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  • 1.
    Abdulwassie, Nura
    et al.
    The Swedish Red Cross University College.
    Medin Restrepo, Julian
    The Swedish Red Cross University College.
    Aspekter i vårdmiljö som påverkar välmående: Allmän litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: When a person becomes unwell and develop an illness, they become vulnerable and more sensitive to the surrounding of the environment. The importance of health care has long been seen as a factor for well-being. The Nursing role as a caregiver is central and paramount and must have a holistic approach to care. AIM: The purpose was to describe the aspects of the healthcare environment that affect well-being. METHOD: A general literature study based on 21 articles with quantitative data was researched. RESULTS: The analysis process of data resulted in the emergence of two main themes with additional SUB themes. The senses- light, sound, smell. Physical environment that includes spaces, technical equipment, garden and design. CONCLUSION: It appears in our literature review, that different aspects of the healthcare environment can have both positive and negative effects in patients, close relatives and nurses' well-being. It is very important to quickly identify which aspects promote well-being and implement it in the healthcare environment to prevent that which leads to adverse effects. IMPLICATIONS: Nurses should have knowledge of the health care environment's effects in order to implement it in their work. By introducing these aspects, it is possible to create a better healthcare environment for patients, close relatives and nurses. More research into the roles of nurses in hospital is required.

  • 2.
    Abebe, Julia
    et al.
    The Swedish Red Cross University College.
    Gustafsson, Linn
    The Swedish Red Cross University College.
    Att leva med urininkontinens: En litteraturstudie ur kvinnans perspektiv2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Urinary incontinence is a common illness among women that has a negative effect on the mental health. The illness affects the everyday life and raise emotions such as dejection and anxiety. The most common risk factors for urinary incontinence are advanced age and post-delivery. Despite sufficient treatment options women do not seek help. Aim: To describe women’s experiences of living with urinary incontinence. Method: General literature study based on ten scientific articles with a qualitative approach. Findings: In order to control urinary leakage women planned the daily activities, adjusting to the unforeseeable nature of the disease. Urinary leakage interfered with their sex life and created feelings of shame and guilt. Urinary incontinence also hampered the ability to practice religion. Despite of the problems that urinary incontinence brought women did not see the disease as a legitimate problem and therefore did not seek care. Women who had sought help had experiences of not being taken seriously. Conclusion: Creating a positive experience of health care was of great importance to make women gain trust for the care system and therefore seek help. Urinary incontinence created feelings of shame and guilt which should be considered by caregivers when facing these women. In order to help these women knowledge is required about experiences of living with urinary incontinence. Relevance to clinical practice: Understanding how women experience living with urinary incontinence can bring caregivers required knowledge for nursing these women in the best way possible. Nurses should ask patients direct questions about urinary incontinence in order to legitimize it and gain knowledge about the disease impact on life.

  • 3.
    Aceijas, Carmen
    et al.
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; School of Health Sciences, University of Salford, Salford, Greater Manchester, UK..
    Brall, Caroline
    Department of International Health, School CAPHRI, Maastricht University, The Netherlands.
    Schröder-Bäck, Peter
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium.
    Otok, Robert
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium.
    Maeckelberghe, Els
    Institute for Medical Education, University Medical Center Groningen, The Netherlands.
    Stjernberg, Louise
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; School of Health Science, Blekinge Institute of Technology.
    Strech, Daniel
    School of Health Science, Blekinge Institute of Technology.
    Tulchinsky, Theodore H
    Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium; Braun School of Public Health, Hebrew University-Hadassah, Ein Karem, Jerusalem, Israel.
    Teaching Ethics in Schools of Public Health in the European Region: Findings from a Screening Survey2012In: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 34, no 1, p. 1-10Article in journal (Refereed)
    Abstract [en]

    A survey targeting ASPHER members was launched in 2010/11, being a first initiative in improving ethics education in European Schools of Public Health. An 8-items questionnaire collected information on teaching of ethics in public health. A 52% response rate (43/82) revealed that almost all of the schools (95% out of 40 respondents with valid data) included the teaching of ethics in at least one of its programmes. They also expressed the need of support, (e.g.: a model curriculum (n=25), case studies (n=24)), which indicates further work to be met by the ASPHER Working Group on Ethics and Values in Public Health.

  • 4.
    Adhan, Sophia
    et al.
    Red Cross University College of Nursing.
    Ahlinder, Susanne
    Red Cross University College of Nursing.
    Ung och söt: en litteraturstudie som beskriver faktorer inom omvårdnad som har betydelse för compliance hos ungdomar med diabetes typ 12010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To be young and have a chronic disease involving the most revolutionary change in life that can affect the whole family. Type 1 diabetes requires a lot from adolescents and their families, such as to follow a regular schedule for insulin intake, blood glucose monitors, to keep a special diet and keep a regular diary of blood glucose control, regular physical activity and to deal with high or low blood sugar. Compliance describes how patients with specific disease follow advice and prescriptions. Aim: The aim of this literature study was to describe the factors that are important for compliance in adolescents with type 1 diabetes. Method: The study was based on 11 scientific articles in both quantitative and qualitative approach. Results: The study emphasized the importance of the nurse, the diabetic trained nurse, and that parents should in the management of diabetes care provide adequate information to adolescents. Adolescents who have a chronic disease achieved good compliance when they had the energy, willpower, motivation and felt responsibility. The factor that has the greatest impact on compliance in adolescents with type 1 diabetes is when family and friends can participate, then the medical establishments and in the third place comes self-care. Conclusion: The disease creates pressures on family and it’s important for the adolescence to have support from families, relatives and friends, nurses and doctors. Adolescents with type1 diabetes must in their daily lives try to keep a steady and stable blood sugar level in order to achieve good treatment outcomes. Exercises improve insulin sensitivity, increase the burning of glucose, reduce cardiovascular disease and prevent obesity.

  • 5.
    Adolfsson, Josefin
    et al.
    The Swedish Red Cross University College.
    Lindström, Jeanette
    The Swedish Red Cross University College.
    Postoperativa halsbesvär efter larynxmask: en jämförande pilotstudie2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The literature describes the laryngeal mask as a gentle alternative to intubation with endotracheal tube. Previous studies show that it is not unusual with throat discomfort postoperatively, in terms of sore throat and/or hoarseness/dysphonia. The aim of this study was to investigate the presence and nature of throat discomfort postoperatively after the use of two different laryngeal masks. The authors conducted a pilot study in which nineteen adult patients, both men and women, who received Pro-Breathe® or I-gel® laryngeal mask during anesthesia was included. The patients were interviewed 60 minutes and 24 hours after the laryngeal mask were removed. The interview consisted of two sealed questions about sore throat and hoarseness/dysphonia and one open question about how it felt in the throat. The open question showed that other types of throat discomforts occurred, including irritability, difficulty swallowing, dryness and swelling sensation. The method of the pilot-study was suitable to use and responded to the study's purpose. The results showed that different types of throat discomfort were common postoperatively. Eight out of ten patients who received Pro-Breathe® and seven out of nine patients who received I-gel® had some type of throat discomfort.

  • 6.
    af Sandeberg, Margareta
    et al.
    Karolinska Institutet / Karolinska University Hospital.
    Johansson, Eva M.
    The Swedish Red Cross University College. Karolinska Institutet.
    Hagell, Peter
    Lund University.
    Wettergren, Lena
    Karolinska Institutet.
    Psychometric properties of the DISABKIDS Chronic Generic Module (DCGM-37) when used in children undergoing treatment for cancer2010In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 8, p. 109-Article in journal (Refereed)
    Abstract [en]

    Background: The aim was to evaluate data quality and psychometric properties of an instrument for measurement of health-related quality of life: DISABKIDS Chronic Generic Module (DCGM-37) used in school-aged children with cancer. Methods: All school-children diagnosed with cancer in Sweden during a two-and-a-half year period were invited to participate in the study. Analysis was performed on combined data from two assessments, two and-a-half and five months after start of cancer treatment (n = 170). The instrument was examined with respect to feasibility, data quality, reliability and construct and criterion-based validity. Results: Missing items per dimension ranged from 0 to 5.3 percent, with a majority below three percent. Cronbach's alpha values exceeded 0.70 for all dimensions. There was support for the suggested groupings of items into dimensions for all but six of the 36 items of the DCGM-37 included in this study. The instrument discriminated satisfactorily between diagnoses reflecting treatment burden. Conclusions: The results indicate satisfactory data quality and reliability of the DCGM-37 when used in children undergoing treatment for cancer. Evaluation of construct validity showed generally acceptable results, although not entirely supporting the suggested dimensionality. Continued psychometric evaluation in a larger sample of children during and after treatment for cancer is recommended.

  • 7.
    Afeworki, Tigisthi
    et al.
    The Swedish Red Cross University College.
    Andersson, Frida
    The Swedish Red Cross University College.
    Alla Lika Olika: Vårdupplevelser för familjer där föräldrarna lever i en samkönad relation2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Historically, people in same-sex relationships, have had a vulnerable position in society and are often victims of discrimination. In Sweden there is a law that prohibits discrimination related to sexual orientation. The aim of the health care law is that the entire population should have an equal health. Despite this, the selfrated heath of those who live in a same-sex relationship is often lower than the rest of the population. In healthcare, there is often a heteronormative approach, which can lead to uncertainty for families with a different constellation than heterosexuals. Aim: The aim of this study was therefore to describe how families with parents who lives in same-sex realtionship experienced meeting within health care. Method: To describe this, a qualitative content analysis with descriptive approach of 10 scientific articles were done. This was then discussed by Levinas's theory of the Other. Results: The results that emerged were that most positive experiences were based in a comfortness, which was born out of an acceptance from the healthcare side. The adverse experiences tended to be imbued with an emotional alienation, which in turn to an increased vulnerability. Conclusion: For all families to feel welcome and obvious, it would probably be helpful if health personell should meet each individual and family with an open mind, without making any assumptions on their lives. As the personell makes open questions and are comfortable with the answers, it might make it easier for all families to be honest with their situation.

  • 8.
    Agduhr, Therese
    et al.
    The Swedish Red Cross University College.
    Grundh, Camilla
    The Swedish Red Cross University College.
    Psykisk stress och depressiva symtom hos tonåringar med diabetes typ 12011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes mellitus type 1 is a chronic disease that affects children and adolescents. Diabetes treatment demands the parents and teenagers to be aware of the treatment and the complications of the disease that might occur if there is low compliance to the treatment. Diabetes type 1 may create a psychological stress due to the importance of achieving satisfactory blood glucose values. Previous research shows that teenagers with type 1 diabetes tend to be at risk for developing depression. Being a teenager with type 1 diabetes and a contemporary diagnosis of depression impairs adherence to diabetes treatment. Purpose: To describe the factors that contribute to psychological stress and depressive symtoms among adolescentes with type 1 diabetes. Method: A literature review based on 13 scientific articles with quantitative data. Results: Six factors were presented as contributing to the fact that adolescents with type 1 diabetes may suffer from psychological stress and depressive symtoms. The factors were: blood sugar control, family conflicts related to diabetes, family structure, gender, and psychological stress and time from onset. Conclusion: Each one of the factors might end up in psychological stress and depressive symtoms, but each factor also as an isolated phenomenon for teenagers with type 1 diabetes. 

  • 9.
    Agefur, Anders
    et al.
    The Swedish Red Cross University College.
    Orshammar, Maria
    The Swedish Red Cross University College.
    Postoperativ shivering efter laparoskopisk kirurgi: en pilotstudie2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Shivering is a phenomenon that occurs in patients postoperatively. This means that the patient has uncontrollable muscles tremors which allow the patient to tremble or shiver in more than 15 seconds. Previous research shows that shivering have a negative effect on the body, but is also an unpleasant and unnecessary suffering for the patient. In step, with today's rapid development in technology, more and more patients undergo surgery with laparoscopic techniques. The pilot- study aimed to investigate the incidence of postoperative shivering in patients who were surgical operated with laparoscopic technique. This empirical study has been done with a quantitative approach. Self-designed questionnaires, together with an instrument were used in the data col-lection. The pilot study enrolled 33 patients in the age range 23-78 years. The results of the pilot study suggest that the presence of shivering was little in relation to laparoscopic surgery, six (n = 6) of all (n = 33) patients in the study was shivering. When the study is made of a small scale is the result not possible to generalize, but you can still see that certain stressors, such as anesthesia drugs may contribute the patient shivering.

  • 10.
    Agheli, Nahal
    et al.
    The Swedish Red Cross University College.
    Svensson, Johan
    The Swedish Red Cross University College.
    Patienters skattning av postoperativt illamående och kräkning efter robotassisterad prostatektomi2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Robotic assisted prostatectomy requires special circumstances for the patient regarding their positioning. They lay with the head tilted down 45 degrees in a position called Trendelenburg and their bowel is insufflated with carbon dioxide which both can cause nausea and vomiting. The aim of this study was to investigate the frequency of postoperative nausea and vomiting 24 hours after a robotic assisted prostatectomy. The patients valued their own nausea according to the MANE-scale which is a 7-pointed scale. The method used was a quantitative non- experimental pilot study. 20 patients participated in the study. The result showed that more than a third of the patients were nauseas or vomited within 24 hours after surgery. Of all 20 participants only one had received antiemetics in preventing purpose. The conclusion was that this study should be proceeded and a larger number of patients should be evaluated too see if there is a need to adjust the antiemethic prophylaxis for this patientgroup in the future.

  • 11.
    Agius, Angeline
    et al.
    The Swedish Red Cross University College.
    Lallet, Sophie
    The Swedish Red Cross University College.
    "Somatik inom psykiatrin är svårt": En intervjustudie om sjuksköterskors upplevelser av det somatiska omvårdnadsarbetet inom psykiatrisk slutenvård2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients with mental illness are at increased risk for physical illness. The number of patients that are admitted to the psychiatric inpatient care has increased over the past decade. The nurse should be able to observe and manage the patient's mental need as well as their physical needs. They should also have a holistic and ethical approach and their work should be based on evidence and science. Aim: The aim of this study was to explore nurses' experiences regarding the care of patients with somatic conditions in psychiatric inpatient care. Method: This study is an empirical study with a descriptive qualitative approach based on semi-structured interviews with four nurses working in a psychiatric inpatient ward. A manifest content analysis was used to analyze the interview material. Results: The analysis emerged into three main categories which describe the experiences of the nurses. The categories are: 1) Experiences of somatic care, 2) The importance of knowledge and 3) Cooperation between the psychiatric and somatic care. Conclusion: The majority of the nurses in this study felt that the somatic care was difficult. Their resources are limited when somatically ill patients are admitted to the ward. They also experience that it is hard to keep the knowledge updated regarding somatic care and that there is a need for training. The nurses also felt that health care was divided between the somatic and the psychiatric care, although some patients are in need of the expertise and professionalism from both the somatic and psychiatric care. Clinical significance: The results of the study may contribute to provide a greater understanding of which factors that influence nurses' experiences of the care of patients with somatic conditions in psychiatric inpatient care.

  • 12.
    Agostinho, Tania Daniela
    et al.
    The Swedish Red Cross University College.
    Bougmza, Mariam
    The Swedish Red Cross University College.
    Stigma mot Hiv-smittade patienter inom vården: En allmän litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The study is about Hiv-infected patients experiences in the Swedish health care system. Sweden is the first country to reach UNAIDS goal named 90-90-90 but stigma against Hiv-infected still occurs in the health care. Aim: The aim was to illustrate stigma against Hivinfected patients in the health care. Method: The study contains six qualitative and four quantitative articles made between 2012-2018. The results from the articles were compiled. Results: Discrimination, prejudice and nurses on other sections’ than infection that showed concerns in front of the patient were found in the results. Immigrants and women that were born outside Sweden were exposed the most. Conclusion: The Swedish health care have evolved through the years but stigma against Hiv-infected patients still appears.

  • 13.
    Aguero-Torres, H
    et al.
    Aging Research Center (ARC).
    Kivipelto, M
    Aging Research Center (ARC).
    von Strauss, Eva
    Aging Research Center (ARC).
    Rethinking the dementia diagnoses in a population-based study: What is Alzheimer's disease and what is vascular dementia? A study from the Kungsholmen Project2006In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 22, no 3, p. 244-249Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the hypothesis that older adults often are affected by more than one disease, making the differential diagnosis between Alzheimer’s disease (AD) and vascular dementia (VaD) difficult. Methods: Incident dementia cases (n = 308) from a population-based longitudinal study of people 75+ years were investigated. The DSM-III-R criteria were used for the clinical diagnosis of dementia. Data on vascular disorders (hypertension, cerebrovascular and ischemic heart diseases, heart failure, atrial fibrillation, diabetes) as well as type of onset/course of dementia were used retrospectively to reclassify dementias. Results: Only 47% of the AD cases were reclassified as pure AD without any vascular disorder. Among subjects with AD and with a vascular component, cerebrovascular disease was the most common (41%). Only 25% of VaD were reclassified as pure VaD. Further, 26% of the pure AD subjects developed a vascular disorder in the following 3 years. Conclusions: Both vascular and degenerative mechanisms may often contribute to the expression of dementia among the elderly. Most of the AD cases have vascular involvements, and pure dementia types in very old subjects constitute only a minority of dementia cases.

  • 14.
    Agüero-Torres, H
    et al.
    Stockholm Gerontology Research Center, Karolinska Institute.
    Fratiglioni, L
    Guo, Z
    Viitanen, M
    von Strauss, Eva
    Winblad, B
    Dementia is the major cause of functional dependence in the elderly: 3-year follow-up data from a population-based study1998In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 88, no 10, p. 1452-1456Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this investigation was to study the role of dementia and other common age-related diseases as determinants of dependence in activities of daily living (ADL) in the elderly. METHODS: The study population consisted of 1745 persons, aged 75 years and older, living in a district of Stockholm. They were examined at baseline and after a 3-year follow-up interval. Katz's index was used to measure functional status. Functional dependence at baseline, functional decline, and development of functional dependence at follow-up were examined in relation to sociodemographic characteristics and chronic conditions. RESULTS: At baseline, factors associated with functional dependence were age, dementia, cerebrovascular disease, heart disease, and hip fracture. However, only age and dementia were associated with the development of functional dependence and decline after 3 years. In a similar analysis, including only nondemented subjects. Mini-Mental State Examination scores emerged as one of the strongest determinants. The population attributable risk percentage of dementia in the development of functional dependence was 49%. CONCLUSIONS: In a very old population, dementia and cognitive impairment make the strongest contribution to both the development of long-term functional dependence and decline in function.

  • 15.
    Agüero-Torres, Hedda
    et al.
    Äldrecentrum, Stockholm / Karolinska Institutet.
    Hillerås, Pernilla
    Äldrecentrum, Stockholm / Sophiahemmet högskola.
    Winblad, Bengt
    Äldrecentrum, Stockholm / Karolinska Institutet.
    Disability in activities of daily living among the elderly2001In: Current Opinion in Psychiatry, ISSN 0951-7367, E-ISSN 1473-6578, Vol. 14, no 4, p. 355-359Article in journal (Refereed)
    Abstract [en]

    The rise in number and proportion of older people, and the functional disability that is associated with increasing age, generate concern regarding the societal consequences of a large number of disabled elderly persons. Therefore, measuring disability in terms of activities of daily living has become routine in surveys of older people in most studies on ageing. Despite methodological obstacles, research into functional ability in the elderly has progressed during the past few decades. A high prevalence of functional disability in the elderly is consistently reported, although considerable variation has been found among studies. In contrast to functionally independent elderly, disabled elderly have been found to make increased use of home help services, and have higher institutionalization rates and premature mortality. Factors that are consistently reported as being associated with increased functional disability are older age, female sex, lower educational level, lack of exercise, chronic disease and impaired cognition. Among the chronic diseases, dementia is a progressive and disabling condition that accounts for a large proportion of the disability in elderly populations. A combination of various strategies must be employed in the approach to reduction of disability in the elderly population. More research is needed to gain a better understanding of risk and protective factors, so that we will be able to detect persons at early stages of disability, and to plan for services or rehabilitation for severely disabled persons.

  • 16.
    Agüero-Torres, Hedda
    et al.
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    von Strauss, Eva
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Viitanen, Matti
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Winblad, Bengt
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Fratiglioni, Laura
    Stockholm Gerontology Research Center and Division of Geriatric Medicine, NEUROTEC, Karolinska Institutet, Stockholm.
    Institutionalization in the elderly: The role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study2001In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 54, no 8, p. 795-801Article in journal (Refereed)
    Abstract [en]

    A population-based study of 1810 persons, aged 75+, was investigated to evaluate the role of dementia and other chronic diseases as determinants of institutionalization in the elderly. The study population was examined at baseline and after a 3-year interval. After adjustment for sociodemographic characteristics, functional dependence, dementia, cerebrovascular disease and hip fracture were associated with living in an institution at baseline. Additionally, functional dependence, hip fracture and dementia were also associated with moving to an institution during the 3-year follow-up. In a similar analysis, including only nondemented subjects, the Mini-Mental State Examination emerged as one of the strongest determinants. The population attributable risk percentage of institutionalization during the 3-year follow-up due to dementia was 61%. This study confirms that dementia and cognitive impairment are the main contributors to institutionalization in the elderly, independently of their sociodemographic status, social network, or functional status.

  • 17.
    Ahlin, Catharina
    The Swedish Red Cross University College, Department of Nursing and Care. Institutionen för medicin, Karolinska Institutet .
    Utveckling av instrument och bedömning av sjuksköterskestudenters kunskaper och färdigheter att genomföra venös provtagning och insättning av perifer venkateter2015Licentiate thesis, comprehensive summary (Other academic)
  • 18.
    Ahlin, Catharina
    et al.
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet and Karolinska University Hospital.
    Klang-Söderkvist, B
    Karolinska Institutet.
    Johansson, E
    Karolinska Institutet and Karolinska University Hospital.
    Björkholm, M
    Karolinska Institutet and Karolinska University Hospital.
    Löfmark, A
    University of Gävle / Western Norway University of Applied Sciences, Haugesund, Norway.
    Assessing nursing students' knowledge and skills in performing venepuncture and inserting peripheral venous catheters2017In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 23, p. 8-14Article in journal (Refereed)
    Abstract [en]

    Venepuncture and the insertion of peripheral venous catheters are common tasks in health care, and training in these procedures is included in nursing programmes. Evidence of nursing students' knowledge and skills in these procedures is limited. The main aim of this study was to assess nursing students' knowledge and skills when performing venepuncture and inserting peripheral venous catheters. Potential associations between level of knowledge and skills, self-training, self-efficacy, and demographic characteristics were also investigated. The assessment was performed by lecturers at a university college in Sweden using the two previously tested instruments "Assess Venepuncture" and "Assess Peripheral Venous Catheter Insertion". Between 81% and 100% of steps were carried out correctly by the students. The step with the highest rating was "Uses gloves", and lowest rating was 'Informs the patients about the possibility of obtaining local anaesthesia'. Significant correlations between degree of self-training and correct performance were found in the group of students who registered their self-training. No associations between demographic characteristics and correct performances were found. Assessing that students have achieved adequate levels of knowledge and skills in these procedures at different levels of the nursing education is of importance to prevent complications and support patient safety.

  • 19.
    Ahlin, Catharina
    et al.
    Red Cross University College of Nursing.
    Klang-Söderkvist, Birgitta
    Brundin, Seija
    Hellström, Birgitta
    Pettersson, Karin
    Johansson, Eva
    Implementation of a written protocol for management of central venous access devices: a theoretical and practical education, including bedside examinations.2006In: Journal of Infusion Nursing, ISSN 1533-1458, E-ISSN 1539-0667, Vol. 29, no 5, p. 253/294 quiz-259/296Article in journal (Refereed)
    Abstract [en]

    The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.

  • 20. Ahlin, Catharina
    et al.
    Löfmark, Anna
    Klang-Söderkvist, Birgitta
    Björkholm, Magnus
    Assessing nursing students´knowledge and skills in performing venepuncture and insertion of peripheral venous catheterArticle in journal (Other academic)
  • 21.
    Ahlin, Catharina
    et al.
    Red Cross University College of Nursing. Department of Medicine, Karolinska Institutet, Stockholm.
    Löfmark, Anna
    Department of Health and Caring Sciences, Gävle.
    Klang-Söderkvist, Birgitta
    Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, Stockholm .
    Johansson, Eva
    Department of Medicine, Karolinska Institutet, Stockholm.
    Development of instruments for assessment of knowledge and skills in performing venepuncture and inserting peripheral venous catheters2013In: Journal of Vascular Access, ISSN 1129-7298, E-ISSN 1724-6032, Vol. 14, no 4, p. 364-372Article in journal (Refereed)
    Abstract [en]

    Purpose: Performing venepuncture is one of the most routinely performed invasive procedures in nursing care. The aim of this study was to develop instruments for the assessment of nursing students’ knowledge and skills when performing venepuncture and inserting a peripheral venous catheter. 
Methods: Two instruments were developed using the following steps. 1) Assessment items of importance for the procedures (venepuncture 48 items and peripheral venous catheter 51 items) were collected from focus groups including nurses, lecturers and patients. 2) The number of items was reduced using a method based on the Delphi method. Experts (n=51) reviewed the instruments in two rounds. The revised versions included 31 items for venepuncture and 33 items for peripheral venous catheter insertion. 3) Usability tests were conducted by nurses who tested the instruments to confirm that items were possible to assess. 4) Inter-rater reliability was assessed by twelve lecturers who in pairs, but independently of each other, used the instruments to assess 50 nursing students. 
Results: Proportion of agreement and Cohen’s kappa coefficient were calculated for each item to determine inter-rater reliability. Among the tested items for both instruments, the median proportion of agreement was 1 (range 0.66-1) and the median kappa was 0.52 (range 0.22-1). 
Conclusions: The instruments developed for assessing nursing students’ knowledge and skills of venepuncture and peripheral venous catheter insertion showed satisfactory inter-rater reliability.

  • 22.
    Akpudo, Judith
    et al.
    The Swedish Red Cross University College.
    Abdirahman, Rahma
    The Swedish Red Cross University College.
    En litteraturstudie om faktorer som inverkar på ensamkommande flyktingbarns psykiska hälsa2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Children and young adolescents have been immigrating alone for decades. However the number of unaccompanied refugee children has increased in recent years in Europe, mainly in countries such as Britain, Sweden, Austria and Norway. In 2008, 13.400 children and young adolescents, immigrated without their parents to Europe and about 80% of them applied for asylum. Sweden alone received about 3,578 unaccompanied refugee children in 2012 and it is expected to increase in coming years. It has also been reported that unaccompanied refugee children have an increased risk of psychiatric morbidity.

    Aims: The aim of this study was to highlight factors affecting unaccompanied refugee children's mental health.

    Method: This study is a literature review based on eight quantitative and two qualitative studies.

    Results: Five themes were identified: Traumatic experiences, the Migration Process, Environment, Age and Gender. Traumatic experiences were the most predominant factor that contributed to the increased risk of developing mental illness. Furthermore the migration process and the environment in the new country had a big impact on these children/adolescents well-being. Additional identified factors were gender and age.

    Conclusion: The result of this study showed that these children / adolescents have suffered from various traumatic experiences highly contributing to an increased risk of developing mental illness. It was also found that the migration process and the environment in the new country contributed to the increased risk of developing mental illness.

    Clinical significance: This study can provide a better understanding of unaccompanied refugee children's mental health and illuminate the factors affecting their psychological well-being. Having knowledge of these factors, may help the nurses to identify these children's care needs.

  • 23.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola / Karolinska Institutet.
    Georgsson, Susanne
    Sophiahemmet Högskola / Karolinska Institutet.
    Lindgren, Helena
    Karolinska Institutet.
    Pettersson, Karin
    Karolinska Institutet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's attitudes, experiences and compliance concerning the use of Mindfetalness- a method for systematic observation of fetal movements in late pregnancy2017In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, no 1, article id 359Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Maternal perception of decreased fetal movements and low awareness of fetal movements are associated with a negative birth outcome. Mindfetalness is a method developed for women to facilitate systematic observations of the intensity, character and frequency of fetal movements in late pregnancy. We sought to explore women's attitudes, experiences and compliance in using Mindfetalness.

    METHODS: We enrolled 104 pregnant women treated at three maternity clinics in Stockholm, Sweden, from February to July of 2016. We educated 104 women in gestational week 28-32 by providing information about fetal movements and how to practice Mindfetalness. Each was instructed to perform the assessment daily for 15 min. At each subsequent follow-up, the midwife collected information regarding their perceptions of Mindfetalness, and their compliance. Content analyses, descriptive and analytic statistics were used in the analysis of data.

    RESULTS: Of the women, 93 (89%) were positive towards Mindfetalness and compliance was high 78 (75%). Subjective responses could be binned into one of five categories: Decreased worry, relaxing, creating a relationship, more knowledge about the unborn baby and awareness of the unborn baby. Eleven (11%) women had negative perceptions of Mindfetalness, citing time, and the lack of need for a method to observe fetal movements as the most common reasons.

    CONCLUSION: Women in late pregnancy are generally positive about Mindfetalness and their compliance with daily use is high. The technique helped them to be more aware of, and create a relationship with, their unborn baby. Mindfetalness can be a useful tool in antenatal care. However, further study is necessary in order to determine whether the technique is able to reduce the incidence of negative birth outcome.

  • 24.
    Akselsson, Anna
    et al.
    Sophiahemmet University / Karolinska Institutet.
    Lindgren, Helena
    Karolinska Institutet.
    Georgsson, Susanne
    The Swedish Red Cross University College. Karolinska Institutet.
    Pettersson, Karin
    Karolinska Institutet.
    Rådestad, Ingela
    Sophiahemmet University.
    Increased labor induction and women presenting with decreased or altered fetal movements - a population-based survey.2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 5, article id e0216216Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Women's awareness of fetal movements is important as perception of decreased fetal movements can be a sign of a compromised fetus. We aimed to study rate of labor induction in relation to number of times women seek care due to decreased or altered fetal movements during their pregnancy compared to women not seeking such care. Further, we investigated the indication of induction.

    MATERIAL AND METHODS: A prospective population-based cohort study including all obstetric clinics in Stockholm, Sweden. Questionnaires were distributed to women who sought care due to decreased or altered fetal movements ≥ 28 week's gestation in 2014, women for whom an examination did not indicate a compromised fetus that required induction of labor or cesarean section when they sought care. Women who gave birth at ≥ 28 weeks' gestation in 2014 in Stockholm comprises the reference group.

    RESULTS: Labor was induced more often among the 2683 women who had sought care due to decreased or altered fetal movements (RR 1.4, 95% CI 1.3-1.5). In women who presented with decreased or altered fetal movements induction of labor occurred more frequently for fetal indication than those with induction of labor and no prior fetal movement presentation (RR 1.6, 95% CI 1.4-1.8). The rate of induction increased with number of times a woman sought care, RR 1.3 for single presentation to 3.2 for five or more.

    CONCLUSIONS: We studied women seeking care for decreased or altered fetal movements and for whom pregnancy was not terminated with induction or caesarean section. Subsequent (median 20 days), induction of labor and induction for fetal indications were more frequent in this group compared to the group of women with no fetal movement presentations. Among women seeking care for altered or decreased fetal movements, the likelihood of induction of labor increased with frequency of presentation.

  • 25.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Karolinska Institutet.
    Georgsson, Susanne
    Sophiahemmet Högskola / Karolinska Institutet.
    Warland, Jane
    University of South Australia, Adelaide, Australia.
    Pettersson, Karin
    Karolinska Institutet.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Daily structured approach to awareness of fetal movements and pregnancy outcome - a prospective study2019In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, p. 32-37Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We investigated how women, seeking care due to decreased movements, had paid attention to fetal movements and if the method of monitoring was associated with pregnancy outcome.

    METHODS: A questionnaire was distributed to women from gestational week 28, who had sought care due to decreased fetal movements in Stockholm between January 1st and December 31st, 2014. Women were included in the study if the examination did not reveal any signs of a compromised fetus requiring immediate intervention. Birth outcome and sociodemographic data were collected from the obstetric record register.

    RESULTS: There were 29166 births in Stockholm in 2014, we have information from 2683 women who sought care for decreased fetal movements. The majority (96.6%) of the women stated that they paid attention to fetal movements. Some women observed fetal movements weekly (17.2%) and 69.5% concentrated on fetal movements daily (non-structured group). One in ten (9.9%) used counting methods daily for observing fetal movements (structured group). Women in the structured group more often had caesarean section before onset of labor (RR 1.6, 95% CI 1.2-2.2) and a lower risk of their baby being transferred to neonatal nursery (RR 0.25, 95% CI 0.03-0.94) compared to women in the non-structured group.

    CONCLUSIONS: Women, who had a daily and structured approach to awareness of fetal movements, were more likely to have a caesarean section but their babies were less likely to be transferred to a neonatal nursery as compared with women who used a non-structured method daily.

  • 26.
    Al ainy, Ghaith
    et al.
    Red Cross University College of Nursing.
    Nanyang, Rosemary
    Red Cross University College of Nursing.
    Kultur och omvårdnad: en litteraturstudie om kulturens betydelse i omvårdnadsarbetet2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Sweden has changed from a monoculture society to a multicultural society. A big part of the Swedish population today consists of people with different cultural backgrounds. These past decades the combination of the ageing population with different cultural backgrounds has put new demands on the Swedish health sector. This means that nurses today and in the future will meet patients from different cultures and with various health needs. Putting this in consideration it is significant to highlight the importance of cultural care and cultural competence in nursing encounter. Background: Patients with different ethnicity can be vulnerable because of problems they face when they move in the new country. Cultural differences and language barriers can be one of the obstacles for a patient to receive sufficient health care. Aim: The purpose of this study is to illustrate the importance of cultural care and cultural competence and the effects it has in nursing. Method: A literature study is designed to answer the aim of the study. Nine qualitative scientific articles and one article composed of both quantitate and qualitative are selected for the study. Results: seven categories were identified in the study: Communication and language barriers, education, cooperation with relatives, nurse’s attitudes, cultural competence, patient perspectives and nursing profession role. Conclusion: The result demonstrates categories in the studies that are important in caring for patients from other cultures. The study focused on highlighting the importance of culture in nursing. Most studies where about nurses but in the results section highlights include the patient's perspective, which essay writers feel that it can also help create awareness among all health care professionals in various fields.

  • 27.
    Albèr, Bjarne
    et al.
    The Swedish Red Cross University College.
    Jonsson, Leonard
    The Swedish Red Cross University College.
    Du får nog skylla dig själv, tror jag: En litteraturstudie om hur stereotyper och myter påverkar attityderna hos studenter till ett offer för våldtäkt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In recent years, male victims of rape have gained increased attention, but the majority of the research still focuses on women. There are many myths and prejudices that affect our attitudes toward victims of rape. A victim suffers from both physical and psychological injuries. Health care personnel have to see beyond their prejudices to give a good and equal care towards all individuals. Aim: The aim of this study was to highlight the similarities and differences regarding students’ attitudes/beliefs towards male and female rape victims. Method: A literature review was written based on nine scientific articles with quantitative approach. Results: The results indicated that men generally have a higher acceptance of rape myths regarding both women and men. Men showed more negative attitudes towards victims, allocated more blame and less sympathy toward victims than women. Both gender and sexuality affect attitudes towards victims, women and homosexual men generally received more blame than heterosexual men and homosexual women. Male and female beliefs/perceptions of rape are also different and it turned out men and women produce various nuisances regarding rape. Education were proven to be a factors influencing attitudes, higher education indicates more positive attitudes towards the victim. Conclusion: Different kinds of myths exist and can be connected to negative attitudes towards a victim of rape. A difference between men and women exists when it comes to myth acceptance. Depending on the victims sexual orientation, sex and character the view upon it changes. Clinical implication: Knowledge about these myths and attitudes can be used for future education for personnel working within this area and to help preventing a secondary victimization for the victim.

  • 28.
    Alderete, Nina
    et al.
    Red Cross University College of Nursing.
    Nylander, Anna-Carin
    Red Cross University College of Nursing.
    Hundens hälsofrämjande effekter inom vård och omsorg: Djurassisterade Interventioner2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Poor health increases today in Sweden in several health areas. Disease or other health problems can lead to a life-changing situation for many individuals. Experiencing insecurity, loneliness, lack of support and affirmation in this context may contribute to further health problems when health workers are affected by stress and lack of time. Antonovsky emphasized the importance of a salutogenic perspective to promote health. Aim: To highlight the health benefits of dogs on patients’ in health care. Method: A literature review based on the analysis of ten scientific articles according to the purpose. Result: The dog as a therapy animal in healthcare shows several health benefits in physical, mental, social and emotional health. The presence of the dog contributed to increased physical activity, energy, Quality of Life and social interaction while pain, stress and mental illness symptoms reduced. Conclusion: There are several health benefits of dogs in health and social care work, which suggests good reasons to further implement them in health care. Clinical importance: The result aims to highlight the potential value of dogs in health and social care work. This to further provide animal-assisted interventions as a complement to traditional health care and thereby achieve optimal health for more patients.

  • 29.
    Al-Edlah, Rami
    et al.
    The Swedish Red Cross University College.
    Mostafa, Chenar Hassan
    The Swedish Red Cross University College.
    Kvinnors psykosociala hälsa efter mastektomi: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common form of cancer affecting women in Sweden and worldwide. Treatment for breast cancer is usually a surgical procedure where parts of the breast or the entire breast are removed, a so-called mastectomy. Breasts are seen as a symbol of femininity, and if removed, the woman's self-image is affected negatively. Previous research has shown that the operation affects a woman's psychosocial health negatively, and beside the woman’s own coping skills, social environment does have a central part in the woman’s psychological health. Aim: The aim of this study was to describe the psychosocial health after a mastectomy in women with breastcancer. Method: This study is a study based on ten qualitative, scientific articles. All articles are analyzed and presented under main- and subcategories. Results: Five major categories and nine sub-categories emerged from the analysis, the main categories are: personal development, work, activities and economics, female identity, mental illhealth and social network. Conclusion: Women's psychosocial health is affected after a mastectomy, but the experience can vary based on their age and how they cope with their feelings. Mastectomized women need individualized care. Clinical significance: Nurses must have a good and individualized care towards these women. This literature study will help nurses to get more knowledge of women with breast cancer experience and psychosocial health after mastectomy.

  • 30.
    Alexandersson, Kristina
    et al.
    Karolinska Institutet.
    Lumikukka, Tuula
    Karolinska universitetssjukhuset, Huddinge.
    Tinghög, Petter
    Karolinska Institutet.
    Åkerlund, Kerstin
    Karolinska universitetssjukhuset, Solna.
    Att uppmärksamma barn till svårt sjuka patienter på en neurologisk klinik - utvärdering av implementering av rutiner och arbetssätt2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 4, p. 485-495Article in journal (Refereed)
    Abstract [sv]

    Barn till allvarligt somatiskt sjuka föräldrar löper en förhöjd risk för egen psykisk ohälsa. Här presenteras resultat från utvärderingen av implementering av rutiner och arbetssätt som syftade till att förbättra arbetet med att identifiera, informera samt stödja minderåriga barn till patienter på en neurologisk klinik. Fyra delstudier genomfördes. Resultaten indikerar att trots betydande insatser för att säkerställa att kliniken lever upp till sina lagstadgade uppgifter, fanns en stor förbättringspotential. Hela 80% av patienter med minderåriga barn hade inte fått information om sina barns rätt till stöd och 40% hade inte tillräckligt stöd för att utöva sin föräldraroll. Samtidigt noterades en tydlig ökning i andelen personal på kliniken som hade kunskap om sin skyldighet att erbjuda information, råd och stöd. 

  • 31.
    Alhall, Birgitta
    et al.
    The Swedish Red Cross University College.
    Buskas, Magnus
    The Swedish Red Cross University College.
    Ventilatorurträningsprotokoll inom intensivvården i Sverige: en totalundersökning2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The consequences of extended mechanical ventilation in the form of increased number of complications and high costs are well documented. The patient needs to wean with an adequate method without delay. Weaning protocols can reduce the risk of ineffective care and medical errors by providing common weaning strategy and terminology. The purpose of this study was to describe the contents of weaning protocols in Swedish intensive care units. The study consisted of a total survey, and all Swedish intensive care units were asked if they had weaning protocols. The protocols were analyzed on the basis of manifest content analysis. Four categories of the weaning process distinguished: readiness to wean criteria, guidelines for reduction in ventilatory support, fatigue criteria and extubation criteria. One fifth (21 %) of intensive care units in Sweden had a weaning protocol. In the 16 protocols 31 readiness to wean criteria, 8 methods for reduction of ventilatory support, 24 fatigue criteria and 9 extubation criteria where found. The most common readiness to wean criteria and fatigue criteria are well in line with what international studies recommends, however some weaning protocols included a large number of these criteria. Despite this no criteria occurs in all weaning protocols. Criteria to predict weaning outcome is almost completely missing in Swedish weaning protocols. The methods for reduction of ventilatory support showed a more united approach in which all lower ventilatory support as a first step. Even in this category some weaning protocols had included a large variety in methods for reduction of ventilatory support. The terminology used in the weaning protocols varies which makes quality evaluation difficult.

  • 32.
    Alipour, Mahdis
    et al.
    The Swedish Red Cross University College.
    Avarzed, Nyamsuren
    The Swedish Red Cross University College.
    Upplevelser av cytostatikabehandling hos patienter med cancer: En allmän litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cancer is a leading cause of death and is one of the biggest threatening factors for human health worldwide. One of the most common treatments for cancer is chemotherapy, cytostatic agents, which cause severe side effects, which affect the patient's daily life.

    Aim: The aim was to describe experiences of chemotherapy in patients with cancer.

    Method: The method used was a general literature study based on ten scientific articles of qualitative data which was analyzed with content analysis.

    Result: In the result, three theme and eight categories emerged. The three themes were: the experience of physical side effects, the experience of psychological side effects and participation.

    Conclusion: The results showed that chemotherapy and its side effects affected the patient's life, both physically, mentally and socially. Obtaining sufficient information from healthcare staff had a great impact on the patient. Patients with cancer often experienced difficulties in managing information and uncertainty in connection with the prognosis as well as the type of treatments available. It also occurred that the patient's quality of life was adversely affected in connection with chemotherapy.

    Suggestions for continued research: Side effects due to chemotherapy are perceived as a major problem for most patients with cancer, then it is important that further research on these areas be done.

  • 33.
    Allansson, Ola
    et al.
    The Swedish Red Cross University College.
    Nylander, John
    The Swedish Red Cross University College.
    De HIV-drabbade och vården: En litteraturöversikt om bemötandet av HIV- drabbade personer2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: HIV is one of the biggest global epidemics. Historically the HIV-infected persons have faced a discriminative and stigmatizing attitude inside the health care-sector. That form of negative reception has been seen as one of the biggest obstacles to decrease the spread of HIV and to create an equal healthcare sector.

    Aim: The aim is to highlight how HIV-infected persons experience the reception from health care professionals in countries with low prevalence of HIV.

    Method: A literature review with nine scientific articles, seven articles were qualitative, one was quantitative and one with mixed method.

    Results: Two main topics arised: The negative reception and The positive reception. The HIV-infected are still experiencing situations where they are treated with a stigmatized and discriminative attitude from the health care-professionals. The result, however, indicates that the reception has improved. The HIV-infected experienced that the positive interactions widely exceeded the negative.

    Conclusion: HIV-stigmatization is still a major issue within the health care sector. The HIV- infected, however, experience the stigmatizing reception in more isolated cases today and the positive reception widely exceeded the negative stigmatizing reception. The HIV-infected experienced health care professionals with high knowledge to give a better reception.

  • 34.
    Alm, Jenny
    et al.
    The Swedish Red Cross University College.
    Furness, Per
    The Swedish Red Cross University College.
    Pupillövervakning: specialistsjuksköterskans användning inom neurokirurgisk intensivvård2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pupil monitoring is part of the neurological assessment of high relevance to the neurosurgical intensive care patients. It is also described as part of pain and sedation monitoring. Objective: To investigate how specialist nurses in neurosurgical intensive care use pupil monitoring in their work. Method: The study was conducted as a semi-structured interview study. Six nurses working in neurosurgical intensive care were interviewed. The material was analyzed and presented in terms of themes and categories. Results: The two themes that emerged were To follow the course and To evaluate reliability. To follow the course meant that the pupil monitoring was described as part of monitoring and evaluating patient status and to take, defer, and evaluate nursing interventions. Documentation and reporting of pupil monitoring proved to be very important to follow patients' progress. The theme To evaluate the reliability revealed that nurses, with the help of pupil supervision, was described to distinguish actual changes in patient status to error values because of technical problems, but also to verify whether a sense of the nurse were in line with reality. Conclusion: Our results have shown that specialist nurses in neurosurgical intensive care use pupil monitoring not only to monitor patients' status and to evaluate interventions but also to evaluate the technology and reliability of emotional influence.

  • 35.
    Alm, Linda
    et al.
    Red Cross University College of Nursing.
    Björk, Jessica
    Red Cross University College of Nursing.
    Lindra lidandet vid stickrädsla: Litteraturstudie om omvårdnadsmetoder vid stickrädsla2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Approximately 10% of the world population suffers from some kind of needle fear. Vaccinations and blood sampling is common in today's modern health care and patients with needle fear may therefore avoid medical care which in turn could have a negative impact on their health. The nurse can alleviate suffering caused on the individual through proven knowledge of needle fear. Aim: To illustrate different nursing practices that can be used to relieve patients suffering from needle fear. Method: Literature review. Result: The results are reported under four themes. The Environment is shown to play a major role for the needle fear patient. The nurse can create a less clinical setting and hide needles, which have shown to help the patient cope with their fears better. The Time given to patients who feel fear and discomfort with vaccinations, blood tests or similar, have been shown to calm the needle fear. Likewise, the nurse's ability to make the process short, if desired, is appreciated by the patient. Distraction has been proven as a very good method to take care of needle fear patients and good examples are conversations, breathing techniques, word games or puzzles. Being taken seriously is often important to give a needle fear patient a good care experience and has also shown to be crucial as to whether the needle patient at a later date would rely on medical services and seek help or not. Conclusion: There are nursing care methods, which have been scientifically proven, that nurse can use to alleviate the suffering from patients with needle fear. Clinical significance: A major problem within the health profession is a lack of knowledge that needle fear occurs among adults. Therefore, the authors hope that by highlighting the topic in health care, adults should receive the same considerate needle fear care as children have access to today.

  • 36.
    Almqvist, C
    et al.
    Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Egmar, Ann-Charlotte
    Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Hedlin, G
    Department of Woman and Child Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm.
    Lundqvist, M
    Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Nordvall, S L
    Institute of Woman and Child Health, Uppsala University, Uppsala.
    Pershagen, G
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm.
    Svartengren, M
    Department of Public Health Sciences, Karolinska Institutet, Stockholm.
    van Hage-Hamsten, M
    Department of Medicine, Unit of Clinical Immunology and Allergy, Karolinska Institutet and Hospital, Stockholm.
    Wickman, M
    Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Direct and indirect exposure to pets: - risk of sensitization and asthma at 4 years in a birth cohort2003In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 33, no 9, p. 1190-1197Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: There are conflicting data on the association between early exposure to pets and allergic diseases. Bias related to retrospective information on pet ownership has been addressed as a reason for distorted study results.

    OBJECTIVE: To elucidate how early exposure to cat and dog relates to IgE-sensitization and asthma in children at 2 and 4 years of age, in a prospective birth-cohort study.

    METHODS: Four thousand and eighty-nine families with children born 1994-1996 in predefined areas of Stockholm answered questionnaires on environmental factors and symptoms of allergic disease at birth, one, two and four years of age. Dust samples collected from the mothers' beds at birth were analysed for Fel d 1 and Can f 1 in a subgroup of the cohort. Blood samples taken at four years from 2614 children were analysed for allergen-specific IgE to common airborne allergens. Risk associations were calculated with a multiple logistic regression model, with adjustment for potential confounders.

    RESULTS: A correlation was seen between allergen levels and reported exposure to cat and dog. Exposure to cat seemed to increase the risk of cat sensitization, OR (odds ratio) 1.44 (95% confidence interval 1.03-2.01), whereas dog exposure did not have any effect on dog sensitization, OR 1.16 (0.79-1.72). Dog ownership was related to a reduced risk of sensitization to other airborne allergens, OR 0.36 (0.15-0.83), and a similar tendency was seen for cat ownership OR 0.63 (0.37-1.07). Early dog ownership seemed to be associated with a lower risk of asthma, OR 0.50 (0.24-1.03), with no corresponding effect after cat ownership, OR 0.88 (0.56-1.38).

    CONCLUSION: Early exposure to cat seems to increase the risk of sensitization to cat but not of asthma at 4 years of age. Dog ownership, on the other hand, appears to be associated with lowered risk of sensitization to airborne allergens and asthma. Both aetiological relationships and selection effects have to be considered in the interpretation of these findings.

  • 37.
    Almqvist, C
    et al.
    The Department of Environmental Health, Karolinska Hospital, Stockholm.
    Larsson, P H
    National Institute for Working Life, Stockholm.
    Egmar, Ann-Charlotte
    The Department of Environmental Health, Karolinska Hospital, Stockholm.
    Hedrén, M
    National Institute for Working Life, Stockholm.
    Malmberg, P
    National Institute for Working Life, Stockholm.
    Wickman, M
    The Department of Environmental Health, Karolinska Hospital, Stockholm.
    School as a risk environment for children allergic to cats and a site for transfer of cat allergen to homes1999In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 103, no 6, p. 1012-1017Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many children are allergic to furred pets and avoid direct pet contact. The school may be a site of indirect exposure to pet allergens, which may induce or maintain symptoms of allergic diseases.

    OBJECTIVE: We sought to investigate airborne levels of cat allergen (Fel d 1) at schools and in homes with or without cats and to study clothes as a route for dissemination of allergens between homes and school.

    METHODS: Airborne cat allergen was collected with personal samplers from (1) children attending classes with many (>25%) or few (<10%) cat owners and (2) homes with or without cats. A recently developed amplified ELISA assay, which detects low levels of airborne cat allergen in pet-free environments, was used. Dust samples were collected from clothes and mattresses.

    RESULTS: There was a 5-fold difference in the median levels of airborne cat allergen between classes with many and few cat owners (2.94 vs 0.59 ng/m3; P <.001). The median airborne cat allergen concentration in classes with many cat owners was significantly higher than that found in the homes of non-cat owners (P <.001) but lower than that found in homes with cats (P <.001). Allergen levels in non-cat owners' clothes increased after a school day (P <.001). Non-cat owners in classes with many cat owners had higher levels of mattress-bound cat allergen (P =.01).

    CONCLUSION: The results indicate significant exposure to cat allergen at school. Allergen is spread through clothing from homes with cats to classrooms. There the allergen is dispersed in air and contaminates the clothes of children without cats. The allergen levels in non-cat owners' homes correlate with exposure to cat allergen at school.

  • 38.
    Almqvist, Catarina
    et al.
    The Department of Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Egmar, Ann-Charlotte
    The Department of Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    van Hage-Hamsten, Marianne
    The Department of Medicine, Unit of Clinical Immunology and Allergy, Karolinska Institutet, Stockholm.
    Berglind, Niklas
    The Department of Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Pershagen, Göran
    The Institute of Environmental Medicine, Karolinska Institutet.
    Nordvall, S Lennart
    The Institute of Woman and Child Health, Uppsala University, Uppsala.
    Svartengren, Magnus
    The Department of Public Health Sciences, Karolinska Institutet.
    Hedlin, Gunilla
    The Department of Woman and Child Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm.
    Wickman, Magnus
    The Department of Occupational and Environmental Health, Karolinska Hospital, Stockholm.
    Heredity, pet ownership, and confounding control in a population-based birth cohort2003In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 111, no 4, p. 800-806Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The association between pet ownership in childhood and subsequent allergic disease is controversial. Bias related to selection of pet exposure has been suggested as a reason for contradictory study results.

    OBJECTIVE: The purpose of this investigation was to elucidate how pet exposure depends on family history of allergic disease, smoking, and socioeconomic factors in a prospective birth cohort.

    METHODS: Parents of 4089 two-month-old children answered a questionnaire that included detailed questions about family history of asthma (maternal, paternal, and sibling), rhinoconjunctivitis, atopic eczema/dermatitis syndrome, pollen and pet allergy, smoking habits, parental occupation, and family pet ownership (cat and dog). Dust samples collected from the mothers' beds were analyzed for Fel d 1 and Can f 1 in a subgroup of the cohort.

    RESULTS: Cats were less frequently kept in families with parental asthma, rhinoconjunctivitis, or pet or pollen allergy (3.5% to 5.8%) than in families without parental allergic disease (10.8% to 11.8%). Dogs were less common in families with (3.3%) than in families without (5.9%) parental atopic eczema/dermatitis syndrome. Families with smoking mothers and those with low socioeconomic index kept cats and dogs more frequently. Cat allergen levels were lower in homes with than in homes without maternal pet allergy, and this tended to hold true even for homes without a cat. Cat ownership decreased from birth to 2 years of age, especially in families with parental history of allergic diseases.

    CONCLUSION: There seems to be a selection of pet exposure based on parental history of allergy, maternal smoking, and socioeconomic factors. This has to be taken into consideration in evaluations of risk associations between pet exposure and allergic disease in childhood.

  • 39.
    Alshaikh, Zahra
    et al.
    Sophiahemmet Högskola.
    Alkhodari, Mohammed
    Sophiahemmet Högskola.
    Sormunen, Taina
    Sophiahemmet Högskola.
    Hillerås, Pernilla
    Sophiahemmet Högskola / Karolinska Institutet.
    Nurses' knowledge about palliative care in an intensive care unit in Saudi Arabia2015In: Middle East Journal of Nursing, ISSN 1834-8742, Vol. 9, no 1, p. 7-13Article in journal (Refereed)
    Abstract [en]

    Background: Most patients die in hospital settings either in intensive care unit (ICU), emergency department (ED) or other departments. In Saudi Arabia, approximately 23,000 persons are diagnosed with cancer every year. According to the World Health Organization (WHO), palliative care is a holistic activity that involves physical, psychosocial and spiritual human needs to enhance quality of life for patients and their families. Palliative care is an essential aspect to be applied for patients with chronic diseases to improve their quality of life. Earlier studies have shown that physicians, nurses and nurse assistants who work in long-term care settings lack the knowledge to enforce palliative care principles due to lack of education. According to the WHO, health care professionals should be educated and trained to apply palliative care.Aim: The aim of this study was to explore nurses' knowledge about palliative care in an intensive care unit in Saudi Arabia. Method: Eight individual qualitative semi-structured interviews were conducted. Interviews were audiotaped and transcribed verbatim. Manifest content analysis was used to analyze the data. Results: The palliative care concept was not familiar for most ICU nurses but it was applied in their daily work. Most nurses provided physical care at the end of life to keep the body intact. Some nurses highlighted that dying patients did not feel pain to be treated and did not have emotions to be supported.Conclusions: Nurses had insufficient knowledge of palliative care and how to apply it in ICU setting. The provision of additional education in palliative care is recommended in order to improve the knowledge of palliative care among nurses.

  • 40.
    Amin, M. Ridwanul
    et al.
    Karolinska Institutet.
    Helgesson, M.
    Karolinska Institutet.
    Runeson, B.
    Karolinska Institutet.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences.
    Mehlum, L.
    National Centre for Suicide Research and Prevention, Oslo, Norway.
    Holmes, E.
    Karolinska Institutet.
    Mittendorfer-Rutz, E.
    Karolinska Institutet.
    The risk of suicidal behaviour in refugees and other immigrants to Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl. 4, p. 191-191Article in journal (Other academic)
  • 41.
    Amir, Catrine
    et al.
    The Swedish Red Cross University College.
    Ringvall, Carolina
    The Swedish Red Cross University College.
    Patient upplevelsen av att leva med tarmstomi: En litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: An intestinal stoma could mean great physical and mental changes and restrictions in a patient's life. Colorectal cancer and inflammatory bowel diseases are the most common causes of intestinal stoma. Stoma therapists are specially trained nurses, when they are not available, it is ordinary nurses that cater to the care of the patient. Aim: To illuminate the patient's experience of living with intestinal stoma. Method: A general literature review based on eleven qualitative articles. Results: The analysis resulted in four themes. Impact on daily life, change of habits that affect the patient's life. Body image, intestinal stoma changed the patient’s view of their body. Support, the importance of the nurse's role in nursing. Information, provided by the nurse was an important element in the self-care. Conclusion: It is of importance that the nurses in their role adapts the care individually and take into account the patient based on the patient’s individual needs. The nurse can also motivate the patient to participate in self-care and provide support for the patient to the adjustment of the intestinal stoma. By relating to the person-centered care the nurse can take the patient’s whole experience into account and gain a deeper knowledge of understanding the patient’s experience of living with an intestinal stoma. Continued research: As a nurse, it is important to always take note of current research in order to improve the care of patients with intestinal stoma. Further research is needed, since specific research was lacking in the area person-centrered and intestinal stoma care

  • 42.
    Andersson, Anna
    et al.
    The Swedish Red Cross University College.
    Holm, Katarina
    The Swedish Red Cross University College.
    Mamma, mamma, barn: lesbiska kvinnors upplevelser av mödravård samt förlossning2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The last decade has brought great changes for homosexuals in laws and regulations. Among other things, the right to be parent is now legally accepted. Many gay couples have therefore decided to create a family. The purpose of this study was to describe lesbian women´s experiences in connection with prenatal care and childbirth. The compilation resulted in five main categories: Communication, Acknowledgment, Defense, Knowledge and Openness, which was worked up from Imogene King´s theory of caring. The results showed that several women had experiences of positive character, but that there also were many who talked about negative experiences. Heteronormativity was a constantly recurring theme that permeated all categories. Caregivers often assumed that the lesbian women were heterosexual without regard to other possibilities. This study shows that health professionals should be aware of their own way to communicate and to ensure the uniqueness of each individual. Positive experiences emerged when the midwife is clearly confirmed the lesbian women as prospective parents. Good care requires that health professionals are aware of heteronormativity, and that creates obstacles to the care of lesbian women.

  • 43.
    Andersson, Ann-Christine
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Elg, Mattias
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Idvall, Ewa
    Malmö högskola, Fakulteten för Hälsa och samhälle.
    Perseius, Kent-Inge
    Landstinget i Kalmar län.
    Five Types of Practice-Based Improvement Ideas in Health Care Services: An Empirically Defined Typology2011In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 20, no 2, p. 122-130Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the health care sector. This study is based on a Swedish county council improvement program. Health care departments and primary health care centers in the Kalmar County Council were invited to apply for money to accomplish improvement projects. A qualitative content analysis was done of 183 proposed applications from various health care departments and primary health care centers. The following 5 types of improvement projects were identified: organizational process, evidence and quality, competence development, process technology, and proactive patient work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. These projects point to the various problems and experiences health care professionals encounter in their day-to-day work. To generalize beyond this improvement program and to validate the typology, we applied it to all articles found when searching for quality improvement projects in the journal Quality Management in Health Care during the last 2 years and found that all of them could be fitted into at least 1 of those 5 categories. This article provides valuable insights into the current state of improvemen work in Swedish health care, and will serve as a foundation for further investigations in this quality improvement program.

  • 44.
    Andersson, Ann-Christine
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Elg, Mattias
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University and Skåne University Hospital, 205 06 Malmö.
    Perseius, Kent-Inge
    Research Unit, Psychiatry Division, Kalmar County Council.
    Practice-based improvement ideas in healthcare services2010Conference paper (Other academic)
    Abstract [en]

    Objective. The present study will contribute to knowledge of how practitioners in a healthcare region engage in quality improvement initiatives. The focus is on individual placement needs, problems/issues and the ability to organize work on the development, implementation and institutionalization of ideas for the healthcare sector.

    Design and settings. This study is based on the Kalmar county council Improvement Program. Healthcare departments and primary healthcare centers in the county council were invited to apply for money to accomplish improvement projects. The aim is to empirically identify and present the different kinds of practice-based improvement ideas developed in healthcare services. The 202 applications received from various healthcare departments and primary healthcare centers are analyzed using qualitative content analysis.

    Outcome and Results. Five types of improvement projects were identified: Organizational Process; Evidence and Quality; Competence Development; Process Technology; and Proactive Patient Work. This illustrates the range of strategies that encourage letting individual units define their own improvement needs. In addition, a common characteristic among the studied project applications is to increase patient safety, effectiveness and availability of care, and education/training. Those intentions are found in many of the applications and therefore give the impression of being most important to caregivers today.

    Conclusions. These projects point to the various problems and experiences healthcare professionals encounter in their day-to-day work. This paper provides valuable insights into the current state of improvement work in Swedish healthcare, and will serve as a foundation for further investigations in this quality program.

  • 45.
    Andersson, Ann-Christine
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Elg, Mattias
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University and Skåne University Hospital, 205 06 Malmö.
    Perseius, Kent-Inge
    Research Unit, Psychiatry Division, Kalmar County Council.
    Who conducts quality improvement initiatives in healthcare services?: An evaluation of an improvement program in acounty council in Sweden2010Conference paper (Other academic)
    Abstract [en]

    Purpose – The aim of this paper is to contribute to the knowledge of who engages in quality improvement initiatives and to describe whether staff professions or gender are relevant variables.

    Design/methodology/approach – This paper contains an evaluation of the participants in a specific defined strategic improvement initiative program in one county council in southeast Sweden. The improvement program was initiated by county council politicians to encourage improvement initiatives and to spread improvement skills and knowledge in the organization. The program is driven both “top down” (teaching/convincing line managers to demand improvements) and “bottom up” through improvement programs using methodology to help teams identify, plan and adopt improvements in their daily work. Data was collected from special applications (called Free Applications, FA) and from participants in the education program (called Improvement Program, IP), both of which include information about profession and 2 gender. A content analysis was made. After the first categorization of which types of improvement projects practitioners engage in, further analysis of staff disciplines, professions (hierarchy) and gender was done. The results were compared to the overall structure of staff presence in the county council.

    Findings – Changes in participation occurred over time. The FA (Free Applications) part (n=202) shows a higher share of leaders and managers (35%), but their participation in the IP (Improvement Program) (n=477) fluctuated (8-26%). Physicians were more represented in the FA than in the IP. The largest single group was nurses. Overall the gender perspective reflects the conditions of the county council, but in FA the representation of women was lower. Five types of improvement projects were identified: 1) Organizational process focus; 2) Evidence and quality; 3) Competence development; 4) Process Technology; and 5) Proactive patient work. Managers were most represented in the category “Organizational process”. The largest difference was seen in the category “Proactive patient work” with the highest occurrence among women (86%) and less among men (17%) and managers (21%). The patient as a contributor taking active part was not found in either the FA or the IP.

    Research limitations/implications – This study shows differences in participation between free applications and methodology-guided programs when it comes to professions and gender in the country council improvement drive. It may be useful for further research regarding how to successfully work for and implement improvements and change in healthcare environments.

    Practical implications – The study will discuss and contribute to further knowledge of whether profession, hierarchy and gender have an impact (obstructive or as an asset) in performing improvement work in healthcare settings.

    Originality/value - Not much has been written about who is accomplishing quality improvements in terms of profession and gender. This paper provides some valuable insights into the differences between staff categories (professions) and gender in the improvement work in Swedish healthcare.

  • 46.
    Andersson, Ann-Christine
    et al.
    Division of Quality Technology and Management, Linköping University, Linköping.
    Elg, Mattias
    Division of Quality Technology and Management and HELIX Vinn Excellence Centre, Linköping University, Linköping.
    Perseius, Kent-Inge
    Nyckeln competence centre for pedagogy in health care, Kalmar County Council, Kalmar.
    Idwall, Ewa
    Faculty of Health and Society, Malmö University, Malmö.
    Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare2013In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, p. 48-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare.

    METHODS:

    A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted.

    RESULTS:

    The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach's alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach's alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work.

    CONCLUSIONS:

    The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

  • 47.
    Andersson, Ann-Christine
    et al.
    Division of Quality Technology and Management, Linköping University, Linköping.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University, Malmö.
    Perseius, Kent-Inge
    Nyckeln Competence Centre for Pedagogic in Health Care, Kalmar County Council, Kalmar.
    Elg, Mattias
    Division of Quality Technology and Management, Linköping University, Linköping.
    Evaluating a Breakthrough Series Collaborative in a Swedish Health Care Context2014In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065, Vol. 29, no 2, p. E1-E10Article in journal (Refereed)
    Abstract [en]

    This study evaluated the use of the Breakthrough Series Collaborative methodology in a Swedish county council improvement program, comparing measurements at the beginning and after 6 months. A questionnaire was used, and improvement processes and outcomes were analyzed. The results showed an overall large engagement in improvements, although the methodology and facilitators were seen as only moderately supportive.

  • 48.
    Andersson, Ann-Christine
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling.
    Idvall, Ewa
    Malmö University.
    Perseius, Kent-Inge
    Kalmar County Council.
    Elg, Mattias
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Kvalitetsteknik.
    Sustainable Outcomes of an Improvement Program: Do Financial Incentives Matter?2013In: Total Quality Management and Business Excellence, ISSN 1478-3363, E-ISSN 1478-3371, Vol. 24, no 7-8, p. 959-969Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate whether an improvement programme can contribute to positive sustainable improvements in an organisation, and whether financial incentives are driving forces for improvements. The material was all projects (n=232) that applied for funding in a county council improvement programme between 2007 and 2010. The projects were analysed as to whether they received funding (n=98) or were rejected (n=95). In addition, a categorisation of the projects' intentions was analysed. Some projects were still ongoing, but 50 projects were implemented and sustained two or more years after being finalised. Implemented improvements were on different levels, from (micro-level) units up to the entire (macro-level) organisation. In addition, 27 rejected projects were finalised without funding. Eighteen of those 27 were sustainably implemented. This study indicates that there are incentives other than financial at work if an improvement programme contributes to sustainable improvements in the organisation. To encourage practice-based improvements is one way of incentivising the intention and effort to become and perform better.

  • 49.
    Andersson, Ann-Christine
    et al.
    The Jönköping Academy for Improvements of Health and Welfare, School of Health Sciences, Jönköping University, Sweden .
    Idvall, Ewa
    Department of Care Science, Faculty of Health and Society, Malmö University and Department of Intensive Care and Perioperative Medicine, Skåne University Hospital, Malmö, Sweden.
    Perseius, Kent-Inge
    The Swedish Red Cross University College. Nyckeln Competence Centre for Pedagogy in Health Care, Kalmar County Council.
    Elg, Mattias
    Division of Quality Technology and Management and HELIX Vinn Excellence Centre, Linköping University, Sweden.
    Two Different Strategies to Facilitate Involvement in Healthcare Improvements: A Swedish County Council Initiative2014In: Global Advances in Health and Medicine, ISSN 2164-957X, E-ISSN 2164-9561, Vol. 3, no 5, p. 22-28Article in journal (Refereed)
    Abstract [en]

    Background: From a management point of view, there are many different approaches from which to choose to engage staff members in initiatives to improve performance.

    Objective: The present study evaluated how two different types of improvement strategies facilitate and encourage involvement of different professional groups in health-care organizations.

    Methods/Design: Empirical data of two different types of strategies were collected within an improvement project in a County Council in Sweden. The data analysis was carried out through classifying the participants' profession, position, gender, and the organizational administration of which they were a part, in relation to their participation.

    Setting: An improvement project in a County Council in Sweden.

    Participants: Designed Improvement Processes consisted of n=105 teams and Intrapreneurship Projects of n=202 projects.

    Intervention: Two different types of improvement strategies, Designed Improvement Processes and Intrapreneurship Projects.

    Main Outcome Measures: How two different types of improvement strategies facilitate and encourage involvement of different professional groups in healthcare organizations.

    Results: Nurses were the largest group participating in both improvement initiatives. Physicians were also well represented, although they seemed to prefer the less structured Intrapreneurship Projects approach. Assistant nurses, being the second largest staff group, were poorly represented in both initiatives. This indicates that the benefits and support for one group may push another group aside.

    Conclusions: Managers need to give prerequisites and incentives for staff who do not participate in improvements to do so. Comparisons of different types of improvement initiatives are an underused research strategy that yields interesting and thoughtful results.

  • 50.
    Andersson, Danielle
    et al.
    The Swedish Red Cross University College.
    Blom, Julia
    The Swedish Red Cross University College.
    Evidensbaserade trycksårsförebyggande insatser för äldre patienter: En kvantitativ litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pressure ulcers are a major problem in health care. They easily occur among elderly patients, and cause suffering for them. One task of being a nurse is to identify the patients' needs of prevention. Many pressure ulcer preventions exist, such as risk assessment, repositioning and support surfaces. Despite this, there is uncertainty about how these preventive measures should be used. This work focuses on describing evidence-based pressure ulcer prevention for the elderly to facilitate nurses' choices regarding the application of their resources, as well as reduce the incidence of pressure ulcers among elderly patients.

    Aim: To describe evidence-based pressure ulcer prevention in elderly patients.

    Method: A literature review containing ten quantitative articles.

    Results: Pressure ulcer incidence can be reduced by use of assessment instruments in combination with the nurse's clinical judgment. Viscoelastic mattress, air alternating mattress and cover have been shown to be effective as pressure ulcer prevention. Repositioning every three hours during the night reduces the incidence of pressure ulcers, and so does repositioning every four hours in combination with a pressure-relieving viscoelastic mattress. Additionally, pressure ulcers on heels can be avoided if a wedge-shaped viscoelastic cushion or a heel guard is used. Pressure relieving wheelchair cushions have been shown to reduce the incidence of pressure ulcers.

    Conclusion: Risk assessment instruments should be combined with the nurse's clinical assessment, and based on the results obtained pressure ulcer prevention efforts can be selected, such as air alternating or viscoelastic mattress, or pressure relieving wheelchair cushion. Repositioning have shown reduced pressure ulcer incidence, but there is uncertainty about the interval that should be used, and therefore more research is needed in this area. There is clear evidence that a wedge-shaped pillow or a heel guard provides reduced pressure ulcer incidence.

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