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  • 251.
    Ragnarsson, Jon
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Spjuth, Susanne
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gastrointestinala besvär hos personer med schizofreni: en registerstudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Schizophrenia is a psychiatric disorder with increased risk of somatic comorbidity. There are a limited number of research studies regarding schizophrenia and gastrointestinal complaints. The symptomatology of schizophrenia can make it difficult to detect gastrointestinal problems. As a specialist nurse in psychiatric nursing, one has the responsibility to supervise care aspects that can be hard to detect.

    Aim: To determine the prevalence of selected gastrointestinal complaints (constipation, diarrhea and nausea/vomiting) in patients with schizophrenia diagnosis. Moreover, compare the results with the prevalence of gastrointestinal complaints in patients with other psychiatric diagnoses and finally, to investigate any gender differences.

    Method: The present study utilized data from a Swedish patient register for psychiatric disorders (Kvalitetsstjärnan). Information about age, gender, psychiatric diagnosis and selected gastrointestinal complaints were retrieved from the register for the years 2011 – 2016. The study population included data on 2056 patients of which 976 had a diagnosis of schizophrenia (58,3% male and 41,7% female) with a mean age of 45 (SD=11,7, min=18, max=88). A descriptive analysis was performed using SPSS.

    Result: Schizophrenic patients reported complaints for constipation (22%), diarrhea (18%) and expressed discomfort of nausea/vomiting (13%). Females reported more frequent and more serious complaints than male patients. The prevalence of gastrointestinal symptoms did not differ between the group of patients with schizophrenia and other psychiatric disorders.

    Conclusion: The present study showed that gastrointestinal complaints were common in persons with schizophrenia, although not more common than in the population of patients with other psychiatric diagnoses. It is important to consider somatic complaints of patients within psychiatric care.

  • 252.
    Rassart, Jessica
    et al.
    University of Leuven, Leuven, Belgium; Research Foundation Flanders, Belgium.
    Apers, Silke
    University of Leuven, Leuven, Belgium.
    Kovacs, Adrienne H.
    University of Toronto, Toronto, Canada..
    Moons, Philip
    University of Leuven, Leuven, Belgium; University of Gothenburg, Gothenburg, Sweden.
    Thomet, Corina
    University Hospital Bern, Bern, Switzerland..
    Budts, Werner
    University of Leuven, Leuven, Belgium; University Hospitals Leuven, Leuven, Belgium.
    Enomoto, Junko
    Chiba Cardiovascular Center, Chiba, Japan..
    Sluman, Maayke A.
    Amsterdam Medical Center, Amsterdam, The Netherlands..
    Wang, Jou-Kou
    National Taiwan University Hospital, Taipei, Taiwan..
    Jackson, Jamie L.
    Nationwide Children's Hospital, Columbus, USA.
    Khairy, Paul
    Montreal Heart Institute, Montreal, Canada..
    Cook, Stephen C.
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital Grand Rapids, MI, USA..
    Subramanyan, Raghavan
    Frontier Lifeline Hospital, Dr. K. M. Cherian Heart Foundation, Chennai, India..
    Alday, Luis
    Hospital de Niños, Córdoba, Argentina..
    Eriksen, Katrine
    Oslo University Hospital, Oslo, Norway..
    Dellborg, Mikael
    University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Gothenburg, Sweden.
    Johansson, Bengt
    University Hospital of Umeå, Umeå, Sweden.
    Rempel, Gwen R.
    University of Alberta, Edmonton, Canada.
    Menahem, Samuel
    Monash Medical Center, Melbourne, Australia..
    Caruana, Maryanne
    Mater Dei Hospital, Msida, Malta.
    Veldtman, Gruschen
    Cincinnati Children's Hospital Medical Center, Cincinnati, USA..
    Soufi, Alexandra
    Hospital Louis Pradel, Lyon, France..
    Fernandes, Susan M.
    Stanford University, Palo Alto, USA.
    White, Kamila S.
    Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, USA..
    Callus, Edward
    IRCCS Policlinco San Donato Hospital, Milan, Italy..
    Kutty, Shelby
    Children's Hospital & Medical Center, Omaha, USA.
    Luyckx, Koen
    University of Leuven, Leuven, Belgium.
    Illness perceptions in adult congenital heart disease: A multi-center international study2017In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 244, p. 130-138Article in journal (Refereed)
    Abstract [en]

    Background Illness perceptions are cognitive frameworks that patients construct to make sense of their illness. Although the importance of these perceptions has been demonstrated in other chronic illness populations, few studies have focused on the illness perceptions of adults with congenital heart disease (CHD). This study examined (1) inter-country variation in illness perceptions, (2) associations between patient characteristics and illness perceptions, and (3) associations between illness perceptions and patient-reported outcomes. Methods Our sample, taken from APPROACH-IS, consisted of 3258 adults with CHD from 15 different countries. Patients completed questionnaires on illness perceptions and patient-reported outcomes (i.e., quality of life, perceived health status, and symptoms of depression and anxiety). Patient characteristics included sex, age, marital status, educational level, employment status, CHD complexity, functional class, and ethnicity. Linear mixed models were applied. Results The inter-country variation in illness perceptions was generally small, yet patients from different countries differed in the extent to which they perceived their illness as chronic and worried about their illness. Patient characteristics that were linked to illness perceptions were sex, age, employment status, CHD complexity, functional class, and ethnicity. Higher scores on consequences, identity, and emotional representation, as well as lower scores on illness coherence and personal and treatment control, were associated with poorer patient-reported outcomes. Conclusions This study emphasizes that, in order to gain a deeper understanding of patients’ functioning, health-care providers should focus not only on objective indicators of illness severity such as the complexity of the heart defect, but also on subjective illness experiences.

  • 253.
    Rejnö, Åsa
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bråd död: ett viktigt begrepp i palliativ vård2016In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, no 4, p. 71-76Article in journal (Other academic)
    Abstract [en]

    Death do not always come quiet and peacefully but sometimes strikes sudden and unexpectedly. The unexpected and hasty course of event gives consequences for the patient as well as next of kin, carers and care. Through a concept analysis the concepts 'bråd' (unexpected sudden) and 'död' (death) have been investigated. The analysis give the concept 'bråd död' a content using the words meaning. Thereby consequences of an unexpected sudden death are captured and show challenges for care in the difficult situation.

  • 254.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Andersson, Per
    Wester, Per
    "StrokeSverige" lär i webbaserad kompetensutbildning2018In: VILÄR Abstraktbok / [ed] Kristina Johansson, Trollhättan: Högskolan Väst , 2018, p. 4-5Conference paper (Other academic)
    Abstract [sv]

    Bakgrund

    Verksamhetsintegrerat lärande omfattar lärande som sker integrerat mellan akademi och arbetsliv. Ofta är integrationen sådan att arbetslivet integreras i akademin. Det omvända är inte lika vanligt. Strokeenhetsvård är sedan 1980-talet ett internationellt evidensbaserat vårdkoncept som minskar mortalitet, institutionsboende och beroende i ADL efter stroke. För att en verksamhet ska få kalla sig strokeenhet ingår att vården ska bedrivas av ett multidisciplinärt team med expertkunnande inom stroke och rehabilitering. Strokekompetensutbildning med både teoretiska och praktiska moment som ger detta expertkunnande ges sedan av STROKE Riksförbundet och drivs lokalt. Antalet som genomgår utbildningen minskar på grund av vårdens pressadef örhållanden vilket gett svårigheter att organisera och driva utbildningen lokalt. Från centralt håll har oro uttryckts då strokekompetensen genom detta minskar vilket potentiellt leder till sämre vård. Syftet med presentationen är att visa hur lokalt drivna utbildningar i arbetslivet kan webbaseras i samarbete med akademin för att möjliggöra personalgruppers möjlighet till kompetenshöjning.

    Metod

    Utbildningen har digitaliserats för att ge förutsättningar för jämlik vård. Alla teoretiska moment har gjorts som filmade föreläsningar av personer med spetskompetens inom sitt område och en tredelad examination har tagits fram som säkerställer att utbildningen ger jämn och hög kvalitet.

    Resultat

    Utbildningen som använder det flippade klassrummet som teoretisk modell är nu en poänggivande högskoleutbildning som ges av Umeå universitet där teambased learning och constructive alignment varit ledord för uppbyggnaden. Utbildningen omfattar filmade föreläsningar, quiz och webbaserad examination som genomförs via lärplattformen, samt material för träffar där praktiska moment ingår som ordnas lokalt av respektive verksamhet, liksom material för såväl individuell examination som gruppexamination. Utöver detta finns länkar till referensmaterial samt fördjupningsmaterial.

    Diskussion

    Med noggrann planering, förankring och tydliga pedagogiska utgångspunkter kan utbildning utvecklas i samarbete mellan offentlig sektor och universitet/högskolor. Utbildningen är exempel på ett initiativ från arbetslivet där akademin är tydligt integrerad för att möjliggöra lärande för personer i arbetslivet. Genom digitaliseringen ges möjlighet för verksamheter att erbjuda personal utbildning inommer flexibla ramar och på tider som passar dem jämfört med traditionella kurser inom högre utbildning. Konceptet kan potentiellt användas för många verksamheter och visar på möjligheterna med digitalisering av högre utbildning för att nå ut till arbetslivet

  • 255.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Berg, Linda
    Institute of Health and Care Sciences, University of Gothenburg, Göteborg, Sweden.
    Communication as a Key in Creating Dignified Encounters in Unexpected Sudden Death by Stroke2018In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 32, no 1_suppl, p. 154-154, article id P253Article in journal (Refereed)
    Abstract [en]

    Background: Communication is present in all encounters in care and of importance to create a caring relation. A good relation between patients, next of kin and health care staff is crucial, not least in times of rapid changes in health and when questions about life and death are at stake such as in palliative care.

    Aims: The aim of this study was to illuminate communication and its meaning in unexpected sudden death with stroke as example, as experienced by next of kin and stroke team members.

    Methods: The design of the study is a secondary analysis of qualitative data as proposed by Heaton, from a project on unexpected sudden death by stroke. Material from four interview studies from the project with all in all twelve next of kin of patients who had died due to the acute stroke during hospital stay and twenty-seven stroke team members from stroke units were utilized. Data were analysed with qualitative content analysis according to Krippendorf and Baxter.

    Results: The analysis reveals communication as the foundation for care and caring. The overarching theme foundation for dignified encounters in care is built up by six themes illuminating the meaning of communication in unexpected sudden death by stroke; creating relationship, information enabling understanding, giving ground for unanimity, personalizing the patient, preconditioning for decisions and giving and experiencing support.

    Conclusions: Communication and its meaning in unexpected sudden death as experienced by next of kin and stroke team members enables dignified encounters in care. Through the next of kin knowledge about the severely ill patient, possibility to preserve and uphold absolute dignity and dignity of identity is given, expressed through respect for the patient's will and desire and derived through talks between carers andnext of kin. Communication is one key to create dignified encounters inpalliative care when unexpected sudden death occurs. It gives ground for unanimity about care and possibility to maintain and uphold dignity incare when acknowledging the next of kin familiarity with the patient.This gives ground for a person centeredness in palliative care despite the patients sever illness.

  • 256.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Department of Medicine, Stroke Unit, Skaraborg Hospital Skövde, Skövde.
    Berg, Linda
    University of Gothenburg, Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg, Sweden.
    Communication, the key in creating dignified encounters in unexpected sudden death: With stroke as example2019In: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 25, no 1, p. 9-17Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to illuminate the communication and its meaning in unexpected sudden death with stroke as example, as experienced by stroke team members and next of kin. Subject and Methods: The study has a qualitative design. Secondary analysis of data from four previous interview studies with stroke team members; physicians, registered nurses, and enrolled nurses from the stroke units (SU) and next of kin of patients who had died due to acute stroke during hospital stay were utilized. <b>Results:</b> Communication is revealed as the foundation for care and caring with the overarching theme foundation for dignified encounters in care built-up by six themes illuminating the meaning of communication in unexpected sudden death by stroke. <b>Conclusion:</b> Communication shown as the foundation for dignified encounters in care as experienced by stroke team members and next of kin enables the patient to come forth as a unique person and uphold absolute dignity in care. Acknowledging the next of kin&#39;s familiarity with the severely ill patient will contribute to personalizing the patient and in this way be the ground for a person centeredness in care despite the patients&#39; inability to defend their own interests. Through knowledge about the patient as a person, the foundation for dignified care is given, expressed through respect for the patient&#39;s will and desires and derived through conversations between carers and next of kin.

  • 257.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Stroke unit, Skaraborg Hospital, Skövde, Sweden.
    Berg, Linda
    University of Gothenburg, Institute of Health and Care Sciences, Göteborg, Sweden.
    Creating dignified encounters in unexpected sudden death by stroke: communication as the key2018In: European Stroke Journal, ISSN 2396-9873, E-ISSN 2396-9881, Vol. 3, no 1_suppl., p. -292, article id AS13-002Article in journal (Other academic)
    Abstract [en]

    Background and Aims: Communication is present in all encounters in stroke care and of importance to create a caring relation. A good relation between patients, next of kin and health care staff is crucial, not least in unexpected sudden death by stroke. The aim of the study was to illuminate communication and its meaning in unexpected sudden death by stroke, as experienced by next of kin and stroke team members. Method: The design is a secondary analysis of qualitative data from a project on unexpected sudden death by stroke. Material from four interview studies from the project with all in all twelve next of kin of patients who had died due to the acute stroke during hospital stay and twentyseven stroke team members from stroke units were utilized. Data were analysed with qualitative content analysis. Results: The analysis reveals communication as the foundation for care and caring in acute stroke care. The overarching theme foundation for dignified encounters in care is built up by six themes illuminating the meaning of communication in unexpected sudden death by stroke. Conclusion: Communication and its meaning in unexpected sudden death by stroke as experienced by next of kin and stroke team members is one key to create dignified encounters in care when unexpected sudden death by stroke occurs. It gives ground for unanimity about care and possibility to maintain and uphold dignity in care when acknowledging the next of kin familiarity with the patient, giving ground for a person centeredness despite the patients sever illness.

  • 258.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Specialist Nursing programme. University West, Department of Health Sciences, Section for nursing - graduate level. Skaraborg Hospital Skövde, Sweden.
    Berg, Linda
    University of Gothenburg.
    Strategies for handling ethical problems in end of life care: obstacles and possibilities2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 7, p. 778-789Article in journal (Refereed)
    Abstract [en]

    Background: In end of life care, ethical problems often come to the fore. Little research is performed on ways or strategies for handling those problems and even less on obstacles to and possibilities of using such strategies. A previous study illuminated stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. These findings have been further explored in this study. Objective: The aim of the study was to illuminate obstacles and possibilities perceived by stroke team members in using strategies for handling ethical problems when caring for patients afflicted by sudden and unexpected death caused by stroke. Research design: A qualitative method with combined deductive and inductive content analysis was utilized. Participants and research context: Data were collected through individual interviews with 15 stroke team members working in stroke units of two associated county hospitals in western Sweden. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. Permission was also obtained from the director of each stroke unit. Findings: All the studied strategies for handling of ethical problems were found to have both obstacles and possibilities. Uncertainty is shown as a major obstacle and unanimity as a possibility in the use of the strategies. The findings also illuminate the value of the concept “the patient’s best interests” as a starting point for the carers’ ethical reasoning. Conclusion: The concept “the patient’s best interests” used as a starting point for ethical reasoning among the carers is not explicitly defined yet, which might make this value difficult to use both as a universal concept and as an argument for decisions. Carers therefore need to strengthen their argumentation and reflect on and use ethically grounded arguments and defined ethical values like dignity in their clinical work and decisions. © 2014, © The Author(s) 2014.

  • 259.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Danielsson, Ella
    University of Gothenburg, Sweden, Mid Sweden University, Sweden.
    Berg, Linda
    University of Gothenburg, Sweden.
    Combining Qualitative and Quantitative Content Analysis: A Way to Utilize Different Types of Data in Research of Ethical Problems in Acute Stroke Care2017Other (Refereed)
    Abstract [en]

    Most people who experience an acute stroke survive, but a substantial number die as a result of it. Stroke is, according to the World Health Organization, the second leading cause of death globally. Research in the area of stroke has previously been less focused on situations when patients die due to an acute stroke in favor of research on medical treatments, rehabilitation, and living with the aftermath of stroke. Research focusing on ethical problems in the care of dying patients can be found both in general and in specific care contexts such as palliative, intensive, and non-hospital care, but knowledge concerning ethical problems in the area of stroke, or arising as a result of acute stroke, was lacking. Both these subjects, death due to acute stroke and ethical problems, were combined for the first author's (Å. R.) thesis. Individual interviews with stroke team members were performed guided by their answers in a three-part form filled out before the interviews. This case study provides an account of how qualitative and quantitative content analysis was used in combination to deepen the results from the study utilizing data obtained from both the three-part forms and the interviews performed. The case highlights some challenges faced when combining the two different types of data. It also gives examples of how the analysis was performed when combining qualitative and quantitative content analysis to support and further explore data.

  • 260.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.
    Nasic, Salmir
    Research and Development Centre, Skaraborg Hospital Skövde, Skövde, Sweden.
    Bjälkefur, Kerstin
    Department of Health and Social Care, Municipality of Lidköping, Sweden.
    Bertholds, Eric
    Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.
    Jood, Katarina
    The Sahlgrenska Academy at University of Gothenburg, Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Gothenburg, Sweden.
    Changes in functional outcome over five years after stroke2019In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 9, no 6, article id e01300Article in journal (Refereed)
    Abstract [en]

    Objectives: Data on the long‐term time course of poststroke functional outcome is limited. We investigated changes in functional outcome over 5 years after stroke in a hospital based cohort.

    Materials and Methods: Consecutive patients who were independent in activities of daily living (ADL) and admitted to a Stroke Unit at Skaraborg Hospital, Sweden for a first acute stroke from 2007 to 2009 (n = 1,421) were followed‐up after 3 months and thereafter annually over 5 years using a postal questionnaire. Clinical variables at acute stroke and 3 months post stroke were obtained from the Swedish Stroke Register. ADL dependency was defined as dependence in dressing, toileting or indoor mobility.

    Results: The proportions of survivors who reported ADL dependency remained stable throughout follow‐up (19%–22%). However, among survivors who were ADL independent at 3 months, about 3% deteriorated to dependency each year. Deterioration was predicted by age (HR 1.11; 95% CI 1.08–1.13), diabetes (HR 1.65; 95% CI 1.12–2.44), NIHSS score (HR 1.07; 95% CI 1.04–1.10), and self‐perceived unmet care needs one year post stroke (HR 2.01; 95% CI 1.44–2.81). Transitions from ADL dependency to independence occurred mainly during the first year post stroke. Improvement was negatively predicted by living alone before stroke (HR 0.41 95% CI 0.19–0.91), NIHSS score (HR 0.90; 95% CI 0.86–0.95) and ischemic stroke (vs. hemorrhagic stroke), HR 0.39; 95% CI 0.17–0.89.

    Conclusion: Transitions between ADL independence and dependency occur up to 5 years after stroke. Some of the factors predicting these transitions are potentially modifiable

  • 261.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nordin, Per
    The Skaraborg Institute for Research and Development, Skövde, Sweden..
    Forsgren Gebring, Susanne
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sundell, Yvonne
    Västra Götalandsregionen.
    Sjuksköterskestudenters närvaro vid läraktiviteter i relation till hur de klarar kursexaminationer2016In: ViLär 8-9 december 2016, Vänersborg / [ed] Kristina Johansson, 2016Conference paper (Other academic)
  • 262.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Stroke Unit, Skaraborg Hospital, 541 85 Skövde, Sweden.
    Nordin, Per
    The Skaraborg Institute for Research and Development, Skövde, Sweden.
    Forsgren, Susanne
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sundell, Yvonne
    University West, Department of Health Sciences.
    Rudolfsson, Gudrun
    University West, Department of Health Sciences, Section for nursing - graduate level. Nord University, Faculty of Professional Studies, Bodø, Norway.
    Nursing students’ attendance at learning activities in relation to attainment and passing courses: a prospective quantitative study2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 50, no March, p. 36-41Article in journal (Refereed)
    Abstract [en]

    Background

    Students' motivation and ways of engaging in their schoolwork are important for their performance, including passing exams. Attendance at learning activities has also been argued to be of major importance, although no causal relationship with passing exams has been established in nursing education.

    Objectives

    The aim of this study was to describe the impact of attendance at nonmandatory learning activities on attainment, in terms of passing or failing of exams, in nursing education courses including both mandatory and non-mandatory activities.

    Design

    A prospective quantitative design.

    Setting

    The nursing education programme at a Swedish university.

    Participants

    Nursing students (n = 361) from two courses and four classes within the nursing programme.

    Methods

    Attendance was registered at every non-mandatory teaching activity by asking the students to note their attendance on a list. Data such as sex, age, and whether the students had passed the exam were also collected for each course and each semester separately.

    Results

    Increased participation was associated with an increasing proportion of students passing the exam. The chance of passing the exam increased by 13% for every additional learning occasion attended. Logistic regression showed an OR of 5.4 for an attendance of 100%.

    Conclusions

    An increase in attendance gave a higher proportion of exam passes. Encouraging students to attend non-mandatory learning activities could be of value, and potentially contribute to an increased graduation rate for nursing students.

  • 263.
    Rejnö, Åsa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Skaraborg Hospital Skövde, Sweden.
    Silfverberg, Gunilla
    Ersta Sköndal University College, Stockholm, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Stockholm, Sweden.
    Reasoning about truth-telling in end-of-life care of patients with acute stroke2017In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 24, no 1, p. 100-110Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ethical problems are a universal phenomenon but rarely researched concerning patients dying from acute stroke. These patients often have a reduced consciousness from stroke onset and thereby lack ability to convey their needs and could be described as 'incompetent' decision makers regarding their own care. OBJECTIVE: The aim of the study was to deepen the understanding of stroke team members' reasoning about truth-telling in end-of-life care due to acute stroke. RESEARCH DESIGN: Qualitative study based on individual interviews utilizing combined deductive and inductive content analysis. PARTICIPANTS AND RESEARCH CONTEXT: A total of 15 stroke team members working in stroke units of two associated county hospitals in western Sweden participated. ETHICAL CONSIDERATIONS: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. FINDINGS: The main findings were the team members' dynamic movement between the categories 'Truth above all' and 'Hide truth to protect'. Honesty was highly valued and considered as a reason for always telling the truth, with the argument of truth as common morality. However, the carers also argued for hiding the truth for different reasons such as not adding extra burden in the sorrow, awaiting a timely moment and not being a messenger of bad news. Withholding truth could both be seen as a way of protecting themselves from difficult conversations and to protect others. DISCUSSION: The results indicate that there are various barriers for truthfulness. Interpreted from a virtue of ethics perspective, withholding of truth might also be seen as an expression of sound judgement to put the patient's best interest first. CONCLUSION: The carers may need support in the form of supervision to be given space to reflect on their experience and thereby promote ethically justified care. Here, the multi-professional team can be of great value and contribute through inter-professional sharing of knowledge.

  • 264.
    Ringnér, Anders
    et al.
    Umeå University, Department of Nursing,SE-901 87 Umeå, Sweden.
    Björk, Maria
    School of Health Sciences, Jönköping University, CHILD Research Group, Department of Nursing Science, Box 1026, SE-551 11 Jönköping, Sweden.
    Olsson, Cecilia
    Karlstad University, Department of Health Sciences, SE-651 88 Karlstad, Sweden..
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Specialist Nursing programme. University West, Department of Health Sciences, Section for nursing - graduate level. Umeå University, Department of Nursing, SE-901 87 Umeå, Sweden.
    Person-centred information to parents in paediatric oncology (the PIFBO study): A study protocol of an ongoing RCT.2015In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, article id 69Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Parents of children with cancer experience a demanding situation and often suffer from psychological problems such as stress. Trying to coping with the complex body of information about their child's disease is one factor that contributes to this stress. The aim of this study is to evaluate an intervention for person-centred information to parents of children with cancer that consists of four sessions with children's nurses trained in the intervention method.

    METHODS/DESIGN: This is a multi-centre RCT with two parallel arms and a 1:1 allocation ratio. The primary outcome is illness-related parental stress. Secondary outcomes are post-traumatic stress symptoms, anxiety, depression, satisfaction with information, expected and received knowledge, and experiences with health care providers. A process evaluation is performed to describe experiences and contextual factors. Data are collected using web questionnaires or paper forms according to the parents' preference, audio recording of the intervention sessions, and qualitative interviews with parents and the intervention nurses.

    DISCUSSION: Few studies have evaluated information interventions for parents of children with cancer using large multi-centre RCTs. This intervention is designed to be performed by regular staff children's nurses, which will facilitate implementation if the intervention proves to be effective.

    TRIAL REGISTRATION: Clinical trials NCT02332226 (December 11, 2014).

  • 265.
    Robertz, A C
    et al.
    Child and Adolescent Psychiatry Outpatient Clinic Uddevalla, NU Hospital Group, Region Västra Götaland, Uddevalla, Sweden.
    Rudolfsson, Gudrun
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tactile massage as a nursing intervention in child and adolescent psychiatry: nurses' experiences2016In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 23, no 8, p. 502-512Article in journal (Refereed)
    Abstract [en]

    WHAT IS KNOWN ABOUT THE SUBJECT?: There is little research on the implementation of tactile massage in child and adolescent psychiatry that describes children's and adolescents' experiences and outcomes. There is also limited knowledge of providing tactile massage in child and adolescent psychiatry. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper describes 10 nurses' experiences of tactile massage as a nursing intervention in child and adolescent psychiatry. The nurses considered tactile massage a non-verbal nursing intervention that could complement other available treatments. It reveals their reflections on the impact of tactile massage on their nursing and on themselves as a person, including the belief that they had developed deepened self-reflection and attentiveness. The nurses highlighted the importance of providing a trusting environment and collaborating with the children and adolescents. They both experienced and observed that tactile massage triggered various physical and mental processes in the children and adolescents, such as improvement in sleep disturbances, an ability to relax in body and mind and a deeper connectedness with their own bodies and feelings. The nurses described instructing next of kin in the use of tactile massage, which they believed could serve as a tool at home, mainly as a way for next of kin to help their children to relax, fall asleep more easily and to deepen connectedness. However, the nurses stressed the need to consider if it was appropriate or desired by the children and adolescents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Tactile massage addresses the individual's emotional and physiological responses and could therefore bring holistic nursing to child and adolescent psychiatry. It could also help nurses in child and adolescent psychiatry to develop their attentiveness and sensitivity in acknowledging the needs of children and adolescents in psychiatric care.

    ABSTRACT:

    Introduction There is limited research on tactile massage in child and adolescent psychiatry and no studies investigating experiences of providing tactile massage in child and adolescent psychiatry were found. Aim The aim was therefore to describe nurses' experiences of providing tactile massage as a nursing intervention in child and adolescent psychiatry. Method Ten nurses trained in tactile massage and employed at five different child and adolescent psychiatry clinics in Sweden participated in a qualitative study. Semi-structured interviews were conducted, transcribed verbatim and analysed by qualitative content analysis. Results Three categories emerged from the analysis. 'Confirming body and mind', 'Building a trusting relationship' and 'Instructing next of kin in tactile massage'. Attentiveness to and respect for the integrity of the children and adolescents were essential for creating a trusting relationship with them. Tactile massage was found to trigger various physical and mental processes in the children and adolescents. The nurses reflected on the impact of tactile massage on their nursing and on themselves as a person, stating that it had led to the development of self-reflection and attentiveness. Implications for practice Tactile massage addresses the individual's emotional and physiological responses and could therefore bring holistic nursing to child and adolescent psychiatry. It might also enhance attentiveness and sensitivity on the part of child and adolescent psychiatry nurses when acknowledging the needs of children and adolescents in psychiatric care.

  • 266.
    Robertz, Anna-Carin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Alhäll, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Mjuk massage som en omvårdnadsåtgärd i barn- och ungdoms psychiatry: Sjuksköterskors upplevelser2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    There is limited research of soft massage (SM) in child- and adolescent psychiatry (CAP), and no research investigating the experiences of giving SM in CAP has been found. The aim was therefore, to describe nurses’ experiences of SM as a nursing intervention in CAP. Ten nurses trained in SM and working at five different CAP clinics in the middle and southern part of Sweden participated. Semi-structured interviews were carried out, transcribed verbatim and analysed by qualitative content analysis. SM was seen as a valuable complement to other treatments there is to offer in the CAP setting. Attentiveness and respect for the youngsters’ integrity was essential in creating a trustful relationship with the youngsters. SM was seen as generating different forms of processes. Being a nurse was seen as a strength, since the nurses used touch massage in combination with psychoeducation on self-care, to extend the relaxing outcomes for the youngsters. Teaching next of kin the massage was seen as giving them a tool to help their youngsters to relax. SM is a holistic nursing intervention in CAP and a complementary method to offer for youngsters experiencing mental illness. The findings can gain insight and knowledge in implementing SM in CAP.

  • 267.
    Rognstadbråten, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rydström, Pia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Det diffusa ansvaret - gör att vi inte förstår varandra: Sjuksköterskors erfarenhet av samverkan mellan psykiatrisk öppenvård och psykiatrisk slutenvård2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Earlier studies show that when psychiatric out- and in-patient care units work together the risk for hospitalization decreases, leads to increased flexibility and shorter in-patient periods. At a psychiatric clinic in western Sweden there are routines in place regarding the transfer of patients from in-patient to out-patient care. The aim of this study was to describe nurses' experience of how out-and in-patient clinics collaborate during patients in-patient care.

    This is a qualitative study with an inductive approach. Ten nurses participated through semi structured interviews. The result ended up in two domains and eight subthemes and one theme, the diffuse responsibility – makes us not understand each other. Nurses in both out- and in-patient care experience uncertainty as to who has the responsibility for patients' treatment-plans and also uncertainty in how communication between the two parties works.

    Nurses in in-patient care experience that the out-patient care are uninterested, and nurses in out-patient care experience that in-patient care does not follow treatment-plans.

    In Conclusion both nurses in out- and in-patient care describe a need for an improved partnership. Some find that they are unsure of their role and their responsibility in the partnership. Structures for an improved partnership need to be implemented from the staff leadership, to be able to live up to the national guidelines and ensure that patients receive the treatment which serious psychiatric illness needs.

  • 268.
    Rudolfsson, Gudrun
    University West, Department of Nursing, Health and Culture. University West, Department of Health Sciences, Section for nursing - graduate level.
    Meanings of suffering from the perspective of nurse leaders2012In: Sailing to the future, 2012Conference paper (Refereed)
    Abstract [en]

    Meanings of suffering from the perspective of nurse leaders. Background: Nursing leadership has previously been investigated by several researchers in terms of general characteristics, for example different leadership styles, quality of leadership and job satisfaction. However, there are few studies focusing on suffering and the meaning of being a nurse leader in a perioperative context. Aim: To capture and interpret the maning of suffering from the perspective of nurse leaders. Method: This study was guided by Gadamer's (1989) hermeneutic philosophy. Ten nurse leaders from operating departments in various hospitals in Sweden participated in interviews with open-ended questions. The understanding was achieved by interpreting the interview text in a circular process, moving from the whole of the text to the individual parts and vice versa, known as the hermeneutic circle. Results: A main theme of suffering emerged as learning and non-learning. Suffering as learning comprised: "struggling to come to terms with being misunderstood", "struggling to patiently wait to be allowed to help", "struggling to manage daily tasks" and "struggling to be worthy of the trust of superiors". Suffering as non-learning comprised; "feeling alone when in charge", "feeling guilty abour not managing daily tasks", "felling mistrusted by superiors", "feeling unfairly criticized", "feeling humiliated due to loss of responsibiblities" and "feeling unable to help". Implications for Nursing Management A greater understanding of nurse leaders' suffering and need of support is necessary.

  • 269.
    Rudolfsson, Gudrun
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Flensner, Gullvi
    University West, Department of Nursing, Health and Culture.
    Suffering and suffering with the other: the perspective of perioperative nurse leaders2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 278-286Article in journal (Refereed)
    Abstract [en]

    Aim To capture and interpret meanings of suffering from the perspective of perioperative nurse leaders.Background There are few studies focusing on suffering and the meaning of being a nurse leader in a perioperative context.Method Hermeneutic interpretation of interviews with nurse leaders.Results A main theme of suffering emerged as learning and non-learning. Suffering as learning comprised struggling to come to terms with being misunderstood, struggling to wait patiently to be allowed to help, struggling to manage daily tasks and struggling to be worthy of the trust of superiors. Suffering as non-learning comprised feeling alone when in charge, feeling guilty about not managing dailytasks, feeling mistrusted by superiors, feeling unfairly criticized,  feeling humiliated owing to loss of responsibilities and feeling unable to help. Conclusion Suffering is good when the mission of caring is mastered and the nurse leader feels recognized as unique and trustable, leading to his or her sense of dignity being preserved. Suffering is evil when the mission of caring is threatened, whenquestioned and not considered a unique and trustable person, leading to loss of dignity.Implications for nursing management Nurse leaders suffering needs to be acknowledged and a caring culture that permeates the entire organization should be developed.

  • 270.
    Rudolfsson, Gudrun
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Nord University, Faculty of Nursing and Health Sciences, Bodø, Norway.
    Karlsson, Veronika
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Interacting with parents in Sweden who hesitate or refrain from vaccinating their child2019In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, article id 1367493519867170Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to explore nurses' experiences of encountering parents who are hesitant about or refrain from vaccinating their child. A qualitative approach was chosen and data collected through individual, semi-structured interviews with 12 nurses. The text was analyzed using thematic analysis. Three themes emerged from the interviews: giving room and time for acknowledging parents' insecurity concerning vaccination, striving to approach the parents' position with tact, and a struggle between feelings of failure and respect for the parents' view. The findings indicate that it was crucial to give time, be tactful when meeting parents, as well as to appear credible and up-to-date. The nurses wanted to be open and respect the parents' views on vaccination but found it difficult and frustrating to be unable to reach out with their message because their quest was to protect the child.

  • 271.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, P.O. Box 235, N-3603, Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, P.O. Box 235, N-3603, Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women's Health, Division of Health Sciences& Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    A qualitative evaluation of healthcare professionals' perceptions of adverse events focusing on communication and teamwork in maternity care2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 3, p. 585-593Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore healthcare professionals' perceptions of adverse events during childbirth with focus on communication and teamwork.

    BACKGROUND: Inadequate communication, a poor teamwork climate and insufficient team training are harmful to women. Reviews of reported adverse events can be used to develop a safety culture based on preparedness for preventing adverse events and strengthening patient safety.

    DESIGN: Action research principles were used to facilitate the implementation and evaluation of this study.

    METHODS: An interprofessional team of healthcare professionals comprising obstetricians, registered midwives and assistant nurses employed at a labour ward agreed to take part. Data were collected from multistage focus group interviews (March 2016 - June 2016) and analysed by means of interpretative thematic analysis.

    FINDINGS: Two analytical themes based on five sub-themes emerged; Promoting interprofessional teamwork and Building capabilities by involving healthcare professionals and elucidating relevant strategies. The findings reveal the importance of facilitating relationships based on trust and respectful communication to ensure a safe environment and provide safe maternity care.

    CONCLUSION: There is a need for formal and informal support for quality interprofessional teamwork. Research on patient safety may reduce adverse events related to miscommunication and poor teamwork. We recommend different forms of communication and teamwork training in interprofessional teams to increase the ability to provide feedback. Accumulated research is required for the evaluation of evidence-based models in the patient safety context. This article is protected by copyright. All rights reserved.

  • 272.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Centre for Women's, Family and Child Health, Department of Nursing and Health Sciences, Faculty of Health Sciences, Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Centre for Women's, Family and Child Health, Department of Nursing and Health Sciences, Faculty of Health Sciences, Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women's Health, Tokyo, Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Qualitative study of women's experiences of safe childbirth in maternity care2018In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 20, no 3, p. 331-337Article in journal (Refereed)
    Abstract [en]

    Few studies have focused on women's childbirth experiences in relation to patient safety. The aim of this study was to explore the meaning of safety as a process phenomenon by outlining women's positive and negative experiences of safety in childbirth. A descriptive explorative design was chosen and 16 interviews were conducted. Qualitative content analysis was used. One main theme emerged: safe childbirth through involvement and guidance, based on four subthemes. The characteristics of women's experiences of safe childbirth included the need to be informed and involved by sharing and receiving trustworthy information. Women's experiences of unsafe childbirth included lack of meaningful and trustworthy information that resulted in feelings of being misled or lulled into a false sense of security. Not being involved evoked feelings of being ignored. In conclusion, this study highlights issues of importance for safe maternity care. The perspectives of childbearing women can contribute to an understanding of how to achieve meaningful improvements to provide safer maternity care.

  • 273.
    Rönnerhag, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Severinsson, Elisabeth
    University of South-Eastern Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, P.O. Box 235, N-3603 Kongsberg, Norway.
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Risk Management: evaluation of healthcare professionals reasoning about and understanding of maternity care2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1098-1278Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate healthcare professionals' explanations of the prerequisites for safe maternity care and understanding of risk management, including the underlying reasons for decision‐making intended to ensure safe care.Background: Risk management focuses on maintaining and promoting safe care by identifying circumstances that place childbearing women at risk of harm, thus reducing risks.Methods: A hermeneutic action research approach was chosen. Through a series of focus group sessions we uncovered healthcare professionals' explanations of risk management.Results: One overriding theme emerged; The consequences of what managers do or fail to do constitute the meaning of taking responsibility for team collaboration to provide safe care. Inadequate support, resources and staff shortages have consequences, such as inability to concentrate on team communication and collaboration, leading to the risk of unsafe care.Conclusion: Communication constitutes a prerequisite for both team collaboration and risk management. Thus, communication is linked to the ability of managers and healthcare professionals to provide safe care.Implications for Nursing Management: In terms of safety management, nurse managers have a significant role in and responsibility for supporting communication training, developing guidelines and providing the prerequisites for interprofessional team reflection.

  • 274. Sahlsten, Monika
    et al.
    Larsson, Inga
    University West, Department of Health Sciences, Section for nursing - graduate level.
    At möte patienten som en ligevaerdig part2019In: Patientindragelse: politik, profession og bruger / [ed] Kim Jörgensen (red.), Samfundslitteratur, 2019, p. 201-223Chapter in book (Other academic)
  • 275.
    Samuelson, Gösta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Blomquist, H K
    Crossner, C G
    Holm, A K
    Grahnén, H
    An epidemiological study of child health and nutrition in a northern Swedish county.: VII. A comparative study of general and dental health, food habits and socio-economic conditions in 4-year-old children.1975In: Acta paediatrica Scandinavica, ISSN 0001-656X, Vol. 64, no 2, p. 241-7Article in journal (Refereed)
    Abstract [en]

    A study of the general and dental health and the food habits of randomly selected 4-year-old Swedish urban children was performed. The results were compared with the findings of an investigation carried out four years earlier in the same area. In comparison with the earlier study no significant differences were found in haemoglobin values, packed red cell volume, microsedimentation rate and anthropometric measurements. The food habits had altered. A reduction in the frequency of between-meal consumption, particularly of sweets and soft drinks, as well as a reduction of the frequency of meat, fish and egg consumption was found. The children had an increased sandwich and milk consumption. The caries frequency was markedly reduced, which might be explained by the decreased between-meal consumption and an increased consumption of fluoride tablets. The food habits and the caries situation were generally influenced by the parents' socio-economic conditions, especially their educational level.

  • 276.
    Samuelson, Gösta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bratteby, L E
    Berggren, K
    Elverby, J E
    Kempe, B
    Dietary iron intake and iron status in adolescents1996In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 85, no 9, p. 1033-8Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the dietary iron intake of 15-year-old adolescents from two different regions of Sweden, in relation to their iron status. The study comprised 185 boys and 209 girls, randomly selected from the official population register. The iron intake was calculated from a 7-day record, and varied between 7 and 35 and 6 and 27 mg per day for boys and girls, respectively. The daily median intakes in boys and girls were 18.7 and 14.2 mg, respectively. S-ferritin, s-iron, and s-transferrin saturation, measured in all the subjects, did not differ significantly between the two regions. However, the mean serum ferritin concentration was significantly higher in the boys (36.4 micrograms l-1) than in the girls (29.4 micrograms l-1) (p < 0.001). Low s-ferritin levels, defined as s-ferritin < 12 micrograms l-1 were found in seven boys (3.7%) and in 29 girls (13.9%). None of the adolescents had iron deficiency anaemia, defined as Hb < 110 gl-1 in combination with s-ferritin < 12 micrograms l-1. Regression and correlation analyses did not show any significant correlation between dietary iron intake and s-ferritin, or between s-ferritin and haemoglobin (Hb), MCH and MCHC. A significant correlation was found, however, between s-ferritin and transferrin saturation (p < 0.005) in both sexes. When the adolescents who still had s-ferritin < 12 micrograms l-1 at a second blood examination were given a 6 weeks trial with oral iron therapy, all of them showed an increase both in s-ferritin and in blood Hb. The 95% confidence intervals of s-ferritin for 15-year-old Swedish boys and girls were defined as 11-90 and 7-85 micrograms l-1, respectively.

  • 277.
    Samuelson, Gösta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Grahnén, H
    Arvidsson, E
    An epidemiological study of child health and nutrition in a northern Swedish county: VI. Relationship between general and oral health, food habits, and socioeconomic conditions1971In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 24, no 11, p. 1361-73Article in journal (Refereed)
  • 278.
    Samuelson, Gösta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjölin, S
    Behandling av anemi: [Drugs and children. 8. Treatment of anemia].1970In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 67, article id Suppl 1:109+Article in journal (Refereed)
  • 279.
    Sandmark, Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Olsson, Linnea
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Specialistsjuksköterskors erfarenheter av att ge stöd till nyblivna föräldrar för att främja amning.2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The nurse at the child health center has the ability to influence and guide the mothers to receive effective breastfeeding information according to the recommendations established by the WHO, which is to promote breastfeeding for six months. Despite the recommendations, many mothers stop breastfeeding earlier. All family conditions are different and the person-centered care is of paramount importance in order for the nurse at the child health center to support breastfeeding mothers.

    Aim: The purpose of the study was to highlight the experiences of nurses in supporting breastfeeding mothers to maintain breastfeeding.

    Method: A qualitative study involving eleven nurses was conducted. The nurses got two questions by mail about situations when the breastfeeding support went well and not work as desired. The texts from the nurses were analyzed by qualitative content analysis.

    Results: The results are presented in three categories: Knowledge and information, the nurse's strategies and participation from the nurse and the. The categories led to a theme. Good self-esteem and knowledge of the mother create confidence that promotes breastfeeding.

    Conclusion: Important aspects of how the nurse at the child health center can provide breastfeeding support and maintain breastfeeding has been identified. Confidence is by the nurses one of the most important factors for mothers to breastfeed.

  • 280.
    Schoultz, Katarina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Svedberg, Maja
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors erfarenheter av hälsofrämjande och förebyggande arbete för barn med övervikt.2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight is a common health problem among school children in Sweden and can provide health consequences. The school nurse has a significant role in work with overweight among children and will provide advice on diet and physical activity.Aim: The purpose of this study was to highlight the school nurse's experience of health promotion and prevention for children with overweight. Method: To answer the purpose of the study a qualitative approach was used. Semi structured interviews were used for data collection and a qualitative content analysis with inductive approach was conducted analysing the text. Results: The result precipitated into four categories and one overall theme. The category Overweight identified by estimation and opinion showed the school nurses' experience of identifying overweight in children. The category To identify the child's circumstances before overweight is discussed showed on school nurses experiences of conversations with children about overweight. The category To create awareness among parents supporting cooperation demonstrated on the school nurses' experiences of encounter resistance and motivate cooperation. The category To support the good habits and custom, long-term work showed how school nurses created motivation and good habits of children and parents. The overall theme A work that must be done with tact displayed at the school nurse's feeling that overweight was a sensitive risk of hurting children and parents. Conclusion: Work with overweight in children can be a challenge because it is a sensitive topic associated with much guilt and shame. School nurses talking with the child about overweight, depending on the child's age and maturity. When the nurses inform parents about child overweight, they meet resistance. The school nurse works with overweight by motivating the change of the healthy habits

  • 281.
    Severinsson, Elisabeth
    et al.
    Buskerud & Vestfold University College, Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway..
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine, Tokyo, Japan..
    Rönnerhag, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Buskerud & Vestfold University College, Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway..
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Patient Safety, Adverse Healthcare Events and Near-Misses in Obstetric Care: A Systematic Literature Review2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 12, p. 1110-1122Article in journal (Refereed)
    Abstract [en]

    Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals' perspectives on ethical conflicts, attributing blame and responsibility, and patients' perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential.

  • 282.
    Severinsson, Elisabeth
    et al.
    University College of Southeast-Norway, Centre for Women’s, Family & Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Haruna, Megumi
    The University of Tokyo, Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine, Tokyo, Japan..
    Rönnerhag, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level. University College of Southeast-Norway, Centre for Women’s, Family & Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Holm, Anne Lise
    Western Norway University of Applied Sciences, Department of Health Sciences, Haugesund, Norway.
    Hansen, Britt S,
    University College of Southeast-Norway, Centre for Women’s, Family & Child Health, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Kongsberg, Norway..
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Evidence of Linkages between Patient Safety and Person-Centred Care in the Maternity and Obstetric Context: An Integrative Review2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 3, p. 378-398Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate the current state of knowledge pertaining to patient safety and its link to person-centred care. The international relevance of patient safety has expanded, as have the models of person-centred care. Inspired by this new trend, we collated and summarized the literature for evidence of the two topics. The study was guided by Russell, Whittemore and Knafl's integrative review framework. An electronic database search was conducted for relevant articles from 2005 to 2016. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The structure and process of the evaluation of the evidence are described and the findings interpreted by means of a thematic synthesis. One theme emerged: trustful, safe communication in the relationship between the patient, family members and healthcare professionals and two domains; safety culture and multidisciplinary capacity building. The dominant dimension in the safety culture domain is respectful communication, which implies sharing experiences that lead to a sense of control during labour and birth and is related to the women's feeling of personal capacity. The dominant dimensions in the multidisciplinary capacity building domain are collaborative teamwork, coordination and risk management, knowledge sharing and patient-centred communication. In conclusion, to enhance patient safety, it is necessary to develop patient-focused, evidence-based skills and guidelines as well as a supportive organization. Due to their interaction with patients, midwives' communication competence on the part of midwives is essential for supporting the birth and fulfilling the women's needs and expectations.

  • 283.
    Sif Reynisdottir, Rannveig
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Henningsson, Carin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors erfarenheter av att möta föräldrar till barn med övervikt2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight among children is a growing problem that can lead to overweight in the adult life and may result in severe consequences like developing diabetes and/or heart diseases. School nurses have a great opportunity to identify children and parents that are in need of guidance regarding a healthier lifestyle. School nurses’ work includes promoting a healthy lifestyle to children. Children cannot take responsibility over their lifestyle choices and therefore it is of great importance to involve their parents.

    Aim: This study aims to describe school nurses’ experiences of encounters with parents of children with overweight.

    Methods: This study was conducted using a qualitative, descriptive method. Eight school nurses were interviewed with open questions and the transcribed text was subjected to qualitative content analysis.

    Results: The result ended up in the theme ‘Daring to raise the topic’. Three categories; ‘being stucked’, ‘a sensitive topic’ and ‘master ones work’ and seven subcategories emerged. It takes courage to raise the difficult topic, because the parents could react with denial or become defensive which is difficult for the nurses to handle. The school nurses also described encounters with parents that were motivated and wanted help with making lifestyle changes.

    Conclusion: It was considered being of great importance that the school nurse had a professional approach, which means meeting the parents where they were both regarding their knowledge and emotional stage.

  • 284.
    Sjöström, Maria
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kvalitetsregister för  beteendemässiga och psykiska symtom vid demenssjukdom (Bpsd): Ett verktyg för personcentrerad vård2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bakground: Most people with dementia disease (90%) does at sometime have Bpsdsymptoms. The symptoms creates suffering for the person, their kin and health proffessionals find the symptoms hard to handle. A new quality registry (Bpsd-registry), which is also a tool, have been developed to help relieve the symptoms. Aim: To describe nursing assistants experience of using the Bpsd- registry in the care of people with dementia disease. Method: Qualitative interview study. Ten semi-structured interviews were excuted with assistant nurses who worked in care of people with dementia disease and who have been using the BPSD-registry in nursing care for at least one year. Results: By using the Bpsdregistry in nursing does the nurse assistants gained increased knowledge of how symptoms and phsyical illness, surrounding environment and staff response effect the person with dementia disease. By knowing the person and having time to sit and discuss the symptoms the nurse assistants often found care measures. The nurse assistants experienced that the Bpsd-registry had led to increased awareness and less Bpsd-symptoms. Conclusion: By using the Bpsd-registry and the persons life stories care can be concidered personcentrered. The nurse assistants needed to get time to discuss together to find care measures. Helping the person with dementia disease made the work meaningful. Using the Bpsd-registry the group resembled a Community of practice. The Nurse contributed with tuturial, knowledge and leadership to safeguard the nursing care.

  • 285.
    Skyvell Nilsson, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Törner, Marianne
    University of Gothenburg, Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Pousette, Anders
    University of Gothenburg, Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
    Professional culture, information security and healthcare quality: an interview study of physicians' and nurses' perspectives on value conflicts in the use of electronic medical records2018In: Safety in health, E-ISSN 2056-5917, Vol. 4, article id 11Article in journal (Refereed)
    Abstract [en]

    Digital healthcare information systems impose new demands on healthcare professionals, and information security rules may induce stressful value conflicts, which the professional culture may help professionals to handle.

    The aim of the study was to elucidate physicians' and registered nurses' shared professional assumptions and values, grounded in their professional cultures, and how these assumptions and values explain and guide healthcare professionals' handling of value conflicts involving rules regulating the use of electronic medical records.

    Methods Healthcare professionals in five organisations in two Swedish healthcare regions were interviewed.

    Results The study identified ensuring the patients' physical health and well-being as the overarching value and a shared basic assumption among physicians and registered nurses. A range of essential professional and organisational values were identified to help attain this goal. In value conflicts, different values were weighted in relation to each other and to the electronic information security rules.

    Conclusions The results can be used to guide effective design and implementation of electronic medical records and information security regulations in healthcare.

  • 286.
    Sluman, Maayke A.
    et al.
    University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands; Department of Cardiology, Jeroen Bosch Hospital, ‘s Hertogenbosch, The Netherlands.
    Apers, Silke
    University of Leuven, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; University of Leuven, Leuven, Department of Public Health and Primary Care, KU Leuven, Belgium.
    Sluiter, Judith K.
    University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands.
    Nieuwenhuijsen, Karen
    University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands.
    Moons, Philip
    University of Leuven, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; University of Gothenburg, Center for Person‐Centered Care (GPCC), Gothenburg, Sweden .
    Luyckx, Koen
    University of Leuven, School Psychology and Development in Context, KU Leuven, Leuven, Belgium ; University of the Free State, Department of Psychology, UNIBS, Bloemfontein, South Africa.
    Kovacs, Adrienne H.
    University Health Network, Department of Psychology, Toronto, Canada; Oregon Health & Science University, The Knight Cardiovascular Institute, Portland, Oregon .
    Thomet, Corina
    University of Bern, Center for Congenital Heart Disease, Inselspital, Bern University Hospital, Bern, Switzerland.
    Budts, Werner
    Congenital and Structural Cardiology, Department of Cardiovascular Sciences, University Hospitals of Leuven, KU Leuven, Leuven, Belgium.
    Enomoto, Junko
    Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan.
    Yang, Hsiao-Ling
    National Taiwan University, School of Nursing, College of Medicine, Taipei, Taiwan.
    Jackson, Jamie L.
    Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio.
    Khairy, Paul
    University of Montreal, Montreal Heart Institute, Montreal, Canada.
    Cook, Stephen C.
    Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, Michigan.
    Subramanyan, Raghavan
    Frontier Lifeline Hospital, Dr. K. M. Cherian Heart Foundation, Chennai, India.
    Alday, Luis
    Division of Cardiology, Hospital de Niños, Córdoba, Argentina.
    Eriksen, Katrine
    9Department of Cardiology, Oslo University Hospital, Oslo, Norway.
    Dellborg, Mikael
    Gothenburg University, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden; Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Center for Person‐Centered Care (GPCC), Gothenburg, Sweden.
    Mattsson, Eva
    Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
    Mackie, Andrew S.
    University of Alberta, Department of Pediatric Cardiology, Edmonton, Canada.
    Menahem, Samuel
    Monash Medical Center, Melbourne, Australia.
    Caruana, Maryanne
    Department of Cardiology, Mater Dei Hospital, Msida, Malta.
    Gosney, Kathy
    Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
    Soufi, Alexandra
    Hospital Louis Pradel, Lyon, France.
    Fernandes, Susan M.
    Adult Congenital Heart Disease Program at Stanford, Lucile Packard Children’s Hospital and Stanford Health Care, Palo Alto, California.
    White, Kamila S.
    Washington University, Adult Congenital Heart Disease Center, ; University of Missouri, Barnes Jewish Heart & Vascular Center, Saint Louis, Missour.
    Callus, Edward
    Clinical Psychology Service, IRCCS Policlinico San Donato Hospital, Milan, Italy.
    Kutty, Shelby
    Adult Congenital Heart Disease Center, University of Nebraska Medical Center/Children’s Hospital & Medical Center, Omaha, Nebraska.
    Bouma, Berto J.
    University of Amsterdam, Amsterdam UMC, Department of Cardiology, Amsterdam, The Netherlands.
    Mulder, Barbara J.M.
    University of Amsterdam, Amsterdam UMC, Department of Cardiology, Amsterdam, The Netherlands.
    Education as important predictor for successful employment in adults with congenital heart disease worldwide2019In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 14, no 3, p. 362-371Article in journal (Refereed)
    Abstract [en]

    Background

    Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an important determinant for quality of life, we assessed this in a large international adult CHD cohort.

    Methods

    Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross-sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models.

    Results

    Median age was 32 years (IQR 25-42) and 94% of patients had at least a high school degree. Overall employment rate was 69%, but varied substantially among countries. Higher education (OR 1.99-3.69) and having a partner (OR 1.72) were associated with more employment; female sex (OR 0.66, worse NYHA functional class (OR 0.67-0.13), and a history of congestive heart failure (OR 0.74) were associated with less employment. Limitations at work were reported in 34% and were associated with female sex (OR 1.36), increasing age (OR 1.03 per year), more severe CHD (OR 1.31-2.10), and a history of congestive heart failure (OR 1.57) or mental disorders (OR 2.26). Only a university degree was associated with fewer limitations at work (OR 0.62).

    Conclusions

    There are genuine differences in the impact of CHD on employment status in different countries. Although the majority of adult CHD patients are employed, limitations at work are common. Education appears to be the main predictor for successful employment and should therefore be encouraged in patients with CHD.

  • 287.
    Solbakken, Rita
    et al.
    Nord University, Faculty of Nursing and Health Sciences, Bodø, Norway.
    Bergdahl, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rudolfsson, Gudrun
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bondas, Terese
    University West, Department of Health Sciences, Section for nursing - graduate level.
    International Nursing: Caring in Nursing Leadership : A Meta-ethnography From the Nurse Leader's Perspective.2018In: Nursing Administration Quarterly, ISSN 0363-9568, E-ISSN 1550-5103, Vol. 42, no 4, p. E1-E19Article in journal (Refereed)
    Abstract [en]

    To explore and derive new conceptual understanding of nurse leaders' experiences and perceptions of caring in nursing.

    RESEARCH QUESTION: What is caring in nursing leadership from the nurse leaders' perspectives? There is a paucity of theoretical studies of caring in nursing leadership. Noblit and Hares interpretative meta-ethnography was chosen because of its interpretative potential for theory development. Caring in nursing leadership is a conscious movement between different "rooms" in the leader's "house" of leadership. This emerged as the metaphor that illustrates the core of caring in nursing leadership, presented in a tentative model. There are 5 relation-based rooms: The "patient room," where nurse leaders try to avoid patient suffering through their clinical presence; the "staff room," where nurse leaders trust and respect each other and facilitate dialogue; the "superior's room," where nurse leaders confirm peer relationships; the "secret room," where the leaders' strength to hang on and persist is nurtured; and the "organizational room," where limited resources are continuously being balanced. Caring in nursing leadership means nurturing and growing relationships to safeguard the best nursing care. This presupposes that leaders possess a consciousness of the different "rooms." If rooms are not given equal attention, movement stops, symbolizing that caring in leadership stops as well. One room cannot be given so much attention that others are neglected. Leaders need solid competence in nursing leadership to balance multiple demands in organizations; otherwise, their perceptiveness and the priority of "ministering to the patients" can be blurred.

  • 288.
    Sparud-Lundin, Carina
    et al.
    University of Gothenburg, Institute of Health and Care Sciences, The Sahlgrenska Academy, Box 457, SE- 405 30, Gothenburg, Sweden.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Box 457, SE- 405 30, Gothenburg, Sweden..
    Moons, Philip
    University of Gothenburg, Institute of Health and Care Sciences, The Sahlgrenska Academy, Box 457, SE- 405 30, Gothenburg, Sweden..
    Bratt, Ewa-Lena
    University of Gothenburg, Institute of Health and Care Sciences, The Sahlgrenska Academy, Box 457, SE- 405 30, Gothenburg, Sweden..
    Health care providers' attitudes towards transfer and transition in young persons with long term illness: a web-based survey2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 260Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Transition programs in health care for young persons with special health care needs aim to maximize lifelong functioning. Exploring health care professionals' perspective may increase the possibility of successful implementation of transition programs. The aim was to survey health care professionals' attitudes towards components and barriers on transition and transfer in young people with long-term medical conditions with special health care needs.

    METHODS: A cross-sectional web-based survey was sent by e-mail to 529 physicians and nurses in Swedish pediatric and adult outpatient clinics. Response rate was 38% (n = 201). The survey consisted of 59 questions regarding different aspects of components and barriers on transition and transfer. Descriptive statistics were computed to summarize demographic data and categorized responses. The Chi square test was used for comparison between proportions of categories.

    RESULTS: Most respondents agreed on the destinations of care for adolescents within their specialty. Age and psychosocial aspects such as maturity and family situations were considered the most important initiators for transfer. Joint meeting with the patient (82%); presence of a transition coordinator (76%) and a written individualized transfer plan (55%) were reported as important transition components. Pediatric care professionals found the absence of a transition coordinator to be more of a transition barrier than adult care professionals (p = 0.018) and also a more important transfer component (p = 0.017). Other barriers were lack of funding (45%) and limited clinical space (19%). Transition programs were more common in university hospitals than in regional hospitals (12% vs 2%, p = <0.001) as well as having a transition coordinator (12% vs 3%, p = 0.004).

    CONCLUSION: The findings highlight a willingness to work on new transition strategies and provide direction for improvement, taking local transition components as well as potential barriers into consideration when implementing future transition programs. Some differences in attitudes towards transitional care remain among pediatric and adult care professionals.

  • 289.
    Staf, Amanda
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tegelström, Emmy
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Mammors upplevelser av professionellt stöd från BVC efter tidigare erfarenhet av intrauterin fosterdöd2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year, several families lose their babies in intrauterine fetal death, also called stillbirth. When the parents choose to get a new baby and are enrolled at the child health centre (CHC), it is important to study how mothers experience the professional support from the health care nurse, after previous experience of a stillbirth. Additional knowledge is needed and is expected to be obtained in this study.

    Aim: The aim of the study is to study the mother's experiences of professional support from the health care nurse at the CHC, when the mothers have giving birth to a baby after having previously lost a baby before birth.

    Method: A qualitative inductive interview study has been conducted. 16 mothers were interviewed by telephone. The analysis of the data was done according to a qualitative content analysis.

    Results: In the study's result, it has emerged that the interviewed mothers experience both good and bad support from the health care nurse at the CHC. A contact before the child's birth was desired to create a safe relationship with the specialist nurse, since there was a lot of concern for previous experience of intrauterine fetal death care and the new child's health. Further our results showed that mothers experienced that the child health nurse did not talk about the dead baby but only existed for the new baby. Some mothers found that the CHC was a support for them.

    Conclusion: What was most important for the mothers was to be able to talk about the loss of their babies, concern for the health of their new babies and about their own health. The result can offer the health care nurse at the CHC and the midwife's at the maternity clinic knowledge of the importance of good treatment and openness when meeting mothers who previously experienced intrauterine fetal death.

  • 290.
    Stedth, Theresa
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Åsberg, Carina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    När svaren uteblir: Sjuksköterskans erfarenhet av att bedöma smärta hos en patient med demenssjukdom2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: As in all elderly individuals, elderly with dementia suffer from pain. Nurses meet a considerable challenge in assessing and measure pain in patients with dementia in order to optimize pain relief. The challenge lies primarily in the patients decreasing ability to communicate needs and experiences; hence do nurses meet difficulties in identifying pain in patients with dementia.

    Aim: The aim is to illustrate nurses' experience in pain assessment and pain measurement in patients with dementia. 

    Method: A qualitative inductive approach was used and ten registered nurses working in either municipal or county settings were interviewed. Qualitative content was used for analysis.  

    Results: The result was based on ten interviews with registered nurses. The results show that assessing pain in patients with dementia is a challenging task. The challenges are primary in the patient´s inability to verbally communicate pain. The result shows varying skills in assessing pain.

    Conclusion: In order to optimize the assessment and measurement of pain in patients with dementia organizational preconditions is required. Implications are made that exchange of knowledge between experienced nurses are also made.  

  • 291.
    Stenborg, Nielsen, Pernilla
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskans/Psykiatrisjuksköterskans upplevelser av att arbeta inom psykiatrisk vård2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background; In today's social debate, much is written and spoken of how poor psychiatric care works, care places are closed and there are difficulties in recruiting nurses / psychiatric nurses. Psychiatric care has problems with its image, and this is based on the media's angle that the people who work there themselves have some kind of psychiatric diagnosis and are ineffective, neurotic and controlling and have no limits to their patients. Media and large parts of society in general have a driving role that contributes to the psychiatric care and psychiatric care patients being stigmatized and the nurse working in psychiatric care is stigmatized through association. This has a negative effect and causes nursing students and registered nurses not to choose psychiatric care. Aim; of the study was to describe how nurses/psychiatric nurses' experiences of working at a psychiatric ward. Method; was a qualitative, descriptive study, based on eight interviews with nurses/psychiatric nurses working in a psychiatric ward. The interviews were analyzed using qualitative content analysis. Results Made up in three categories as "Stigma by association", "Experienced deficiencies" and "Work joy. The nine subcategories were "Stamped", "Stagnation", "Competence and recruitment problems", "Leadership", "Poor working environmen", "Mentor's role", "A rewarding and fun work", "Developing", "Good patient relationship". Conclusion; The informant think they have a educational and fun job but they are sad and frustrated that they are experiencing shortcomings and do not have the correct conditions for doing the best work. Stigma by association is obtained through the work.

  • 292.
    Stolt, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjöholm, Sara
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Barnhälsovårdssjuksköterskors erfarenheter av hembesök när barnet är 8 månader: En intervjustudie.2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Home visits to all new parents are fundamental in Swedish child health care. According to the new National Child Health Program, all families must be offered two homevisits from the child health care service, the first when the child is newborn and the other when the child is eight months. Child health nurses (CHN) has a central role in child health care, which through a national program offers initiatives to all children and their parents but also directed efforts to children with special needs in order to promote children's health, well-being and development. Few Swedish studies are available that describe the CHN´s experience of home visits when the child is 8 months old.

    Aim: To highlight child health nurses experience of home visits when the child is 8 months old.

    Method: A qualitative descriptive content analysis with inductive approach has been used as an analysis method and nine CHN´s within the Province of Västra Götaland (Sweden) have been interviewed.

    Result: The result showed that the child health nurses were positive to be in the child's and family's home environment. In the home environment, information, advice and support could be given more clearly and directly connected to the child and the family's environment, this more easily than during the meeting at the Child Health Centre. The home visit gave the CHN´s the opportunity to create an overall picture of the family and the relationship with the family was deeper.

    Conclusion: The Child Health Nurses' of this study describe the home visit when the child is 8 months as valuable and that it provided added value to the CHN´s health promotion work. Also, a better understanding of the family was created when the CHN´s saw the family in their home environment. Obstacles to performing home visits were also portrayed by the CHN´s as lack of time and practical obstacles.

  • 293.
    Styrud, Julia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Diabetessjuksköterskans upplevelse av omvårdnaden för personer med typ 2-diabetes: inom svensk primärvård2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2-diabetes is a growing public health problem that cause suffering for people living with the disease and it is expensive for the Swedish healthcare system. The diabetes specialist nurse is often the person who stands for the continuity in the diabetes care and therefore has a big inpact on the outcome. The aim of this study was to describe the diabetes nurse’s experience of nursing care for adults with type 2-diabetes in primary care. The used method is qualitative. Eight diabetes nurses were interviewed with semi structured interviews and the content was analysed with qualitative content analysis. The result showed obstacles, dilemmas and possibilities experienced in diabetes care. Conclusion: There is a winning in knowing about obstacles, dilemmas and possibilities that can be experienced by diabetes specialist nurses in order to maintain a good diabetes care. The experienced obstacles and dilemmas needs to be continuously studied in order to keep evolving the diabetes care.

  • 294.
    Suhonen, Riitta
    et al.
    University of Turku, Department of Nursing Science, University of Turku, Turku, Finland.
    Charalambous, A.
    Cyprus University of Technology,Department of Nursing Studies, Limassol, Cyprus..
    Berg, Agneta
    University West, Department of Health Sciences, Section for nursing - graduate level. Kristianstad University, Kristianstad, Sweden.
    Katajisto, J.
    University of Turku, Department of Mathematics and Statistics, Turku, Finland.
    Lemonidou, C.
    National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
    Patiraki, E.
    National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
    Sjövall, K.
    Lund University, Department of Health Sciences and Skåne University Hospital, Lund, Sweden.
    Stolt, M.
    University of Turku, Department of Nursing Science, University of Turku, Turku, Finland.
    Radwin, L. E.
    Center for Healthcare Organization & Implementation Research (CHOIR), Veteran Administration Boston Healthcare System, Boston, MA, USA.
    Hospitalised cancer patients' perceptions of individualised nursing care in four European countries2018In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 27, no 1, article id e12525Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe hospitalised cancer patients' perceptions of individualised care in four European countries and compare these perceptions using the patients' socio-demographic characteristics and the Individualized Care Scale. The patients' socio-demographic characteristics used were: education, age, gender, type of hospital admission, previous hospitalisation and hospital length of stay. The Individualized Care Scale has two parts (1) nurses' support of individuality and (2) patients' receipt of individuality. Data (n = 599) were collected in Cyprus (n = 150), Finland (n = 158), Greece (n = 150) and Sweden (n = 141). Multivariate analysis of variance models were constructed and differences in perceptions of individualised care were analysed using the patients' socio-demographic characteristics as covariates. The level of support for individuality and receipt of individualised care was reported as moderate and good respectively. Generally, the highest assessments were made by the Swedish respondents and the lowest by those in Greece. This study revealed some between-country differences in patients' perceptions of care individualisation. These differences, for example, conceptual, educational, based in clinical practice or in the health organisation, require further research. Enquiry into the individualised care perceptions of health care providers and the families of cancer patients would also be useful.

  • 295.
    Sundqvist, Anna-Karin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Barns och ungdomars delaktighet inom barn och ungdomspsykiatrisk vård: Sjuksköterskors erfarenheter2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The new Swedish patient law advocates patient's participation in public healthcare. Swedish surveys indicate that patients in child and adolescent mental health care experience lack of opportunities to participate and to be involved in decision-making about their care. This might indicate shortcomings in nursing care in that regard. Person-centred care manifests lifeworld perspective and patient participation and is one of the core competences in nursing.

    Aim: To explore nurses experiences of children and adolescent's participation in psychiatric care.

    Method: An interview based descriptive qualitative study with qualitative content analysis.

    Results: Nurses experience that children and adolescents´ participation in their care is crucial for caring results. Nurses had experiences of using a variety of nursing interventions to motivate and facilitate involvement of children and adolescents in their care although it could often be a difficult task. Three main categories and seven subcategories emerged from the result.

    Conclusion: Participation by children and youth in their care had several positive outcomes in terms of caring results and would often demand nursing interventions on many levels and a variety of methods to achieve. The use of person-centred nursing interventions was beneficial to achieve participation of children and youth.

  • 296.
    Söderberg, Jacob
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Andersson, Jonas
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nyanställda sjuksköterskors upplevelser av hot och våld i psykiatrisk slutenvård2019Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Nurses in psychiatric care have a particularly high risk of being exposed to threats and violence. It is difficult to get an accurate picture of how large the incidence of threats and violence is, as there is probably a large number that goes unreported. One reason may be that threats and violence can be considered part of the job. Workplace-related threats and violence can lead to mental and physical symptoms. Young and inexperienced staff have shown to have a higher risk of being exposed to threats and violence than older and more experienced staff.

    Aim To describe newly employed nurse's experiences of threats and violence in psychiatric inpatient care.

    Method A qualitative, descriptive method together with a qualitative content analysis has been used in this study. Ten newly employed nurses from all over Sweden and from different wards were interviewed.

    Results The existence of threats and violence differed among the nurses but everyone has experienced it in some way or another at work. As a new employee, one could feel insecure and afraid of threatening situations. The nurse's recovery process was affected because of trouble letting go of certain situations from work. The support from colleagues and the head of the ward was very helpful. Peer group supervision was considered a good tool and supportive in instances where it was available. The participants asked for more education mainly in the form of how to approach patients.

    Conclusion Newly employed nurses in psychiatric inpatient care need education and proper support so they can feel secure at work. This is a prerequisite to be able to deliver good patient care.

  • 297.
    Tengelin, Ellinor
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Bülow, Pia H
    University of the Free State, Department of Social Work, Bloemfontein, South Africa.Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Norm-Critical Potential in Undergraduate Nursing Education Curricula: A Document Analysis2019In: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 42, no 2, p. E24-E37Article in journal (Refereed)
    Abstract [en]

    The documents and literature that regulate nursing education are based on certain values and knowledge, and the underlying power in the curriculum raises the question of how health care professionals are molded during the course of their education. Norm criticism is a concept with its roots in critical pedagogy and gender and queer studies, emphasizing the origins as well as the consequences of marginalization, power, and knowledge of what is generally accepted as "normal" and "true." Norm criticism is used in this article to analyze the documents and literature underlying a nursing program in Sweden, which are shown to include a sometimes politically correct rhetoric, but one lacking a firm basis in social justice values.

  • 298.
    Tengelin, Ellinor
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Cliffordson, Christina
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Constructing the Norm-critical awareness scale: A scale for use in educational contexts promoting awareness of prejudice, discrimination, and marginalisation2019In: Equality, Diversity and Inclusion, ISSN 2040-7149, E-ISSN 2040-7157Article in journal (Refereed)
    Abstract [en]

    Purpose: Healthcare professionals' conscious or unconscious norms, values and attitudes have been identified as partial explanations of healthcare inequity. Norm criticism is an approach that questions what is generally accepted as "normal" in society, and it enables professionals to identify norms that might cause prejudice, discrimination and marginalisation. In order to assess norm-critical awareness, a measurement scale is needed. The purpose of this paper is to develop a scale for measuring norm-critical awareness. Design/methodology/approach: The scale-development process comprised a qualitative item-generating phase and a statistical reduction phase. The item pool was generated from key literature on norm criticism and was revised according to an expert panel, pilot studies and one "think aloud" session. To investigate the dimensionality and to reduce the number of items of the scale, confirmatory factor analysis was performed. Findings: The item-generation phase resulted in a 46-item scale comprising five theoretically derived dimensions revolving around function, consequences, identity, resistance and learning related to norms. The item-reduction phase resulted in an instrument consisting of five dimensions and 20 items. The analyses indicated that a summary score on the scale could be used to reflect the broad dimension of norm-critical awareness. Originality/value: The Norm-critical awareness scale comprises five theoretically derived dimensions and can be used as a summary score to indicate the level of norm-critical awareness in educational contexts. This knowledge is valuable for identifying areas in greater need of attention. © 2019, Emerald Publishing Limited.

  • 299.
    Tengelin, Ellinor
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Discourses with potential to disrupt traditional nursing education: Nursing teachers’ talk about norm-critical competence2017In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 24, no 1, article id UNSP e12166Article in journal (Refereed)
    Abstract [en]

    This paper describes the discourses underlying nursing teachers’ talk about their own norm-critical competence. Norm criticism is an approach that promotes awareness and criticism of the norms and power structures that exert an excluding effect in society in general and in the healthcare encounter in particular. Given the unequal relationships that can exist in healthcare, for example relationships shaped by racism, sexism and classism, a norm-critical approach to nursing education would help illuminate these matters. The studied empirical material consisted of focus group interviews. Nursing teachers discussed their norm-critical competence based on the university course "Norm-Aware Caring" in which they had recently participated. Through a critical discourse analysis, three discourses were identified in their talk, all of which had the potential to disrupt traditional, normative nursing education. However, in all three discourses there was an underlying discourse of normality, clearly positioning the teachers as exemplifying the "normal." The binary constructed between normality and otherness contradicts a basic tenet of the norm-critical approach and may hamper the development of genuine norm-critical competence in nursing education. © 2016 John Wiley & Sons Ltd.

  • 300.
    Tengelin, Ellinor
    et al.
    Högskolan i Jönköping, Hälsohögskolan.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Utveckling av ett instrument som kan mäta normkritisk medvetenhet2017Conference paper (Refereed)
    Abstract [en]

    Bakgrund. Normkritisk kompetens är en förutsättning för att kunna ifrågasätta rådande, begränsande normer som skapar ojämlikhet. Att kunna mäta normkritisk medvetenhet är nödvändigt av flera skäl, exempelvis för att kunna identifiera kunskapsbehov eller utvärdera insatser. Idag finns dock inget vetenskapligt baserat instrument för detta ändamål. Syfte. Studien syftar till att utveckla ett instrument som kan mäta graden av normkritisk medvetenhet. Metod. Utvecklingen av instrumentet omfattade två faser: (1) generering och test av items samt (2) reducering av items genom konfirmatorisk faktoranalys. I den första fasen formulerades och testades validiteten i items genom expertbedömningar, pilotstudier och samtal med studenter, vilket resulterade i 46 items. I nästa fas analyserades dessa med konfirmatorisk faktoranalys i syfte att reducera instrumentet till 20-25 items för att få ett mer lätthanterligt instrument. Resultat. Faktoranalysen resulterade i 20 items och fyra dimensioner. Dimensionerna var Normers konsekvenser, Att lära sig normer, Motstånd mot normer och Normers funktion. Det visade sig också att de fyra dimensionerna tillsammans mäter en bred dimension (normkritisk medvetenhet). Diskussion. Utvecklingsprocessen reser frågor kring styrkor och svagheter med att operationalisera och kvantifiera kvalitativa fenomen så som medvetenhet om normkritik. Det utvecklade instrumentet kan användas för att mäta normkritisk medvetenhet i olika sammanhang, exempelvis effekten av normkritiska utbildningssatsningar inom högre utbildning.  

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