) with families in residential homes for older people.METHODS: The intervention FamHC was accomplished at three residential homes for older people. FamHC is a family systems nursing (FSN) intervention developed to support families facing the ill health of someone in the family. One RN from each residential home conducted the conversations. The RNs wrote diary notes directly after each conversation. The RNs were also interviewed 1 month after they had each conducted four FamHCs. The diary notes and the interviews were analysed separately by qualitative content analysis, and the findings were then summarized in one theme and further discussed together.FINDINGS: The main findings were that the RNs experience the conversations as a valuable professional tool involving the whole family. The RNs grasped that silence can be a valuable tool and had learned to attentively listen to what the families were saying without interrupting, allowing them and the families to reflect upon what the family members said.CONCLUSION: The findings show that the FamHC can be helpful for RNs in their work, helping them to perceive and understand the needs and desires of the families.
  •  
43.
  • Dorell, Åsa, 1974- (author)
  • Tröst genom hälsostödjande familjesamtal : upplevelser och effekter av en familjecentrerad intervention
  • 2016
  • Doctoral thesis (other academic/artistic)abstract
    • Aim: The overall aim of this thesis was to evaluate the experiences of nurses and families participated in Family Health Conversations (FamHC) and the effects of this intervention on those families with a family member living in a residential home for older people. Methods: This thesis comprises four studies. The FamHC were structured as three conversations held at two-week intervals and a closing letter. In two of the studies (I and II), group interviews with family members were interpreted using qualitative content analysis. A mixed-method research design was used in study three (III). Data were collected through group interviews with families and by using the instruments FHI and SWED-QUAL completed by the family members. The qualitative and quantitative data were analyzed and then integrated. In the fourth study (IV), registered nurses who had performed the FamHC participated in individual interviews after they had completed four conversation series each. The RNs also wrote diary notes about what they experienced directly after conducting each conversation. The interviews and diary notes were interpreted with qualitative content analyses. Result: The findings from study I one month after participating in the conversations showed that the families felt alleviated from guilty consciences. The FamHC gave the family members confirmation that they were, indeed, good enough. Study II showed that, six months after participating in the conversations, the families had experienced the FamHC as healing because the sharing and reflections through dialogue within the conversations mediated confirmation, which made the families feel consoled. Study III revealed that the families’ emotional wellbeing had increased six months after participating in the FamHC. The families also showed an improved ability to work together. In study IV, the nurses reported that the FamHC was a useful care action in their work with families. Conclusion: The overall conclusion from the findings is that the families were consoled by participating in the FamHC. The conversations offered an arena for families to listen to each other’s narration which provided a better relationship and cooperation within the family and a greater sense of well-being for the family members. 
  •  
44.
  •  
45.
  • Egberg Thyme, Karin, 1943-, et al. (author)
  • Individual brief art therapy can be helpful for women with breast cancer : A randomized controlled clinical study
  • 2009
  • In: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 7:1, s. 87-95
  • Journal article (peer-reviewed)abstract
    • Objective: Recent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy.Methods: The participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List–90).Results: At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axilliary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms.Significance of results: The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.
  •  
46.
  • Egberg Thyme, Karin, 1943-, et al. (author)
  • The entangled butterfly and the blue cactus : two case studies on time-limited psychodynamic art psychotherapy
  • Other publication (other academic/artistic)abstract
    • The aim of these two case studies is an in-depth analysis of the practice of scribbling in time- limited psychodynamic art psychotherapy. Our hypothesis is that the answers to "What do you see?" change as therapy proceeds, due to changes in emotions and cognitions expressed in scribbles and amplifications. The treatment is one hour per week for ten weeks, exempli- fied by two women with depression selected for differences in age, demographics and art expression. Analysis of the pictures and words is in two steps. The pictures were first tran- scribed into words using a phenomenological approach and then analysed according to con- tent analysis. Correspondingly, the words of the sessions were first transcribed verbatim and then analysed according to content analysis. The results show that the even if the two women have the same diagnosis at inclusion according to DSM IV, the symptoms of depression are expressed differently both in how they are manifested and in latent messages in the content analysis. The two women’s therapies can be divided into three phases each marked by turning points in the pictures – hence the pictures rather than the words set the theme for the phase. On leaving therapy the patients are able to use their drawings, their amplifications are in a complete form, they symbolise in words what they have expressed in pictures.The study’s conclusion is that the practice of scribbling seems to give a better capacity to regulate affects and, hence, a better regulation of the self. The women used not only their intellects but also their bodies in making latent communications manifest; their self-esteem improved as therapy proceeded, and they regained a sensitivity of "me – not me", i.e. better boundaries. The clinical implications are that the time-limited model of art psychotherapy is well suited to process emotions connected with depression, and that the patient’s problem should determine the length of the time limit. 
  •  
47.
  • Egberg Thyme, Karin, 1943-, et al. (author)
  • The outcome of short-term psychodynamic art therapy compared to short-term psychodynamic verbal therapy for depressed women
  • 2007
  • In: Psychanalytic Psychotherapy. - : Routledge, Taylor & Francis Group. - 0266-8734 .- 1474-9734. ; 21:3, s. 250-264
  • Journal article (peer-reviewed)abstract
    • The primary aim of this randomized controlled clinical trial was to compare the outcome from two types of short-term psychodynamic psychotherapy. The participants were thirty-nine women with depression. Half of the participants (n = 18) received art psychotherapy and the other half received verbal psychotherapy (n = 21). Data was collected before and after psychotherapy, and at a 3-month follow-up using self-rating scales and interviewer-based ratings. Results showed that art and verbal psychotherapies were comparable, and at follow-up, the average participant in both groups had few depressive symptoms and stress-related symptoms. The conclusion was that short-term psychodynamic art therapy could be a valuable treatment for depressed women.
  •  
48.
  • El-Serafi, Ahmed, 1977-, et al. (author)
  • Vitamin D levels and busulphan kinetics in patients undergoing hematopoietic stem cell transplantation, a multicenter study
  • 2021
  • In: Bone Marrow Transplantation. - : SPRINGERNATURE. - 0268-3369 .- 1476-5365. ; 56, s. 807-817
  • Journal article (peer-reviewed)abstract
    • Vitamin D (Vit-D), an essential nutrient, interacts with different drugs including chemotherapeutic agents like busulphan, an alkylating agent used for conditioning prior to stem cell transplantation. The correlation between Vit-D plasma levels and busulphan clearance was investigated in an uncontrolled prospective study in patients and mice. Plasma 25(OH)D levels were measured and busulphan pharmacokinetics calculated in 81 patients. Adults received oral busulphan (n = 34) while children received busulphan orally (n = 19) or intravenously (n = 28). Patients received no Vit-D supplementation. To confirm our findings, pharmacokinetics after a single dose of busulphan (oral or intravenous) were evaluated in two groups of mice (n = 60) receiving high or standard-level Vit-D supplementation. Both busulphan clearance (P < 0.0001) and 25(OH)D levels (P = 0.0004) were significantly higher in adults compared to children. A significant negative correlation (P = 0.041) was found between busulphan clearance and 25(OH)D levels in children treated orally. No such correlation was observed in adults or in children receiving intravenous busulphan. In addition, no significant effect of Vit-D levels on busulphan pharmacokinetics in mice regardless of the administration route. In conclusion, 25(OH)D can affect oral busulphan pharmacokinetics in children and its level should be considered when personalizing oral busulphan treatment. Further studies are warranted to confirm the underlying mechanisms.
  •  
49.
  • Etminani, Farzaneh, 1984-, et al. (author)
  • Randomised, siteless study to compare systematic atrial fibrillation screening using enrichment by a risk prediction model with standard care in a Swedish population aged ≥ 65 years : CONSIDERING-AF study design
  • 2024
  • In: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 14:1
  • Journal article (peer-reviewed)abstract
    • INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia and confers an increased risk of mortality, stroke, heart failure and cognitive decline. There is growing interest in AF screening; however, the most suitable population and device for AF detection remains to be elucidated. Here, we present the design of the CONSIDERING-AF (deteCtiON and Stroke preventIon by moDEl scRreenING for Atrial Fibrillation) study. METHODS AND ANALYSIS: CONSIDERING-AF is a randomised, controlled, siteless, non-blinded diagnostic superiority trial with four parallel groups and a primary endpoint of identifying AF during a 6-month study period set in Region Halland, Sweden. In each group, 740 individuals aged≥65 years will be included. The primary objective is to compare the intervention of AF screening enrichment using a risk prediction model (RPM), followed by 14 days of a continuous ECG patch, with no intervention (standard care). Primary outcome is defined as the incident AF recorded in the Region Halland Information Database after 6 months as compared with standard care. Secondary endpoints include the difference in incident AF between groups enriched or not by the RPM, with and without an invitation to 14 days of continuous ECG recording, and the proportions of oral anticoagulation treatment in the four groups. ETHICS AND DISSEMINATION: This study has ethical approval from the Swedish Ethical Review Authority. Results will be published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER: NCT05838781. © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
  •  
50.
  • Faraci, M., et al. (author)
  • Gonadal Function after Busulfan Compared with Treosulfan in Children and Adolescents Undergoing Allogeneic Hematopoietic Stem Cell Transplant
  • 2019
  • In: Biology of Blood and Marrow Transplantation. - : Elsevier BV. - 1083-8791. ; 25:9, s. 1786-1791
  • Journal article (peer-reviewed)abstract
    • Gonadal impairment is an important late effect with a significant impact on quality of life of transplanted patients. The aim of this study was to compare gonadal function after busulfan (Bu) or treosulfan (Treo) conditioning regimens in pre- and postpubertal children. This retrospective, multicenter study included children transplanted in pediatric European Society for Blood and Marrow Transplantation (EBMT) centers between 1992 and 2012 who did not receive gonadotoxic chemoradiotherapy before the transplant. We evaluated 137 patients transplanted in 25 pediatric EBMT centers. Median age at transplant was 11.04 years (range, 5 to 18); 89 patients were boys and 48 girls. Eighty-nine patients were prepubertal at transplant and 48 postpubertal. One hundred eighteen children received Bu and 19 Treo. A higher proportion of girls treated with Treo in the prepubertal stage reached spontaneous puberty compared with those treated with Bu (P = .02). Spontaneous menarche was more frequent after Treo than after Bu (P < .001). Postpubertal boys and girls treated with Treo had significantly lower luteinizing hormone levels (P = .03 and P = .04, respectively) compared with the Bu group. Frequency of gonadal damage associated with Treo was significantly lower than that observed after Bu. These results need to be confirmed in a larger population. © 2019
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