| 11. |
- Janson, Staffan, 1945-, et al.
(författare)
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Äldre i Värmland : Om hälsa, levnadsvanor och livssituation 2006
- 2007
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Landstinget har i samarbete med Karlstads universitet gjort flera befolkningsundersökningar i Värmland och publicerat rapporter om både den vuxna befolkningens och barns hälsa, senast med rapporten Värmlänningarnas Liv och Hälsa 2004. Någon befolkningsstudie av de äldres hälsa och livsvillkor har dock inte gjorts tidigare.Efter tre års förarbeten och samråd mellan landstinget, Värmlands kommuner och flera institutioner vid Karlstads universitet genomfördes den föreliggande studien av de äldres hälsa under senhösten 2006, i form av en omfattande postenkät. Urvalet utgjordes av 2500 slumpmässigt uttagna kvinnor och män som var 80 år eller äldre. Svarsfrekvensen var 60 procent, vilket får betraktas som mycket bra med tanke på att cirka 15 procent i denna åldersgrupp lever i särskilda boenden.Studien avspeglar således hälsan och livsvillkoren för de äldre. Överlag visar det sig att de äldre mår bra och har stor kapacitet att fungera som aktiva samhällsmedborgare. Samtidigt är det många som har kroniska besvär, med värk, syn- och hörselnedsättning, inkontinensbesvär etc. Det föreligger också en klar social gradient, där särskilt äldre kvinnor med arbetarbakgrund har både mer sjukdom och större ekonomiska problem än de övriga.
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| 12. |
- Johansson, Inger, 1943-, et al.
(författare)
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Acute confusion states, pain, health, functional status and quality of care among patients with hip fracture during hospital stay
- 2013
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 17:3, s. 120-130
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Tidskriftsartikel (refereegranskat)abstract
- AimThe aim of the study was to investigate: acute confusional states, pain and pain relief, physical health, psychological well-being and functional status among patients with hip fracture during hospital stay. A further aim was to describe patient's perceptions of quality of care.MethodForty-nine patients with hip fracture ⩾70 years old were consecutively included in the study at two hospitals in Sweden. Data were collected by interview and observation using structured questionnaires at four occasions.ResultsThe incidence of acute confusion was 32% on admission and the day after surgery and 14% the day before discharge. Additional diagnosis and on-going medication were significantly more common among confused patients. Patients with confusion experienced more intense pain at rest on admission and the day before discharge than non-confused patients. On perceived reality in quality of care patients' reported most favourable scores with regard to respect and empathy from the nurses and less favourable scores with regard to the information of responsible persons and information after procedures. The overall subjective importance of quality of care was higher than on the perceived quality of care.ConclusionMore attention, systematic observations and preventive actions should be taken when there are signs of acute confusion, pain and pain relief among patients with hip fracture. Patients' ratings of the subjective nature of care were higher than the perceived reality of quality of care and needs to be given attention since subjective importance reflects how the patients want their care to be.
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| 13. |
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| 14. |
- Kvist, Linda J, 1952-, et al.
(författare)
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A descriptive study of Swedish women with symptoms of breast inflammation during lactation and their perceptions of the quality of care given at a breastfeeding clinic
- 2007
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Ingår i: International Breastfeeding Journal. - : Springer Science and Business Media LLC. - 1746-4358. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWomen's perceptions of quality of care during episodes of breast inflammation have been scantily explored. It was the objective of the present study to describe a cohort of breastfeeding women with inflammatory symptoms of the breast during lactation regarding demographical variables, illness history and symptoms at first contact with a breastfeeding clinic and to explore their physical health status, psychological well-being and perceptions of quality of care received, at a six-week postal follow-up.MethodsThis is a descriptive study set at a midwife-led breastfeeding clinic in Sweden, which included a cohort of women with 210 episodes of breast inflammation. The women had taken part in a RCT of acupuncture and care interventions and were recruited between 2002 and 2004. Of the total cohort, 176 (84 %) responded to a postal questionnaire, six weeks after recovery.ResultsOf the 154 women for whom body temperature was recorded at the first visit, 80 (52%) had fever ranging from 38.1°C to 40.7°C. There was no significant difference between those with favourable outcomes (5 or less contact days) and those with less favourable outcomes (6 or more contact days) for having fever or no fever at first contact. Thirty-six percent of women had damaged nipples. Significantly more women with a less favourable outcome (6 or more contact days) had damaged nipples. Most women recovered well from the episode of breast inflammation and 96% considered their physical health and 97% their psychological well-being, to be good, six weeks after the episode. Those whose illness lasted 6 days or more showed less confidence in the midwives and in the care given to them. Twenty-one (12%) women contacted health care services because of recurring symptoms and eight of the 176 responders (4.5%) were prescribed antibiotics for these recurring symptoms. A further 46 women (26% of the responders) reported recurring symptoms that they managed without recourse to health care services.ConclusionInitial fever may not be indicative of outcomes for women with inflammatory breast symptoms and treatment by antibiotic therapy may be necessary less often than has been supposed. Women who are also suffering from damaged nipples may need special attention. Those with protracted symptoms were less satisfied with care and showed less confidence in caregivers. International research collaboration might help us find the optimal level of antibiotic therapy for this group of women. This is an important consideration for the global community.
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| 15. |
- Kvist, Linda J, 1952-, et al.
(författare)
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A randomised-controlled trial in Sweden of acupuncture and care interventions for the relief of inflammatory symptoms of the breast during lactation
- 2007
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 23:2, s. 184-195
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Tidskriftsartikel (refereegranskat)abstract
- Objectivesto further compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms.Designrandomised, non-blinded, controlled trial of acupuncture and care interventions.Settinga midwife-led breast feeding clinic in Sweden.Participants205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture among the care interventions and one without acupuncture. All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe).Findingsno significant difference was found in numbers of mothers in the treatment groups, with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. No statistically significant differences were found between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast feeding clinic or for number of mothers prescribed antibiotics. Significant differences were found in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (⩾6 contact days, n=61) were, at first contact with the midwife, more often given advice on correction of the baby's attachment to the breast. An obstetrician was called to examine 20% of the mothers, and antibiotic treatment was prescribed for 15% of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes.Key conclusions and implications for practiceif acupuncture treatment is acceptable to the mother, this, together with care interventions such as correction of breast feeding position and babies’ attachment to the breast, might be a more expedient and less invasive choice of treatment than the use of oxytocin nasal spray. Midwives, nurses or medical practitioners with specialist competence in breast feeding should be the primary care providers for mothers with inflammatory symptoms of the breast during lactation. The use of antibiotics for inflammatory symptoms of the breast should be closely monitored in order to help the global community reduce resistance development among bacterial pathogens.
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| 16. |
- Persenius, Mona, 1958-, et al.
(författare)
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Clinical nursing leaders’ perceptions of nutritionquality in Swedish stroke wards : a national survey
- 2015
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Ingår i: Journal of Nursing Management. - : Wiley-Blackwell. - 0966-0429 .- 1365-2834. ; 23:6, s. 705-715
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Tidskriftsartikel (refereegranskat)abstract
- AimTo describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards.BackgroundA high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality.MethodUsing a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants.ResultMost clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results.ConclusionUsing the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed.Implications for nursing managementThe use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework.
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| 17. |
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| 18. |
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| 19. |
- Sandin-Bojö, Ann-Kristin, 1953-, et al.
(författare)
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Women’s perception of intrapartal care in relation to WHO’s recommendations
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:22, s. 2993-3003
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aim of intrapartal care in normal birth is to achieve a healthy mother and child using the least possible number of interventions that is compatible with safety. Aim. The aims of this study were to elucidate women’s perception of intrapartal care and women’s perceptions of normal birth. Methods. A questionnaire developed from the WHO’s recommendations for care in normal birth was answered by 138 (response rate 66·0% Swedish women. The women were asked to evaluate items in two ways: their perceived reality of care received and the subjective importance of each item. Results. Most women reported receiving care in the category (A) practices that are good and should be encouraged. However, women to a minor degree reported assessment for physical health, enquiring about support needs and pain assessment on admission. Many women received electronic foetal monitoring, repeated vaginal examinations, oxytocin augmentation and suturing after birth which fall under the category (B) practices that are harmful, (C) insufficient evidence exists and (D) practices frequently used inappropriately. The women who reported ‘Yes’ for perceived reality also reported high subjective importance for those items regardless of category A–D. Eighty-four per cent of the women perceived that they had a normal delivery. Conclusion. The result suggests that women have great trust that the care midwives give them is the best care. Midwives, therefore, have an ethical responsibility to keep themselves informed about the best evidence-based care and to implement critical reviewing of their practice as part of continuing professional development. The women’s perceptions of a normal birth allows for a wide range of interventions. Relevance for clinical practice. The result emphasises the importance of midwives’ knowledge of evidence-based care and how to implement this into practice. Further research should include elucidation of the meaning of normal childbirth to childbearing women.
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| 20. |
- Smith-Stoner, Marilyn, et al.
(författare)
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Nursing students' concerns about end of life in California, Norway, and Sweden
- 2011
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Ingår i: International Journal of Palliative Nursing. - : Mark Allen. - 1357-6321 .- 2052-286X. ; 17:6, s. 271-277
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate concerns about dying for newly admitted nursing students from California, Norway, and Sweden. Method: A total of 389 undergraduate nursing students who had just started their nursing programme participated. Data was collected with a questionnaire that included two instruments-the Concerns about Dying instrument and the Sense of Coherence instrument-and background questions. The data was analysed using statistical and content analysis. Results: There were statistically significant differences between the three groups of students in terms of their age, their experience in health care, whether they had previously attended a dying patient, the age at which they first encountered the death of a loved one, and their concerns about dying. Two main categories emerged from the analysis of the open questions: 'attending to dying and grieving persons' and 'thinking about one's own death'. Conclusion: The study provides important insights into the concerns that newly admitted students bring to the nursing programme.
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