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  • 1. Eriksson, S
    et al.
    Hedman, Ann-Marie
    Vad är handledning?: en kvalitativ studie av sjuksköterskestuderandes uppfattningar av handledning i praktisk utbildning1992Independent thesis Basic level (degree of Bachelor)Student thesis
  • 2.
    Fonad, Edit
    et al.
    Karolinska Institutet.
    Robins Wahlin, Tarja-Brita
    Karolinska Institutet / The University of Queensland School of Medicine, Brisbane, Queensland, Australia.
    Hedman, Ann-Marie
    The Swedish Red Cross University College, Department of Nursing and Care.
    Associations between falls and general health, nutrition, dental health and medication use in Swedish home-dwelling people aged 75 years and over.2015In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 23, no 6, p. 594-604Article in journal (Refereed)
    Abstract [en]

    ABSTRACT The vast majority of elderly people in Sweden live in private homes in their communities for as long as possible. Poor health and a high risk of falls are very common among this group. This cross-sectional study investigates the association between falls and general health, appetite, dental health, and the use of multiple medications among home-dwelling men and women aged ≥75 years. Data were collected between October 2008 and March 2009 using a postal questionnaire. A total of 1243 people participated in the questionnaire survey (74% response rate), of which 1193 were included in the analysis. The majority of participants were women (n = 738, 62%). Falls in the previous 12-month period were reported by 434 (36%) participants. Most fallers (n = 276, 64%) were women. The majority of the fallers lived in a flat (n = 250, 58%). Poor health (aOR: 1.61; CI: 1.34-1.95), poor dental health (aOR: 1.22; CI: 1.07-1.39) and the use of four or more types of medication daily (aOR: 1.13; CI: 1.03-1.25) were significantly associated with falls in all participants. Poor dental health was found irrespectively of living in a flat (aOR: 1.23; CI: 1.04-1.46) or living in a house (aOR: 1.28; CI: 1.02-1.61), and both were significantly associated with falls. The use of more than four different types of medication daily (aOR: 1.25; CI: 1.11-1.41) was associated with falls for those living in a flat. The results highlight that falls are associated with poor general health, poor dental health and the use of four or more types of medication daily. Health professionals should provide health promotion education and investigate dental health and risk factors for oral disease. Likewise, medical and clinical practices of physicians and community care nurses should include assessing the risk of falling, and treatment that predisposes falls.© 2015 John Wiley & Sons Ltd.

  • 3.
    Hedman, Ann-Marie
    Red Cross University College of Nursing.
    Aktivitet, rörelse och rörlighet2009In: Omvårdnadens grunder: Hälsa och ohälsa / [ed] Edberg, Anna-Karin, Lund: Studentlitteratur, 2009, 1. uppl.Chapter in book (Other academic)
  • 4.
    Hedman, Ann-Marie
    Karolinska institutet. Institutionen för klinisk neurovetenskap och allmänmedicin.
    Demenssjukdomens betydelse vid rehabilitering av patienter med höftfraktur1997Independent thesis Advanced level (degree of Master (One Year))Student thesis
  • 5.
    Hedman, Ann-Marie
    et al.
    The Swedish Red Cross University College, Department of Nursing and Care.
    Brantberg, Anna-Lena
    Vo Ortopedi, Södersjkhuset.
    När det inte blev som planerat2015Conference paper (Other academic)
    Abstract [sv]

    Bakgrund

    Vid ortopedisk proteskirurgi i höft- eller knäled är postoperativa infektioner ett allvarligt hot mot den nya inopererade leden och kan leda till långa behandlingstider som påverkar patientens livskvalitet under lång tid.

    Tidig upptäck av en postoperativ infektion samt patientens delaktighet och kunskap om tecken på infektion är avgörande för att förhindra allvarliga konsekvenser av en infektion.

    Svenska höft- och knäprotesregistret har visat på en oroande ökning av andelen protesrelaterade infektioner. Nationella in-satser har gjorts för att minska andelen infektioner, till exempel genom projektet Protesrelaterade Infektioner ska Stoppas, PRISS. 

    Patientens delaktighet är viktig för att minska andelen infektioner men hur har patienten förstått given information?

    Frågeställningar

    • Har patienten fått information och förstått informationen om tidiga tecken på infektion?

    • Har patienten kunnat vara en aktiv part i upptäckten av postoperativ infektion utifrån given information?

    Metod

    • Kvalitativ intervjustudie med 10 patienter som drabbats av djup postoperativ infektion efter höft- eller knäproteskirurgi 

    • Journalgranskning av demografisk- och klinisk data

    Resultat

    Resultatet visade att patienterna upplevde det svårt att tolka symtomen och kände sig osäkra på vad som är normalt och vad som inte är normalt.  Information hade getts i varierad grad och förmågan att ta tills sig informationen var också olika. Bristande tillgänglighet, bristande rutiner för informationsöverföring och bristande rutiner för att säkerställa att patienten förstått den information som getts var bidragande orsaker till att patienten inte omedelbart tog kontakt med vården trots tecken på infektion.

    Slutsats

    • För att information ska övergå i kunskap måste den anpassas efter patientens behov och förmågor att ta till sig information.  Rutiner för att säkerställa att given information övergår i kunskap behöver förbättras.

    • Personcentrerad vård kan vara ett redskap för att öka patientens delaktighet och öka förutsättningarna för att ge anpassad information och säkerställa en god kunskapsöverföring.

  • 6.
    Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing. Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Division of Geriatric Medicine, Karolinska Institutet, Stockholm.
    Grafström, Margareta
    Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Division of Geriatric Medicine, Karolinska Institutet, Stockholm.
    Conditions for rehabilitation of older patients with dementia and hip fracture: – the perspective of their next of kin2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 2, p. 151-158Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the conditions for rehabilitation of older patients with dementia and hip fracture from the perspective of their next of kin. Twenty patients at orthopaedic wards were examined postfracture using a short cognitive test. The same number of next of kin answered four open-ended questions about rehabilitation as well as about the patient’s physical function. Qualitative content analysis was used to identify categories. The findings indicate that the conditions for rehabilitation of older patients with dementia and hip fracture are related to the patients’ competence, specific needs of support in the light of competence, environmental factors and classification of the rehabilitation activities. The study confirms that the conditions for rehabilitation are related to symptoms of dementia disease and arise from a decline in competence making the patient unable to cope with the environmental pressure and to perform rehabilitation activities. Because of difficulties in assessing competence, patients with dementia are being judged as incapable of managing rehabilitation. A supportive strategy is necessary to encourage the recovery process.

  • 7.
    Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing.
    Jansson, Wallis
    Karolinska Institutet.
    Äldrevård och äldreomsorg2015Book (Other academic)
  • 8.
    Hedman, Ann-Marie
    et al.
    Neurotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm, Sweden.
    Ljunggren, Gunnar
    Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    Grafström, Margareta
    Mälardalen University, Department of Caring Science, Eskilstuna, Sweden.
    Strömberg, Lars
    Division of Orthopaedics, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Dementia, delirium and other comorbid conditions in acute hip fracture care: Traditions, attitudes and local policies rather than actual state guide diagnose making?2005In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 25, no 4, p. 25-29Article in journal (Refereed)
    Abstract [en]

    In the elderly, hip fracture is a common disease. Previous studies show that more than half of these patients has a co-existing dementia and/or delirium diagnose. We found a cognitive disorder diagnose code registered in only 11% of 14,993 hip fracture patients, 65 years or older, in Stockholm, Sweden during 1994–1999. Although most common in the clinical setting, acute confusional state (delirium) was hardly ever diagnose-coded (1%). Furthermore, the share of dementia/delirium registrations ranged from 6 to 17% between hospitals and within a single hospital from 1 to 20 %. The lack of pattern in diagnosis coding became even more evident in the patients who were transferred from acute care to geriatric rehabilitation – it was unusual that the diagnosis was given at both specialities. Also regarding secondary diagnoses on the whole, large differences on hospital level was found (range 0.4 – 2.2/patient). The over all impression of the findings was that recording of comorbid conditions in acute somatic care depends on other factors than the patient’s actual state such as traditions, attitudes and local policies (or the lack thereof). In conclusion, significant conditions crucial for planning, treatment and prognosis in the hip fracture population are virtually invisible in this administrative database.

  • 9.
    Kraft, Mia
    et al.
    The Swedish Red Cross University College.
    Blomberg, Karin
    Medical and Health Sciences, Örebro University.
    Hedman, Ann-Marie
    The Swedish Red Cross University College.
    The health care professionals' perspectives of collaboration in rehabilitation: an interview study2014In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 3, p. 209-216Article in journal (Refereed)
    Abstract [en]

    Background

    In previous literature, it has been recognised that the extent to which different healthcare professionals collaborate may affect both the quality and safety of care, and patient outcomes. Collaboration appears to be an essential part of professional practice, yet there is a lack of knowledge and understanding of collaboration in the context of short-term care units. Therefore, this study was undertaken to better understand how professionals in this context view collaboration.

    Aim

    To describe collaboration in rehabilitation from the perspective of healthcare professionals.

    Methods

    Qualitative interviews were conducted with ten healthcare professionals, including: occupational therapists, physiotherapists and nurses, who worked in three different short-term care settings. The interviews were transcribed, and qualitative content analysis was used.

    Findings

    Four categories, all of which included both positive and negative descriptions of collaboration, were identified: (i) Crossing professional and organisational boundaries (ii) Awareness of own professional identity (iii) Information and knowledge transfer and (iv) Balancing between patient, system and process.

    Conclusions

    The findings indicate the importance of leadership and organisational structures for stimulating communication, and promoting collaboration between team members. In addition, working as a professional in short-term care requires individual skills in collaboration efforts, including awareness of one's own professional identity.

    Relevance to clinical practice

    Opportunities for supervision could be one way to increase individuals' awareness of their own role in the team.

  • 10.
    Kraft, Mia
    et al.
    The Swedish Red Cross University College, Department of Nursing and Care.
    Kästel, Anne
    The Swedish Red Cross University College, Department of Nursing and Care.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Nursing and Care.
    Rydholm Hedman, Ann-Marie
    The Swedish Red Cross University College, Department of Nursing and Care.
    Global Nursing: a literature review in the field of education and practice2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 3, p. 122-133Article, review/survey (Refereed)
  • 11. Lönnstedt, Minna
    et al.
    Häckter Ståhl, Cecilia
    Red Cross University College of Nursing.
    Hedman, Ann-Marie
    Red Cross University College of Nursing.
    Living with long-lasting pain: patients’ experiences of neuropathic pain2011In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 3, no 4, p. 469-475Article in journal (Refereed)
    Abstract [en]

     Aim. The aim of this study was to describe the lived experiences of patients with neuropathic pain.

    Background. An estimated 132 000 (1·5%) Swedes are affected by some form of neuropathic pain, but the exact prevalence is uncertain. Neuropathic pain is a syndrome that is often under-diagnosed. Earlier studies focusing on the experience of neuropathic pain show that it has a huge impact on life and that pain-related limitations result in social withdrawal.

    Conclusions. The present study contributes to nursing knowledge by presenting a picture of living with neuropathic pain. It confirms earlier data which found that living with neuropathic pain often brings major changes in a person’s way of life, influencing daily activities and social life. The findings indicate the importance of being met with empathy and a positive attitude from healthcare professionals and pointed out the negative impact on a patient’s trust when healthcare professionals question them about the pain. The findings confirm that feelings of loneliness and vulnerability emerged when patients were not met with trust.

    Relevance for clinical practice. The findings are clinically relevant for nurses and other healthcare professionals, because they provide information on the patients’ symptoms and the strategies they use to deal with neuropathic pain on a daily basis. The current study indicates that more attention must be placed on the healthcare professionals’ attitude when meeting patients living with neuropathic pain. The findings highlight that professional and positive encounters between healthcare staff and patients should be emphasised, as a part of nursing education and in clinical practice, as this has a profound effect on the patient’s trust in care.

  • 12.
    Rydholm Hedman, Ann-Marie
    Red Cross University College of Nursing.
    Aktivitet, rörelse och rörlighet2014In: Omvårdnadens grunder: Hälsa och ohälsa / [ed] Edberg, Anna-Karin; Wijk, Helle, Lund: Studentlitteratur AB, 2014, 2:a uppl., p. 333-361Chapter in book (Other academic)
  • 13.
    Rydholm Hedman, Ann-Marie
    Institutionen för neurobiologi, vårdvetenskap och samhälle, Karolinska Institutet, Stockholm.
    Unequal opportunities for patients with and without cognitive impairment: relatives' and significant others' views on care and rehabilitation after hip fracture2007Doctoral thesis, comprehensive summary (Other academic)
  • 14. Rydholm Hedman, Ann-Marie
    et al.
    Blomberg, K.
    Wadström, C.
    Langius Eklöf, E.
    Self-reported Quality of Life in women with breast cancer: 1 year follow-up study2011Conference paper (Other academic)
  • 15.
    Rydholm Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing.
    Fonad, Edit
    Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm.
    Sandmark, Hélène
    School of Health, Mälardalen University, Care and Social Welfare, Public Health Sciences, Västerås.
    Older people living at home: associations between falls and health complaints in men and women2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 19-20, p. 2945-2952Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To investigate the associations between self-reported falls and health complaints, among persons aged 75 years and older living at home, and to investigate gender differences in the associations.

    Background

    There are several studies concerned with risk factors for falling, and others related to health complaints, but not many with associations between falls and health complaints. There are some inconsistent data of incidence and gender-related differences in falling.

    Design

    Case–control community-based study.

    Methods

    In total, 1243 persons living in two municipal districts in Sweden answered a questionnaire. Odds ratios (OR) and regression models with 95% confidence interval (CI) were used to determine the associations between self-reported falls and different health complaints.

    Results

    The adjusted (multivariate) linear regression showed that urinary incontinence, self-rated health and tiredness were significantly associated with falls for both men and women living at home. The gender-related differences in falling were associated with the variables such as self-rated health for men and tiredness and pain in the hands, elbows, legs or knees for women.

    Conclusion

    An association is evident between falls and urinary incontinence, poor self-rated health and tiredness for older persons living at home. Gender differences in falls show an association with poor self-rated health, tiredness and pain in the hands, elbows, legs or knees.

    Relevance to clinical practice

    As older people are expected to live in their own homes as long as possible, more knowledge is required about what determines the risk of falling. Nurses in community care are recommended to use assessment tools that include urinary incontinence in order to detect the risk of falling.

  • 16.
    Rydholm Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing.
    Heikkilä, Kristina
    Grafström, Margareta
    Strömberg, Lars
    Red Cross University College of Nursing.
    Hip fractures and cognitive state: patient outcomes and proxies’ perceptions of the rehabilitation period2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 3, p. 178-186Article in journal (Refereed)
    Abstract [en]

    Background.  Numerous studies are available on hip fracture and rehabilitation outcomes, some mention dementia but very few from a family/proxy perspective.

    Aim.  To investigate whether cognitive state influences the hip fracture patients’ rehabilitation outcomes as well as the proxies’ perceptions of the 6-month rehabilitation period.

    Design.  A survey with structured and unstructured questions. Statistics and content analysis.

    Methods.  The questionnaire was sent to 40 proxies of hip fracture patients with and without cognitive impairment, 32 replied. Statistics and content analysis were used to analyse the data.

    Results.  In the cognitively impaired group, physical function decreased (P = 0.0241) as well as locomotion (P = 0.0005) compared to pre-fracture. This group mainly participated in rehabilitation sessions in institutions (P = 0.0001) and their main support came from nursing staff. The cognitively impaired group assessed the rehabilitation period as being of a much lower quality than the cognitively intact group (P = 0.0048). In the impaired group, hindrances to rehabilitation were low level of staffing, and lack of access to rehabilitation resources such as physiotherapists.

    Conclusions and relevance for clinical practice.  Hip fracture patients are a dichotomous group and cognition is decisive for physical and social outcomes as well as type of rehabilitation support.

  • 17. Rydholm Hedman, Ann-Marie
    et al.
    Strömberg, Lars
    Grafström, M.
    Heikkilä, K.
    Significant others ‘experiences of the hip fracture recovery period of older patients with and without cognitive impairment2009Conference paper (Refereed)
  • 18.
    Rydholm Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing. Division of Nursing, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm.
    Strömberg, Lars
    Red Cross University College of Nursing. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
    Grafström, Margareta
    Division of Nursing, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm.
    Heikkilä, Kristina
    Linnaeus University, School of Health and Caring Sciences, Växjö.
    Hip fracture patients’ cognitive state affects family members’ experiences: a diary study of the hip fracture recovery2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 451-458Article in journal (Refereed)
    Abstract [en]

    Background:  Many patients with hip fractures suffer from dementia disease, which has shown to affect the outcome of recovery strongly, as well as care and treatment. As most hip fracture patients are discharged home early after surgery, caregiving often falls on family members – spouses, daughters, sons, or even neighbours become informal carers.

    Aim:  To explore how hip fracture patients’ cognitive state affect family members’ experiences during the recovery period.

    Methods:  Eleven diaries written by family members’ of hip fracture patients were analysed by means of qualitative content analysis.

    Findings:  The analysis generated two main categories with four categories. The first main category was; ‘Being a family member of a cognitively impaired patient’ with the categories ‘Dissatisfaction with lack of support’ and ‘Emotional distress due to the patient’s suffering’. The second main category was ‘Being a family member of a cognitively intact patient’ with the categories ‘Satisfaction with a relative’s successful recovery’ and ‘Strain due to their caring responsibilities’. Being a family member of a patient with cognitive impairment and a hip fracture meant being solely responsible for protecting the interests of the patient; in regard to care, rehabilitation and resources. The family members were also burdened with feelings of powerlessness and sadness due to the patients’ suffering. On the contrary, family members of cognitively intact hip fracture patients had positive experiences. The family members expressed pleasure from seeing their close ones make progress. However, when the healing process was delayed this led to strain on the family members.

    Conclusions:  The findings suggest the hip fracture patient’s cognitive state is more decisive than the hip fracture itself for the family members’ experiences.

  • 19.
    Sandmark, Helene
    et al.
    Department of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås.
    Fonad, Edit
    Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm.
    Hedman, Ann-Marie
    Red Cross University College of Nursing.
    Factors Associated with falls in Elderly Living at Home in Sweden2012In: Primary Health Care: Open Access, ISSN 2167-1079, Vol. 2, no 4, p. 1000124-Article in journal (Refereed)
    Abstract [en]

    Background: Falls among elderly constitute a major public health issue of increasing magnitude. For the prevention of fall at population level, it is necessary to study risk factors among community-dwelling elderly people in the population. The aim of this explorative study is to show associations between falls and self-rated health, physical exercise, physical functioning and physical disorders in elderly men and women living in their own homes in urban areas in a high-income country.

    Methods: The associations between reported falling during the previous year and factors such as physical functioning, physical disorders, exercise, and self-rated health were investigated in a case-control study. The study base included all men and women aged 75 years and older living in their own homes in two municipal districts, one in the Stockholm area and one in the south of Sweden, from October 2008 to March 2009. A questionnaire was developed, but with questions used in earlier studies.

    Results: Of the 1243 who participated in the study, 434 (35%) reported that they had fallen at least once during the previous year, and 759 (61%) reported no falls at all during the same period. Of the fallers, 158 (36%) were men, and 276 (64%) women. Unsteady gait (log reg 1.38, 95% CI 1.09-1.75) and poor self-rated health (log reg 2.04, 95% CI 1.29-3.20) were associated with falls during the previous year.

    Conclusion: The results from this study indicate that the most important factors related to falls are within physical functioning, and that there are differences between men and women regarding the strength in the associations, and regarding marital status and age.

  • 20.
    Sigvardsdotter, Erika
    et al.
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Vaez, Marjan
    Karolinska Institutet.
    Hedman, Ann-Marie
    The Swedish Red Cross University College, Department of Nursing and Care.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Public Health and Medicine. Karolinska Institutet.
    Prevalence of torture and other war-related traumatic events in forced migrants: A systematic review2016In: Journal on Rehabilitation of Torture Victims and Prevention of Torture, ISSN 1018-8185, E-ISSN 1997-3322, Vol. 26, no 2, p. 41-73Article in journal (Refereed)
    Abstract [en]

    Aim: To describe and appraise the research literature reporting prevalence of torture and/or war-related potentially traumatic experiences (PTEs) in adult forced migrants living in high-income countries.

    Methods: A search for peer-reviewed articles in English was conducted in PubMed, Web of Science, PILOTS, key journals, and reference lists. Studies based on clinical samples and samples where less than half of participants were forced migrants were excluded. Data was extracted and a methodological quality appraisal was performed.

    Results: A total of 3,470 titles and abstracts were retrieved and screened. Of these, 198 were retrieved in full-text. Forty-one articles fulfilled inclusion criteria and the total number of study participants was 12,020 (median 170). A majority focused on specific ethnic groups or nationalities, Southeast Asian, Middle Eastern and Balkan being the most frequent. Reported prevalence rates of torture ranged between one and 76 % (median 27 %). Almost all participants across all studies had experienced some kind of war-related PTE.

    Conclusions: Reported prevalence rates of torture and war-related PTEs vary between groups of forced migrants. Trauma history was often studied as a background variable in relation to mental health. The heterogeneity of data, as well as the methodological challenges in reaching forced migrants and defining and measuring traumatic experiences, prevent generalisation concerning trauma history across groups.

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