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  • 251.
    Filtness, Ashleigh J
    et al.
    Queensland University of Technology.
    Anund, Anna
    Swedish National Road and Transport Research Institute, Traffic and road users, Human-vehicle-transport system interaction.
    Fors, Carina
    Swedish National Road and Transport Research Institute, Traffic and road users, Human-vehicle-transport system interaction.
    Ahlström, Christer
    Swedish National Road and Transport Research Institute, Traffic and road users, Human-vehicle-transport system interaction.
    Åkerstedt, Torbjörn
    Stockholms Universitet.
    Kecklund, Göran
    Stockholms Universitet.
    Sleep-related eye symptoms and their potential for identifying driver sleepiness2014In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 23, no 5, p. 568-75Article in journal (Refereed)
    Abstract [en]

    The majority of individuals appear to have insight into their own sleepiness, but there is some evidence that this does not hold true for all, for example treated patients with obstructive sleep apnea. Identification of sleep-related symptoms may help drivers determine their sleepiness, eye symptoms in particular show promise. Sixteen participants completed four motorway drives on two separate occasions. Drives were completed during daytime and night-time in both a driving simulator and on the real road.

    Ten eye symptoms were rated at the end of each drive, and compared with driving performance and subjective and objective sleep metrics recorded during driving. 'Eye strain', 'difficulty focusing', 'heavy eyelids' and 'difficulty keeping the eyes open' were identified as the four key sleep-related eye symptoms. Drives resulting in these eye symptoms were more likely to have high subjective sleepiness and more line crossings than drives where similar eye discomfort was not reported. Furthermore, drivers having unintentional line crossings were likely to have 'heavy eyelids' and 'difficulty keeping the eyes open'. Results suggest that drivers struggling to identify sleepiness could be assisted with the advice 'stop driving if you feel sleepy and/or have heavy eyelids or difficulty keeping your eyes open'.

  • 252.
    Flink, Maria
    et al.
    Karolinska Institutet, Sweden.
    Tessma, Mesfin
    Karolinska University Hospital, Sweden.
    Cvancarova Småstuen, Milada
    Oslo and Akershus University College of Applied Sciences, Norway.
    Lindblad, Marléne
    Ersta Sköndal Bräcke University College, Sweden.
    Coleman, Eric A
    University of Colorado Denver Anschutz Medical Campus, USA.
    Ekstedt, Mirjam
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet, Sweden.
    Measuring care transitions in Sweden: validation of the care transitions measure2018In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 30, no 4, p. 291-297Article in journal (Refereed)
    Abstract [en]

    Objective: To translate and assess the validity and reliability of the original American Care Transitions Measure, both the 15-item and the shortened 3-item versions, in a sample of people in transition from hospital to home within Sweden.

    Design: Translation of survey items, evaluation of psychometric properties.

    Setting: Ten surgical and medical wards at five hospitals in Sweden.

    Participants: Patients discharged from surgical and medical wards.

    Main outcome measure: Psychometric properties of the Swedish versions of the 15-item (CTM-15) and the 3-item (CTM-3) Care Transition Measure.

    Results: We compared the fit of nine models among a sample of 194 Swedish patients. Cronbach's alpha was 0.946 for CTM-15 and 0.74 for CTM-3. The model indices for CTM-15 and CTM-3 were strongly indicative of inferior goodness-of-fit between the hypothesized one-factor model and the sample data. A multidimensional three-factor model revealed a better fit compared with CTM-15 and CTM-3 one factor models. The one-factor solution, representing 4 items (CTM-4), showed an acceptable fit of the data, and was far superior to the one-factor CTM-15 and CTM-3 and the three-factor multidimensional models. The Cronbach's alpha for CTM-4 was 0.85.

    Conclusions: CTM-15 with multidimensional three-factor model was a better model than both CTM-15 and CTM-3 one-factor models. CTM-4 is a valid and reliable measure of care transfer among patients in medical and surgical wards in Sweden. It seems the Swedish CTM is best represented by the short Swedish version (CTM-4) unidimensional construct.

  • 253.
    Fluur, Christina
    et al.
    Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Strömberg, Anna
    Division of Nursing Sciences, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Thylen, Ingela
    Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
    Patients' experiences of the implantable cardioverter defibrillator (ICD); with a focus on battery replacement and end-of-life issues2013In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 42, no 3, p. 202-207Article in journal (Refereed)
    Abstract [en]

    Background: ICD deactivation at end-of-life is technically uncomplicated. However, it may present a psychological challenge to healthcare professionals, patients, and next-of-kin. Objective: This study explored patients' experiences of complex issues of battery replacement and deactivation of the ICD. Methods: Semistructured interviews were administered to 37 medically stable ICD-recipients. Results: The ICD-recipients lived with an uncertain illness trajectory, but the majority had not reflected on battery replacement or elective ICD deactivation. Healthcare professionals had rarely discussed these issues with patients. However, this was consistent with the ICD-recipients' wishes. Many patients had misconceptions about the lifesaving capacity of the ICD and the majority stated that they would not choose to deactivate the ICD, even if they knew they were terminally ill, and it meant they would receive multiple shocks. Conclusion: The ICD-recipients tended not to think about end-of-life issues, which imply that many patients reach the final stages of life unaware of the option of ICD deactivation. © 2013 Elsevier Inc.

  • 254.
    Fluur, Christina
    et al.
    Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Strömberg, Anna
    Division of Nursing Sciences, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Thylen, Ingela
    Division of Nursing Sciences, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Spouses’ reflections on Implantable Cardioverter Defibrillator treatment with focus on the future and the end-of-life: a qualitative content analysis2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 8, p. 1758-1769Article in journal (Refereed)
    Abstract [en]

    Aim. To explore future reflections of spouses living with an implantable cardioverter defibrillator recipient with focus on the end-of-life phase in an anticipated palliative phase.

    Background. A history of or risk for life-threatening arrhythmias may require an implantable cardioverter defibrillator. Despite the life-saving capacity of the device, eventually life will come to an end. As discussion about preferences of shock therapy at end-of-life phase seldom takes place in advance, the implantable cardioverter defibrillator recipients may face defibrillating shocks in the final weeks of their lives, adding to stress and anxiety in patients and their families.

    Design. Qualitative study with in-depth interviews analysed with a content analysis.

    Methods. Interviews were performed with 18 spouses of medically stable implantable cardioverter defibrillator recipients during 2011–2012.

    Results. The spouses described how they dealt with changes in life and an uncertain future following the implantable cardioverter defibrillator implantation. Six subcategories conceptualized the spouses' concerns: Aspiring for involvement; Managing an altered relationship; Being attentive to warning signs; Worries for deterioration in the partner's health; Waiting for the defibrillating shock; and Death is veiled in silence.

    Conclusion. Despite the partner's serious state of health; terminal illness or death and the role of the device was seldom discussed with healthcare professionals or the implantable cardioverter defibrillator recipient. Open and honest communication was requested as important to support coping with an unpredictable life situation and to reduce worries and uncertainty about the future and end-of-life. © 2013 John Wiley & Sons Ltd.

  • 255.
    Flygare, Gunborg
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Att vara förälder vid placering av barn: Föräldrars åsikter, tankar och behov vid socialtjänstens LVU-placeringar av barn och ungdom  2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Övervägande delen av forskning kring socialtjänstens placeringar av barn och ungdom riktar sig mot barnens situation vid dessa insatser eller föräldrarnas upplevelser av skiftande familjebehandlingar. Det har heller inte påträffats forskning riktad mot föräldrars upplevelser av barn och unga placerade i HVB-hem typ behandlingshem.

     I aktuell studie delger sex föräldrar med barn, placerade enligt LVU, individuellt sina synpunkter och tankar kring samarbete med socialtjänsten och olika vårdgivare såsom familjehem och HVB - hem.

    Denna kvalitativa studie, med en tematisk analys på narrativ bas, visar att föräldrarna är i stora drag nöjda med det samarbete som pågår gällande sina barn och ungdomar placerade p.g.a. eget beteende. Föräldrarna har dock därmed inte avsagt sig föräldraskapet utan önskar fortsatt information och delaktighet beträffande sina barn. Studien tar också fäste på anknytningsteorin både ur barnet och förälderns synvinkel gällande fortsatt relation. Fokus ligger också på den förändrade föräldrarollen som informanterna önskar få hjälp att hantera. Det saknas stöd för föräldrarnas egen situation då kris samt skam- och skuldkänslor uppstår i samband med barnens placering.

    Denna studie, visar stora likheter med utfallet av den studie Allmänna Barnhuset ansvarat för, gällande föräldrars röster om hur det är att ha sina barn placerade i fosterhem. (Höijer, 2007)

  • 256.
    Fläckman, Birgitta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Skovdahl, Kirsti
    Norway.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Kihlgren, Mona
    Örebro universitet.
    Kihlgren, Annica
    Örebro universitet.
    Consequences of working in elder care during changes and cutbacks in the organisation while education and clinical supervision was provided: A mixed methods study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 9, p. 813-827Article in journal (Refereed)
    Abstract [en]

    Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.

  • 257.
    Folke, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Landstinget Dalarna, Dept Psychiat, Falun, Sweden.
    Hursti, Timo
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Kanter, Jonathan W
    Arinell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Tungström, Stefan
    Söderberg, Per
    Ekselius, L
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Exploring the relationship between activities and emotional experience using a diary in a mental health inpatient setting.2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 276-286Article in journal (Refereed)
    Abstract [en]

    Mental health inpatient milieus have repeatedly been found to be associated with passivity, social disengagement, and low levels of interaction with staff. However, little is known about patients' experiences related to different ward activities. In the present study, we aimed to study the reports of activities and associated experiences of patients admitted to acute psychiatric inpatient wards. Disengaged, inactive, and solitary activities were hypothesized to be associated with less reward and more distress than their counterparts. We also aimed to investigate if such activities predicted distress, and if they were associated with clinical severity. Participants (n = 102) recorded their activities along with concurrent ratings of reward and distress in a structured 1-day diary, and nurses provided clinical severity ratings. On average, 3.74 of the 11 hours assessed (34%) were spent doing nothing, only 0.88 hours (8%) were spent with staff, and most of the time was spent in solitude. Doing nothing, being alone, and passivity were associated with the greatest levels of distress and lowest levels of reward, whereas informal socializing demonstrated the opposite pattern. Distress was not predicted by activity or reward when adjusting for baseline distress. Clinical severity was not associated with the amount of time spent alone or the experience of reward during activity. In conclusion, the risk for passivity and social disengagement during admission prevails. This activity pattern could have detrimental emotional consequences and warrants action, but more studies are needed to determine if activity actually precedes emotional experience.

  • 258.
    Folke, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Stefan, Tungström
    Per, Söderberg
    Arinell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kanter, Jonathan W.
    Hursti, Timo
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Behavioral Activation for Depressive Symptoms in the Transition from Inpatient to Outpatient Psychiatry: a Pragmatic Randomized Clinical TrialManuscript (preprint) (Other academic)
  • 259.
    Folke, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Söderberg, Per
    Tungström, Stefan
    Hursti, Timo
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Kanter, Jonathan W.
    Arinell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Targeting Treatment Engagement on Psychiatric Inpatient Units with a Behavioral Group Intervention: an Interrupted Time Series Study.Manuscript (preprint) (Other academic)
  • 260.
    Follin, Görel
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Westberg, Marie
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Närståendes behov inom palliativ vård: En litteraturöversikt2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: När en familjemedlem blir svårt sjuk har det en stor påverkan på hela familjen. Närstående har och känner ofta ångest, depression och maktlöshet. Familjemedlemmens sjukdom kan också leda till att rollerna i familjen ändras, och en förändring i den ekonomiska situvationen och en ökad påfrestning för familjen. Syfte: Syftet med studien var att belysa behov som närstående till patienter inom palliativ vård kan ha. Metod: En litteraturstudie genomfördes med sökningar i Pubmed och Cinahl. Innehållsanalys gjordes av de 11 inkluderade artiklarnas huvudresultat. Tydliga framträdande fenomen i texten kondenserades, kodades och katogoriserades i underkategorier och kategorier. Resultat: I studiens resultat framkom att närstående till patienter inom palliativ vård har ett stort behov av kommunikation, information och stöd. Diskussion: Att ha en fungerande kommunikation fanns var något som var viktigt för de närstående, då det gav dem en känsla av trygghet. Det var även viktigt att rätt infomation gavs till de närstående, att den gavs vid rätt tillfällen och att de närstående kunde förstå informationen.För att stödja närstående spelar vårdpersonal en viktig roll, då de kan bidra med uppmuntran och hopp i en svår situation.

  • 261.
    Fordell, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Bodin, Kenneth
    Umeå University, Faculty of Science and Technology, High Performance Computing Center North (HPC2N).
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    A virtual reality test battery for assessment and screening of spatial neglect2011In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 123, no 3, p. 167-174Article in journal (Refereed)
    Abstract [en]

    Background – There is a need for improved screening methods for spatial neglect.

    Aim – To construct a VR-test battery and evaluate its accuracy and usability in patients with acute stroke.

    Method –  VR-DiSTRO consists of a standard desktop computer, a CRT monitor and eye shutter stereoscopic glasses, a force feedback interface, and software, developed to create an interactive and immersive 3D experience. VR-tests were developed and validated to the conventional Star Cancellation test, Line bisection, Baking Tray Task (BTT), and Visual Extinction test. A construct validation to The Rivermead Behavioral Inattention Test, used as criterion of visuospatial neglect, was made. Usability was assessed according to ISO 9241-11.

    Results –  Thirty-one patients with stroke were included, 9/31 patients had neglect. The sensitivity was 100% and the specificity 82% for the VR-DiSTRO to correctly identify neglect. VR-BTT and VR-Extinction had the highest correlation (r2 = 0.64 and 0.78), as well as high sensitivity and specificity. The kappa values describing the agreement between traditional neglect tests and the corresponding virtual reality test were between 0.47–0.85. Usability was assessed by a questionnaire; 77% reported that the VR-DiSTRO was ‘easy’ to use. Eighty-eight percent reported that they felt ‘focused’, ‘pleased’ or ‘alert’. No patient had adverse symptoms. The test session took 15 min.

    Conclusions –  The VR-DiSTRO quickly and with a high accuracy identified visuospatial neglect in patients with stroke in this construct validation. The usability among elderly patients with stroke was high. This VR-test battery has the potential to become an important screening instrument for neglect and a valuable adjunct to the neuropsychological assessment.

  • 262.
    Forsberg, Rebecca
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Conditions affecting safety on the Swedish railway: Train drivers' experiences and perceptions2016In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 85, p. 53-59Article in journal (Refereed)
    Abstract [en]

    Major changes have been implemented in recent years within the rail bound sector. There is, therefore, a need to consider if and how these large alterations affect rail safety. The aim of the study was to explore train drivers' experiences and perceptions of conditions affecting safety of the Swedish railway system. Narrative semi-structured interviews were performed with ten train drivers. Qualitative content analysis was used to analyze the interviews. The results were captured in two main categories: (1) Facing structural changes includes results unclarity in responsibility assignment, deteriorated tracks and insufficient safety culture and (2) facing technology development, covered safety systems such as ATC and ERTMS which were seen as high-quality safeguards with both benefits and challenges due to new technical devices. The new challenges that have entered the arena should be offset by increased coordination and by a party responsible for safety within the industry. Finally, restrictions and regulations regarding the use of the tablets and smart phones are desirable. 

  • 263.
    Forsberg, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    One hundred years of railway disasters and recent trends2011In: Prehospital and disaster medicine, ISSN 1049-023X, Vol. 26, no 5, p. 367-373Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Globally, railway transport is increasing steadily. Despite the adoption of diverse safety systems, major railway incidents continue to occur. Higher speeds and increased passenger traffic are factors that influence the risk of mass-casualty incidents and make railway crashes a reality that merits extensive planning and training.

    METHODS: Data on railway disasters were obtained from the Centre for Research on the Epidemiology of Disasters (CRED), which maintains the Emergency Events Database (EM-DAT). This descriptive study consists of 529 railway disasters (≥10 killed and/or ≥100 non- fatally injured) from 1910 through 2009.

    RESULTS: The number of railway disasters, people killed, and non-fatally injured, has increased throughout the last hundred years-particularly during the last four decades (1970-2009), when 88% of all disasters occurred. In the mid-20th century, a shift occurred, resulting in more people being non-fatally injured than fatally injured. During 1970-2009, 74% of all railway disasters occurred in Asia, Africa, and South and Central America, combined. The remaining 26% occurred in Europe, North America, and Oceania, combined. Since 1980, railway disasters have increased, especially in Asia and Africa, while Europe has had a decrease in railway disasters. The number killed per disaster (1970-2009) was highest in Africa (n = 55), followed by South and Central America (n = 47), and Asia (n = 44). The rate was lowest in North America (n = 10) and Europe (n = 29). On average, the number of non-fatal injuries per disaster was two to three times the number of fatalities, however, in the African countries (except South Africa) the relation was closer to 1:1, which correlates to the relation found in more developed countries during the mid-20th century. The total losses (non-fatally and fatally injured) per disaster has shown a slight decreasing trend.

    CONCLUSIONS: Despite extensive crash avoidance and injury reduction safety systems, railway crashes occur on all continents, indicating that this type of incident must be accounted for in disaster planning and training. Better developed safety, crashworthiness, and rescue resources in North America and Europe may be factors explaining why the number of crashes and losses has stabilized and why the average number of people killed per disaster is lowest on these continents.

  • 264.
    Forsberg, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Iglesias Vazquez, Jose Antonio
    A Case Study of the High-speed Train Crash Outside Santiago de Compostela, Galicia, Spain2016In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 31, no 2, p. 163-168Article in journal (Refereed)
    Abstract [en]

    Introduction: The worldwide use of rail transport has increased, and the train speeds are escalating. Concurrently, the number of train disasters has been amplified globally. Consequently, railway safety has become an important issue for the future. High-velocity crashes increase the risk for injuries and mortality; nevertheless, there are relatively few studies on high-speed train crashes and the influencing factors on travelers' injuries occurring in the crash phase. The aim of this study was to investigate the fatal and non-fatal injuries and the main interacting factors that contributed to the injury process in the crash phase of the 2013 high-velocity train crash that occurred at Angrois, outside Santiago de Compostela, Spain. Methods: Hospital records (n = 157) of all the injured who were admitted to the six hospitals in the region were reviewed and compiled by descriptive statistics. The instant fatalities (n = 63) were collected on site. Influencing crash factors were observed on the crash site, by carriage inspections, and by reviewing official reports concerning the approximated train speed. Results: The main interacting factors that contributed in the injury process in the crash phase were, among other things, the train speed, the design of the concrete structure of the curve, the robustness of the carriage exterior, and the interior environment of the carriages. Of the 222 people on board (218 passengers and four crew), 99% (n = 220) were fatally or non-fatally injured in the crash. Thirty-three percent (n = 72) suffered fatal injuries, of which 88% (n = 63) died at the crash site and 13% (n = 9) at the hospital. Twenty-one percent (n = 32) of those admitted to hospital suffered multi-trauma (ie, extensive, severe, and/or critical injuries). The head, face, and neck sustained 42% (n = 123) of the injuries followed by the trunk (chest, abdomen, and pelvis; n = 92; 32%). Fractures were the most frequent (n = 200; 69%) injury. Conclusion: A mass-casualty incident with an extensive amount of fatal, severe, and critical injuries is most probable with a high-velocity train; this presents prehospital challenges. This finding draws attention to the importance of more robust carriage exteriors and injury minimizing designs of both railway carriages and the surrounding environment to reduce injuries and fatalities in future high-speed crashes.

  • 265.
    Fossum, Maren
    et al.
    Norwegian University of Science and Technology, Trondheim, Norway / KTH.
    Strömberg, Emma
    KTH.
    Sanchez, Javier
    Karolinska Institutet.
    Rotstein, Samuel
    Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet.
    Aune, Ragnhild E
    Norwegian University of Science and Technology, Trondheim, Norway.
    Preliminary In-Vitro Study of Surface Altera1ons of Subcutaneous Venous Access Ports Exposed to Antineoplastic Drugs and Whole Blood2015In: TMS 2015, 144th Annual Meeting & Exhibition: Supplemental Proceedings, John Wiley & Sons, 2015, p. 645-652Conference paper (Refereed)
  • 266.
    Fridberg, Helena
    et al.
    Dalarna Univ, Sch Educ Hlth & Social Studies, S-79188 Falun, Sweden.
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Dalarna Univ, Sch Educ Hlth & Social Studies, S-79188 Falun, Sweden.
    Self-efficacy in Activities of daily living and symptom management in people with dizziness: a focus group study2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 6, p. 705-713Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-efficacy is associated with health status, health behaviour and health behaviour change in various chronic health conditions.

    PURPOSE: To describe self-efficacy in relation to Activities of daily living and symptom management in people with dizziness.

    MATERIAL AND METHODS: Thirteen women and three men, aged 45-82 years, with persistent dizziness (duration 4 months to 30 years) were recruited from an outpatient physiotherapy unit. A qualitative study was conducted using four focus groups and one individual interview and was then analysed with qualitative content analysis.

    RESULTS: The participants conveyed, in-depth information concerning two predefined main categories. Self-efficacy in Activities of daily living was related to challenging body positions and motions, environments, social activities, work tasks, and complex cognitive behaviours. Self-efficacy in symptom management was related to distress and aggravated symptoms, unfamiliar environment, and unknown people.

    CONCLUSIONS: People with dizziness describe how self-efficacy for specific activities varies according to the perceived difficulty of the task, the context of the activity, and day-to-day variations in general wellbeing. The results underscore the importance of targeting self-efficacy in the rehabilitation of people with dizziness. Our findings can guide the rehabilitation process by providing a deeper understanding of self-efficacy judgements in relation to Activities of daily living and symptom management in people with dizziness. Implication for rehabilitation This study adds important in-depth knowledge to the rehabilitation area on self-efficacy beliefs in relation to Activities of daily living and symptom management in people with dizziness. Self-efficacy for specific activities varies according to the perceived difficulty of the task, the context in which the activity takes place and day-to-day variations in perceived general well-being. The results can be used as a topic list to guide rehabilitation efforts in exploring and intervening aspects of people's everyday activities that are affected by low self-efficacy judgements. Activities perceived to be crucial to everyday life and important for well-being should be targeted in rehabilitation to increase self-efficacy and thereby activity performance and participation in people with dizziness.

  • 267.
    Fridh, Isabell
    et al.
    Högskolan i Borås, Göteborgs universitet.
    Kenne Sarenmalm, Elisabeth
    Ersta Sköndal University College, Palliative Research Centre, PRC. Skaraborgs sjukhus.
    Falk, Kristin
    Göteborgs universitet.
    Henoch, Ingela
    Göteborgs universitet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Ozanne, Anneli
    Göteborgs universitet.
    Jakobsson Ung, Eva
    Göteborgs universitet.
    Extensive human suffering: a point prevalence survey of patients' most distressing concerns during inpatient care2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, p. 444-453Article in journal (Refereed)
    Abstract [en]

    AIM: To explore patients' most distressing concerns during a hospital stay.

    BACKGROUND: The characteristics of hospitalised patients have changed. Care is provided at a higher age, lengths of stay have fallen and the nursing workload is increasing. It is presumed that hospitalised patients are more seriously ill and have more palliative needs than previously. Studies show that inpatients suffer from more distress than similar outpatients although there is a lack of overall knowledge about inpatients' distress and major concerns, regardless of age, diagnosis or care setting.

    METHODS: This study was part of a point prevalence survey (PPS) concerning symptom prevalence. Of the 710 patients who participated in the PPS, 678 (95%) answered an open-ended question in a questionnaire: What is your main concern or what is most distressing or troublesome for you at present? Using a life-world approach, the text was analysed qualitatively and patients' concerns were interpreted in two main dimensions, an intersubjective dimension and a temporal dimension.

    FINDINGS: The patients reported extensive suffering due to illness, symptoms and failing health. Patients were concerned about family members, existential issues and the future. Three aspects of the patients' most distressing concerns were interpreted: The suffering self, The suffering person in close relations and The suffering person in a threatening world.

    CONCLUSION: Hospitalised patients are affected by severe illness, distressing symptoms and existential quandaries, revealing extensive human suffering in the midst of the demanding activities that take place during an ordinary day in a hospital. To support patients and alleviate suffering, hospital staff need to be more sensitive to patients' most distressing concerns. This presupposes a hospital environment in which the value system supports caring and comforting behaviour.

  • 268.
    Fröberg, Andreas
    et al.
    University of Gothenburg.
    Raustorp, Anders
    University of Gothenburg.
    Metoder för att minska vuxnas stillasittande2017In: Fysioterapi, ISSN 1653-5804, no 2, p. 28-34Article, review/survey (Other academic)
    Abstract [sv]

    I takt med den växande kunskapen om stillasittandets potentiella negativa hälsokonsekvenser har flera studier publicerats där forskare utvärderat effekten av interventioner som syftar till att minska stillasittande. Denna artikel sammanfattar forskningsläget kring detta och ger exempel på de metoder som har använts och utvärderats. Resultatet visar att metoder som innebär rekonstruktion av miljö som bland annat höj- och sänkbara arbetsbord och självregleringstekniker som monitorering med stegräkning har varit framgångsrika metoder för att minska stillasittande. Även metoder där problemlösning och tillhandahållande av information ingått har visat sig användbara. Förslag ges på hur fysioterapeuter kan gå till väga vid målformulering samt -utvärdering av insatser för att minska vuxnas stillasittande.

  • 269.
    Fröberg, Andreas
    et al.
    University of Gothenburg.
    Raustorp, Anders
    University of Gothenburg.
    Så påverkas hälsan av vårt stillasittande: En kunskapsöversikt ur ett livsloppsperspektiv2017In: Fysioterapi, ISSN 1653-5804, no 1, p. 26-31Article, review/survey (Other academic)
  • 270.
    Fyhr, Sofia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Yosifpour, Galawish
    Ersta Sköndal University College, Department of Health Care Sciences.
    Vårdpersonalens attityder gentemot äldre patienters sexualitet: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sexuality is important for all individuals, then it is a part of the humans physical and mental needs. For older people regardless of sexual orientation (hetero– bi- gay) sexuality is important for the experience of a healthy life. Research shows that many of the older people just lack of love and a physical close contact. Patient ́s sexual expressions in the form of verbal and sexual acts sometimes creates anxiety among the care staff because of their lack of knowledge in this area. This is a problem too as it is the nursing staff tasked with helping to pay the society ́s negative image this topic with a positive image.

    Aim: To highlight professional healthcarer ́s attitudes of older patient́s sexuality.

    Methods: This project is a literature review where twelve scientific articles reviewed. The databases was CINAHL Plus With Full Text, Nursing and Allied Health Source, MEDLINE With Full Text and PubMed. The keywords was staff, nurse, nursing student, attitude, perceptions, experiences, barriers, perspektives, knowledge, older people, older adults, aged residential care, care, sexuality, sexual health.

    Results: Sexual health is a complicated subject for professionals to deal with, discussions about sexual health issues have low priority and routines are not established for this. This result also revealed that health professionals are aware of older people ́s sexual needs but that they lack the skills to handle with its expression. Other influencing factors include age, gender, religion and origin.

    Method – discussion: There are both strength and weaknesses with the selected method. For all involved articles the weaknesses can be that they were written in English, which may lead to misinterpretation when this is not the author ́s native language. What can be both a strength and weakness is that the articles include various participating countries.

    Result – discussion: In the result it was concluded that older peoples sexuality is not a priority in health care and a major influencing factor in this may be that health professionals lack the specialist training include older people and sexuality. The healthcare environment is in most cases not suitable for the elderly to express their sexuality.

  • 271.
    Fält, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Wallby, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Agreement between mothers', fathers', and teachers' ratings of behavioural and emotional problems in 3-5-year-old children2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0206752Article in journal (Refereed)
    Abstract [en]

    Background: The Strengths and Difficulties Questionnaire (SDQ), a valid and reliable instrument for measuring children's mental health, is available in parent- and teacher versions, making it an ideal tool for assessing behavioural and emotional problems in young children. However, few studies have evaluated inter-parent agreement on the SDQ, and in most studies on SDQ agreement, parent scores are either provided by only one parent or have been combined into one parent score. Furthermore, studies on SDQ inter-rater agreement usually only reflect degree of correlation, leaving the agreement between measurements unknown. The aim of the present study was therefore to examine both degree of correlation and agreement between parent and teacher SDQ reports, in a community sample of preschool-aged children in Sweden.

    Methods: Data were obtained from the Children and Parents in Focus trial. The sample comprised 4,46 children 3-5-years-old. Mothers, fathers and preschool teachers completed the SDQ as part of the routine health check-ups at Child Health Centres. Inter-rater agreement was measured using Pearson correlation coefficient and intraclass correlation (ICC).

    Results: Results revealed poor/fair agreement between parent and teacher ratings (ICC 0.25-0.54) and good/excellent agreement between mother and father ratings (ICC 0.66-0.76). The highest level of agreement between parents and teachers was found for the hyperactivity and peer problem subscales, whereas the strongest agreement between parents was found for the hyperactivity and conduct subscales.

    Conclusions: Low inter-rater agreement between parent and teacher ratings suggests that information from both teachers and parents is important when using the SDQ as a method to identify mental health problems in preschool children. Although mothers and fathers each provide unique information about their child's behaviour, good inter-parent agreement indicates that a single parent informant may be sufficient and simplify data collection.

  • 272.
    Fältström, Anne
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Jönköping County, Rehabilitation Centre, Ryhov County Hospital, Jönköping, Sweden.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Functional Performance Among Active Female Soccer Players After Unilateral Primary Anterior Cruciate Ligament Reconstruction Compared With Knee-Healthy Controls2017In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 45, no 2, p. 377-385Article in journal (Refereed)
    Abstract [en]

    Background: Good functional performance with limb symmetry is believed to be important to minimize the risk of injury after a return to pivoting and contact sports after anterior cruciate ligament reconstruction (ACLR).

    Purpose: This study aimed to investigate any side-to-side limb differences in functional performance and movement asymmetries in female soccer players with a primary unilateral anterior cruciate ligament (ACL)–reconstructed knee and to compare these players with knee-healthy controls from the same soccer teams.

    Study Design: Cross-sectional study; Level of evidence, 3.

    Methods: This study included 77 active female soccer players at a median of 18 months after ACLR (interquartile range [IQR], 14.5 months; range, 7-39 months) and 77 knee-healthy female soccer players. The mean age was 20.1 ± 2.3 years for players with an ACL-reconstructed knee and 19.5 ± 2.2 years for controls. We used a battery of tests to assess postural control (Star Excursion Balance Test) and hop performance (1-legged hop for distance, 5-jump test, and side hop). Movement asymmetries in the lower limbs and trunk were assessed with the drop vertical jump and the tuck jump using 2-dimensional analyses.

    Results: The reconstructed and uninvolved limbs did not differ in any of the tests. In the 5-jump test, players with an ACL-reconstructed knee performed worse than controls (mean 8.75 ± 1.05 m vs 9.09 ± 0.89 m; P = .034). On the drop vertical jump test, the ACL-reconstructed limb had significantly less knee valgus motion in the frontal plane (median 0.028 m [IQR, 0.049 m] vs 0.045 m [IQR, 0.043 m]; P = .004) and a lower probability of a high knee abduction moment (pKAM) (median 69.2% [IQR, 44.4%] vs 79.8% [IQR, 44.8%]; P = .043) compared with the control players’ matched limb (for leg dominance). Results showed that 9% to 49% of players in both groups performed outside recommended guidelines on the different tests. Only 14 players with an ACL-reconstructed knee (18%) and 15 controls (19%) had results that met the recommended guidelines for all 5 tests (P = .837).

    Conclusion: The reconstructed and uninvolved limbs did not differ, and players with an ACL-reconstructed knee and controls differed only minimally on the functional performance tests, indicating similar function. It is worth noting that many players with an ACL-reconstructed knee and controls had movement asymmetries and a high pKAM pattern, which have previously been associated with an increased risk for both primary and secondary ACL injury in female athletes.

  • 273. Färdig, Rickard
    et al.
    Lewander, Tommy
    Melin, Lennart
    Folke, Fredrik
    Fredriksson, Anders
    A randomized controlled trial of the illness management and recovery program for persons with schizophrenia.2011In: Psychiatric Services, ISSN 1075-2730, E-ISSN 1557-9700, Vol. 62, no 6, p. 606-12Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the study was to evaluate the effects of the illness management and recovery (IMR) program on symptoms and psychosocial functioning of individuals with schizophrenia or schizoaffective disorder in an outpatient setting in Sweden.

    METHODS: A total of 41 persons with schizophrenia or schizoaffective disorder who were receiving treatment at six psychiatric outpatient rehabilitation centers were randomly assigned to either an IMR group for nine months or to treatment as usual (control condition). Assessments were conducted at baseline, posttreatment (nine months), and follow-up (21 months) and included self-reports and ratings by clinicians (both blind and nonblind to treatment assignment) of illness management, psychiatric symptoms, recovery, coping, quality of life, hospitalization, insight, and suicidal ideation.

    RESULTS: As measured by self-report and ratings of nonblinded clinicians, IMR program participants demonstrated significantly greater improvement in illness management than participants in the control condition. Ratings of psychiatric symptoms by blinded clinicians using the Psychosis Evaluation Tool for Common Use by Caregivers and self-reported ratings of psychosocial functioning on the Ways of Coping Questionnaire also showed better outcomes than for participants in treatment as usual. A statistically significant decrease in suicidal ideation between baseline and follow-up was found for IMR program participants.

    CONCLUSIONS: The study supports previous findings and suggests that the IMR program is effective in improving the ability of individuals with schizophrenia to better manage their illness.

  • 274.
    Gagner, Sandra
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jägerstedt, Mika
    Halmstad University, School of Social and Health Sciences (HOS).
    Betydelsefull närhet och nödvändig distans: Sjuksköterskans professionella förhållningssätt inom palliativ vård2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Palliative care is an approach which has the main emphasis on the patient’s quality of life. It is characterized by a holistic view towards the patient’s physical, psychological, social and existential need. The nurse can work with palliative care in many different contexts, and to various degrees. Nonetheless, the nurse who conducts palliative care will always have a relation building function, and the relation between the nurse and the patient will have large impact of the patient’s perceived well-being. A nurse’s professional approach to palliative care is generally thought of as her taking on a compassionate role against her patients. The purpose of this paper was to describe the nurse’s experience of establishing and keeping a professional approach to her patients in palliative care. The study was conducted as a scientific literature review with a systematic gathering and scrutinizing of data. In total, eleven qualitative scientific articles were included in the review. Three main conclusions could be drawn. First, the nurses experienced that the relations within palliative care were characterized by closeness and emotional engagement. The close relationship between the nurse and her patients was regarded as being positive, although it constituted a risk of emotional overload. Second, it was found to be necessary for the nurse to maintain a professional distance to the patient to be able to separate work from private life. Third, many nurses identified a challenge of striking an appropriate balance between closeness and distance in order to be able to be personal without being private.

  • 275.
    Galak, Eduardo
    et al.
    National University of La Plata, Buenos Aires, Argentina; Federal University of Minas Gerais, Belo Horizonte, Brazil.
    Varea, Valeria
    The University of Queensland, Brisbane, Australia; National University of La Plata, Buenos Aires, Argentina.
    Introducción2013In: Cuerpo y Educación Física: Perspectivas latinoamericanas para pensar la educación de los cuerpos / [ed] Valeria Varea & Eduardo Galak, Buenos Aires: Editorial Biblos , 2013, p. 9-14Chapter in book (Refereed)
  • 276.
    Gambe, Tova
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Friberg, Kristina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Validering av Narrowing Beam Walking Test (NBWT) för transtibialt amputerade protesanvändare.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 277.
    Gardsten, Cecilia
    et al.
    Kristianstad University.
    Blomqvist, Kerstin
    Kristianstad University.
    Mörtberg, Christina
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Ethical considerations in Participatory Action Research (PAR)2014In: Nordic Conference in Nursing Research: methods and networks for the future, 10-12 June, 2014, Odense, 2014Conference paper (Other academic)
  • 278.
    Gelhaus, Petra
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Department of Psychiatry and Habilitation.
    The desired moral attitude of the physician: (I) Empathy2012In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 15, no 2, p. 103-113Article in journal (Refereed)
    Abstract [en]

    In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired underlying attitude of physicians. In this article, one of them—empathy—is presented in an interpretation that is meant to depicture (together with the two additional concepts compassion and care) this attitude. Therefore empathy in the clinical context is defined as the adequate understanding of the inner processes of the patient concerning his health-related problems. Adequacy is scrutinized on behalf of the emotional and subjective involvement of he physician, and on the necessary dependence on medical—moral—goals. In the present interpretation, empathy alone is no guarantee of the right moral attitude, but a necessary instrumental skill in order to perceive and treat a patient as an individual person. The concepts of compassion and care that will be discussed in two forthcoming articles are necessary parts to describe the desired moral attitude of the physician more completely.

  • 279.
    Gelhaus, Petra
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Department of Psychiatry and Habilitation.
    The desired moral attitude of the physician: (II) Compassion2012In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 15, no 4, p. 397-410Article in journal (Refereed)
    Abstract [en]

    Professional medical ethics demands of health care professionals in addition to specific duties and rules of conduct that they embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired implied attitude of physicians. In a sequel of three articles, a set of three of these concepts is presented in an interpretation that is meant to characterise the morally emotional part of this attitude: “empathy”, “compassion” and “care”. In the first article of the series, “empathy” has been developed as a mainly cognitive and morally neutral capacity of understanding. In this article, the emotional and virtuous core of the desired professional attitude—compassion—is elaborated. Compassion is distinguished from sympathy, empathy and pity. Several problems of compassion as a spontaneous, warm emotion for being a professional virtue are discussed: especially questions of over-demand, of justice and of concerns because of a possible threat to the patient’s dignity and autonomy. An interpretation of compassion as processed and learned professional attitude, that founds dignity on the general idea of man as a sentient being and on solidarity, not on his independence and capacities, is developed. It is meant to rule out the possible side effects and to make compassion as a professional attitude and as professional virtue attractive, teachable and acquirable. In order to reach the adequate warmth and closeness for the particular physician-patient-relation, professional compassion has to be combined with the capacity of empathy. If appropriate, the combination of both empathy and compassion as “empathic compassion” can demand a much warmer attitude towards the patient than each of the elements alone, or the simple addition of them can provide. The concept of “care” that will be discussed in a forthcoming article of this sequel is a missing necessary part to describe the active potential of the desired moral attitude of the physician more completely. The reconstruction of the desired professional attitude in terms of “empathic compassionate care” is certainly not the only possible description, but it is a detailed proposal in order to give an impulse for the discussion about the inner tacit values and the meaning of medicine and clinical healthcare professions.

  • 280.
    Gelhaus, Petra
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Department of Psychiatry and Habilitation.
    The desired moral attitude of the physicians: (III) Care2013In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 16, no 2, p. 125-139Article in journal (Refereed)
    Abstract [en]

    In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired moral attitude of physicians. In a series of three articles, three of the discussed concepts are presented in an interpretation that is meant to characterise the morally emotional part of this attitude: “empathy”, “compassion” and “care”. In the first article of the series, “empathy” has been developed as a mainly cognitive and morally neutral capacity of understanding. In the second article, the emotional and virtuous core of the desired professional attitude—compassion—has been presented. Compassion as a professional attitude has been distinguished from a spontaneous feeling of compassion, and has been related to a general idea of man as vulnerable and solidary being. Thus, the dignity of the patient is safeguarded in spite of the asymmetry of compassion. In this article, the third concept of the triad—“care”—is presented. Care is conceived as an attitude as well as an activity which can be directed to different objects: if it is directed to another sentient being, it is regarded as intrinsically morally valuable; implying (1) the acceptance of being addressed, (2) a benevolent inclination to help and to foster, and (3) activity to realize this. There are different forms of benevolence that can underlie caring. With regard to the professional physician’s ethos, the attitude of empathic compassion as developed in the two previous articles is proposed to be the adequate underlying attitude of care which demands the right balance between closeness and professionalism and the right form of attention to the person of the patient. ‘Empathic compassionate care’ does not, however, describe the whole of the desired attitude of a physician, but focuses on the morally-emotive aspects. In order to get also the cognitive and practical aspects of biomedicine into the picture, ‘empathic compassionate care’ has to be combined with an attitude of responsibility that is more directed to decision-making and outcome than a caring attitude alone can be. The reconstruction of the desired professional attitude in terms of “empathic compassionate care” and “responsibility” is certainly not the only possible description, but it is a detailed proposal in order to give an impulse for the discussion about the inner tacit values and the meaning of medicine and clinical healthcare professions.

  • 281.
    Georgsson, Mattias
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics2016In: JAMIA Journal of the American Medical Informatics Association, ISSN 1067-5027, E-ISSN 1527-974X, Vol. 23, no 1, p. 5-11Article in journal (Refereed)
    Abstract [en]

    Objective Mobile health (mHealth) systems are becoming more common for chronic disease management, but usability studies are still needed on patients' perspectives and mHealth interaction performance. This deficiency is addressed by our quantitative usability study of a mHealth diabetes system evaluating patients' task performance, satisfaction, and the relationship of these measures to user characteristics. Materials and Methods We used metrics in the International Organization for Standardization (ISO) 9241-11 standard. After standardized training, 10 patients performed representative tasks and were assessed on individual task success, errors, efficiency (time on task), satisfaction (System Usability Scale [SUS]) and user characteristics. Results Tasks of exporting and correcting values proved the most difficult, had the most errors, the lowest task success rates, and consumed the longest times on task. The average SUS satisfaction score was 80.5, indicating good but not excellent system usability. Data trends showed males were more successful in task completion, and younger participants had higher performance scores. Educational level did not influence performance, but a more recent diabetes diagnosis did. Patients with more experience in information technology (IT) also had higher performance rates. Discussion Difficult task performance indicated areas for redesign. Our methods can assist others in identifying areas in need of improvement. Data about user background and IT skills also showed how user characteristics influence performance and can provide future considerations for targeted mHealth designs. Conclusion Using the ISO 9241-11 usability standard, the SUS instrument for satisfaction and measuring user characteristics provided objective measures of patients' experienced usability. These could serve as an exemplar for standardized, quantitative methods for usability studies on mHealth systems.

  • 282.
    Georgsson, Mattias
    Blekinge Institute of Technology, Faculty of Computing, Department of Creative Technologies.
    Using activity theory as a framework for the usability evaluation process and task determination in mhealth self-management systems for diabetes2018In: Studies in Health Technology and Informatics, IOS Press , 2018, Vol. 249, p. 158-163Conference paper (Refereed)
    Abstract [en]

    mHealth systems can be used for patients in their diabetes selfmanagement, but usability evaluations are often needed to determine how to make them more useful for the diabetes patient user in the monitoring and managing of their disease. Activity Theory (AT) was developed within Russian psychology to define the work and activity process in an activity system. AT was here considered to also be a particularly suitable framework for inspiration in usability evaluation both for the whole evaluation process and also for the usability task determination in this process for diabetes patient users. In the following paper, examples are provided from four usability studies using both user-based and expert usability methods in evaluation showing how AT was applied to guide the thoughts in evaluating the usability of two mHealth self-management systems for diabetes. Experiences and insights are provided from this process. © 2018 The authors and IOS Press. All rights reserved.

  • 283. Gerdle, Björn
    et al.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Rudling, Karin
    Jansen, Gunilla Brodda
    Fischer, Marcelo Rivano
    Jämför inte äpplen och päron vid utvärdering av rehabiliteringsgarantin2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 47, p. 2111-2112Article in journal (Refereed)
  • 284.
    Gerdle, Björn
    et al.
    Linkoping Univ, Pain & Rehabil Ctr, Dept Med & Hlth Sci, SE-58185 Linkoping, Sweden.
    Åkerblom, Sophia
    Skane Univ Hosp, Dept Pain Rehabil, Lund, Sweden;Lund Univ, Dept Psychol, Lund, Sweden.
    Jansen, Gunilla Brodda
    Danderyd Hosp, Div Rehabil Med, Dept Clin Sci, Stockholm, Sweden.
    Enthoven, Paul
    Linkoping Univ, Pain & Rehabil Ctr, Dept Med & Hlth Sci, SE-58185 Linkoping, Sweden.
    Ernberg, Malin
    Karolinska Inst, Dept Dent Med, Huddinge, Sweden;SCON, Huddinge, Sweden.
    Dong, Huan-Ji
    Linkoping Univ, Pain & Rehabil Ctr, Dept Med & Hlth Sci, SE-58185 Linkoping, Sweden.
    Stålnacke, Britt-Marie
    Umea Univ, Dept Community Med & Rehabil, Rehabil Med, Umea, Sweden.
    Äng, Björn O.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Huddinge, Sweden;Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Boersma, Katja
    Orebro Univ, Sch Law Psychol & Social Work, Orebro, Sweden.
    Who benefits from multimodal rehabilitation - an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation2019In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 12, p. 891-908Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individual's life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments. Methods: Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods. Results: Based on >35,000 patients, 35%-40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%-24% vs 6%-8% in the category without psychological distress) and low education level (20.7%-20.8% vs 26%-27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R-2 =0.40-0.48; P>0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901 16,119; subgroup 2: n=20,690-20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, P<0.001) but showed the largest improvements in outcomes. Conclusion: The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.

  • 285.
    Germundsson, Per
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research.
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Swedish Institute for Disability Research.
    Vocational rehabilitation, interagency collaboration and social representations2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 42, no 4, p. 507-517Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study is to describe and analyse two important dimensions of vocational rehabilitation for disadvantaged groups and persons with disabilities: interagency collaboration and social representations.

    Participants: Four focus group discussions were conducted. The participants were 20 officials of various agencies who had taken part in collaboration projects in vocational rehabilitation.

    Methods: Qualitative content analysis was used for the analysis. The material was categorised and central themes identified.

    Results: Three themes emerged: 'Collaboration Process', 'Other Agencies' and 'Object for Collaboration'. The results indicate that interagency collaboration is very important in vocational rehabilitation, but that there are a number of obstacles to smooth collaboration. The professionals of the different agencies shared social representations to a great extent. Working with people with psychiatric disorders is especially challenging, and conflicts tended to arise between the projects and the home organisations.

    Conclusions: Recognition of others' knowledge and respectfulness toward other professions facilitated vocational rehabilitation and the interagency collaboration process. The agencies' lack of flexibility increased the risk of conflicts as attempts were made to integrate the new working methods developed within the projects into the ordinary activities of the agencies.

  • 286.
    Ghorbani, Ramin
    et al.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Schmidt, Florian M.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Extended breath CO analysis: baseline and diurnal variation of pulmonary gas exchange parametersManuscript (preprint) (Other academic)
  • 287.
    Giardina, Rebecca
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Familjeterapins roll vid ångest-behandling av barn och ungdomar: - en systematisk litteraturöversikt2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Antalet barn och unga som drabbas av psykisk ohälsa fortsätter att öka i Sverige. Detta ställer höga krav på att vården kan erbjuda effektiv hjälp för de lidande samt ständigt utvärdera om insatserna är bra eller behöver utvecklas. Ångestsyndrom hos barn och unga är ett tillstånd som innebär ett signifikant lidande för den drabbade och den unges familj. I Socialstyrelsens allmänna riktlinjer från 2010, rekommenderas i första hand kognitiv beteendeterapi för dessa barn och ungdomar. Då alla barnpsykiatriska tillstånd uppkommer och utvecklas i ett familjesammanhang (oavsett genes), fanns en önskan om att ta reda på vilken aktuell forskning som finns gällande familjeterapeutiska interventioner vid behandling av barn och unga med ångestsyndrom. 

    Metod/Resultat: 

    Som metod användes systematisk litteratursökning på kliniska studier de senaste 10 åren där familjeterapeutiska interventioner använts vid ångestbehandling av barn och unga. Resultaten visade på två huvudfynd; dels att det finns få kliniska studier gällande familjeterapeutiska interventioner vid ångesttillstånd hos barn och unga samt att de studier som gjorts visade på god effekt vid tillägg av familjeterapeutiska interventioner och då i synnerhet när insatserna var mer omfattande. 

    Slutsatser

    De slutsatser som dras av studien är dels att mer forskning kring familjeterapi och ångestsyndrom hos barn och unga behövs, att familjeterapeutiska interventioner ger lovande resultat samt att forskningen inom kognitiv beteendeterapi banat

  • 288.
    Gilenstam, Kajsa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports Medicine.
    Geithner, Christina
    Body Composition of Women’s Ice Hockey Players: Comparison of Estimates Using Skinfolds and iDXA2017In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to compare percent fat (% Fat) estimates from anthropometric equations using skinfolds (SKF) in women’s ice hockey players to estimates obtained from Lunar iDXA. Data were collected on 19 elite female Swedish hockey players (mean age ± SD = 18.4 ± 2.4 y). Four skinfolds (SKF) (triceps, abdominal, suprailiac, and thigh) were measured within two hours of iDXA assessments. The % Fat estimates from iDXA and four anthropometric equations were compared using paired t-tests, and a one-way ANOVA was used to compare % Fat estimates from the anthropometric equations. Bland Altman analyses were used to assess agreement between % Fat estimates from SKF and iDXA. The significance level was set a priori at p<0.05. The % Fat estimates from anthropometric equations were significantly lower than those from iDXA (mean ± SD: 26.85 ± 4.93%,p=0.000). Bland Altman analyses indicated mean differences of -7.96 to -10.13 percentage points between anthropometric equations and iDXA. Estimates of % Fat from anthropometric equations (range: 16.72% to 18.89%) were within the range reported in earlier studies using the Sum of 7 SKF. Thus, SKF offer a reasonable alternative to iDXA for this population, but result in underestimates of % Fat relative to iDXA. Strength and conditioning coaches should use the same body composition assessment method consistently, and interpret the results with caution, as they are estimates and not true values.

  • 289.
    Gjessing, Kristian
    et al.
    Linköpings universitet, Avdelningen för samhällsmedicin.
    Torgé, Cristina Joy
    Linköpings universitet, NISAL - Nationella institutet för forskning om äldre och åldrande.
    Hammar, Mats
    Linköpings universitet, Avdelningen för kliniska vetenskaper.
    Dahlberg, Johanna
    Linköpings universitet, Avdelningen för mikrobiologi och molekylär medicin.
    Faresjö, Tomas
    Linköpings universitet, Avdelningen för samhällsmedicin.
    Improvement of quality and safety in health care as a new interprofessional learning module – evaluation from students2014In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, no 7, p. 341-347Article in journal (Refereed)
    Abstract [en]

    Background: Interprofessional teamwork is in many ways a norm in modern health care, and needs to be taught during professional education.

    Description: This study is an evaluation of a newly introduced and mandatory learning module where students from different health profession programs used Improvement of Quality and Safety as a way to develop interprofessional competence in a real-life setting. The intention of this learning module was to integrate interprofessional teamwork within the students' basic education, and to give students a basic knowledge about Improvement of Quality and Safety. This report focuses on evaluations from the participating students (n=222), mainly medical and nursing students.

    Materials and methods: To evaluate this new learning module, a questionnaire was developed and analyzed using a mixed methods design, integrating both qualitative and quantitative methods. The evaluation addressed learning concepts, learning objectives, and interprofessional and professional development.

    Results and conclusion: A majority of students responded positively to the learning module as a whole, but many were negative towards specific parts of the learning module and its implementation. Medical students and male students were less positive towards this learning module. Improvements and alterations were suggested. 

  • 290.
    Gjessing, Kristian
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Torgé, Cristina Joy
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Arts and Sciences.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Dahlberg, Johanna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Improvement of quality and safety in health care as a new interprofessional learning module – evaluation from students2014In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, no 7, p. 341-347Article in journal (Refereed)
    Abstract [en]

    Background: Interprofessional teamwork is in many ways a norm in modern health care, and needs to be taught during professional education.

    Description: This study is an evaluation of a newly introduced and mandatory learning module where students from different health profession programs used Improvement of Quality and Safety as a way to develop interprofessional competence in a real-life setting. The intention of this learning module was to integrate interprofessional teamwork within the students' basic education, and to give students a basic knowledge about Improvement of Quality and Safety. This report focuses on evaluations from the participating students (n=222), mainly medical and nursing students.

    Materials and methods: To evaluate this new learning module, a questionnaire was developed and analyzed using a mixed methods design, integrating both qualitative and quantitative methods. The evaluation addressed learning concepts, learning objectives, and interprofessional and professional development.

    Results and conclusion: A majority of students responded positively to the learning module as a whole, but many were negative towards specific parts of the learning module and its implementation. Medical students and male students were less positive towards this learning module. Improvements and alterations were suggested. 

  • 291. Gladh, K.
    et al.
    Lo Martire, R.
    Äng, Björn
    Lindholm, P.
    Nilsson, J.
    Westman, A.
    Decelerations of parachute opening shock in skydivers2017In: Aerospace Medicine and Human Performance, ISSN 2375-6314, Vol. 88, no 2, p. 121-127Article in journal (Refereed)
  • 292. Gladh, K.
    et al.
    Äng, Björn
    Lindholm, P.
    Nilsson, J.
    Westman, A.
    Decelerations and muscle responses during parachute opening shock2013In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, no 11, p. 1205-10Article in journal (Refereed)
  • 293.
    Gonzalez-Calvo, Gustavo
    et al.
    Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Valladolid, Valladolid, Spain.
    Varea, Valeria
    Örebro University, School of Health Sciences.
    Martinez-Alvarez, Lucio
    Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Valladolid, Valladolid, Spain.
    'I feel, therefore I am': unpacking preservice physical education teachers' emotions2019In: Sport, Education and Society, ISSN 1357-3322, E-ISSN 1470-1243Article in journal (Refereed)
    Abstract [en]

    The teaching profession requires an understanding of teachers' and students' emotions, and teachers' emotions can influence their teaching practice, professional development and pedagogical approaches. Furthermore, emotions are embodied and they may have a detrimental effect on wellbeing if they are not addressed properly. This paper explores the emotional dimensions of preservice primary teachers' practicum experiences in physical education (PE). Body journals were used to collect data which were analysed using a Sociology of Emotions (SoE) approach. The findings revealed that preservice teachers' emotions manifest physically during their practicum, especially at particular junctures, such as at the beginning of their teaching. Preservice teachers felt the need to make a 'good impression' within the school through the regulation of their emotions as they faced continual challenges to succeed in unfamiliar teaching circumstances. The conclusions of this study demonstrate the benefits of providing opportunities for preservice PE teachers to reflect on their emotions during the practicum and the consequences that these may have on their bodies and teaching practices.

  • 294.
    González-Calvo, Gustavo
    et al.
    Department of Musical, Plastic and Body Expression, University of Valladolid, Palencia, Spain.
    Varea, Valeria
    Örebro University, School of Health Sciences.
    A Turning Point as an Opportunity to (Re)Think and Give a Voice to One’s Own Body2019In: Societies, E-ISSN 2075-4698Article in journal (Refereed)
    Abstract [en]

    This article explores the intersectionalities of masculinity, fatherhood, and physical activity in relation to a Physical Education teacher who has been diagnosed with an illness. In so doing, we draw on autobiographical narratives to delve into how embodied subjectivities are constructed to advance knowledge on a new embodied way of being a man and a PE teacher that can be accepted and embraced. The results are organised into three main themes: (1) narratives of continuation: the “before” of chronic illness; (2) narratives of disruption: back pain and temporary physical disability; and (3) restitution narratives: damn it, now that I am a father. The results suggest that narratives such as those presented in this article contribute to the continuously changing process of life projects and that illness can assist in redefining and reconstituting the persona of a PE teacher.

  • 295.
    González-Calvo, Gustavo
    et al.
    University of Valladolid, Valladolid, Spain.
    Varea, Valeria
    School of Education, University of New England, Armidale, NSW, Australia.
    Martínez-Álvarez, Lucio
    University of Valladolid, Valladolid, Spain.
    Health and body tensions and expectations for pre-service physical education teachers in Spain2019In: Sport, Education and Society, ISSN 1357-3322, E-ISSN 1470-1243, Vol. 24, no 2, p. 158-167Article in journal (Refereed)
    Abstract [en]

    The importance of the Physical Education (PE) teacher’s body, particularly for teaching PE, has been highlighted in literature. PE teachers are expected to be clear role models to students through their acts, behaviours and bodies. However, their strong embodied subjectivities, particularly those related to their teaching practices, may be problematised. This paper explores the ways in which a group of 15 pre-service PE teachers from a Spanish university constructed perspectives about the body and health in relation to their professional practices. Body journals were used to collect data, which were analysed using a Deleuze-Guattarian approach. The findings reveal the significant emphasis participants placed on their own bodies while teaching PE and the pressure they felt to conform to certain expectations of their professional roles. In response, we propose critical reflection on the content of Physical Education Teacher Education (PETE) programmes and incorporation of alternative pedagogical approaches to alleviate the heavy reliance on pre-service teachers’ bodies.

  • 296.
    Grahn Vera Gajardo, Jannette
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. 6406282787.
    ”Man vill ha bekräftelse på att allt rullar åt rätt håll” - En intervjustudie om föräldrars upplevelse av 3-års teambesöket på BVC i Värmland2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Föräldrarnas levnadsvanor kan vara avgörande för hur barnets framtida levnadsvanor kommer att se ut och är därför väsentliga ur ett folkhälsoperspektiv.

     

    Syftet med denna studie var att undersöka de värmländska föräldrarnas upplevelse av 3-års teambesök på barnavårdscentralerna (BVC) i Värmland. Teambesöket, där både barnhälsovårdsläkare och barnhälsovårdssjuksköterska träffar föräldrarna tillsammans har som syfte att prata om levnadsvanor med alla föräldrar ur ett hälsofrämjande perspektiv som innebär att utgå från faktorer som bidrar till att främja och bevara hälsan.

     

     

    För att svara på syftet användes kvalitativ induktiv metod. Urvalet, tio föräldrar, var strategiskt och kompletterades med ett bekvämlighetsurval. Datainsamlingen skedde genom intervjuer som spelades in, transkriberades och analyserades med kvalitativ innehållsanalys metod. Resultatet från denna studie visar att upplevelsen av 3-års teambesöket på BVC i Värmland skiljer sig åt avseende personalens bemötande. Faktorer som avgjorde upplevelse av ”det goda mötet” berodde inte endast på BVC-personalens tidsbrist utan upplevelsen påverkades också av förhållningssättet, innefattande struktur och arbetssätt på teambesöket. Det var viktigt för en positiv upplevelse att känna att alla blev delaktiga i ett samtal som inte är utpekande och som kan ge möjlighet till reflektion samt bekräftelse på att man som förälder gör rätt.  Det är dessa aspekter som leder till att föräldrarna känner sig stärkta i sitt föräldraskap. Föräldrarna upplevde levnadsvanefrågor som viktiga likaså uppföljningen av BVC samt att tilliten till BVC:s arbete med att övervaka och följa upp barns hälsa var stark.

     

    Mot bakgrund av studiens resultat föreslås åtgärder för att förbättra struktur, samarbete och roller på teambesöket på BVC i Värmland.

  • 297.
    Grape Viding, Christina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Osika, Walter
    Bojner Horwitz, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    "You Can´t Feel Healthier than Your Caregiver": The Ripple Effect of Trust and Empathy for Patients and Health Care Staff, Cultivated through Cultural Activities2017In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 6, no 5, article id 1000422Article in journal (Refereed)
    Abstract [en]

    Introduction: Stress-related problems, including burnout, cause personal suffering, disability and result in costly sick leave. The use of different cultural activities within a health care system may help to prevent burnout, but very few studies have focused on what happens after such activities.

    Methods: Interventions with different cultural activities were conducted for burn out patients in four primary health care settings during three months. Focus group interviews were conducted with patients, cultural producers and health care nurses. The aim was to provide a description of the participant’s experiences after the activities.

    Results: The cultural activities were found to affect both participants' emotions and behaviour and created a sense of belonging and equality among them. Positive 'spill-over' effects were also seen on nurses of health care management.

    Conclusion: We find that the cultural activities help to create a trustful and empathic health care environment where the wellbeing of staff and that of patients have an impact on each other. We suggest the incorporation of arts into health care as a possible contributor to the development of a sustainable health care system.

  • 298.
    Grenklo, Tove Bylund
    et al.
    Karolinska Institutet, Stockholm Sjukhem Foundation.
    Kreicbergs, Ulrika C
    Karolinska Institutet, Sophiahemmet.
    Valdimarsdóttir, Unnur A
    Karolinska Institutet, University of Iceland, Reykjavík, Iceland, Harvard School of Public Health, Boston, USA.
    Nyberg, Tommy
    Karolinska Institutet.
    Steineck, Gunnar
    Karolinska Institutet, Göteborgs universitet.
    Fürst, Carl Johan
    Karolinska Institutet, Stockholm Sjukhem Foundation, Lunds universitet.
    Communication and trust in the care provided to a dying parent: A nationwide study of cancer-bereaved youths.2013In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 31, no 23, p. 2886-2894Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To assess children's trust in the care provided to a dying parent during the final week of life in relation to end-of-life medical information about disease, treatment, and death.

    METHODS: This nationwide population-based survey included 622 (73%) of 851 youths who, 6 to 9 years earlier, at age 13 to 16 years, lost a parent to cancer. We asked about the children's reception of end-of-life professional information and trust in the care provided. We also asked about depression and several potential risk factors of distrust in the care provided.

    RESULTS: A majority (82%) reported moderate/very much trust in the care provided. Compared with children who received end-of-life medical information before their loss, the risk of distrust in the care provided was higher in those who received no information (risk ratio [RR], 2.5; 95% CI, 1.5 to 4.1), in those who only received information afterward (RR, 3.2; 95% CI, 1.7 to 5.9), and in those who did not know or remember if end-of-life medical information was provided (RR, 1.7; 95% CI, 1.1 to 2.5). Those reporting distrust in the care provided had an RR of 2.3 (95% CI, 1.5 to 3.5) for depression. Furthermore, the risk of distrust in the care provided was higher among children reporting poor efforts to cure (RR, 5.1; 95% CI, 3.6 to 7.3), and/or a poor relationship with the surviving parent (RR, 2.9; 95% CI, 2.0 to 4.1).

    CONCLUSION: Our study suggests that children's trust in the care provided to a dying parent was highest when they received end-of-life medical information before their loss.

  • 299.
    Grill, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Jönsson, Inger
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Hur skapar terapeuten ett samtalsklimat där patienten kan förmedla sitt dilemma med öppenhet och tillit?2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Som kliniker värderar vi energin i det terapeutiska samtalet. Studien syftar till att undersöka vad

    som möjliggör för patienter att sätta ord på livets mångfald, tillkortakommanden och existentiella

    dilemman i ett psykoterapeutiskt sammanhang. Kvalitativ metod tillämpades. En initierad

    kollega intervjuade en av författarna i hens roll som terapeut tillsammans med tre patienter och

    deras anhöriga vid olika tillfällen. Patienterna hade diagnoserna psykos, GAD (=generaliserad

    ångest) och depression och är knutna till öppenpsykiatrin. Intervjun genomfördes enligt

    samforskningsmetoden och filmades. Författarna har tittat spontant på de filmade intervjuerna

    och skrivit ned direkta reflektioner. Därefter särskådades materialet metodiskt för att identifiera

    samband och upprepningar. Analys av inspelningarna bekräftar vikten av terapeutens personliga

    egenskaper: Att kunna inge trygghet, och inspiration, att ha förmåga till inkännande, samt tilltro

    till patientens kapacitet under och utanför samtalen. Våra slutsatser stämmer väl med tidigare

    publicerade forskningsresultat.

  • 300.
    Grim, Katarina
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Rosenberg, David
    Umeå universitet.
    Svedberg, Petra
    Högskolan Halmstad.
    Schon, Ulla-Karin
    Högskolan Dalarna.
    Development and Usability Testing of a Web-Based Decision Support for Users and Health Professionals in Psychiatric Services2017In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, no 3, p. 293-302Article in journal (Refereed)
    Abstract [en]

    Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.

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