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  • 151.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University, Health and Social Sciences, Kristianstad, Sweden.
    Granskär, Monica
    Kristianstad University, Health and Social Sciences, Kristianstad, Sweden.
    Berg, Agneta
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level. Kristianstad University, Health and Social Sciences, Kristianstad, Sweden.
    Challenges Highlighted During Peer Supervision by Mental Health Nurses and Social Workers Recently Trained as Case Managers in Sweden2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 10, p. 809-816Article in journal (Refereed)
    Abstract [en]

    This study looked at 13 mental health nurses and social workers who were recently trained as case managers (CMs) and the work-related challenges they faced in community mental health services. Data were collected during ten peer supervisions sessions. Participants expressed pride and enthusiasm about their new function as CMs, but they also acknowledged that their new position meant they had to confront existing systems and posed several challenges, including organizational hindrances, economic prerequisites, nominated administrators, role function, and model fidelity. We conclude that the existing organizations seemed to be unprepared to hold and facilitate more person-centered approaches, such as designating CMs. The model fidelity is important, but has to be flexible according to clients' daily state.

  • 152.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University.
    Persson, Irené
    Kristianstad University.
    Berg, Agneta
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 1, p. 42-50Article in journal (Refereed)
    Abstract [en]

    This study illuminates nine psychiatric disabled per-sons’ lived experience of a newly established community based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenologicalhermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.

  • 153.
    Jansson, Helena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors hälsofrämjande arbete: en litteraturöversikt2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of health promotion is to increase student´s physical and mental health. The mental health among children and young people has increased, above all among girls. There is correlation between student´s health and their school results. School nurse´s health function is considered to be unclear and needs to be made visible. The aim of this study is to describe the school nurses' health promoting work. The method was a systematic literature search according to the SBU. Thirteen scholarly articles were included and analyzed according to Polit and Beck. The result showed that the school nurses through health promotion can identify and strengthen the students' internal and external forces and also the sense of coherence and ability to deal with stress. The school nurse is seen as a trustful person to talk to about health. The professional secrecy helps the student to feel confident that their problems are not passed on without their consent. There is a requirement for the school nurse to always be present. This can be a hinder for developing their professional skills. The uncertainty and lack of evidence-based practices can lead to misunderstandings and wrong expectations at the school nurse's health-promoting work. It is therefore important to clarify the health-promoting work and use evidence-based methods and theories that can be evaluated.

  • 154.
    Jansson, Leila
    et al.
    Umeå University, Department of Nursing , Umeå , Sweden..
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nurses' Experiences of Assessing Suicide Risk in Specialised Mental Health Outpatient Care in Rural Areas2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 554-560Article in journal (Refereed)
    Abstract [en]

    This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress. Consequently, in order to prevent ill health among these nurses, there is a need for a tolerant work climate and an organisation that provides support to its employees. Assessing suicide risk is a demanding task within mental health outpatient care. Further, nurses operating in rural areas have to initiate and conduct assessments on their own, and they are, together with the physician in charge, also held individually responsible for their assessments. Consequently, it is important to describe nurses' experiences of how they deal with questions concerning suicide risk. Their experiences can foster awareness of the responsibility and the ethical standpoints related to assessing suicide risk, can help outline the need for further education and supervision, and can improve support from co-workers and management.

  • 155.
    Jensen, Charlotte
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Svensson, Jennie
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Dialog: en begreppsanalys2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Well analyzed generally accepted concepts can help the nurse identify and solve complex care situations and thus more easily communicate with patients and ascertain their needs, develop nursing diagnoses and choose the appropriate nursing interventions.AimThe aim of this study was to unveil the concept of dialogue and elucidate its meaning. Method The concept analysis method developed by Koort was used. Results The analysis revealed that the word dialogue was first mentioned in the early 1200s and is derived from the old French word "dialoge". The concept of dialogue is described as a conversation between two people. When dictionaries and encyclopedias were reviewed we found twenty eight synonyms for the concept of dialogue, on further examination it emerged that many of the words were not relevant to nursing science. Conclusion Dialogue is an attitude characterized by proximity, a mutual exchange takes place between two or more people. The relationship between a health professional and a patient should be characterized by both seeing themselves as free and by recognizing that both of them have the knowledge needed for the patient to regain health. Both parts have obligations, rights and responsibilities towards each other.

  • 156.
    Jepsen, Linda
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Toresdotter, Elin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    ”Men visst känner man glädje när föräldrar beslutat sig för en vaccination som de varit tveksamma till”: Föräldrar som väljer att tacka nej till att vaccinera sina barn – Sjuksköterskans upplevelser och strategier i mötet2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In the mid-20th century, vaccines began to be routinely administered to children in order to prevent illness. This is seen as the foremost medical effort made for public health. The vaccination coverage in Sweden is high, but some parents choose to refuse the Swedish childhood vaccination program. Previous research shows that meeting with parents who refuse vaccination is perceived as difficult for nurses. In order to understand why parent´s refuse and how nurses best can meet them more knowledge is needed. Aim: To describe the nurse's idea of why parents refuse to vaccinate their children and how the nurse responds to these parents. Method: Web-based questionnaire with 15 questions, both open-ended and closed, was used and sent to nurses working in the child health care sector and in primary school. The questionnaire was analyzed with qualitative content analysis and descriptive statistics. Results: In the result, three main categories emerged: Influence on the child, Mistrust of vaccination and The specialist nurse's strategies. The main categories are made up of a total 10 subcategories. Conclusion: The result showed that nurses felt insecure meeting parents who refuse vaccinations. In order to reduce insecurity, nurses highlighted the importance of asking about the cause of the parents' decision and make time for these conversations. Finding a structure for the conversation was important and one example was motivational conversations. Individualizing the conversation and the questions after each parent created a safe environment and an approach of a person-centered care.

  • 157.
    Joelsson, Britta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Linnéa
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Samverkan mellan primärvård och specialistpsykiatri: Två sidor av samma mynt2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is increasing in society. Collaboration between primary care and specialist psychiatry is ongoing. The experience is that many people with mental illness refer to different activities and being left without treatment. Good interaction is important for persons seeking mental health care to get the right help.

    Aim: to describe the primary care nurse's experience of collaboration with specialist psychiatry.

    Method: a qualitative study based on semistructured interviews of primary care nurses. The material was analyzed by qualitative content analysis.

    Results: appeared in the following categories; Collaboration characterized by differences with the subcategories Good collaboration for emergency transfers and poor accessibility and inadequate feedback between the activities. Unclear division of responsibilities with the subcategories care different assessments of the same person, Inadequate knowledge on the division of responsibilities between the professions and gray zone patient - primary care or specialist psychiatry. Last category are resource shortage and low interest in mental health with the subcategories Inadequacy and Interest and respect for psychiatry.

    Conclusion: Working according to the division of responsibilities can be an obstacle to cooperation in such a way that the nurse expires blindly from the division of responsibilities without knowing what he/she refers to. Resource shortage, in turn, leads to experiences of insufficiency of nurses. Increased knowledge of each other's activities could lead to closer cooperation and understanding of each other. The person-centered care would benefit from the fact that both instances took care of more people than they actually consider to be part of their area of responsibility.

  • 158.
    Johansson, Ann-Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö, Sweden.
    Grankvist, Gunne
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Brink, Eva
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 9, p. 591-604Article in journal (Refereed)
    Abstract [en]

    Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

  • 159.
    Johansson, Ann-Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Brink, Eva
    University West, Department of Health Sciences. University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Cliffordson, Christina
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Axelsson, Malin
    Malmö University, Department of Care Science, Faculty of Health and Society, Malmö.
    The function of fatigue and illness perceptions as mediators between self-efficacy and health-related quality of life during the first year after surgery in persons treated for colorectal cancer.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1537-E1548Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the present study was twofold: 1) to measure changes in health-related quality of life (HRQoL), two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for CRC during the first year after surgical treatment, and 2) to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect HRQoL at 12 months post-surgery.

    BACKGROUND: There are fluctuations in HRQoL during the first year after treatment for colorectal cancer (CRC), and fatigue may negatively influence HRQoL. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with HRQoL in other cancer diagnoses. Concerning CRC, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to HRQoL at 12 months.

    DESIGN: A prospective longitudinal design.

    METHODS: Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostoma, participated. HRQoL, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used.

    RESULTS: No changes were reported in levels of HRQoL, fatigue, or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on HRQoL at 12 months.

    CONCLUSION: Persons treated for CRC who have lower self-efficacy 3 months post-surgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue.

    RELEVANCE TO CLINICAL PRACTICE: Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, i.e., carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy. This article is protected by copyright. All rights reserved.

  • 160.
    Johansson, Carina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Äsplöf Bergsten, Jenny
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tonåringar med attention deficit hyperactivity disorder: Kartläggning av register2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Attention deficit hyperactivity disorder (ADHD) is a disability and affected executive functions and working memory, which requires changed in the classroom. Integrated healing process included the patient, the family, the structures and the systems. Psychiatric nursing care integrated physical and spiritual health and participation in society. The improwement of nursing was a neverending process.

    The registerstudy mapped registrations in the quality register, which was responsible for follow up treatment of secured ADHD. This study was a quantitative method with a cross sectional study. The population was boys and girls between 13 to 17,5 years old. There where 1956 boys and 796 girls. The mainly inattention is a symptom of ADHD. About the boys , 19,5 % of these had mainly inattention. About the girls, 25 % of these, had mainly inattention.

    The main common form of schooling without additional support is one sort of schooling in the study. About the boys, 44,1 % of the boys, were in the main common schoolform without additional support. About the girls, 47, 5 % of the girls, were in the main common schoolform without additional support. About the parparticipants in the main common schoolform without additional support, there were 18,9 o% of these who had psychosocial problems.

    The custom of studies is another sort of schooling in the study. About this schooling there were 41,8 % of the participants who had psychosocial problems. This could be perceived as ADHD diagnosis effect of executive functions and gave varying severity.

  • 161.
    Johansson, Caroline
    University West, Department of Health Sciences, Section for nursing - graduate level.
    BVC-sjuksköterskors upplevelser av språkbedömningssituationen för barn som inte har svenska som modersmål2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background One of the functions in child health care is to observe language development. Research shows that language delays which are not treated can cause difficulties in learning and socialization. When the child does not have Swedish as their mother tongue it may be difficult for the child health care nurses (CHC nurses) to make language assessment. The aim of this study is to illuminate the CHC nurses experiences of the language assessment situation among children who do not have Swedish as their mother tongue.

    Method Then the aim of this study was to illuminate experiences a qualitative inductive method was chosen. Multistage focus groups were used, where the CHC nurses who worked in a multicultural area were interviewed on two occasions. When analyzing the transcribed text qualitative content analysis were used.

    Result The analysis culminated into three categories; The interpretation situation, Importance of parents, The own competence in the language assessment situation and the theme; Feelings of doubt and uncertainty in the language assessment situation. The results showed that it is varied quality of the interpreters. The language assessment takes longer when an interpreter is present and it is not for the benefit if an interpreter and family are familiar with each other. Many times CHC nurses rely on parental assessment of the language development. It is felt by the CHC nurses to be cultural differences whether parents stimulate language development. CHC nurses feel themselves that they have a lack of cultural competence.

    Conclusion CHC nurses strives to be responsive and have the child in focus during the assessment but they experience feelings of doubt and uncertainty whether their assessment is correct or not. There are factors that are important for proper assessment; interpreter quality and parents' sincerity. The lack of cultural competence can do a risk of not understanding the child's situation.

  • 162. Johansson, Caroline
    et al.
    Berggren, Ingela
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Nursing. University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    Child health nurses' experiences of language assessment in children: A Swedish study2017In: Journal of Health Visiting, ISSN 2050-8719, Vol. 5, no 4, p. 187-195Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to discover Swedish child healthcare (CHC) nurses' experiences of language assessment in children who do not have Swedish as their mother tongue. A CHC nurse has qualifications in child health, and their role is to promote good health and prevent illness. As immigration to Sweden is at the highest level ever recorded (Statistics Sweden, 2014), there is an increasing need for language assessment. In this study, ‘mother tongue’ is defined as the language a child learns first, which is synonymous with the term ‘first language’ (Oxford Learner's Dictionaries, 2016). The CHC nurses in this study were Swedish-speaking, but conducted speech and language assessments among children who did not speak Swedish; for example, who had a mother tongue other than Swedish. It is important to acquire knowledge of CHC nurses' experiences of language assessment.

  • 163.
    Johansson, Marie-Louise
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Simberg, Jenny
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Barnhälsovårdssjuksköterskans erfarenheter av barn med funktionell förstoppning2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Many children suffer from functional constipation. In case of functional constipation there is no underlying disease. In Sweden, functional constipation is very common in children. Risk factors include lack of physical activity, irregular toilet habits and insufficient intake of fibers and fluids. Child health nurse has the knowledge and skills to advise and treat children in functional constipation and to support and reduce the suffering. Aim: The aim of the study was to illuminate child health nurses' experiences in the care of children with functional constipation. Method: Ten child health nurses were interviewed during a semi structured interview used openended questions. The interviews were recorded as digital files and transcribed verbatim and then analyzed according to a qualitative content analysis. Results: The child health nurses described experiences in the care of children with functional constipation. There were two categories from the analyzed data: "to base on the child`s needs" and "the child´s physical and psychosocial environment". Conclusion: This study shows the child health nurses experiences in the care of children with functional constipation. The care is based on the childs neeeds and the environment around the child in terms of physical and psychosocial environment is taken into account. The child health nurses should be aware of the reason why parents seek care, how to find the cause of functional constipation and how to relieve the child's suffering. She creates a health promotion meeting with children and parents seeking care for functional constipation.

  • 164.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Sweden.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Voices used by nurses when communicating with patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1640-E1650Article in journal (Refereed)
    Abstract [en]

    AIM: To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Communication is an essential tool for nurses when working with older patients and their relatives but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome.

    DESIGN: An ethnographic design informed by the sociocultural perspective was applied.

    METHOD: Forty participatory observations were conducted and analyzed during the period October 2015 to September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semi-structured follow-up interviews were conducted with five nurses.

    RESULTS: In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualized, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices this indicates a shift in the orientation or situation.

    CONCLUSION: The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved.

    RELEVANCE TO CLINICAL PRACTICE: Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. This article is protected by copyright. All rights reserved.

  • 165.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Striving to establish a care relationship-Mission possible or impossible?: Triad encounters between patients, relatives and nurses2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction.

    OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people.

    DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective.

    METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis.

    RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view.

    CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible.

  • 166.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    What are they talking about? Content of the communication exchanges between nurses, patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1651-E1659Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore and describe the content of the communication exchanges between nurses, patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Information, messages and knowledge are constantly being communicated between nurses, older patients and relatives in the healthcare sector. The quality of communication between them has a major influence on patient outcomes. A prerequisite for good care to be given and received is that there is mutual understanding between the parties involved.

    DESIGN: An ethnographic study was informed by a sociocultural perspective.

    METHOD: Data were collected through 40 participatory observations of meetings between nurses and older patients and/or relatives which covered 135 hours of nurse-patient-relative interaction, field notes, 40 field conversations with 24 nurses and 40 field conversations with patients (n=40) and relatives (n=26). Five semi-structured interviews were conducted with nurses. An ethnographic analysis was performed.

    RESULTS: The analysis identified three categories of content of the communication exchanges: medical content focusing on the patient's medical condition, personal content focusing on the patient's life story, and explanatory content focusing on the patient's health and nursing needs. The content is influenced by the situation and context.

    CONCLUSIONS: Nurses would benefit from more awareness and understanding of the importance of the communication content and of the value of asking the didactic questions (how, when, what and why) in order to improve the patients' and relatives' understanding of the information exchanges and to increase patient safety.

    RELEVANCE TO CLINICAL PRACTICE: Nurses can use the communication content to create conditions enabling them to obtain a holistic view of the patient's life history and to develop an appropriate person-centered care plan. This article is protected by copyright. All rights reserved.

  • 167.
    Jonsson, Bosse
    et al.
    Mälardalen University.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Work Integrated Learning and Learning Integrated Work: An Approach to Unite Theory and Practice to Praxis2016In: Handbook of Research on Quality Assurance and Value Management in Higher Education / [ed] Nuninger, Walter & Châtelet, Jean-Marie, Hersey, PA: IGI Global , 2016, p. 139-159Chapter in book (Refereed)
    Abstract [en]

    The difference between the professional competence conveyed during education and the competence demanded in working life is substantial and needs to be taken seriously. In this chapter where the case is nursing education, Work Integrated Learning (WIL) and Learning Integrated Work (LIW), are suggested as pedagogical approaches in Higher Education aiming to integrate scientific knowledge and with practical knowledge, and to provide an analytical perspective where students have the opportunity to develop metacognitive skills and praxis by learning through experiences during internship. One way to achieve this in vocational education to learn from the knowledge and skills used when performing inpractice. By integrating scientific and practical vocational knowledge, one promotes professionalization that is exhibited as Learning Integrated Work (LIW), i.e. the capability to perform the expected tasks and learn at work by using a critical and development-oriented attitude in daily work and actively participate in renewals of work assignments.

  • 168.
    Jungevik Edvinsson, Carola
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lund Petersen, Hannah
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av att vårda patienter med samsjuklighet inom psykiatrisk vård2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Co-morbidity between mental illness and addiction is a common occurrence in psychiatric care. Such co-morbidity affects the illness and the prognosis of the treatment as well as the caregiving needs of the patient. International studies show that nurses experience certain impediments in caring for patients with co-morbidity. There is, however, a lack of national research in the same regard.

    Aim: The aim of the study was to describe nurses' experience in caring for patients with co-morbidity in psychiatric care

    Method: Ten semi-structured interviews were conducted with nurses working in either psychiatric in-patient, or out-patient care. The interview-data was analyzed using qualitative content analysis.

    Results: The result is presented in three categories; To meet and to treat, To identify caregiving-needs and To devise and execute care. Nurses described the importance of creating a trusting relationship free from bias, in order to explore the patients´ complex of problems and plan caregiving efforts accordingly.

    Conclusion: The result of the study emphasizes the importance of the therapeutic relationship between nurse and patient in order to meet patients´ needs and develop the care of patients with co-morbidity. A therapeutic relationship takes time to develop and constitutes the frame within which the nurse can identify the caregiving needs of the patient and devise and execute care. The nurses in the study felt that they lacked time and resources to adequately meet the caregiving needs of patients with co-morbidity, and there is room for development within the organization.

  • 169.
    Jämtén, Sofia
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Möller Ranch, Matilda
    University West, Department of Health Sciences, Section for nursing - graduate level.
    First-time mothers' experiences of professional breastfeeding support and evaluation of the Mother-Perceived-Professional-Support scale2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Breastfeeding has decreased all over the world. World health organisation recommends exclusive breastfeeding for six months. Even though it's the natural way of feeding the baby it has to be learnt. It´s not unusual that problems occur and supporting breastfeeding is important. In Sweden most children under the age of six are on regular check-ups at child health care centres, where they meet a pediatric nurse who is supposed to support and help the family.

    The aim of the study was to explore first time mothers' personal experiences of professional breastfeeding support from the pediatric nurse and to evaluate and develop the scale "The Mother Perceived Support from Professionals" (MoPPS).

    Methods A qualitative design with both inductive and deductive approaches was chosen. Nine first time mothers were interviewed about their experience of professional breastfeeding support from the pediatric nurse. Semi structured interviews were used. There after the mothers were asked to grade their experience of breastfeeding support on the MoPPS-scale and commented their answers. Qualitative content analysis were used when analysing the data, both on the inductive (interviews) and deductive (the scale) part.

    Results The result reveals that the mothers felt a desire to breastfeed and they all experienced some difficulties. They wanted the pediatric nurse to give them professional support from their own experience and wanted her to be perceptive and understanding to their will. When the pediatric nurse gave time and booked extra appointments the mothers felt supported. The theme was: When having a desire to breastfeed, the mothers need to walk on a path of professional breastfeeding-support from the pediatric nurse. Three main categories were identified; Need of support, Lack of support and Received support. The result from the MoPPS-scale showed similar result as the interviews and the questions on the scale were seen as relevant to the aim. Comparing the result from the inductive and deductive analyses it was found that the mothers found it important that the pediatric nurse had enough knowledge about breastfeeding. It was also seen as important that the pediatric nurse involved the partner in the breastfeeding support.

    Conclusion There might be a benefit for pediatric nurses to have good knowledge about breastfeeding to be able to support mothers in a good way. The MoPPS-scale can be used as an easy way for the pediatric nurse to evaluate a mother´s experience of breastfeeding-support.

  • 170.
    Jörgensen, Lorena
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Zanders, Karin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Abandoning inpatient care: Reasons why psychiatric nurse specialists choose to leave psychiatric inpatient care2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to describe reasons why psychiatric nurse specialists choose to leave psychiatric inpatient care. In this study psychiatric nurse specialists were interviewed about their reasons for leaving psychiatric inpatient care. A total of nine semi-structured interviews were completed from within a Swedish psychiatric specialist health care setting. Interviews were transcribed verbatim and subjected to qualitative content analysis. Four themes emerged; 'wanting to use newly gained competence and develop advanced nursing care'; 'dissatisfaction with labour management'; 'lack of resources for advanced nursing care' and; 'the lack of personal balance between work and private life'. This study described the psychiatric nurse specialists' strong commitment to their former workplace, and to the patients they cared for in inpatient psychiatric care. This study also showed that the reasons why psychiatric nurse specialists choose to leave psychiatric inpatient care are multidimensional. The psychiatric nurse specialists want to use their newly gained competence and develop advanced nursing care, but, a lack of resources to perform advanced nursing care and dissatisfaction with labour management in combination with the lack of balance between work and their private lives may cause psychiatric nurse specialists to leave psychiatric inpatient care.

  • 171.
    Karlsson, Ida
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Karlsson, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av att vårda patienter som gjort suicidförsök2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: About 1100 people commit suicide in Sweden in the year of 2015, but there is a larger number of people that makes suicide attempt. Many of this people are treated in psychiatric care. The nurses have a great responsibility in the care of these patients. Caring for these patients can bring out a lot of feelings and emotions among nurses.

    Aim: The aim of this study was to describe nurses' experiences of caring for patients who committed suicide attempts in a psychiatric care context.

    Method: Two focus group interviews where used to collect data. The data was transcribed and analyzed using qualitative content analysis.

    Results: The analysis revealed four categories and nine subcategories. The categorize in the result are "to assess the suicide risk" "to create a caring relationship" "to feel frustration" and "to handle emotions". In the suicide-assessment the nurses use their experiences, clinical look and intuition. The nurses could feel frustration in the work with the patient and towards the organization. To work with patients who has made a suicide attempt caused many emotions in nurses. These emotions had to be processed.

    Conclusion: It is a complex work to care for patients whom has made a suicide attempt. The nurses needed guidance and tutoring to process their emotions and to strengthen their role in the nursing. This also lead to increased health and less frustration.

  • 172.
    Karlsson, Ingrid
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tillsyn hos personer som är äldre och multisjuka vid hemkomst från sjukhus2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Elderly patients older than 65 years with multimorbidity and an increased need of healthcare are at risk of being readmitted to the hospital several times after discharge. By offering a supervised home visit and follow up after hospitalisation, the district nurse can      provide comfort for the elderly patient. This in turn may prevent rehospitalisation and patient suffering. Aim: To describe district nurses’ experiences with supervision of a newly homecoming hospitalised elderly patient with multimorbidity. Method: A qualitative interview study of 10 half structured interviews were conducted. The material was transcribed and analysed according to a qualitative content analysis. Results: The results are presented in two categories: Relieve worry at home and Create trust at home. The category Relieve worry at home was generated by using sub-categories; To be prepared and Respond to patient’s thoughts. To be prepared the district nurses had to plan and prepare the supervision. Routines were absent so the district nurses had to take part of information available from discharge notes, informing why the patient had been hospitalised. In general, the district nurse experienced that patients had many unanswered questions, and the district nurse had to respond to patients thoughts to their hospital stay and their medicine, which needed to be discussed and solved. The category Create trust at home was achieved by using sub-categories; To have the overall responsibility and State of health follow up. The district nurse’s experience of supervision was that it created trust at home and comfort in the nursepatient relationship. By implementing a state of health follow up, the district nurse could have an overall responsibility and make an own impression of the patient’s health condition and wellbeing, hence being able to see if the patient was in need for further help and support.  Conclusion: The results show that a home supervision by the district nurse prevented illness, created comfort and reduced the risk of impairment for elderly patients with multimorbidity.  

  • 173.
    Karlsson, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rydberg, Magdalena
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Äldre sköra personer söker främst akutvård?: erfarenheter av kontakt med akutmottagningen.2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Two million of Sweden’s population is 65 years of age or older and the number is increasing. Elderly patients are more frequent users of the emergency department. Forty percent of the visitors in the emergency department are represented by this patient category. Nurses need to understand how individual experiences of care might affect the next visit for the patient. Frail elderly has limited resources to spare and the emergency department is not suited for them. Nurses need to see how they can change and/or adapt to fulfil the needs of this group. The need for knowledge is always a requirement for nurses.

    Aim The purpose of this study was to describe frail elderly person´s experiences of the emergency department.

    Method The method was a literature-based study based on the analysis of nine qualitative studies.

    Results Three main themes emerged in the results; accessibility of the emergency department, experiences leading to seek care in the emergency department and moments that has affected the experience of the emergency department. Experience of the emergency department was also affected by the patient’s health-literacy.

    Conclusion The quality of care, the past experience of care and the accessibility to comprehensive care were factors that influenced why frail elderly choose to seek non urgent treatment in the emergency department, even though they knew they would have to wait. The main reason for seeking care in the emergency department was based on the experience of convenience.

  • 174.
    Karlsson, Margareta
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. Åbo Academi University.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kasén, Anne
    Åbo Academi University.
    Wärnå-Furu, Carola
    Åbo Academi University.
    Söderlund, Maud
    University of Gävle, Åbo Academi University.
    A Qualitative Metasynthesis From Nurses’ Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care2015In: International journal for human caring, ISSN 1091-5710, Vol. 19, no 1, p. 40-48Article in journal (Refereed)
    Abstract [en]

    This metasynthesis aimed to translate, interpret, and present a synthesis of qualitative studies from nurses' perspectives dealing with ethical dilemmas and ethical problems in end-of-life care and to gain a deeper understanding of the phenomena. Nurses and other care professionals need to gain a deeper understanding and alleviate the suffering of patients through evidence-based practice end-of-life care. The metasynthesis, inspired by Noblit and Hare, generated an overarching metaphor, The Loving Eye. The Loving Eye illustrates how nurses are deeply involved with patients as human beings and connotes an inner responsibility to struggle for patients' best interests and wishes at the end of life. With The Loving Eye, nurses can see and feel patients' need to be confirmed, comforted, and healed approaching the end of life.

  • 175.
    Karlsson, Margareta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hedemalm, Azar
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Assessment and decision-making of Swedish primary care nurses in relation to the use of interpreters2017In: Journal of Health Visiting, ISSN 2050-8719, Vol. 5, no 9, p. 454-460Article in journal (Refereed)
    Abstract [en]

    Communicating with immigrants in primary care can be a challenge for nurses who must assess language proficiency and decide whether to use an interpreter. The aim of this study was to examine primary care nurses’ experiences of assessment and decision-making in relation to the use of interpreters. A qualitative inductive research design was chosen and nurses with experience of professional interpreters were recruited for focus group interviews. The study results showed that primary care nurses respected immigrants as human beings and recognised their right to decline an interpreter in sensitive situations. The purpose of primary care nurses’ experiences of assessment and decision-making in relation to the use of interpreters was ensuring patient safety, the importance of reciprocal information and respect for patient autonomy.

  • 176.
    Kihlberg, Pernilla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Österberg, Sophia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Upplevelser av den egna arbetsmiljön hos sjuksköterskor inom kommunal hälso- och sjukvård i Fyrbodal och Lilla Edet: en enkätundersökning2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Working as a nurse today can be stressful and studies show that many nurses tend to leave their work. The nurse can be described as a spider that pull in many threads at the same time. The nurse in the community setting is working in the patient's home without many of the resources you can find in hospital, which is challenging.

    Aim: The aim of this study was to investigate nurses' in community settings in Fyrbodal and Lilla Edet experiences of their work environment.

    Method: A cross- sectional quantitative study with questionaries and a qualitative part with one open question.

    Results: The result showed that nurses over all thrive at work and have good relations with their colleagues. Further nurses found their work meaningful to a great extent. Whether the nurses could finish their work at time it seemed to be diverse meanings about and also about nurse's experiences of their first line manager. The result also showed that nurses in small community's experiences that their leader was fair when work is distributed. Nurses in small communities were also statistically significantly more positive to changes in work for example that nurses were able to be involved in the change process.

    Conclusion: Nurses are proud of their profession. They believe that the work they are performing has a meaning. The spirit among colleagues is good and the nurses support and care for each other. At the same time nurses ask for more participation, improved leadership and more time to do their work.

  • 177.
    Kjellberg, Carl
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Peci, Indira
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Psykiatrisjuksköterskors erfarenheter av självmordsriskbedömning i det vardagliga arbetet inom psykiatrisk slutenvård: En kvalitativ intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this study is to illuminate psychiatric nurses' experiences of suicide assessment in their daily work of a psychiatric inpatient ward.

    Background: The majority of all suicides are committed by people with some kind of psychiatric diagnosis and suicides within psychiatric hospital departments are increasing. In more than half of the cases where patients have committed suicide in the psychiatric hospital, the patient's suicidal risk assessment has failed and the patient has been able to leave the department and commit suicide. Previous research suggests that suicide risk assessments are important and nurses need more skills and time to be able to pay attention to patients' behavior.

    Design: This is a qualitative descriptive study based on eight individual semi-structured interviews that have been analyzed using qualitative content analysis by Lundman and Hällgren Graneheim (2012).

    Method: Data analysis was based on Lundman and Hällgren Graneheim (2012) description of qualitative content analysis. Semi-structured interviews with the addition of narrative questions was conducted. The participants were eight registered psychiatric nurses from four different psychiatric departments at a hospital in Västra Götaland. A male psychiatric nurse and seven female psychiatric nurses participated with at least one years of experience participated.

    Results: The results showed that the psychiatric nurses had difficulties defining a general suicide behavior. On the other hand, different behavior patterns were identified as more suicidal. Such patterns could be rapid twists in emotional state, strong anxiety, impulsivity and backwardness. Three categories emerged during the analysis process: Clinical Glance, Alliance Work and Experiences Collaboration and Knowledge, and all three had three related subcategories.

    Conclusion: The suicidal process is complex and the difficulty lies in identifying where in the process the patient is. Psychiatric nurses have responsibility identifying early signs considered by psychiatric nurses to be an important part of suicide assessment. Experience about the patient and knowledge of suicide is something that psychiatric nurses experience as significant to be able to make good suicide risk assessments.

  • 178.
    Kjellberg, Mimmi
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Therese
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Föräldrars erfarenhet av BVC-sjuksköterskans första hembesök2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background shows how the child health care is established in Sweden, which laws and convention that controls the nurses work with the families. It describes different ways for the nurse to support the families in their parenthood, how the parents can connect to their child and support the parents in trusting their ability to raise their child. The aim of the study was to illuminate parents' first experience of the first home visit from the nurse from the child health clinic and through interviews with first time parents gain an understanding of what their needs might be. The method was an empirical qualitative study with descriptive design. The study was performed by two focus groups and three phone interviews. Total ten parents were selected through convenient sampling. The interviews were recorded, transcribed and analyzed according to qualitative content analysis. The analysis resulted in three main categories; Parents' expectations and feelings, Parents need of support and the interaction is important for the experiences. The conclusion is that first time parents are in need of support in their parenthood, that they are in need of information and they really appreciated when the nurses managed to involve both the mother and the father in the conversation that took place in the first home visit. The first time parents looked forward to the home visit despite their concern that the nurse would supervise their home.

  • 179.
    Kleiven, Joffen
    University West, Department of Health Sciences, Section for nursing - graduate level.
    HBTQ+ personers upplevelser av bemötandet från sjuksköterskan inom psykiatrisk vård2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background LGBT persons do not receive a good treatment by healthcare professionals due to insufficient knowledge. Studies indicate LGBT persons are exposed to health-related discrimination to a greater extent. If the treatment is incorrect, the persons may choose not to seek psychiatric care. If the nurse lacks relevant competence, this can lead to suffering for the person and also lead to the person's death.

    Aim LGBT persons' experience of personal interaction with a psychiatric nurse.

    Method A qualitative inductive study with semi-structured interviews. There were ten people who identified themselves as HBTQ + persons who participated in the study. Qualitative content analysis was used for analysis of the data.

    Results There were both good and less good meetings. Important factors for creating a good meeting were broader knowledge about LGBT persons. Participants in the study felt they were better treated by younger nurses compared to older ones. Pride symbols had a good effect by creating a more inclusive feeling, in that the care focus had a tolerance for greater openness, something that made the participants dare to open up more easily to the nurse. There were differences between meeting with the nurse in smaller and larger cities. In smaller towns and cities, participants experienced a lesser understanding and was met with more prejudice and discrimination. In larger cities, patients felt more satisfied meeting with the nurse who showed a greater experience, more openness and had a non-heteronormative approach.

    Conclusion The participants described how they want to be treated individually, while at the same time being treated like everyone else.

  • 180.
    Klomp, Sara
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Warlin, Linda
    University West, Department of Health Sciences, Section for nursing - graduate level.
    "Målet är ju att barnet ska må bra i sin familj": en intervjustudie om hur BHV-sjuksköterskor arbetar med att ge stöd2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One of the main public health goals is safe and good childhood conditions for all children. It is therefore important to pay attention to the circumstances children live under since it may affect health even in adult life. Some parents have difficulties meeting the needs of their child, and child healthcare therefore has an important task in identifying risk factors in order to provide the support that each family needs.

    Aim: The aim of this study was to describe the child healthcare nurses´ experiences of providing support to families when the parents' life situation poses a health risk to the child.

    Method: Ten semi-structured interviews were conducted, and the data was analyzed using a qualitative content analysis.

    Results: The results showed that the child healthcare nurses identified support needs in different ways. The child healthcare nurses worked with strategies building a trustworthy relationship, being available and guiding parents through encouragement and confirmation. In order to provide support, the child health care nurses also needed support themselves.

    Conclusion: The child healthcare nurses are important to identify support needs in families and for providing individually customized support to different families. By cooperation with other professions with focus on building good relationships with the families and providing safety and trust, the families are enabled to receive the support. This is a necessary work in order being able to promote good health for all children.

  • 181.
    Ko, Jong Mi
    et al.
    The University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Cardiology, Dallas, TX, USA.
    White, Kamila S
    University of Missouri, Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center,Saint Louis, MO, USA.
    Kovacs, Adrienne H
    University Health Network, University of Toronto, Peter Munk Cardiac Centre, Toronto, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA.
    Tecson, Kristen M
    Baylor Heart and Vascular Institute, Dallas, TX, USA.
    Apers, Silke
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
    Luyckx, Koen
    KU Leuven - University of Leuven, School Psychology and Child and Adolescent Development,Leuven, Belgium.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; KU Leuven - University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium..
    Enomoto, Junko
    Department of Adult Congenital Heart Disease,Cardiovascular Center, Chiba, Chiba, Japan.
    Sluman, Maayke A
    Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
    Wang, Jou-Kou
    Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
    Jackson, Jamie L
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA.
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA.
    Chidambarathanu, Shanthi
    Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden; University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Mackie, Andrew S
    University of Alberta, Division of Cardiology, Stollery Children's Hospital, Edmonton, Canada.
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta.
    Veldtman, Gruschen
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Fernandes, Susan M
    Stanford University School of Medicine, Department of Pediatrics and Medicine, Divisions of Pediatric Cardiology and Cardiovascular Medicine, Palo Alto, CA, USA.
    Callus, Edward
    Università degli Studi di Milano, Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy; Department of Biomedical Sciences for Health, Milan, Italy.
    Kutty, Shelby
    Adult Congenital Heart Disease Center, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA.
    Moons, Philip
    KU Leuven - University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium; Centre for Person-Centred Care (GPCC), Gothenburg, Sweden; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Cedars, Ari M
    Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
    Differential impact of physical activity type on depression in adults with congenital heart disease: A multi-center international study2019In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 124, article id 109762Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed to examine the association between physical activity (PA) and depression in a large international cohort of adults with congenital heart disease (ACHD) as data about the differential impact of PA type on depression in this population are lacking.

    METHODS: In 2018, we conducted a cross-sectional assessment of 3908 ACHD recruited from 24 ACHD-specialized centers in 15 countries between April 2013 to March 2015. The Hospital Anxiety and Depression Scale was used to assess self-reported depressive symptoms and the Health-Behavior Scale-Congenital Heart Disease was used to collect PA information. Cochran-Armitage tests were performed to assess trends between depressive symptom levels and PA participation. Chi-Square and Wilcoxon Rank Sum tests were utilized to examine relations between depressive symptom levels and patient characteristics. Stepwise multivariable models were then constructed to understand the independent impact of PA on depressive symptoms.

    RESULTS: The overall prevalence of elevated depressive symptoms in this sample was 12% with significant differences in rates between countries (p < .001). Physically active individuals were less likely to be depressed than those who were sedentary. Of the 2 PA domains examined, sport participation rather than active commute was significantly associated with reduced symptoms of depression. After adjustment in multivariable analysis, sport participation was still significantly associated with 38% decreased probability of depressive symptoms (p < .001).

    CONCLUSIONS: Sport participation is independently associated with reduced depressive symptoms. The development and promotion of sport-related exercise prescriptions uniquely designed for ACHD may improve depression status in this unique population.

  • 182.
    Ko, Jong Mi
    et al.
    The University of Texas, Department of Internal Medicine, Division of Cardiology, Southwestern Medical Center, Dallas, Texas.
    White, Kamila S
    University of Missouri, Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, Saint Louis, Missouri.
    Kovacs, Adrienne H
    University of Toronto, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
    Tecson, Kristen M
    Baylor Heart & Vascular Institute, Baylor Scott & White Research Institute, Dallas, Texas.
    Apers, Silke
    KU Leuven-University of Leuven, KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
    Luyckx, Koen
    KU Leuven-University of Leuven, School Psychology and Child and Adolescent Development, Leuven, Belgium.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Inselspital-Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    KU Leuven-University of Leuven, Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium.
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.
    Sluman, Maayke A
    Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
    Wang, Jou-Kou
    National Taiwan University, School of Nursing, College of Medicine,Taipei, Taiwan.
    Jackson, Jamie L
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio.
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, Michigan.
    Subramanyan, Raghavan
    Frontier Lifeline Hospital, Dr. K. M. Cherian Heart Foundation, Chennai, India..
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    The Sahlgrenska Academy at University of Gothenburg, Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, Sweden; University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Mackie, Andrew S
    University of Alberta, Division of Cardiology, Stollery Children's Hospital, Edmonton, Canada.
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta.
    Veldtman, Gruschen
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Fernandes, Susan M
    Stanford University School of Medicine, Department of Pediatrics and Medicine, Divisions of Pediatric Cardiology and Cardiovascular Medicine, Palo Alto, California.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy.
    Kutty, Shelby
    University of Nebraska Medical Center/ Children's Hospital and Medical Center, Adult Congenital Heart Disease Center, Omaha, Nebraska, USA.
    Gandhi, Amarendra
    KU Leuven-University of Leuven, School Psychology and Child and Adolescent Development, Leuven, Belgium.
    Moons, Philip
    University of Gothenburg, KU Leuven Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium; Centre for Person-Centred Care (GPCC), Gothenburg, Sweden; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden..
    Cedars, Ari M
    The University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Cardiology, Dallas, Texas.
    Physical Activity-Related Drivers of Perceived Health Status in Adults With Congenital Heart Disease2018In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 122, no 8, p. 1437-1442, article id S0002-9149(18)31423-1Article in journal (Refereed)
    Abstract [en]

    Data on the differential impact of physical activity on perceived health status (PHS) in a large adult congenital heart disease (ACHD) patient population are lacking. We conducted a cross-sectional assessment of 4,028 ACHD patients recruited from 24 ACHD-specialized centers in 15 countries across 5 continents to examine the association between physical activity and PHS in a large international cohort of ACHD patients. A linear analog scale of the EuroQol-5D 3 level version and the 12-item Short Form Health Survey-version 2 were used to assess self-reported health status and the Health-Behavior Scale-Congenital Heart Disease was used as a subjective measurement of physical activity type, participation, and level. Correlation analyses and Wilcoxon Rank Sum tests examined bivariate relations between sample characteristics and PHS scores. Then, multivariable models were constructed to understand the impact of physical activity on PHS. Only 30% of our sample achieved recommended physical activity levels. Physically active patients reported better PHS than sedentary patients; however, the amount of physical activity was not associated with PHS. Further statistical analyses demonstrated that specifically sport participation regardless of physical activity level was a predictor of PHS. In conclusion, the majority of ACHD patients across the world are physically inactive. Sport participation appears to be the primary physical activity-related driver of PHS. By promoting sport-related exercise ACHD specialists thus may improve PHS in ACHD patients.

  • 183.
    Korabi, Lindita
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av att vårda patienter med flyktingbakgrund inom psykiatrisk vårdverksamhe2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: As a nurse in healthcare, it is important to have an insight into the circumstances of refugees and how it can affect their mental health. Laws and guidelines currently limit refugees the access to mental care and as the world's refugee flow is increasing so are the mental illness of refugee. Purpose: The purpose of the study was to describe nurses' experiences of caring for patients with a refugee background in mental health care.Methods: A qualitative methodology and design were chosen where seven nurses who worked in mental health care were individually interviewed. The interviews were recorded, transcribed and analyzed based on qualitative content analysis. Results: Based on qualitative content analysis, four categories were formed with a total of eleven subcategories. The four categories highlighted the meeting with the patient, challenges in the nurse´s professional role, what was required to work with the patient and the interaction within and outside the workplace. Conclusion: The study showed shortcomings that nurses noted in contact with patients with refugee background in the mental health care. Current care was not found to be adequate for patients and needs were expressed for more structured care and more support for nurses in their work.

  • 184.
    Kristiansson, Susanne Olsson
    et al.
    Central Infant Welfare Unit, Fyrbodal, Sweden.
    Wijk, Sofia
    Central Infant Welfare Unit, Göteborg och Södra Bohuslän, Sweden.
    Alsén, Pia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Participation in parental group support offered by the Child Health Service in Sweden: A qualitative study2018In: Journal of Health Visiting, E-ISSN 2052-2908, Vol. 6, no 3, p. 142-150Article in journal (Refereed)
    Abstract [en]

    All new parents in Sweden are invited to participate in parent groups by the Child Health Service (CHS), but not all choose to attend. The aim of this study was to identify factors that promote and impede the participation of parents in parent groups managed by the CHS during their child's first year. Twelve parents with children aged 10–12 months were interviewed during 2013. The interview text was analysed using qualitative manifest content analysis. The analysis resulted in eight categories. Those describing promoting factors were: feeling personally invited; having social hopes; being influenced by those around you; experiencing social fellowship; and being satisfied with the group leader. Categories describing impeding factors were: the parent group is not perceived to be addressed to both parents; the parents do not prioritise the group sessions offered; and expectations are not met. The study found that it is important for parents to feel personally invited and that the group leader's actions may be significant both for promoting and impeding participation in parent groups. The CHS nurse needs to be aware of parents' and children's individual needs and work actively to make all group participants feel included.

  • 185.
    Lagerqvist, Katarina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Persson, Rebecca
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Yogans effekt på aggression, stressnivå samt uppmärksamhet och impulskontrollstörning hos kvinnor i anstaltsmiljö2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: While the number of female criminals increases in Sweden, their care and eventual treatment still is mainly based on evidence from research with male interns. Studies shows that this group has an increased vulnerability, with high frequency of mental health problems.Aim: To investigate the effects of yoga on aggression, perceived levels of stress, attention and impulse control disorder of female prisoners.Method: Freely committing female inmates were randomized into two groups: (1) yoga group, where subjects participated in 90 minutes hatha yoga every week during a 10 weeks period, and (2) control group, where subjects participated in 90 minutes of physical activity every week during the same study period. A survey including self-rated instruments and the computerized performance test were completed by each participant before randomization and at the end of the 10 weeks study period.Results: The yoga group reported a decreased aggression and an attenuated level of stress, while the control group reported an increased level of perceived stress. In the computerized performance test an improvement in impulse control could be measured in the yoga group, while in the control group an increased prevalence of attention difficulties were detected.Conclusion: : There are strong indications that regular yoga exercise can contribute to decreased aggression, lower level of perceived stress and to increase control of impulsivity and attention. It may be a tool for individual-adjusted care to manage their mental health.

  • 186.
    Lantz, H
    et al.
    Sahlgrenska University Hospital, Department of Medicine.
    Brattby, L.-E
    Uppsala University Hospital, Department of Medical Sciences, Clinical Physiology.
    Fors, H.
    Northern Älvsborg Hospital, Trollhättan,Department of Paediatrics.
    Sandhagen, B.
    Uppsala University Hospital, Department of Medical Sciences, Clinical Physiology.
    Sjöström, L.
    Sahlgrenska University Hospital, Department of Medicine.
    Samuelson, Gösta
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Body composition in a cohort of Swedish adolescents aged 15, 17 and 20.5 years2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 12, p. 1691-1697Article in journal (Refereed)
  • 187.
    Larsson, Emelie
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ahlstrand, Ilona
    University West, Department of Health Sciences, Section for nursing - graduate level.
    "Sista utvägen": Sjuksköterskors erfarenheter av hot och våld inom sluten psykiatrisk vård2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A serious problem in the work environment are threats and violence. This is a growing problem in health care. Workplaces providing mental health care is one of the workplaces that is at risk of exposure. Nurses may suffer from severe psychological and physical consequences afterwards.

    Aim: The aim of the study was to describe nurses' experiences of threats and violence in the field of mental health care.

    Method: The study was conducted at a hospital in southern Sweden. Ten nurses were interviewed for 30-60 minutes. The interviews were recorded in order to be written down later. The material was subjected to qualitative content analysis.

    Results: The processed material was subdivided into four categories: The view on threats and violence, approach to threats and violence over time, reactions on threats and violence and safety-creating factors. Everyone in the study had been exposed to threats and violence at work. Nurses described that with growing work experience, their approach to meet threats and violence changed. They were not as much affected as they were in the beginning of their work, and rather stood back instead of entering into confrontation with the patients. Experienced staff, education and secure premises are some of the factors to increase safety to staff.

    Conclusion: Working within psychiatric in-patient care department inevitably entails coming into contact with threats and / or violence at some point. Patients with a variety of psychiatric disorders may have difficulties expressing their needs in an appropriate manner. One last resort, when a patient is lacking a feeling of being understood, can be to communicate his needs through threats and violence. Linking a patient's behavior to his illness often helps nurses to gain a better understanding of why the patient is acting out.

  • 188.
    Larsson, Inga
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Att leda patientnära omvårdnadsarbete2014In: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] Elisabeth Dahlborg Lyckhage (red.), Lund: Studentlitteratur AB, 2014, 2:a, p. 197-215Chapter in book (Other academic)
  • 189.
    Larsson, Inga
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Leda patientnära omvårdnadsarbete2019In: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] E. Dahlborg-Lyckhage, Lund: Studentlitteratur AB, 2019, 3:e uppl, p. 197-215Chapter in book (Other academic)
  • 190.
    Larsson, Inga
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Leda patientnära omvårdnadsarbete2019In: Att bli sjuksköterska: en introduktion till yrke och ämne / [ed] Elisabeth Dahlborg, Lund: Studentlitteratur AB, 2019, 3., p. 247-279Chapter in book (Other academic)
  • 191.
    Larsson, Inga
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sahlsten, Monika J.M.
    Department of Health and Education, University of Skövde, Sweden.
    The Staff Nurse Clinical Leader at the Bedside: Swedish Registered Nurses’ Perceptions2016In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, p. 1-8, article id 1797014Article in journal (Refereed)
    Abstract [en]

    Registered nurses at the bedside are accountable for and oversee completion of patient care as well as directly leading and managing the provision of safe patient care. These nurses have an informal leadership role that is not associated with any given position. Leadership is a complex and multifaceted concept and its meaning is unclear, especially in the staff nurse context. The aim was to describe registered nurses’ perceptions of what it entails to be the leader at the bedside in inpatient physical care. A phenomenographic approach was employed. Interviews were performed with Swedish registered nurses (). Five descriptive categories were identified: demonstrating clinical knowledge, establishing a good atmosphere of collaboration, consciously structuring the work in order to ensure patients’ best possible nursing care, customized presence in the practical work with patients according to predetermined prerequisites, and monitoring coworkers’ professional practice. Registered nurses informal role as leader necessitates a social process of deliberate effort to attain and maintain leader status and authority. Participants used deliberate communicative approaches and interactive procedures. Leader principles grounded in the core values of the nursing profession that ensure nursing values and person-centered attributes were a key aspect.

  • 192.
    Larsson, Inga
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Sahlsten, Monika
    University of Skövde, (School of Life Sciences, Högskolevägen 1, 541 28 Skövde, Sweden.
    Segesten, Kerstin
    University College of Borås, Institute of Health and Care Sciences, Allégatan 1, 501 90 Borås, Sweden.
    Plos, Kaety
    Gothenburg University, Institute of Health and Care Sciences, The Sahlgrenska Academy , Box 457, 405 30 Gothenburg, Sweden.
    Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study2011In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, article id 534060Article in journal (Refereed)
    Abstract [en]

    Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT) was employed. Interviews were performed with patients (), recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

  • 193.
    Larsson, Lena
    et al.
    Umeå University, Heart Center and Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Johansson, Bengt
    Umeå University, Heart Center and Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Sandberg, Camilla
    Umeå University, Heart Center and Department of Public Health and Clinical Medicine, Umeå, Sweden; Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå, Sweden.
    Apers, Silke
    University of Leuven, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
    Kovacs, Adrienne H.
    Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, United States.
    Luyckx, Koen
    University of Leuven, School Psychology and Development in Context, KU Leuven, Leuven, Belgium.
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Inselspital — Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; University of Leuven, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.
    Sluman, Maayke A.
    Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands.
    Wang, Jou-Kou
    Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
    Jackson, Jamie L.
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States.
    Khairy, Paul
    Université de Montréal, Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C.
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, United States.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden;Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; nstitute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Rempel, Gwen
    University of Alberta, Northern Alberta Adult Congenital Heart Clinic, Edmonton, Canada.
    Menahem, Samuel
    Monash University, Monash Heart, Monash Medical Centre, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Msida, MSD 2090, Malta.
    Tomlin, Martha
    The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
    Soufi, Alexandra
    Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France.
    Fernandes, Susan M.
    Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children's Hospital, Stanford Health Care, Stanford School of Medicine, Palo Alto, CA, United States.
    White, Kamila
    University of Missouri, Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, Saint Louis, MO, United States.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; Università degli Studi di Milano, Department of Biomedical Sciences for Health, Milan, Italy.
    Kutty, Shelby
    University of Nebraska Medical Center, Division of Pediatric Cardiology, Children's Hospital & Medical Center, Omaha, NE, United States.
    Moons, Philip
    University of Leuven, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
    Geographical variation and predictors of physical activity level in adults with congenital heart disease2019In: International Journal of Cardiology : Heart & Vasculature, ISSN 2352-9067, Vol. 22, p. 20-25Article in journal (Refereed)
    Abstract [en]

    Background

    Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease(CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin.

    Methods

    3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models.

    Results

    On average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%–Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52–2.08), NYHA-class I (OR 3.10, 95%CI 1.71–5.62) and less complex disease (OR 1.46, 95%CI 1.16–1.83). In contrast, older age (OR 0.97, 95%CI 0.96–0.98), lower educational level (OR 0.41, 95%CI 0.26–0.64) and being unemployed (OR 0.57, 95%CI 0.42–0.77) were negatively associated with reaching WHO recommendations.

    Conclusions

    A significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions.

  • 194.
    Laurell, Alexandra
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Carlsson, Galina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    En resa man inte klarar av på egen hand: En kvalitativ studie som beskriver gastric bypass-opererade personers behov av stöd2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Obese individuals face multiple problems like depression, vascular diseases, diabetes type 2 and infertility. Gastric bypass surgery is an effective method for persons with obesity who cannot lose weight with lifestyle changes or medical treatment. Several studies are pointing out that a large proportion of persons operated with gastric bypass begin to gain weight a few years after surgery. Aim: To describe what kind of support persons operated with gastric bypass needs. Method: A qualitative content analysis with inductive approach was carried out and ten persons who underwent gastric bypass surgery were interviewed by using skype and/or messenger videocalls. Results: The analysis resulted in seven main categories: The need of information and knowledge before the surgery, the need of multiprofessional and continuous follow-up, the need of competent caregivers, the need of professional psychological support, the need of support in lifestyle-change, support from relatives and support from other persons operated with gastric bypass. Conclusion: There is a special need for increased knowledge about gastric bypass surgery among caregivers in the primary care settings. Multiprofessional and continuous follow-up needs to support these patients in their lifestyle-changes.

  • 195.
    Lexén, Sofia
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Trulsson, Sofie
    University West, Department of Health Sciences, Section for nursing - graduate level.
    "Vi kallar dem huvudfotingar": Hur vårdpersonal kan stödja personer med utmattningssyndrom2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress-related ill-health including exhaustion syndrome is increasing sharply. Exhaustion syndrome means a human suffering for the affected and a burden for our society. There is no scientific evidence yet for how people with exhaustion syndrome should be treated.

    Aim: To investigate how healthcare professionals can support people with exhaustion syndrome.

    Method: Semi-structured interviews were conducted. The selection consisted of seven healthcare providers who all worked with people with exhaustion syndrome. The data was analyzed with a qualitative content analysis with an inductive approach.

    Result: What the informants described as support for people with exhaustion syndrome was to provide a care based on the person's needs, to work to strengthen the patient's own abilities, to provide the opportunity for a conscious presence, to create a balance between activity and rest and to give the patient knowledge.

    Conclusion: Healthcare professionals can support people with exhaustion syndrome by providing a care based on the person's conditions and disease phase. The supportive efforts must be person-centered and have the purpose of providing knowledge and tools on how the person can handle their illness. Cooperation between professions is important. To include the psychiatric nurse and / or the district nurse in the care of these persons would be beneficial as in many cases nursing is a missing factor.

  • 196.
    Lind, Emelie
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Åsén, Emma
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kom så bär jag dig: en studie om föräldrars upplevelse av att bära sitt barn medhjälp av bärdon2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Becoming a parent is a lifechanging event that can be demanding in todays' stressful living. Carrying babies with baby-carrier/baby-slings is becoming more and more acceptable in the society. To meet the requirements of promoting health and growth among children the nurse need greater understanding of parent's experiences of carrying their babies close with the help of a baby-carrier or baby-sling.

    The aim of this study was to exam parent's experience of carrying their child with the help of a baby-carrier or baby-sling.

    In this qualitative study eleven parents were interviewed with the help of a semi-structured question guide. Content analyse where used as a method and two themes emerged; Parent-perspective and Child-perspective.

    The parent's perception of using a baby-carrier or baby-sling was that it is a tool in everyday life as well as a good way to promote bonding and attachment. Parents need information about carrying babies with the help of a baby-carrier or baby-sling and desire it from healthcare professionals. The nurse specialist has a great responsibility in promoting good cooperation with parents and to promote health and growth for the children. It is therefore important that the nurse encourages parents to have their babies close. Using a baby-carrier or baby-sling is an easy tool that can help parents to have their baby close.

  • 197.
    Linde, Susanna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Synen på personcentrerad vård av äldre, hos personal som vårdar patienter inom akut ortopedi: Nuläge, problem och vad som underlättar2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Person-centered care shows good results for elderly patients. Despite this, hospital care is often still organized around tasks. Aim: The opinions on person-centered care for elderly, among staff caring for elderly acute orthopaedic patients.

    Method: semi structured interviews, analysed with systematic text-condensation, according to Kerstin Malterud.

    Results: The view of how person-centered the care is on the ward varies among the staff. Stress, dementia and confusion, and the opinion that the patients do not always know their own best, are obstructing person-centered care. Mobilization, and when the patients are not involved in the decision-making of the doctor, creates situations that are especially hard to handle. Thoughts and characteristics of the elderly and their next of kin can also obstruct. Finally, how person-centered the care is depends on which staff is doing the work. Contributory factors of person-centered care are to give time, to listen and see, to give information, getting to know each other and to work together with the elderly and their next of kin to a joint goal.

    Conclusion: The staff has not transformed from task-centered care, but they want to work more person-centered, and they see the obstructing factors as negative. The lack of transformation can be explained with both theories of person-centered care and the theory of transformative learning, as they have much in common. The fact that the staff does not have a joint approach of the care is in itself an obstruction of the transition.

  • 198.
    Lindgren, Britt-Marie
    et al.
    Umeå University, Department of Nursing, Umeå, Sweden.
    Ringnér, Anders
    Umeå University, Department of Nursing, Umeå, Sweden. Umeå University, Department of Paediatrics, Umeå, Sweden..
    Molin, Jenny
    Umeå University, Department of Nursing, Umeå, Sweden.
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level. Umeå University, Department of Nursing, Umeå, Sweden.
    Patients' experiences of isolation in psychiatric inpatient care: Insights from a meta-ethnographic study.2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 1, p. 7-21Article in journal (Refereed)
    Abstract [en]

    Historically, people with mental ill-health have been isolated from society. Although mental health care has moved from closed to more open forms of care, in many societies care is still provided in locked wards, and people with mental ill-health are sometimes secluded from their fellow patients, families, friends, and visitors. The aim of this study was to illuminate patients' experiences of isolation in psychiatric inpatient care. A systematic review of qualitative research was conducted, and the key findings were subjected to meta-ethnographic synthesis. The findings were twofold: 'being admitted to prison' and 'having access to shelter'. The experience of isolated care as prison-like symbolizes patients' longing for freedom and feeling restricted and limited by rules, stripped of rights, abandoned, controlled, powerless, and unsupported. In contrast, the experience of isolation as shelter symbolizes safety and the opportunity to regain control over one's own situation. A stigmatizing public view holds that people with mental ill-health are dangerous and unpredictable and, therefore, unsafe to themselves and others. Being placed in isolation because these fears contribute to self-stigma among patients. Promoting a sheltered experience in which isolation is used with respect for patients and the reasons are made explicit may encourage recovery. A shift in emphasis in ward culture from observation to engagement is needed to reduce blame, shift patient experiences from prison to shelter, and to support autonomy as a therapeutic intervention.

  • 199.
    Lindstedt, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Olofsson Janson, Marina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Diabetessjuksköterskors upplevelse av omvårdnaden för personer över 75 år med diabetes typ 22019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is on the rise globally, partly due to the aging population. People with type 2 diabetes aged over 75 years have varying degrees of comorbidity, thus individually customized care is essential for maintaining quality of life, preventing hypoglycemia and reducing hospitalization it is important that care is individually customized. Aim: To describe the diabetes nurses´ experience of caring for people aged over 75 years with type 2 diabetes. Method: Qualitative interview study with descriptive content analysis. Results: Diabetes nurses want their patients to feel involved and experience well-being. When a patient is allocated to homecare there are uncertainties regarding the diabetes nurses´ responsibilities and concerns about the possibility of deficiencies in the diabetes care. The diabetes nurses reported a lack of knowledge about the disease among older patients and sometimes an absence of interest in self-care management. Conclusion: The level of education of diabetes nurses is significant for patient care, as their approach changes with greater knowledge, leading to enhanced support and encouragement for patient learning, thus reinforcing the patient´s own decisions and sense of responsibility.

  • 200.
    Ljungquist, Marie
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Vårdande gärningar och vanor för en caritativ hållning i den vårdande akten2018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The research interests address a need for knowledge regarding the importance of 'acts of caring' for a caritative approach when performing tasks in the care of the elderly. The overall aim of the research was to deepen the understanding of ethics and describe the actions and habits that are important in the 'acts of caring' for both patients and caregivers in relation to the caritative nursing and ethics of care relevant to the caritative care theory. The design of the study design is based on and from a human-scientific perspective and founded on a hermeneutic tradition based on Gadamer's philosophy. Data was collected partly from qualitative interviews with patients and caregivers and partly from a questionnaire for caregivers. The interviews were carried out in several home healthcare contexts. The data has been analysed and interpreted by means of qualitative content analysis. The result shows that the caregiver's caring and non-caring deeds have significance for caregiving and this is manifested in the caregiver's attitude, consciously or unconsciously. And it also shows that repetition results in either good habits or bad habits. With caritative ethics of care, good habits appear that alleviate suffering and promote health in an 'act of caring'. Bad habits, which lead to bad deeds, have no place in the ethics of care and nursing theory, because a non-caring deed cannot create an 'act of caring'. All forms of caring deeds and good habits can be connected to the character traits, virtues and moral integrity of the caregiver, and intertwine in such a way that the good habits of care may arise from another good habit or lead to a new good habit.

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