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  • Hägg Martinell, Ann
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Hult, Håkan
    Karolinska Institutet.
    Henriksson, Peter
    Karolinska Institutet.
    Kiessling, Anna
    Karolinska Institutet.
    Nursing Students Learn to Handle Stress and to Prioritize in a Complex Context During Workplace Learning in Acute Internal Medicine Care – An Ethnographic Study2020In: Advances in Medical Education and Practice, ISSN 1179-7258, E-ISSN 1179-7258, Vol. 11, p. 21-30Article in journal (Refereed)
    Abstract [en]

    Introduction: A common focus in many studies, in the short-term perspective, is to evaluate students’ workplace learning and its outcome. However, the outcome can be perceived differently depending on when it was evaluated. The aim of this study was to explore student nurses’ learning activities in an acute internal medicine unit and the nurses perceived learning outcome in a long-term perspective.

    Material and Methods: Repetitive ethnographic observations were performed in an internal medicine care unit at a teaching hospital in Sweden between 2011 and 2013. Four student nurses and supervisors were repetitively observed. Two years later retrospective interviews were performed with four nurses who had performed workplace learning, as students, in this unit during the observation period. An inductive comparative analysis involving all interviews and observational data was applied.

    Results: Three themes were identified: To handle shifting situations – illustrating how student nurses learnt to adapt to shifting situations, to manage stress, to create structure and space for learning and to deal with hierarchies; To build relationships – illustrating how student nurses learnt to collaborate and to interact with patients; To act independently – illustrating how student nurses trained to act independently in the unit, took responsibility, and prioritized in this complex context.

    Conclusion: Learning activities in a complex acute medical unit setting were characterized by a high workload and frequent stressful situations, and a demand on students to interact, to take responsibility, and to prioritize. To learn in such a stressful context, have in a long-term perspective, a potential to develop students’ embodied understanding of and in practice, making them more prepared to work and independently apply their nursing expertise in similar contexts as graduated nurses.

  • Johansson, Agnes
    et al.
    The Swedish Red Cross University College.
    Sannerblom Vargas, Carolina
    The Swedish Red Cross University College.
    Antikroppar och antirörelser: Varför föräldrar väljer att inte vaccinera sina barn2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The anti-vaccination movement has gained attention in the media over the last few years, which has revived the debate as to whether parents should vaccinate their children or not. Infections, whose incidence has previously been declining as a result of compliance to national immunization programmes, have made a resurgence and the protection of the society that comes with vaccinations is decreasing. Vaccines are one of the most cost-efficient measures available to health care to prevent spreading of diseases and decrease mortality at the population level.

    Aim: To study the factors that influence parents’ decisions not to vaccinate their children in accordance with national immunization programmes to increase the understanding of these decisions.

    Method: A scoping review of articles retrieved from the databases PubMed and CINAHL. A content analysis was used to interpret content and create context. The result was based on 23 articles.

    Results: Several reasons why parents don't vaccinate their children were uncovered. A fear of adverse effects and a lack of trust in health care, authorities and vaccines were prominent reasons for vaccination refusal. Where parents gathered information, how they defined health and culture or religion where other factors that influenced the decision not to vaccinate.

    Conclusion: The main findings indicate a lack of trust in authorities, health care or vaccines among parents. Gathering information from the internet and media have contributed to ignorance about and a fear of the effects of vaccines. Health care staff need to improve their person-centered care and adapt information about vaccines to the recipient.

  • Åkerlund, Joar
    The Swedish Red Cross University College.
    En god död: En litteraturstudie om betydelsen av sjuksköterskans omvårdnad2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund:Patienteni livets slutskedeställs inför faktum att vårdens inriktning ej är kurativ. Palliativ vård är en specialiserad vårdform ochbör ges till alla svårt sjuka och döende patienter oavsett vart de erhåller vård. Värdet av en individualiserad och personcentrerad vård i livets slutskede blir mer aktuell för att lindra den existentiella kris som kan uppstå hos patienten.

    Syfte: Att beskriva hur sjuksköterskans omvårdnad, genom interaktion och intersubjektivt utbyte,kan lindra existentiell kris och bidra till en god död för svårt sjuka och döende patienter.

    Metod: En allmän litteraturstudieav tolv vetenskapliga artiklar. Resultat:Tre teman identifieradesvidinnehållsanalysav artiklarna:kommunikation, relationer och utbildning. Relevansen av att sjuksköterskors omvårdnadskompetens och interaktion blev framträdande i mötet med svårt sjuka och döende patienter.

    Slutsats: Bekräftelse av patientens autonomi och värdighet emedan denne erhöll omvårdnad av sjuksköterskan påvisadesminska patientersexistentiella kriser. Detta ökade även möjligheten till en god död.

    Klinisk betydelse: Litteraturstudien påvisadeatt det existerar ett behov av att sjuksköterskor erhåller vidareutbildning och stöd i sitt arbete. Sjuksköterskor som möter svårt sjuka och döende patienter behöver en ökad insikt och förståelse i värdet av att ett holistiskt perspektiv av patienten kanresultera ien mer patientsäker och ökad person centrerad vårdvilket kan kopplas tillökad möjlighet till lindrad existentiell kris och en god död.

  • Maaniit, Nele
    et al.
    The Swedish Red Cross University College.
    Hult, Erik
    The Swedish Red Cross University College.
    Patienters erfarenheter av att leva med ett svårläkt bensår: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Lång läkningstid kan orsaka fysisk och psykisk lidande hos patienter med svårläkta bensår. Vården misslyckas att se helheten kring dessa personer. Syfte: Syftet med studien var att belysa patienters erfarenheter av att leva med ett svårläkt bensår. Metod: En allmän litteraturstudie med 12 artiklar varav sex var kvantitativa, fem kvalitativa och en med blandade metoder. Resultat: Två huvudteman identifierades: fysiska besvär och förändrad livskvalitet. Utifrån dessa kunde flera underteman framställas. De vanligaste fysiska besvären var smärta, fysisk inaktivitet och förekomst av sårsekret och -lukt. Förändrad livskvalitet innebar en förändrad vardag som begränsade de drabbade samt en negativ påverkan på det emotionella välbefinnandet. Slutsats: Resultatet visade att patienter med svårläkta bensår upplever både fysiska och känslomässiga besvär. Vården tar inte tillräckligt hänsyn till alla dessa aspekter. Mer förståelse behövs för hur vårdpersonalen upplever sin roll i omvårdnad av denna patientgrupp. Nyckelord: litteraturstudie, livskvalitet, patientperspektiv, smärta, svårläkta bensår

  • Amin, Ridwanul
    et al.
    Karolinska Institutet.
    Helgesson, Magnus
    Karolinska Institutet.
    Runeson, Bo
    Karolinska Institutet.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences.
    Mehlum, Lars
    University of Oslo, Oslo, Norway.
    Qin, Ping
    University of Oslo, Oslo, Norway.
    Holmes, Emily A
    Karolinska Institutet / Uppsala universitet.
    Mittendorfer-Rutz, Ellenor
    Karolinska Institutet.
    Suicide attempt and suicide in refugees in Sweden - a nationwide population-based cohort study2019In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, p. 1-10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite a reported high rate of mental disorders in refugees, scientific knowledge on their risk of suicide attempt and suicide is scarce. We aimed to investigate (1) the risk of suicide attempt and suicide in refugees in Sweden, according to their country of birth, compared with Swedish-born individuals and (2) to what extent time period effects, socio-demographics, labour market marginalisation (LMM) and morbidity explain these associations.

    METHODS: Three cohorts comprising the entire population of Sweden, 16-64 years at 31 December 1999, 2004 and 2009 (around 5 million each, of which 3.3-5.0% refugees), were followed for 4 years each through register linkage. Additionally, the 2004 cohort was followed for 9 years, to allow analyses by refugees' country of birth. Crude and multivariate hazard ratios (HRs) with 95% confidence intervals (CIs) were computed. The multivariate models were adjusted for socio-demographic, LMM and morbidity factors.

    RESULTS: In multivariate analyses, HRs regarding suicide attempt and suicide in refugees, compared with Swedish-born, ranged from 0.38-1.25 and 0.16-1.20 according to country of birth, respectively. Results were either non-significant or showed lower risks for refugees. Exceptions were refugees from Iran (HR 1.25; 95% CI 1.14-1.41) for suicide attempt. The risk for suicide attempt in refugees compared with the Swedish-born diminished slightly across time periods.

    CONCLUSIONS: Refugees seem to be protected from suicide attempt and suicide relative to Swedish-born, which calls for more studies to disentangle underlying risk and protective factors.

  • Nilsson, Henrik
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet / Swedish Red Cross Treatment Center for Persons Affected by War and Torture.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Gustavsson, Catharina
    The Swedish Red Cross University College. Uppsala University.
    Malm, Andreas
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet / Swedish Red Cross Treatment Center for Persons Affected by War and Torture.
    Gottvall, Maria
    The Swedish Red Cross University College, Department of Health Sciences. Uppsala University.
    Trauma-afflicted refugees' experiences of participating in physical activity and exercise treatment: a qualitative study based on focus group discussions2019In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 10, no 1, article id 1699327Article in journal (Refereed)
    Abstract [en]

    Background: Refugees with prolonged and repeated experiences of trauma, often in combination with post-migration living difficulties, are subjected to severe levels of stress and stress-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever. However, the effect of PA and exercise has received scarce attention in the context of PTSD, and particularly in the field of refugees' health.

    Objective: The objective of this study was to explore the experience of participation in PA and exercise as part of the treatment for trauma-afflicted refugees.

    Method: An explorative qualitative research design was used. Six focus group discussions were conducted with 33 female and male participants that had experience of group-based PA and exercise treatment. The gathered data was analysed by qualitative content analysis.

    Results: The analysis resulted in one over-arching theme reflecting the participants overall experience of PA and exercise as a process of building resilience. Participants experienced improvements in both physical and mental health domains. Increased self-awareness and self-confidence were seen as additional important benefits, and the interruption of daily stressors provided a sense of relief and recovery. The treatment group settings were experienced as becoming a vehicle for overcoming social fear and isolation, which also carried an empowering and strength-building impact over to participants' family life and social relationships. Treatment characteristics were experienced as highly supportive and often referred to as the basis of other positive experiences and perceived health benefits.

    Conclusions: The result of this study outlines a detailed account of trauma-afflicted refugees' experiences and preferences of PA and exercise-based treatment from a broad range of perspectives. These findings provide a starting point for future research in this field and indicate a particular need for both research and intervention development to include the real-life impact of participating in such treatments.