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  • 151.
    Berg, Lena
    et al.
    Karolinska institutet.
    Källberg, Ann-Sofie
    Karolinska institutet.
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Karolinska institutet.
    Göransson, Katarina
    Karolinska institutet.
    Interruptions and disturbances in emergency department work assignments2014Conference paper (Refereed)
  • 152. Berg, Lena M
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karonlinska institutet.
    Östergren, Jan
    Discacciati, Andrea
    Göransson, Katarina E
    Associations between crowding and ten-day mortality among patients allocated lower triage acuity levels without need of acute hospital care on departure from the emergency department2019In: Annals of Emergency Medicine, ISSN 0196-0644, E-ISSN 1097-6760, Vol. 74, no 3, p. 345-356Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVE: We describe the association between emergency department (ED) crowding and 10-day mortality for patients triaged to lower acuity levels at ED arrival and without need of acute hospital care on ED departure.

    METHODS: This was a registry study based on ED visits with all patients aged 18 years or older, with triage acuity levels 3 to 5, and without need of acute hospital care on ED departure during 2009 to 2016 (n=705,699). The sample was divided into patients surviving (n=705,076) or dying (n=623) within 10 days. Variables concerning patient characteristics and measures of ED crowding (mean length of stay and ED occupancy ratio) were extracted from the hospital's electronic health records. ED length of stay per ED visit was estimated by the average length of stay for all patients who presented to the ED during the same day and shift and with the same acuity level. The 10-day mortality after ED discharge was used as the outcome measure. Multivariable logistic regression analyses were conducted.

    RESULTS: The 10-day mortality rate was 0.09% (n=623). The event group had larger proportions of patients aged 80 years or older (51.4% versus 7.7%) and triaged with acuity level 3 (63.3% versus 35.6%), and greater comorbidity (age-combined Charlson comorbidity index median interquartile range 6 versus 0). We observed an increased 10-day mortality for patients with a mean ED length of stay greater than or equal to 8 hours versus less than 2 hours (adjusted odds ratio 5.86; 95% confidence interval [CI] 2.15 to 15.94) and for elevated ED occupancy ratio. Adjusted odds ratios for ED occupancy ratio quartiles 2, 3, and 4 versus quartile 1 were 1.48 (95% CI 1.14 to 1.92), 1.63 (95% CI 1.24 to 2.14), and 1.53 (95% CI 1.15 to 2.03), respectively.

    CONCLUSION: Patients assigned to lower triage acuity levels when arriving to the ED and without need of acute hospital care on departure from the ED had higher 10-day mortality when the mean ED length of stay exceeded 8 hours and when ED occupancy ratio increased.

  • 153. Berg, Lena M
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Göransson, Katarina E
    Significant changes in emergency department length of stay and case mix over eight years at a large Swedish University Hospital2019In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 43, p. 50-55Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Describe the longitudinal development of crowding and patient/emergency department (ED) characteristics at a Swedish University Hospital.

    METHODS: A retrospective longitudinal registry study based on all ED visits with adult patients during 2009-2016 (N = 1,063,806). Patient characteristics and measures of ED crowding (ED occupancy ratio, length-of-stay [LOS], patients/clinician's ratios) were extracted from the hospital's electronic health record. Non-parametric analyses were conducted.

    RESULTS: The proportion of unstable patients (triage level 1-2) increased while the proportion of admitted patients decreased. All crowding variables were stable, except for LOS, which increased by 9 min/visit/year (95% CI: 8.8-9.1). LOS for visits by patients ≥ 80 years increased more compared to those 18-79 (248 min vs. 190 min, p < 0.001). Unstable patients increased their median LOS compared to stable patients (triage level 3-5). LOS for discharged patients increased with an average of 7.7 min/year (95% CI: 7.5-7.9) compared to 15.5 min/year (95% CI: 15.2-15.8) for those being admitted.

    CONCLUSION: Fewer admissions, despite an increase of unstable patients, is likely related to lack of in-hospital beds and contributes to ED crowding. The increase in median ED LOS, especially for patients in the subgroups unstable, ≥80 years and admitted to in-hospital care reflects this problem.

  • 154. Berg, Lena M
    et al.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Djärv, Therese
    Göransson, Katarina E
    Reasons for interrupting colleagues during emergency department work: a qualitative study2016In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 29, no SI, p. 21-26Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Emergency department team members frequently need to interact with each other, a circumstance causing multiple interruptions. However, information is lacking about the motives underlying these interruptions and this study aimed to explore clinicians' reasons to interrupt colleagues during emergency department work.

    METHOD: Semi-structured interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. The interviews were analyzed inductively using content analysis.

    RESULTS: The working conditions to some extent sustained the clinicians' need to interrupt, for example different routines. Another reason to interrupt was to improve the initiator's work process, such as when the initiators perceived that the interruption had high clinical relevance. The third reason concerns the desire to influence the work process of colleagues in order to prevent mistakes and provide information for the person being interrupted to improve patient care.

    CONCLUSION: The three identified categories for why emergency department clinicians interrupt their colleagues were related to working conditions and a wish to improve/influence the work processes for both initiators and recipients. Several of the reasons given for interrupting colleagues were done in order to improve patient care. Interruptions perceived as negative to the recipient were mostly related to the working conditions.

  • 155. Berg, Lena M
    et al.
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medicine Solna, Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Djärv, Therese
    Brixey, Juliana J
    Göransson, Katarina E
    Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing: a qualitative study2016In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 27, p. 11-16Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context.

    METHOD: Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis.

    RESULT: Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred.

    CONCLUSION: Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.

  • 156.
    Bergdahl, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Löfgren, Josefin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Följsamhet till råd om egenvård hos patienter med diabetes typ 2: En litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is an endocrine disorder and a global health problem, with the

    number falling ill persons greatly increases. Treatment of type 2 diabetes consists mainly of

    self-care, which places great demands on the patient and the healthcare system. A lack of

    compliance to advice on self-care can lead to poorer health for the patient and increased costs

    for society.

    Aim: The purpose of this literature review was to describe the factors that influence

    compliance to advice on self-care in patients with type 2 diabetes.

    Method: A literature review based on 15 scientific articles, both qualitative and quantitative

    articles were reviewed. The databases CINAHL and PubMed were used.

    Results: Factors affecting compliance to advice on self-care were identified and resulted in

    five broad categories: Information; Knowledge; Social support; technological support and

    Life situation revealed as important factors for low compliance to advice on self-care.

    Conclusion: It is very important to try to identify each individual's different conditions, in

    order to thus be able to cu

  • 157.
    Bergendahl, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lövstrand, Madelene
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans preoperativa information för patientens postoperativa smärtupplevelse: - En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Hip surgery is a common operation, for both elective and acute approach. Nurses’ duties includes pain prevention and information to the patient. This with the patient always in focus. Studies have shown that it is most common to give the information verbally, and that patients want to know more preoperative about the postoperative phase to be more involved.

    Aim

    : The purpose of this literature review was to investigate the importance of nurses’ preoperative information for postoperative pain management.

    Methods

    : For the research the database CINAHL and PubMed was used. A review template was used, and only the articles with a medium high score has been used. This work is based on 17 articles which has been divided in main categories that was elective, acute, information and pain.

    Results

    : A relationship between preoperative information and postoperative pain was found in 13 of the articles. This connection indicate that the given information provided the patients to manage their postoperative pain. Patients undergoing elective surgery was better prepared and was given more patient activated education preoperative than acute surgery. Preoperative individual strategies was identified.

    Conclusion:

    Most of the studies showed that preoperative information is used to reduce postoperative pain by increasing patients’ participation and their ability to cope better. Since a connection was found between most of the articles in this work it increases the likelihood that there is a relationship between nurses’ preoperative information and patients’ postoperative pain experience.

  • 158.
    Bergens, Katarina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Palmer, Ellinor
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Det goda bemötandet inom prehospital akutsjukvård: En litteraturöversikt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna litteraturöversikt var att beskriva vad som kännetecknar ett gott bemötande inom den prehospitala akutsjukvården och vilken betydelse bemötandet har för vården. Metod: Studien genomfördes som en litteraturöversikt och artiklar söktes via databaserna CINAHL och PubMed. De elva inkluderade artiklarna resulterade i kategorier och subkategorier som beskriver vad som är utmärkande för ett gott bemötande inom den prehospitala sjukvården och vilken betydelse det har för vården. Resultat: Resultatet visade att ambulanspersonalen ska anpassa kommunikationen efter patientens förutsättningar och de ska ha ett förhållningssätt som baseras på respekt, ödmjukhet och empati. En förutsättning för en god omvårdnad är att en omvårdnadsrelation, baserad på tillit och förtroende, upprättas. Omvårdnadsrelationen synliggör patientens sårbarhet, vilket ställer krav på ambulanspersonalen att visa respekt för patientens integritet. Slutsats: Patienten har inte bara fysiska utan även psykiska och sociala behov. Att ambulanspersonalen har en holistisk människosyn gör att patienten blir bemött som en unik individ och därmed får en bättre prognos medan brister i den prehospitala vårdkedjan kan äventyra patientsäkerheten.

  • 159.
    Bergens, Marika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johnson, Pernilla
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Arbetsrelaterade stressfaktorer ochsjuksköterskans möjlighet till en patientsäker vård2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this literature review was to describe the factors that influence work-related stress and how it affects the ability to provide a safe patient care.Methods: The study was conducted through a literature review and the articles were searched through databases CINAHL and PubMed. The 14 included articles resulted in two themes and five subthemes that describes factors for work-related stress and its effects.Results: The degree of workload, lack of communication and poor relationships at work was largely a contributing cause of work-related stress. Staff shortages did increase stress to the nurses who worked and came with additionally high risk of exhaustion and burnout. Time pressure meant that nurses did not manage important aspects of nursing care. The focus was on carrying out practical tasks while patient care did suffer. These factors contributed greatly to the compromise of patient safety, in terms of the nurses reduced concentration, which among other things led to missed or failed documentation and medication errors.Conclusion: Staff shortages and time pressure is greatly contributing factors in nurses become stressed and burned out. These factors make it difficult to maintain an evidence-based and patient-safe care.

  • 160.
    Berggren, Emma
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Graf, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar sjuksköterskors följsamhet till riktlinjer för handhygien utifrån en beteendeteori En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Healthcare-associated infections are a global problem and good handhygiene

    is the main tool in the fight against healthcare- associated infections.

    Adherence to hand hygiene is globally low. The nurse’s hands are the main source

    of spreading infection, and because of that the nurse’s behavior towards hand

    hygiene is important. The nurse’s intention to perform hand hygiene can be

    explained by the internal dimension, who are, according to the Theory of planned

    behaviour, attitudes, subjective norms and perceived behavioural control.

    Aim: The aim of this literature review was to describe the attitudes, subjective

    norms and perceived behavioural controls that affect nurses’ adherence to guidelines

    for hand hygiene.

    Method: This study was conducted as a literature review and based on fourteen

    articles of quantitative and qualitative method from the databases PubMed,

    CINAHL and Web of Science.

    Results: The results of the literature review demonstrate that, from the perspective

    of the Theory of planned behaviour, there were attitudes, subjective norms and

    perceived behavioural controls that affected nurses’ adherence to guidelines for

    hand hygiene. Nurses felt that personal protection was an important attitude that

    motivated to hand hygiene. In subjective norm the patient, colleagues and role

    models emerged as motivating factors to perform hand hygiene and the feeling that

    it is easy to perform hand hygiene was the most prominent factor under perceived

    behavioural control.

    Summary: Adherence to guidelines for hand hygiene is low in spite of national

    efforts and campaigns to increase adherence. The results showed that nurses’

    adherence to guidelines for hand hygiene was mainly influenced by personal

    protection, the patient, peers, role models and the feeling that it is easy to perform

    hand hygiene. The results of this literature review can be used to increase the

    knowledge in this area and develop new strategies to increase nurses’ adherence to

    guidelines for hand hygiene.

  • 161.
    Bergholm Andersson, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erfarenheter av att vårda personer med demenssjukdom: En kvalitativ intervjustudie med distriktssköterskor2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: District nurses come in contact with people who have dementia diagnosis to different extent.

    Aim: The aim of this study was to examine nurses' experiences in meeting people with dementia diagnosis and how they adapt giving care that are based on the patient's needs.

    Method: The study was qualitative and based on interviews with four district nurses. For processing the collected data content analysis was used.

    Results: The analysis revealed the three domains, the nurse's situation, the person with dementia diagnosis´ situation and adapting care measures. Further analysis led to four categories, facing a complex care situation, to be challenged, to take care of resources and to adapt their health care measures to the individual or to the dementia. The district nurses identified that people with dementia is a fragile and vulnerable group and to care for them was a challenge on many levels. It requires in-depth knowledge and an ability to see all the factors that surround this population, it´s challenging, complex and exciting. Working person-centered is something that both sought and done in practice, they also take good care of resources that will benefit the patients.

    Conclusion: The district nurses showed joy and commitment that were prominent and seemed to be linked to their education and knowledge. Research including people with dementia and others with limited decision-making capacaty are needed and desirable. Their participation would provide valuable knowledge that could lead to the development in the care concerning this vulnerable population.

  • 162.
    Bergholm, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bertilsson, Hans-Erik
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser av att leva med bensår: Litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Leg ulcer is a symptom caused by different underlying illnesses of

    which poor venous circulation is the most common one. People over 65 years of

    age are at the highest risk. Leg ulcer is a burden both for the patient and the

    healthcare system.

    Aim:

    To describe patients experiences of life with leg ulcers.

    Method:

    This study was conducted as a literature review, in which 16 articles was

    included using the databases Cinahl, Pubmed and Psycinfo. The articles were of

    qualitative and quantitative design.

    Result:

    Patient experiences of living with leg ulcers resulted in three categories:

    To experience suffering, to feel restricted and to experience lack of knowledge.

    The patients experienced a lot of suffering regarding pain, sleep deprivation and

    negative emotions. The patients also experienced limitations caused by

    immobility, limitations in the choice of clothes and shoes and social restrictions.

    The patients lack of knowledge, information and the nurses lack of knowledge

    about leg ulcer treatment was obvious in this study.

    Conclusion:

    Patient perceived a lot of suffering and limitations caused by life with

    leg ulcers. Pain was the most dominant symptom and was rarely assessed or

    treated properly. Pain caused deterioration and enhancement of other symptoms

    with profound effect on patient's wellbeing. Added support, information and pain

    control could improve patient wellbeing.

  • 163.
    Berghov, Emmelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Danielsson, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att vårdas i ett isoleringsrum vid infektion eller risk för infektion – patientens upplevelse.: En litteraturöversikt.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim:

    To describe the experience of being cared for in an isolation room in patients with infection or at risk for infection.

    Background:

    Patients may need to be isolated for various reasons, either to prevent infection or to protect infection-sensitive patients. Multiresistant bacteria are an increasing problem around the world. In order to reduce antibiotic resistance and prevent infection of multiresistant bacteria, a measure is to isolate patients who are infected.

    Method:

    A literature review. The result is based on 14 articles, both qualitative and quantitative articles have been used.

    Result:

    There were both positive and negative experiences of being cared for in an isolation room. Among the positive experiences were feelings of security and the opportunity to privacy. The negative experiences were connected with the physical environment, ignorance and emotions like anxiety and loneliness. Also the healthcare professional´s attitudes, response and compliance with routines affected the patient´s experience of isolation care.

    Conclusion:

    The isolation experience is unique to each individual and factors that can affect the experience are the healthcare professional’s ability to provide adequate information, have a good behavior, and give the patient the opportunity to preserve social contacts.

  • 164.
    Berglund, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pelleberg, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans bemötande av patienter med psykisk ohälsa inom somatisk vård: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: People with mental health problems often have a somatic comorbidity. Research shows that patients with mental health problems often experience that they are treated unfairly and being misunderstood when seeking somatic care. Good encountering is a prerequisite for the creation of a caring relationship which forms the foundation for good care. Encountering also affect the patient's health, compliance, and experience of care. Aim: The aim was to illuminate factors of significance for the encountering of patients with mental health problems in somatic care from nurse’s perspective. Method: A literature review based on 15 articles with both quantitative and qualitative design. Searches were made in the databases PubMed and Cinahl. Result: Factors of significance for encountering could be divided into three themes: attitudes, factors related to the patient meeting and factors related to organization. Both positive and negative attitudes to patients with mental health emerged. Factors related to the patient meeting were anxiety and fear, complex communication, and insufficient skills. Factors related to organization were environment, time and resources, support and prioritization of somatic care. Conclusion: Conclusions that may be drawn from this study are that several different factors may be relevant to encountering, and that there is room for improvement. Important areas of improvement that emerged are nurse´s attitudes and competence. The result also indicates that the organization within somatic care is not adapted to the care and encountering of patients with mental health problems.

  • 165.
    Berglund, Camilla
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Skrijelj, Seada
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Bröstcancer: Kvinnors upplevelser och behov av stöd efter radikal mastektomi2007Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med denna systematiska litteraturstudie var att beskriva de bröstcancerdrabbade kvinnornas upplevelser efter radikal mastektomi och deras behov av stöd efter operationen. Studien baserades på 20 vetenskapliga artiklar med både kvalitativ och kvantitativ ansats. Urvalet av artiklar genomfördes genom att använda Högskolan Dalarnas databaser där olika sökord kombinerades. Även manuell sökning genomfördes. Granskningen av artiklarna utfördes med hjälp av en modifierad granskningsmall. Resultatet visade att en mängd olika reaktioner uppstod efter operationen. Kvinnorna upplevde en negativ bild av sig själva vilket medförde att de inte accepterade sin nya kropp och identitet. Det var även vanligt att de bröstcanceropererade isolerade sig från omgivningen och skylde sin bröstförlust inför andra. Kvinnors bröst var ofta förknippat med sexualitet och när de miste sitt bröst efter mastektomin påverkade det även relationen till partnern. Efter operationen var de bröstcancerdrabbade i stort behov av stöd. Det sociala och emotionella stödet innebar för kvinnorna att de hade någon som lyssnade och stöttade dem. Genom att erbjuda dem informativt stöd upplevde de en större trygghet inför framtiden. Även det praktiska stödet var betydelsefullt för kvinnorna då de fick hjälp av familj och vänner med olika göromål.

  • 166.
    Berglund, Jenny
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Janérs, Laila
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Patientutbildning om diabetes: En systematisk litteraturstudie2005Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med litteraturstudien var att ta reda vad olika studier kommit fram till angående patientutbildning om diabeteskost, motion, hur patientutbildningen bedrivs och uppföljning av vad patienterna fått med sig för kunskaper genom utbildningen. Datainsamlingen har skett i databaserna Elin, Blackwell-Synergy, PubMed och Elsevier. Vid sökningen gjordes begränsning till svensk, norsk och engelskspråkiga tidskrifter och alla artiklar var vetenskapliga. Sökorden som användes i olika kombinationer var: patient education, diabetes, education, exercise och diet. I de artiklar som hämtades via databassökningen valdes ytterligare artiklar från referenslistor. Urvalet gjordes med tanke på litteraturstudiens syfte och frågeställningar. De valda artiklarna granskades med avseende på vetenskaplig kvalité och poängsattes med hjälp av granskingsmallar. Studien baseras på 23 vetenskapliga artiklar, 16 från databassökning och 7 artiklar från referenslistor, daterade från år 2000 och fram till år 2005. Resultatet visade att patientutbildningen i samband med diabetes är nödvändigt, och det är viktigt att den anpassas utifrån patientens egna behov och resurser. Patienterna har olika motivation och förståelse för att ändra sitt förhållningssätt till kost och motion. Det är viktigt att patientundervisningen innehåller både grupp- och individuell undervisning i kombination med teoretisk- och praktisk undervisning under en längre tidsperiod.

  • 167.
    Berglund, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Nicklas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans omvårdnadsåtgärder för att förebygga vårdrelaterad urinvägsinfektion – en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of the literature review was to describe the nursing interventions the nurse can take to prevent health care related urinary tract infection.

    Background: According to Swedish national board of health and welfare (u.å.a) about 10 % of the hospitalized patients in 2008 was affected with a nosocomial infection. The most common nosocomial infection is urinary tract infection. This means more suffering for patients and costs society money. A nurse has a responsibility to promote health, prevent illness, restore health and prevent suffer for patients.

    Method: The study was conducted as a literature review. The articles were searched via the database PubMed and Cinahl. The result is based on 15 articles that met the inclusion criteria and quality control.

    Results: For the nurse to prevent health care -related urinary tract infection it requires nurse care measures like documentation, accurate indication, good hand hygiene , education and adherence to procedures at the insertion of the catheter.

    Conclusion: By following nursing interventions such as documentation, accurate indication, good hand hygiene, and adherence to routines, the essay writers claims that VRUI can be prevented and also prevent healthcare suffering of the patient. What the essay writers have taken up and discussed is something that the essay writers believe are included in the nurse's daily work. If the nurse takes responsible for their actions, update their knowledge, implement good hand hygiene, and follow the guidelines the essay writers claims that VRUI can be prevented.

  • 168.
    Berglund, Wivi-Ann
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Fahlstad, Madelene
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Vårdgivares upplevelse av palliativ vård samt deras behov av stöd: en systematisk litteraturstudie2006Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med denna litteraturstudie var att belysa närståendevårdares och sjuksköterskors upplevelse av det palliativa vårdandet samt deras behov av stöd och vilka stödåtgärder som upplevdes vara betydelsefulla. Litteratursökningen har skett genom databaserna PubMed och ELIN@Dalarna. Kvalitetsgranskningen av artiklarna resulterade i ett urval av 13 kvalitativa och en kvantitativ studie samt en artikel med både kvalitativ och kvantitativ metod. Dessa vetenskapliga artiklar var publicerades mellan år 2000 och 2005. Artiklarnas resultat visade att närståendes situation förändrades i samband med vårdandet av den anhörige i livets slutskede. Närstående upplevde ofta känslor som trötthet, hjälplöshet, vrede och skuld som i sin tur kunde leda till fysiska och psykiska symtom. Ibland upplevde närståendevårdarna bristfälligt stöd från vårdpersonalen. Närståendevårdarna upplevde det som värdefullt när familj och vårdpersonal gav dem stöd, då detta lättade den känslomässiga bördan av det palliativa vårdandet. Sjuksköterskor som arbetade inom palliativ vård upplevde ofta känslor som oro, rädsla, ensamhet och otillräcklighet. Vårdandet av palliativa patienter upplevdes vara känslomässigt tröttsamt och sjuksköterskorna kände ett behov av stöd. Sjuksköterskorna delade ofta den känslomässiga bördan med sina kollegor och upplevde att de kunde få stöd genom kollegor.

  • 169.
    Bergman, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wanke, Julia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    HBTQ-personers erfarenheter av vårdpersonalens bemötande inom sjukvården – en litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund. Synen på HBTQ-personer i samhället är under förändring och i takt

    med att fler vågar vara öppna med sin sexuella läggning, konfronteras det

    heteronormativa synsättet. Historiskt sett är detta en grupp som mötts av

    diskriminering och stigmatisering ute i samhället och även i vårdsituationer och i

    mötet med vårdgivare. Lagändringar har framtagits för att stoppa

    marginaliseringen av denna grupp, vilket lett till attitydförändringar i samhället.

    Syftet med litteraturöversikten var att undersöka HBTQ-personers erfarenheter av

    vårdpersonalens bemötande inom sjukvården. Metod. Litteraturöversikt med 17

    kvalitativa och kvantitativa artiklar. Resultatet visade att denna grupp fortfarande

    erfar stigmatisering och diskriminering i mötet med vård och vårdgivare, samt att

    vårdpersonalen saknade betydande kunskap om denna grupp. Slutsats. Det finns

    fortsatta behov av forskning inom området, utbildning av vårdpersonal, samt

    införande av ämnet HBTQ i utbildningen för allmänsjuksköterskor.

  • 170.
    Bergman Bruhn, Åsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Utvärdering av Hemsjukvården i Dalarna 2014: Slutrapport2019Report (Other academic)
  • 171.
    Bergman, Josefin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pettersson, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors, sjuksköterskestudenters och vårdpersonals kunskap och förhållningssätt till vårdhygien och meticillinresistenta Staphylococcus aureus (MRSA): En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Vårdrelaterade infektioner och MRSA är ett stort problem i vården. Bristande följsamhet till vårdhygien är en orsak till smittspridning. Den legitimerade sjuksköterskan har ett personligt och arbetsledande ansvar för arbetet med evidensbaserad vård och för att gällande riktlinjer efterföljs. Syfte: Att belysa vilka kunskaper och förhållningssätt sjuksköterskor, sjuksköterskestudenter och vårdpersonal har till vårdhygien och MRSA samt vilka faktorer som påverkar följsamhet till vårdhygien. Metod: Litteraturöversikt. Resultat: Bristande kunskap och förhållningssätt är faktorer som påverkar följsamhet till vårdhygien och MRSA. Aktivt ledarskap och samlade strategier mot smittspridning påverkar följsamhet till vårdhygien positivt. Hög arbetsbelastning kan vara en negativ påverkansfaktor. Kunskapsbrist inom hela vårdorganisationen om vårdhygien och MRSA har identifierats. Bristande kunskap kan leda till låg följsamhet och felaktigt förhållningssätt. Bristfälligt förhållningssätt till evidensbaserade riktlinjer leder till att sjuksköterskor skapar egna hygienrutiner. Åtgärder som förbättrar följsamhet innefattar; goda hygienförebilder, förbättrad kommunikation, arbete för en engagerad personalgrupp samt att vårdpersonal får utbildning i vårdhygien och MRSA. Slutsats: En bristande kunskap om vårdhygien och MRSA har påvisats. Sjuksköterskan har som arbetsledare en viktig roll i att påverka annan vårdpersonal positivt. Ökad kunskap om vårdhygien och MRSA, ett positivt förhållningssätt, ett aktivt ledarskap och samlade strategier förbättrar följsamheten.

  • 172.
    Bergman, Karolina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Malin
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Äldres upplevelser av att flytta från det egna hemmet och att bo på ett särskilt boende.2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva upplevelsen av att flytta från det egna hemmet och att bo på ett särskilt boende utifrån den äldres perspektiv.

    Metod: Studien genomfördes som en litteraturöversikt. De vetenskapliga artiklarna söktes via databaserna PubMed, Academic Search Elite, Cinahl och Vård i Norden, vilket resulterade i 14 artiklar. De vetenskapliga artiklarnas kvalitet granskades utifrån granskningsmallar och endast artiklar med medelgod eller hög kvalitet har använts i resultatet.

    Resultat: Förändrad boendesituation medförde en stor omställning för den äldre. Betydelsefullt för anpassningsförmågan var den äldres delaktighet i beslutet att flytta och förberedelse inför flytten. Många äldre var nöjda med omvårdnaden. De fysiska behoven som exempelvis förflyttning prioriterades av personalen, medan de sociala och psykiska behoven inte uppmärksammades i lika stor utsträckning. Personalbrist och inarbetade rutiner innebar begränsningar och liten möjlighet för den äldre att påverka det dagliga livet. Att känna trygghet, värdighet och bli bemött på ett respektfullt sätt av personal var viktiga faktorer för upplevelsen.

    Slutsats: Delaktighet i flyttningsbeslutet och förberedelse inför flytten var viktiga faktorer för den äldres anpassning till det nya boendet. Genom att personalen lyssnade på den äldre ökade förutsättningarna för att bemöta den äldres behov och önskningar. Individuellt anpassad omvårdnad där hänsyn tas till hela människan och dennes livsvärld, bidrar till upplevelsen av värdighet, livskvalitet och välbefinnande hos den äldre som bor på ett särskilt boende.

  • 173.
    Bergman, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder som kan stödja nutritionsintaget för personer med demens – en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    In Sweden, around 160,000 people live with a dementia diagnosis, which is a neurological condition where brain tissue has faded. This will lead to a decrease in physiological and cognitive abilities. Nursing interventions related to a person with dementia focus on relieving symptoms and providing assistance towards the functional decrease. These interventions can be applied to nutritional intake since meal situations can be a complex task for people with dementia. To accommodate the individual, these actions can be performed from a person-centered spectra.

    Aim

    The aim of the literature review was to explore person-centered nursing measures that a nurse can apply for various factors to optimize nutrition intake in people with dementia.

    Method

    An overview compiled of 11 scientific articles.

    Findings

    Five interventions that benefited the nutritional intake for people with dementia were listen to music during the meal, receive personal assistance to aid food intake, verbal prompting as support, how the food was presented, training programs at mealtime.

    Conclusion

    From this overview, interventions have been identified that are beneficial to the person with dementia in connection with nutritional intake. When no interventions are applied to meals, the condition of the person with dementia could be worsened dramatically through, for example, disease and immobility, resulting in deterioration in quality of life.

    The interactions presented could be provided by caregivers and relatives through simple approaches.

  • 174.
    Bergman, Marie
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Norrmalm, Lina
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Övervikt och fetma hos barn: Betydelsen av kost och fysisk aktivitet samt vårdens insatser2007Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka vad kost och fysisk aktivitet har för betydelse för övervikt och fetma hos barn. Metod: En systematisk litteraturstudie där artiklarna är hittade på databaserna Elin@dalarna, Pubmed+ och Blackwell Synergy. Resultat: Kost och fysisk aktivitet har stor betydelse för övervikt och fetma bland barn och ungdomar. Goda kostvanor tillsammans med fysisk aktivitet bör föräldrarna introducera för barnen redan i tidig ålder, eftersom barnen fortsätter leva med de vanor de lär sig i barndomen. Föräldrarna kan introducera goda kostvanor genom att sätta gränser för hur mycket onyttig mat barnen får äta och alltid se till att barnen har tillgång till frukt och liknande hemma, eftersom det ökar deras intag av detta. TV och andra stillasittande aktiviteter ökar vilket i sin tur leder till att övervikten ökar bland barn. Genom att begränsa dessa aktiviteter och inte tillåta barnen att ha egen TV på rummet kan föräldrarna lättare hjälpa barnen att bibehålla deras normalvikt. Genom att begränsa TV tittandet begränsas också mängden reklam som har visat sig påverka barnen negativt. Primärvård och barnhälsovård bör vara uppmärksamma på barn som är överviktiga och ge föräldrar information om hälsosam mat och vikten av fysisk aktivitet.

  • 175.
    Bergstrand, Emelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Andersson, Mikaela
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelse av omhändertagande vid fysiskt trauma på en akutmottagning: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Trauma is the leading cause of death for people up to 40 years and

    causes great suffering for the affected person. When the person comes into the

    emergency department, it requires fast treatment and a structured approach from

    all of the trauma group. Every minute is important for the patient's prognosis. The

    encounter between the patient and the nurse is often short and intense.

    Aim: The purpose of this study is to describe patients' experience of care for

    physical trauma in an emergency department.

    Method: Articles have been applied for in the various relevant databases. Articles

    that answered the purpose was gathered and data were marked. This is to get an

    overview of the state of knowledge, which is compiled in the result.

    Results: The result shows that the communication and information were an

    important part of the care. Patients wanted the nurses to be honest and give clear

    information for patients, because it had impact on the experience of care. Feelings

    that arose in the connection with trauma was fear of the unknown, and not to hold

    control over their lives.

    Conclusion: Trauma care is a complex situation. The patient, purely somatic are

    in a life threatening situation but the mind is still present with many thoughts and

    questions. As the situation is life-threatening, the psychosocial needs will never be

    a priority of the traumacare. It will probably always remain, if no changes in the

    trauma team structure occurs.

  • 176. Bergstrom, Cecilia
    et al.
    Persson, Margareta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mogren, Ingrid
    Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy: pain status, self-rated health and family situation2014In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, article id 48Article in journal (Refereed)
    Abstract [en]

    Background: Pelvic girdle pain (PGP) in pregnancy is distinct from pregnancy-related low back pain (PLBP). However, women with combined PLBP and PGP report more serious consequences in terms of health and function. PGP has been estimated to affect about half of pregnant women, where 25% experience serious pain and 8% experience severe disability. To date there are relatively few studies regarding persistent PLBP/PGP postpartum of more than 3 months, thus the main objective was to identify the prevalence of persistent PLBP and PGP as well as the differences over time in regard to pain status, self-rated health (SRH) and family situation at 12 months postpartum. Methods: The study is a 12 month follow-up of a cohort of pregnant women developing PLBP and PGP during pregnancy, and who experienced persistent pain at 6 month follow-up after pregnancy. Women reporting PLBP/PGP (n = 639) during pregnancy were followed up with a second questionnaire at approximately six month after delivery. Women reporting recurrent or persistent LBP/PGP at the second questionnaire (n = 200) were sent a third questionnaire at 12 month postpartum. Results: A total of 176 women responded to the questionnaire. Thirty-four women (19.3%) reported remission of LBP/PGP, whereas 65.3% (n = 115) and 15.3% (n = 27), reported recurrent LBP/PGP or continuous LBP/PGP, respectively. The time between base line and the 12 months follow-up was in actuality 14 months. Women with previous LBP before pregnancy had an increased odds ratio (OR) of reporting 'recurrent pain' (OR = 2.47) or 'continuous pain' (OR = 3.35) postpartum compared to women who reported 'no pain' at the follow-up. Women with 'continuous pain' reported statistically significant higher level of pain at all measure points (0, 6 and 12 months postpartum). Non-responders were found to report a statistically significant less positive scoring regarding relationship satisfaction compared to responders. Conclusions: The results from this study demonstrate that persistent PLBP/PGP is a major individual and public health issue among women 14 months postpartum, negatively affecting their self-reported health. However, the perceived relationship satisfaction seems to be stable between the groups.

  • 177. Bergström, Anna
    et al.
    Peterson, Stefan
    Namusoko, Sarah
    Waiswa, Peter
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Knowledge translation in Uganda: a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework2012In: Implementation science, ISSN 1748-5908, Vol. 7, article id 117Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting.

    METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data.

    RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT.

    CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

  • 178. Bergström, Anna
    et al.
    Skeen, Sarah
    Duc, Duong M.
    Blandon, Elmer Zelaya
    Estabrooks, Carole
    Gustavsson, Petter
    Hoa, Dinh Thi Phuong
    Kallestål, Carina
    Malqvist, Mats
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings2015In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 10, article id 120Article in journal (Refereed)
    Abstract [en]

    Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose.

    Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries.

    Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge.

    Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

  • 179. Bergström, Eva-Britt
    et al.
    Wallin, Lars
    Karolinska Institutet.
    Thomson, Gill
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Postpartum depression in mothers of infants cared for in a Neonatal Intensive Care Unit: Incidence and associated factors2012In: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 18, no 4, p. 143-51Article in journal (Refereed)
    Abstract [en]

    This longitudinal cohort study investigated the incidence of postpartum depression (PPD) among mothers of infants cared for in two Neonatal Intensive Care Units (NICU) and factors related to PPD onset. 123 mothers were posted the Edinburgh Post-Natal Depression Scale (EPDS) and a questionnaire to record infant and maternal data at 1 month, and a repeat EPDS scale at 4 months post-discharge. PPD incidence was 15% at 1 month, 14% at 4 months, and varied by NICU (23% vs. 8%). Pre-pregnancy and/or antenatal depression was significantly associated with the incidence of PPD. Mothers who experienced PPD at 1 month had an almost eight fold risk of experiencing PPD at 4 months. Women who were not offered counselling during their infant’s stay on the NICU had a 60% increased risk for PPD onset. The findings highlight the need for routine pre-natal screening and targeted support for mothers with infants admitted to NICU.

  • 180.
    Bergström, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sambandet mellan viktförlust och hälsorelaterad livskvalitet efter intensivvård - en retrospektiv tvärsnittsstudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients who survived critical illness or injury often experience physical and mental health problems during the recovery period. Weight/muscle loss and pain are common problems. The purpose of this study was to describe how weight loss affects health-related quality of life and to investigate the diagnostic groups that had the greatest weight loss and experienced reduced mental health and pain at the time of the follow-up visit to intensive care clinic.

    Method: A retrospective cross-sectional study in which 185 patients undergoing critical illness were followed up after hospitalization. Weight before ICU and at the time of follow-up was recorded. Health-related quality of life was assessed by health-survey SF-36. Data were presented by descriptive- and analytical statistics.

    Results: Men estimated significantly improved physical function compared to women while women estimated significantly better mental health than men. Patients with gastrointestinal disorders and trauma had a significantly greater weight loss compared to patients with lung-related conditions. Only patients aged 73 years or older had a significantly impaired physical function. Factors that affect physical function was pain and mental well-being. Patients with aortic aneurysms had significantly poorer mental health and more pain compared with patients suffering from gastrointestinal problems. Patients with aortic aneurysm and intracerebral- and lung-related disorders had significantly more pain than gastrointestinal- and trauma patients.

    Conclusion: By identifying the diagnostic- and age groups suffering most from weight loss, physical and psychological problems after intensive care measures can be initiated early and possibly physical and mental suffering reduced.

  • 181.
    Bergsvind, Ulrica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Söderqvist, Beatrice
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors upplevelse av att drabbas av hjärtinfarkt: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : When it comes to heart disease, women are degraded. Women get worse treatment, more often wrong or no diagnosis and research is less in women. As the man is the norm and reference the women also get treated after the same criteria. Women’s symptoms are different compered to men.

    Aim

    : The aim of this study was to explore women’s experiences of suffering from a myocardial infarction.

    Methods

    : The design is a literature review. Data collection occurred in the databases Cinahl and PubMed which resulted in eleven qualitative articles.

    Result

    s: Women experienced symptoms from different parts of the body, which may be from the gastrointestinal area, extremities and breast region. They deny the symptoms and try to find reasons why they occur. Care provides give lack of information and does not take them seriously, which causes women to feel insecure. Women still feel bad several months after the infarction and have difficulty coping with everyday life. They need support from the family that can give them support and help, although they do not always tell family how they feel.

    Conclusion

    : Women experience a variety of symptoms when they suffer from myocardial infarction, and symptoms may start from different parts of the body, not just in the breast region. They also experience that the caregiver provides inadequate information and do not take them seriously when they seek medical care. Many women have remaining symptoms several months after the infarction.

  • 182.
    Berneström, Anette
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Senior Alert och urininkontinens – en beskrivande registerstudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The

    purpose of the study is to identify urinary incontinence work with quality registry Senior Alerts urinary incontinence module in two municipalities over a fixed period January to June 2014 and from January to June 2015. The method was to use the registry data that is later held by the Depositary of the Senior Alert. The result showed that more than half of the individuals in risk assessments were conducted on municipal G had any form of urinary incontinence in both periods. The municipality M proportion was even higher, about 80%. Underlying causes of urinary incontinence was found to be the aspects mentioned in the Senior Alerts module except constipation problems and loss of sensation in the genital area that is not revealed as clearly as the other aspects. Using Senior Alert, a pattern emerged, and it is possible to provide individually tailored measures for people with incontinence problems. With simple measures, can patients with feces regime, toilet assistance, testing of incontinence aids can the scale of Senior Alert be helpful. The scale demonstrates what assistance may be needed for patients, health professionals then perform the action.

  • 183.
    Berntoft, Nina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johanna, Kallberg
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar informationsutbytet mellan sjuksköterskor hos olika vårdgivare vid in- och utskrivning av äldre patienter2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att belysa vilka faktorer som hindrade och möjliggjorde ett patientsäkert informationsutbyte mellan sjuksköterskor hos olika vårdgivare, vid in- eller utskrivning av äldre patienter.

    Metod: Uppsatsen utformades som en litteraturöversikt. Artiklar söktes i databaserna Cinahl, Pubmed och Web of science. Av de 14 artiklarna som användes var 8 kvalitativa, 3 kvantitativa och 3 artiklar hade en mixad kvalitativ/kvantitativ ansats.

    Resultat: Faktorer som hindrade ett patientsäkert informationsutbyte var: hög arbetsbelastning, bristfälliga rutiner, brist på kunskap, negativa attityder bland vårdpersonalen, brist på kontaktinformation samt information som var bristfälligt anpassad till mottagaren. Faktorer som möjliggjorde ett patientsäkert informationsutbyte identifierades som: Förbättrade rutiner, ökad samverkan mellan vårdgivare, att införa samordnare, bättre framförhållning, anpassad information till mottagaren samt att införa standardformulär.

    Slutsats: Ett patientsäkert informationsutbyte mellan hälso- och sjukvårdspersonal vid in- och utskrivning av äldre patienter, kräver ett omfattande samarbete mellan vårdgivare och ställer höga krav på sjuksköterskans kunskaper i kommunikation.

  • 184.
    Berntsson, Annika
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Anhörigas upplevelser i samband med vård av en äldre person i hemmet: En litteraturöversikt2011Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    SAMMANFATTNING Syftet: Syftet med denna systematiska litteraturstudie var att studera hur anhöriga till äldre personer upplevde sin situation i i samband med att de vårdade sina äldre hemma, hur de hanterade sin situation, samt vilka strategier de använde sig av för att hantera sin roll som anhörigvårdare. Metod: Databaserna Cinahl och Medline användes i sökningarna efter relevanta artiklar. Sökord som användes var relative and older people and home care, home health care and family caregiver elderly people, family caregivers and care givers of aging people, elderly people and family care givers of aging people, family care givers of older people, family caregivers and frail elderly, family caregiver and older people and home care, home care older people and family caregivers older people, family caregivers older people. Efter genomläsning bedömdes 16 artiklar vara användbara i resultatet. Dessa kom från vetenskapliga tidskrifter och artiklarna innehöll både kvalitativa studier som kvantitativa studier. Resultat: De flesta anhörigvårdare var kvinnor, de kunde uppleva en högre belastning än män. De anhöriga påverkades både mentalt, fysiskt och emotionellt. De kände sig bundna men kunde även känna ett välbefinnande i vården av den äldre personen. Anhöriga upplevde sin roll som anhörigvårdare till äldre personer i hemmen som att de var delaktiga i omsorgen genom praktiskt som känslomässigt stöd. Deras situation hade även inverkan på deras upplevelse av stress och hur de hanterade situationen. En del äldre anhörigvårdare var själva äldre och i behov av hjälp. Konsekvenserna av deras reaktioner/upplevelser beskrevs som både subjektiv och objektiv belastning. Samt att de även var mindre benägna att söka stöd i form av avlastning för sina äldre personer. Slutsats: Rollen som anhörigvårdare till äldre personer som vårdas i hemmen innebar förändringar i anhörigas livssituation, de fick ta ett stort ansvar för den äldre personen. De upplevde stora påfrestningar både känslomässigt som praktiskt, många kände sig ensamma utan stöd, andra hade olika sätt att hantera sin situation. Äldre anhörigvårdare var mer utsatta för belastning av olika skäl när de vårdade äldre personer i hemmet, dels var de själva äldre samt att de själva kunde vara i behov av hjälp för sina hälsoproblem. Kvinnorna var den grupp anhörigvårdare som upplevde störst belastning i vården av äldre personer i hemmet. När det gällde att söka hjälp och stöd såg det olika ut bland anhörigvårdarna, trots att kvinnorna upplevde störst belastning var de minst benägna att söka hjälp.

  • 185.
    Bertils, Petra
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Norgren, Ellinor
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Raserat moderskap - ett outhärdligt avsked: Mammors upplevelser av avskedet från sitt dödfödda barn2011Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [sv]

    Barnmorskan har en central roll när barnet är dödfött. Bemötande och stöd har betydelse för sorgeprocessen. Studien beskriver mammors upplevelse av avskedet från sitt dödfödda barn vid hemgången från sjukhuset. Förfrågan fanns på Spädbarnsfondens hemsida och medverkan i studien initierades av mödrarna själva. Elva län inom Sverige är representerade. Tjugosex kvinnor som fått ett dödfött barn intervjuades. Semistrukturerade frågor användes för en djupintervju som analyserades med kvalitativ innehållsanalys. Studien påvisar mammornas förlust av det förväntade moderskapet. De upplevde samhörighet och närhet till barnet med en outhärdlig tomhetskänsla i grunden som återkom under hela avskedsprocessen. Övergripande tema ”Moderskapet raseras” framträder i analysen, där tre kategorier identifieras; 1. Att känna samhörighet med sitt dödfödda barn. 2. Att hantera avskedet. 3. Vägen tillbaka till livet. Mammorna utnyttjade tiden tillsammans med sitt döda barn. De fick vara delaktiga och avgjorde själva när det var dags att ta avsked. De behövde stöd och hjälp att förbereda sig inför avskedet. Tydliga, enhetliga riktlinjer med information och omvårdnadsrutiner avseende bemötande och vårdtid, bör utformas och finnas tillgängliga på involverade vårdinrättningar.

  • 186.
    Bertilsson, Torbjörn
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Sundqvist, Anneli
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Livskvalitet hos cancerpatienter inom palliativ vård: Mätmetoder och patienters upplevelser : En litteraturstudie2005Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    I den sista tiden i en människas liv var det viktigt att livskvaliteten var hög, samtidigt var livskvalitet någonting som var högst subjektivt och ibland svårt att mäta. Syftet med denna litteraturstudie var att beskriva vilka metoder som användes för att värdera cancerpatientens livskvalitet, samt patientens egen upplevelse av livskvalitet i det palliativa skedet, då endast en begränsad tid av livet återstod. Underlag till litteraturstudien framkom genom artikelsökning via databaserna Blackwell Synergy, Elin samt EBSCO Host. Vid sökningen användes enkla sökord eller sökord i kombination. Sökningen begränsades till svensk och engelsk litteratur. Totalt valdes 40 artiklar ut. Vid efterföljande granskning ansågs 15 artiklar av sådan kvalitet att de inkluderades i resultatet. Resultatet visade att mätningar av palliativa cancerpatienters livskvalitet genomfördes med hjälp av specifika frågeformulär utifrån cancertyp eller med hjälp av intervjuer. Frågeformulären var bra att använda när en snabb, övergripande bild av patientens livskvalitet efterfrågades. I många fall användes också/eller djupintervjuer av patienterna vilket gav en mer detaljerad bild av vad livskvalitet var för patienterna. Vad gällde palliativa cancerpatienters upplevelser av livskvalitet visade det sig att cancerrelaterad smärta med sjukdomsspecifika symtom liksom oro för ekonomi och social isolering påverkade livskvaliteten negativt.

  • 187.
    Bihl, Eva-Britt
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Söderman, Lillemor
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Nutritionens betydelse för patienter med KOL - Kronisk Obstruktiv Lungsjukdom: Metoder för sjuksköterskans bedömning av nutritionsstatus2008Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med denna studie var att belysa hur viktig nutritionen är för patienter med diagnosen KOL (Kronisk Obstruktiv Lungsjukdom). Författarna ville även visa på enkla metoder för sjuksköterskan att bedöma nutritionsstatus för att förebygga malnutrition hos dessa patienter. Denna studie är en systematisk litteraturstudie där författarna använt sig av databaserna ELIN@Dalarna, CINAHL, Blackwell Synergy och SWEMED+ för att söka vetenskapliga artiklar. Sökorden som användes i olika kombinationer var: COPD, nutrition, malnutrition, undernutritioned, nutritionalstatus, nutritional supplement, BMI, energy expenditure, caring och nursing. Resultatet visade att nutritionen är av central betydelse i behandlingen av KOL patienter där sjuksköterskan har en viktig roll i samarbetet med andra yrkeskategorier såsom läkare, dietist, sjukgymnast, arbetsterapeut, kurator och psykolog. Bedömningen av patientens nutritionsstatus är en väsentlig del av sjuksköterskans omvårdnad av KOL patienter då det påverkar prognosen. Patienternas försämrade nutritionsstatus ökar risken för exacerbationer och därmed också risken för dödlighet. Sjuksköterskan kan använda sig av enkla mätmetoder för att upptäcka malnutrition, till exempel BMI (Body Mass Index) och MNA (Mini Nutritional Assessment). Ett steg i att förebygga malnutrition är regelbundna viktkontroller och att varje patient har en individuell åtgärdsplan då patientens behov alltid ska komma i första hand. Det är också viktigt att se till psykosociala aspekter runt måltiderna för dessa patienter. En noggrann planering krävs runt deras måltider som patienten kan behöva hjälp med då sjukdomen utgör ett hinder. För en ökad livskvalitet är det angeläget med information om nutritionens betydelse både till patienten och hans anhöriga.

  • 188.
    Bihl, Sofi
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lausch Granlund, Elin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder vid förstoppning hos vuxna: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva omvårdnadsåtgärder vid förstoppning hos vuxna.

    Design: En litteraturöversikt

    Metod: Artiklar till arbetet har sökts i databaserna PubMed och Cinahl. Resultatet

    har granskat, jämfört och sammanställt av författarna.

    Resultat: Författarna har funnit flera omvårdnadsåtgärder som visat signifikant

    förbättring av symtom vid förstoppning. De omvårdnadsåtgärder som undersökts i

    studierna är fibrer, rörelseträning vid toalettbesök, massage, probiotika, vätska och

    införande av protokoll där flera åtgärder visat signifikant förbättring vid

    förstoppning.

    Slutsats: Olika åtgärder har gjorts på flera olika patientkategorier där resultatet

    har varierat från objektiva fynd som exempelvis förbättrade tarmrörelser till

    subjektiva fynd så som ökad livskvalitet.

  • 189.
    Birgersson, Christina
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelse av problem och svårigheter samt användandet av kunskapsunderlag för beslut i sjukvårdsrådgivning per telefon.: En Delphi-studie och en prospektiv kartläggning i primärvård.2006Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [sv]

    SAMMANFATTNING Syftet med studien var att beskriva sjuksköterskors användande av underlag för beslut samt problem och svårigheter som de upplever vid sjukvårdsrådgivning per telefon i primärvård. Metod och urval: För insamlandet av data gällande kunskapsunderlag för beslut användes ett formulär som fylldes i konsekutivt under fem vardagar av sjuksköterskor i samband med telefonrådgivningssamtal vid sex vårdcentraler. Identifieringen av problem och svårigheter gjordes med Delphi-metoden i tre frågerundor till tjugosex sjuksköterskor utvalda med lämplighetsurval, tjänstgörande i sjukvårdsrådgivning per telefon inom primärvården i ett landsting. Resultat: Under insamlingsperioden registrerades 364 samtal. I 85 (24%) av samtalen användes någon form av beslutsstöd. PM/checklista var det mest använda beslutsstödet som användes vid 27 (85%) samtal. Tjugosex sjuksköterskor besvarade den öppna frågan: ”Vilka problem och svårigheter upplever Du att det finns vid sjukvårdsrådgivande situationer per telefon?” Frågan genererade 159 uttalanden. Det mest frekventa uttalandet var problem med att tillfredställa patientens krav och önskemål, när det inte är medicinskt indicerat. Uttalanden kategoriserades i 28 olika problemkategorier. Kategorierna rankades i en andra frågerunda och det högst rankade problemet var brist på läkartider. I sista frågerundan bedömdes de tio högst rankade problemen inbördes och de slutligen svårast upplevda problemen var svårigheter med att värdera problem hos patienter med annat etniskt ursprung och/eller språksvårigheter följt av brist på läkartider och svårigheter att bemöta patienter som är aggressiva, irriterade, hotfulla eller skäller på sjuksköterskan.

  • 190.
    Bivesjö, Jonna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strid, Emelie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelse av delaktighet i sin vård i livets slutskede: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    80% of the people that die every year in Sweden are believed to have benefited from palliative care. In order for patients to be involved in their care, they must be well informed about their condition. Reports show that not all palliative patients get a breakpoint conversation, which increases the risk that patients don’t feel involved in their care.

    Aim:

    To investigate patients’ experiences of participation in their end-of-life care

    Methods:

    The design is a literature review. Data collection has been done through searches in the databases PubMed and CINAHL.

    Results:

    The result was based on 15 scientific articles and were divided into four categories: patients’ need for information, shared decision-making, patients’ preferences, and experience of a good death. Most patients wanted information about their condition, but not everyone felt that they received it. It varied in how much patients wanted to be involved in the decision-making. Patients who wanted shared decision-making felt less that their wishes were met.

    Conclusions:

    To ensure that patients feel involved in their care, it is important to investigate the individual's needs and to adjust the care accordingly, as well as being aware that this may change over time.

  • 191.
    Bjuhr, Madelen
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordlander, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nyutexaminerade sjuksköterskors upplevelser under det första yrkesverksamma året - en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim was to explore the experiences of recently graduated nurses during their first year of practice.

    Method: A literature review based on fifteen scientific articles that were sought out in the databases PubMed and CINAHL.

    Results: Six categories were identified: not feeling prepared for the profession, lack of support, how relationships with colleagues and physicians were experienced, bullying from peers, the feeling of not being able to live up to the ideals and transition. Most participants felt that the demands put on them when they entered the work force were high and they felt ill-prepared to meet them, and also that they received little support and wanted more support than they were getting. Slightly more than half of the studies described predominantly positive relationships with colleagues. One or more study participants was exposed to bullying in almost half of the articles. Almost all newly qualified nurses felt that it was difficult, stressful and frustrating to start working, but after about six months, they felt competent to handle routine tasks, more comfortable in the professional role, more independent and confident.

    Conclusion: The first few months were perceived as difficult and overwhelming, but after six months, most began to feel comfortable in the professional role.

  • 192. Bjurbo, Camilla
    et al.
    Eriksson, Ulrika
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Muntlin Athlin, Åsa
    Early identification of frail older patients by using the FRESH-instrument in the emergency department: a pilot study2018Conference paper (Refereed)
  • 193.
    Björ, Louise
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Svanberg, Sofia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Den äldre patientens upplevelse av vård utifrån ett personcentrerat perspektiv: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The elderly is a group that will be a major part of the population in the future. With increasing age, the risk of suffering from one or more diseases increases, which will place higher demands on healthcare. Swedish law states that healthcare has an obligation to promote patient integrity, participation and self-determination, but this is invalid in the care of the elderly. Many complex illnesses in an elderly person necessitate nursing based on the patient's individual needs. Person-centered nursing is about a partnership between the individual and healthcare staff, where the individual is at the center of care.

    Aim:

    To highlight the elderly patient's experience of care based on a person-centered perspective.

    Method:

    A literature review was conducted and the data was found in the databases CINAHL and PubMed, 13 articles with qualitative method were selected.

    Result:

    The results showed that there were similarities and differences in how the elderly patient experiences their care. These experiences can be divided into three main categories: self-determination, participation and integrity. The elderly patient had a longing for independence and self-determination, however, this was reversed due to a lack of time and competence shortage. The elderly had a desire to be involved in their care, where the relationship and communication were an important basis for creating participation. Many of the elderly did not feel confirmed as a unique individual of nursing staff.

    Conclusion:

    In order to promote the role of the elderly in their care, must a holistic perspective and a person-centered approach be applied, where the elderly is respected as a unique individual. With the older individual at the heart of his care, his right to self-determination, participation and integrity is strengthened, which in turn can lead to an increased quality of life.

  • 194.
    BJÖRK, ANN-SOFIE
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    NYGREN, SUSANNE
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Kvinnors upplevelser av cervixcancer samt sjukvårdens bemötande - En litteraturstudie2010Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet med denna studie var att beskriva kvinnors upplevelser av cervixcancer samt deras upplevelser av sjukvårdens bemötande. Studien genomfördes som en litteraturstudie som grundades på 14 vetenskapliga artiklar som var framtagna från databaserna Cinahl och Medline. I resultatet framkom att vissa av kvinnorna känt skamkänsla och genans över att ha drabbats av cervixcancer. Kvinnorna beskrev även att hoppet hade stor betydelse för att orka gå vidare i sin sjukdom. Efter behandling för cervixcancer upplevde kvinnorna en försämring av deras sexuella funktioner och för en del var det påfrestande att umgås med vänner och bekanta och kvinnorna blev på grund av det socialt isolerade. I det positiva av sjukvårdens bemötande betonar kvinnorna vikten av sjukvårdspersonalens och framför allt sjuksköterskans roll att hjälpa dem med hanteringen av sjukdomen. I det negativa bemötandet från sjukvården beskrev kvinnorna läkarna som kalla och okänsliga. Resultatet av studien visade att livet efter att ha fått en cervixcancer diagnos förändrats för de flesta av kvinnorna. De beskrev hur kroppen påverkats samt hur deras psykiska hälsa försämrades. Det sociala livet påverkades även det. Kvinnorna beskrev att sjukvården hade en stor central roll i deras liv men att den tyvärr inte alltid levde upp till deras önskningar och förväntningar.

  • 195.
    Björk, Eleonora
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Thorildsson, Mari
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Childbirth self-efficacy inventory in Tanzania: a pilot study2007Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [en]

    Background. To give birth can be a stressful experience and women cope with this stress in many different ways and have different personal outcomes. Self-efficacy or confidence in ability to cope with labour can be considered as an important factor affecting pregnant women’s motivation of normal childbirth and their interpretation of the childbirth event. The aim. The purpose of this study was to test the Chinese short form of the instrument Childbirth self-efficacy instrument (CBSEI) in Tanzania, that measure pregnant women’s self-confidence and coping abilities during childbirth. Method. The Chinese short form of the CBSEI was used to pilot test the pregnant women’s confidence of childbirth to see if the questions were understood in the Tanzanian culture. Besides this instrument socio-demographic data was collected together with two open questions asking about attitudes and experiences of childbirth. The instrument was translated into Kiswahili. A sample of 60 pregnant women who were visiting antenatal clinic (ANC) regularly were asked to participate and with help from midwifes at two ANC places the questionnaires were filled out. Result. The result shows that the validity and reliability of the two subscales OE-16 and EE-16 were established. The internal consistency reliability of the two subscales were high, suggesting that each of the subscale mean score provides a good overview of self- reported belief in coping ability for childbirth. The results further show that the instrument, CBSEI in this pilot study is not able to identify women who need extra support during childbirth. Conclusion. The reliability and validity of information presented in this pilot study support the use of the Chinese short form of the CBSEI as a research instrument in the Tanzania culture. Further studies are recommended to get a wider understanding about women’s coping abilities in a culture like Tanzania.

  • 196.
    Björk, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelse och beskrivning av kommunikation med vuxna patienter med ADHD inom öppenvårdspsykiatrin: En kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Studies show patients' experience of communication with nurses, nurses need to have knowledge of communication and knowledge of disability patients with ADHD may have. Previous studies also illustrate various communication theories that are useful in healthcare relationships, but not so much regarding nurses’ experiences.

    Aim: To describe how nurses at outpatient psychiatric experience describe communication with adult patients with ADHD.

    Methods: The study had a qualitative design where data was collected through semi-structured interviews. Qualitative content analysis was used as analytical method.

    Results: The analyses resulted in one theme, four categories and eleven subcategories. Nurses at outpatient clinics experienced communication with patients with ADHD nourishing and debilitating at the same time. Various communication techniques were used in combination with the knowledge of disabilities to create the best conditions for communication with patients. Good attitude and a good approach were reported to be important.

    Conclusion: Nurses in outpatient psychiatry experienced communication with patients with ADHD as both nourishing and debilitating. The nurses adapt their communication to the patient’s needs and abilities, and they treat all needs of the patients' different with respect. Nurses felt that a good attitude and a good treatment was important for communication with patients with ADHD.

  • 197.
    Björk, Ingela
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Sand, Gunilla
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskans tillvägagångsätt vid blodtrycksbesök: en observationsstudie2010Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [sv]

    Sammanfattning Syftet: Syftet med studien var att undersöka distriktssköterskans tillvägagångssätt vid planerade blodtrycksbesök avseende samtalsämnen, tidsåtgång, dokumentation och uppföljning. Metod: Studien var en kvantitativ observationsstudie där populationen var distriktssköterskor från vårdcentraler i Dalarna. Studien bygger på 50 observationer av blodtrycksbesök utifrån en strukturerad checklista som utvecklats för denna studie. Resultatet: I genomsnitt ägnades 14 minuter åt patienten vid blodtrycksbesök. Samtal om livsstilsfaktorer förekom oftare med yngre personer och en signifikant skillnad (p=0,024) påvisades mellan åldersgrupperna 51-64 år och 65-92 år. Fysisk aktivitet var den livsstilsfaktor som det samtalades oftast om, en signifikans påvisades (p = 0,002) mellan åldersgrupper och kön (p = 0,044). Alkohol och sömn samtalades det minst om. Blodtrycksläkemedel och biverkningar samtalades om i 74 procent av besöken. Vid 22 procent av blodtrycksbesöken bestämdes ingen uppföljning av blodtrycket. Slutsats: Tiden vid planerade blodtrycksbesöken hos distriktssköterskan var övervägande kort. Samtal om blodtrycksläkemedel förekom i högre grad än livsstilsfaktorer, och oftast berördes endast en livsstilsfaktor vid besöket. Generellt samtalades det mindre med äldre om livsstilsfaktorer.Primärvårdens organisation av patienter med högt blodtryck bör ses över för att ta till vara distriktssköterskans specifika kompetens i livsstilsfrågor.

  • 198.
    Björk, Ulrika
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Malmlöf, Jessica
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Upplevelser av att leva med hjärtsvikt: ur patienters perspektiv2007Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Syftet var att utifrån aktuell vetenskaplig litteratur beskriva människors upplevelser av att leva med hjärtsvikt. Sjuksköterskans uppgifter är att planera, genomföra och utvärdera omvårdnaden kring hjärtsviktspatienten. En systematisk litteraturstudie gjordes för att belysa aktuell forskning inom ämnet. Artikelsökningarna gjordes i databaserna PubMed, Blackwell Synergy och Cinahl. För att säkra studiens kvalitet användes kvalitativa och kvantitativa granskningsmallar. Resultatet visade att patienter med hjärtsvikt upplevde oro och stress kring sina symtom. Flertalet beskrev en inre turbulens och en förlorad självständighet. Upplevelserna skilde sig bland könen. De flesta kände sig fysiskt begränsade på grund av tröttheten, vilket ledde till en känsla av social isolering. Stödet från omgivningen varierade. Studierna visade att behovet av omvårdande insatser var stort. Flertalet av patienterna hade försämrad aptit och led av oöverkomlig törst. Många drabbades av andnöd och sömnstörningar som gav konsekvenser i det dagliga livet. Kommunikationsproblem mellan sjukvårdspersonal och patienter förekom. Sjuksköterskan kan genom sina omvårdande insatser och sitt engagemang förbättra patientens situation. Litteraturstudien ger ökad förståelse för livssituationen hos patienter med hjärtsvikt.

  • 199.
    Björk, Veronica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ingvarsson, Anngela
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors uppfattning om arbetet med den äldre personens resurser: En fenomenografisk studie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Hospitalization can bestow a feeling of autonomy deprivation and loss of abilities for the elderly persons. The elderly person expects to be seen by the nurse as an autonomous person and have their individual assets identified.

    Purpose: Purpose is to describe the nurses´ perceptions of the work with elderly persons´s assets during inpatient stay at a Geriatric ward.

    Method: Method is qualitative interview study with a phenomenographic methodology.

    Results: Nurses’ perceptions of the work with elderly person’s assets during inpatient stay at a Geriatric ward can be described in an overriding category and four categories. The overriding category was nurses have different understanding for the term assets. The four categories were; possibilities given to let de elderly person do what him/herself can do, the work with the elderly persons assets is sprung from a person-centered mindset, the elderly persons assets can be hidden and the elderly persons assets is not taken at use.

    Conclusion: Nurses’ percept an absence of work with the elderly persons assets despite theoretical awareness. Thru a person-centered way of working can the elderly persons assets be taken care of. As a nurse identify assets is a way of strengthen the elderly persons health and quality of life.

  • 200. Björkelund, Cecilia
    et al.
    Svenningsson, Irene
    Hange, Dominique
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Petersson, Eva-Lisa
    Ariai, Nashmil
    Nejati, Shabnam
    Wessman, Catrin
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Göteborgs universitet; Karolinska institutet.
    Westman, Jeanette
    Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial.2018In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 19, no 1, article id 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden.

    METHODS: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged ≥ 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU).

    OUTCOME MEASURES: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle.

    RESULTS: One hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [- 0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group.

    CONCLUSIONS: Care managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients.

    TRIAL REGISTRATION: Identifier: NCT02378272 . February 2, 2015. Retrospectively registered.

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