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  • 1.
    Aav, Christoffer
    et al.
    Swedish Red Cross University.
    Norgren, Erik
    Swedish Red Cross University.
    Sökandet Efter Trygghet: HBTQ+ Flyktingars Upplevelser av Vårdmöten Efter Migration2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of forced migrants is increasing globally. The health and human rights of lesbian, gay, transgender, queer people and other people with diverse sexuality and gender identities [LGBTQ+], are challenged, as well as those of migrants and refugees. Forced migrants self-identifying as LGBTQ+ are exposed to severe violence and health-related burdens during and after their migration. Nurses are responsible to ensure universal and person-centred healthcare.

    Aim: The aim of this study was to synthesise qualitative research exploring post-migration experiences of healthcare encounters between LGBTQIA+ forced migrants and health professionals, based on the perspectives of both parts.

    Method: Literature review of qualitative empirical research. Structured searches were performed in four databases and eight scientific reports were included following screening. Methodological quality was appraised and the results in the reports were analysed using qualitative metasynthesis.

    Results: All reports were appraised to have high methodological quality. Safety and security were essential for LGBTQIA+ migrants’ experience of healthcare encounters. LGBTIA+ migrants experienced barriers to healthcare as well as discriminatory attitudes in healthcare systems post migration. Knowledge and understanding of LGBTQIA+ migrants were important to create safe and dignified healthcare encounters.

    Conclusion: More research about this group is needed in a variety of geographic regions and different clinical settings. Reflective practice and affirming care can create safer healthcare encounters for LGBTQIA+ migrants.

  • 2.
    Abadi, Mahnour
    et al.
    Swedish Red Cross University.
    Akter, Mst Tohmina
    Swedish Red Cross University.
    Sjuksköterskors erfarenheter av att stödja patienter med diabetes typ 2 till egenvård inom primärvården: En allmän litteraturstudie2024Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is an increasingly prevalent public health issue characterized by a progressive disease course. It is attributed to various factors, including lifestyle, reduced physical activity, and genetics. Enhanced knowledge among primary care nurses can enable patients to implement lifestyle changes effectively.

    Aim: The purpose was to describe nurses’ experiences of supporting patients with type 2 diabetes to selfcare in primary health care settings.

    Method: This study employs a general literature review methodology with qualitative approaches, drawing on 10 scientific articles.

    Results: The analysis identified two main categories: communication as well as knowledge and motivation. These categories were crucial from the nurse´s side to achieve self-care in the patient. Different experiences emerged from nurse´s side to achieve motivation and communication.

    Conclusion: Type 2 diabetes is a growing public health concern. A significant barrier to effective management is the lack of knowledge among both nurses and patients. There is a critical need for competent nurses in primary care to motivate patients towards lifestyle modification and self-care.

  • 3.
    Abdieva, Gulnoza
    et al.
    Swedish Red Cross University.
    Fredmer, Daniela
    Swedish Red Cross University.
    Palliativ vård i hemmet: En litteraturstudie om vårdade personers erfarenheter2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bakground: Palliative care is based on the concept that a person at the end of life should still have agood life quality. The care received should also be based on the sick persons wishes and preferences. During palliative care the person cared for should be able to chose where they want to receive the care and a lot of people want to die at home.

    Aim: The aim of this study is to describe the experiences of people receiving palliative care at home.

    Method: This is a literature study with a qualitative approach that follows Polit and Beck's nine-stepmodel. Ten articles were identified and analyzed using a thematic analysis.

    Results: The results show two themes and four subtemes: Communication with subtemes Accessibility and Partnership. Well-being with subtemes Comprehensive care and Security & Insecurity.

    Conclusions: People who receive palliative care at home are in need of feeling safe and being seen asa whole person in nursing. It is important for the sick people to have a good relationship with their caregivers based on partnership and accessibility. Home care should be well-planned and organizedas poor communication can lead to insecure care.

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  • 4.
    Abdille, Fadumo Yusuf
    et al.
    The Swedish Red Cross University College.
    Barseye, Leyla Hussein
    The Swedish Red Cross University College.
    Sjuksköterskors upplevelse av att vårda patienter med självskadebeteende: En litteraturstudie2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Nonsuicidal self-injuries behavior is common at all ages. Individuals with nonsuicidal self-injuries behavior face stigma and discrimination. Nurses can make a big difference for these patients by treating them in a respectful way.

    Aim: The purpose was to describe nurses' experience of caring for patients with self-harming behavior in a varied healthcare context. 

    Method: The study has a literature review design and use nine qualitative original articles. The articles were searched in the databases CINAHL and PubMed. Data were analyzed with qualitative content analysis.

    Results: Two categories were identified; the care relationship is perceived as complex with the subcategories emotional impact and feeling of insecurity in nursing-role as well as challenges in the daily work with subcategories need for time for communication and need for education. 

    Conclusions: Spreading of knowledge and increased awareness of the subject is needed to improve care for patients with nonsuicidal self-injuries behavior.

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  • 5.
    Abdisalaan, Hannah
    et al.
    Swedish Red Cross University.
    Yilmaz, Leyla
    Swedish Red Cross University.
    Föräldrars upplevelser av pediatrisk palliativ slutenvård: En litteraturstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pediatric palliative care involves the care of both child and parents as parents have an important role in the care of their child. Many of the children who die annually in Sweden receive palliative care in inpatient care. The nurse should provide person-centered care for both the child and parents. A key factor in being able to conduct person-centered care is to understand the importance of parents' perspectives. Thus, it is important to describe parents' experiences of pediatric palliative inpatient care. Aim: The aim was to describe parents' experiences of pediatric palliative inpatient care. Method: A literature review performed with qualitative content analysis. Results:Both positive and negative experiences of pediatric palliative inpatient care emerged. Three categories were identified: Communication, Participation and Support that describe parents' experiences. Conclusion: Parents play a  crucial role in pediatric palliative care because they form a patient group together with the child. Parents' experiences of care and their desire for how to improve care can give the nurse an increased understanding of the importance of the person-centered approach.

  • 6.
    Abdollahzadeh, Avishan
    et al.
    Swedish Red Cross University.
    Sangarnegar, Andreas
    Swedish Red Cross University.
    Erfarenheter vid tillämpning av m-hälsa och digital hälsoteknik bland personer med diabetes typ 22022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is a chronic disease and a global public health problem. Healthcare in many countries are working hard to reduce diabetes-related complications. Patient self-care and self-management of type 2 diabetes play a major roll during the treatment. Digital health technology and mHealth are resources that can enable patients to feel involved and independent in the management of type 2 diabetes. These health initiatives have the potential to increase the patient’s well-being and quality of life. 

    Aim: The aim was to describe experiences of the use of mHealth and digital health technologies among patients with type 2 diabetes. 

    Method: General literature review with thematic analysis based on 11 original scientific articles with a qualitative approach. 

    Results: The data analysis resulted in five themes: Improved self-care and empowerment, Increased knowledge and patient coaching, Integrity, safety and credibility, Accessibility to care providers, Challenges- costs and technical experience. The results showed that there are both opportunities and challenges with the use of m-health and digital health technology for patients with type 2 diabetes. These health resources could strengthen patients' ability to self-care which contributed to increased autonomy and independence in patients.

    Conclusions: The patients had a positive experience of applying digital heath technologies and mHealth regarding to self-care activities as well as knowledge and control over the disease state. Digital health care services in long distance enabled easy and convenient access to healthcare professionals for patient with type 2 diabetes, increased their satisfaction and reduced the need for physical visits by healthcare professionals. The cost of technology equipment and low levels of digital competence limited patients’ experience of the opportunities that might be used of these resources. Good and equal health can be achieved by increasing awareness of the opportunities offered by mHealth and digital health technologies. 

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  • 7.
    Abdul Majeed, Abdul Hameed
    et al.
    Swedish Red Cross University.
    Gidlund, Johanna
    Swedish Red Cross University.
    Hur patienter med typ 2-diabetes upplever sin egenvård: En litteraturstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes mellitus typ 2 är en folksjukdom som ökar globalt. För att förhindra progression av typ 2 diabetes (T2D) behöver personen leva ett sundare liv. En bra balans mellan fysisk aktivitet, kost och medicinering kan vara avgörande i behandlingen av T2D. Egenvård är även en viktig del av behandlingen.

    Syfte: Syfte med denna litteraturstudie är att beskriva hur personer med diabetes typ 2 upplever sin egenvård.

    Metod: En allmän litteraturstudie som består av 11 kvalitativa vetenskapliga artiklar. Vid analysering av artiklarna används tematisk innehållsanalys.

    Resultat: Två huvudteman identifierades, Hantering av egenvård samt subteman: Hinder och motivation till egenvård, Utmaningar med glukoskontroll, Utmaningar med kost, Utmaningar med fysiskaktivitet samt Utmaningar med medicinering. Andra huvudtema var Stöd vid egenvård samt subtema: Stöd från närstående och vänner samt Bristande stöd från hälso- och sjukvården. Resultaten visade att egenvård vid diabetes upplevdes utmanande, på grund av alla krav som sjukdomen ställde i vardagen.

    Slutsats: Det finns många hinder för att patienter med T2D skall kunna hantera sin egenvård. Det finns även kunskapsbrister både hos personer med T2D och deras närstående, när det kommer till sjukdomen och egenvårdshantering.

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    Hur patienter med typ 2-diabetes upplever sin egenvård
  • 8.
    Abdulahi Jama, Saido
    et al.
    The Swedish Red Cross University College.
    Munter, Nanna
    The Swedish Red Cross University College.
    Omvårdnad vid urininkontinens hos kvinnor2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Urinary incontinence (UI) is a public health problem, globally and nationally. UI means a reduced quality of life for those suffering from it and at the same time it means high costs for the care. Within the patients, women are overrepresented. Nearly half of all women are at risk of UI in adult age. There are about 500,000 people in Sweden with such severe degrees of UI, that it effects their everyday lives. 

    Aim: The aim was to highlight nursing measures given to women with urinary incontinence. Method: A literature review with thematic analysis. Scientific articles used include 

    qualitative and quantitative studies. 

    Result: Three themes were identified. “Pelvic floor training as nursing measure” with categories “Training recommendations”, “Yoga and bioassisted-technic”, “Conservative treatment and motivational interviewing” with categories “Follow-up” and “Adapted nursing measures” and “Barriers that prevent nursing measures” with the categorie “Need for competence” and “Lack of documentation and stigma”. 

    Conclusion: Conservative management measures aren ́t enough, although the combination of motivational interviewing, clear instructions, with yoga or bio-assisted-technique, reduced UI are shown. Lack of knowledge according to detection, preventive nursing measures of and documentation. Difficulties in talking about UI, related to stigma, lead to patients not receiving the care needed. 

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  • 9.
    Abdulkader, Diana
    et al.
    Swedish Red Cross University.
    Ericsson, Albin
    Swedish Red Cross University.
    Faktorer som kan påverka sjuksköterskors bemötande av patienter med psykisk ohälsa på somatiska vårdavdelningar: En litteraturöversikt2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Psykisk ohälsa är ett ökande folkhälsoproblem som drabbar människor i alla åldrar. Denna patientgrupp upplever hur attityder, stigmatisering och bristande kunskap påverkar deras somatiska vård. För sjuksköterskor inom den somatiska vården kan det bli en utmaning att vårda dessa patienter, till följd av bristande kunskap, rädsla och fördomar.

    Syfte: Studiens syfte var att beskriva faktorer som kan påverka sjuksköterskors bemötande motpatienter med psykisk ohälsa på somatiska vårdavdelningar.

    Metod: Studien bygger på en litteraturöversikt med en kvalitativ ansats. Åtta originalartiklar granskades med en kvalitativ innehållsanalys och SBU:s granskningsmall.

    Resultat: De tre kategorierna som identifierades var ”Bristande resurser” med tillhavande underkategorier ”Behov av större insatser för behandling av mental-somatisk multisjukhet” och ”Kommunikation och vårdrelation förbättrar behandlingsmöjligheterna”, ”Kunskap och erfarenhet” med underkategorier ”Bristande kunskap och psykisk ohälsa” och ”Yrkeserfarenhet kan påverka sjuksköterskornas attityd” samt ”Stigmatisering” med tillhavande underkategori “Förutfattade meningar och psykisk ohälsa”

    Slutsats: Studien påvisar utmaningar inom somatisk vård, där sjuksköterskor ofta känner sig obekväma i mötet med patienter som lider av psykisk ohälsa. Sjuksköterskor redogör för bristande kunskap och kompetens, känslor av rädsla och obehag, samt brist på resurser. Slutsatsen finns det ett tydligt behov av förbättrad utbildning och stöd för sjuksköterskor inom somatisk vård för att bättre kunna möta behoven hos denna patientgrupp.

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  • 10.
    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.

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  • 11.
    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.

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  • 12.
    Abrahamsson, Anna
    et al.
    Swedish Red Cross University.
    Carlsson, Lina
    Swedish Red Cross University.
    Borde jag ta bort mina bröst?: Aspekter som påverkar kvinnors beslutsfattande vid profylaktisk mastektomi2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common cancer diagnosis, and BRCA 1/2 gene mutations increases breast cancer risk. Affected women receive information about treatment strategies, which are discussed with relatives and healthcare professionals and lay the foundation for treatment choices. Women´s experiences of prophylactic mastectomy are affected by many aspects, highlighting the importance of nursing competence. 

    Aim: To synthesize qualitative research exploring aspects affecting women´s decision-making regarding prophylactic mastectomy in case of increased breast cancer risk or existing unilateral breast cancer.   

    Method: A literature review with a qualitative approach based on 13 original articles, analyzed using thematic content analysis.  

    Result: Three themes were identified; “Existential choices”, “The importance of information” and “Physical impact”. “Existential choices” resulted in the subthemes, “Mastectomy as anxiety reliever” and “Reducing the risk of (re)occurrence”. “The importance of information” presented the subthemes “Informational needs” and “The experiences/opinions of others”. “Physical impact” offered subthemes “View of body and femininity” and “Breastfeeding”.  

    Conclusion: Aspects influencing women's decision-making regarding prophylactic mastectomy were revealed, e.g. fears, information and physical aspects. The results indicate a need for further research to deepen understanding and enhance healthcare competence for person-centered and holistic care. 

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  • 13.
    Abrahamsson, Linnéa
    et al.
    The Swedish Red Cross University College.
    Adeleng, Josefin
    The Swedish Red Cross University College.
    Nyanlända kvinnors upplevelse av att söka hälso- och sjukvård: En allmän litteraturstudie utifrån ett intersektionellt perspektiv2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It is estimated that by the end of 2019, 79.5 million people were forcibly displaced in the world, approximately half of them are women and girls. Newly arrived women are less likely to seek healthcare compared to men in the same situation and non- immigrant women. There’s a need for more knowledge about newly arrived women’s experiences of healthcare seeking. Aim: The aim was to describe newly arrived women's experiences of healthcare seeking. Method: A general literature review was conducted with ten scientific articles with qualitative data. Data was analyzed and categorized through a content analysis where meaningful units were highlighted, condensed and coded into themes and subthemes in accordance with Polit and Beck ́s nine-step model. Results: Two main themes and four sub themes were identified. The two main themes were accessibility andtreatment. Results show that newly arrived women experience varying and sometimes similar obstacles to accessing adequate care. Conclusion: When newly arrived women seek care and the care isn’t individualized and the needs of the individual isn’t met it can lead to a negative experience and suffering. The need of the unique individual can be met to a greater extent when nurses providing person-centered care. With intersectionality as a point of view we can increase awareness and competence about how structural factors and system of power affect the individual. Proposals for further research: Results indicate that newly arrived women experience obstacles for healthcare seeking which indicate the need for further research from the individual’s perspective with the question of what would facilitate care seeking for the individual.

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  • 14.
    Abrahamsson, Linnéa
    et al.
    Swedish Red Cross University.
    Johansson, Josefine
    Swedish Red Cross University.
    Nyligen stamcellstransplanterade patienter i behov av intensivvård: Intensivvårdssjuksköterskans erfarenheter2024Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Approximately 400 allogeneic stem cell transplants is performed in Sweden each year. The treatment is critical and carries the risk of serious complications. 10-50 % of patients are in need of intensive care during the transplant pathway. More knowledge is needed about critical care nurses´experiences of caring for recent stem cell transplant recipients in need of intensive care.

    Aim: The aim was to describe critical care nurses´experiences of caring for adult patients in need of intensive care who recently underwent an allogeneic stem cell transplant.  

    Method: Qualitative interview study based on six semi-structured interviews which were analysed with qualitative content analysis. 

    Results: Two main categories; The complexity of care and Teamwork and communication facilitate good nursing care, as well as four subcategories were identified. The patients are perceived as fragile and have an extensive medical need as well as an hSCT-specific nursing need. Recent stem cell transplant recipients are a small patient group in the ICU, the critical care nurses´experience challenges such as lack of resources, lack of routines and lack of competence. Teamwork, exchange of experience and relatives contributes to making the critical care nurses´work easier. 

    Conclusion: The patient group is perceived as challenging to care for in intensive care, which can lead to moral stress for the critical care nurse. The critical care nurses´call for training and guidelines as well as closer cooperation between the transplant ward and the ICU. 

    Proposal for further resarch: A project to increase collaboration between the ICU and the transplant ward through the implemetation of a coordinator. 

  • 15.
    Abrahamsson, Matilda
    et al.
    The Swedish Red Cross University College.
    Båveryd, Maria
    The Swedish Red Cross University College.
    När ett barn får cancer: En litteraturstudie om närståendes erfarenheter2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cancer is the most occurring reason for death of children in high-income countries. About 300 children are every year diagnosed with cancer in Sweden, approximately 80% survives their illness. When a child undergoes cancer treatment it is of importance to nclude the child along with their next of kin in the treatment and in conversations regarding treatment. While the sick child tends to be in focus, it is common for next of kins’ feelings to be overlooked. Aim: To describe the experiences of next of kin when a child has been diagnosed with cancer. Method: A literature study with a qualitative study design has been chosen for the implementation, based on ten scientific articles with a qualitative approach. A thematic analysis has been applied to formulate the study’s themes. Result: The results revealed four different themes, which have two sub-themes each. These themes are Information, Experiences, Impact on everyday life and Support. Conclusion: The importance of providing good support and having a good attitude and understanding for the child who has been diagnosed with cancer and their next of kin has been established. Anxiety and stress are emotions experienced by the next of kin during and after the child’s treatment.

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  • 16.
    Abreu Pimenta, Isabelle
    et al.
    Swedish Red Cross University.
    Berger, Cecilia
    Swedish Red Cross University.
    Patienters upplevelser av att erhålla palliativ omvårdnad i livets slutskede: En litteraturstudie2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients with cancer who receive palliative care go through great suffering together with their relatives. The nurse's role in the care of these patients is to alleviate suffering and preserve the patients' dignity with the help of person-centered nursing with the aim of giving the patients as good a final time in life as possible.

     

    The aim was to map the experiences of patients with cancer who receive palliative care at the end of life.

     

    Method: A literature review of qualitative design based on ten scientific articles from the databases PubMed and CINAHL. Elo & Kyngä's method for qualitative content analysis was used to analyze the data. 

     Results: Three categories were identified: limitations accompanying the illness, the importance of being seen and heard, approaching death, to these six subcategories emerged.

     Conclusion: The patients felt that dignified treatment and meaningful communication were important in the final stage of life. Adequate pain relief made patients feel zest for life and well-being, a challenge was finding acceptance in being a burden to the family related to a limiting physical ability. More research is needed from the perspective of nurses and relatives regarding their needs in order to provide more adequate palliative care.

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  • 17.
    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.

  • 18.
    Adamek, Emelie
    et al.
    The Swedish Red Cross University College.
    Jangebrink Skavmo, Cecilia
    The Swedish Red Cross University College.
    Psykiskt välbefinnande hos kvinnor med bröstcancer: En allmän litteraturstudie med ett patient- och vårdpersonalperspektiv2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common cancer disease among women. Surgical removal of breast, breast reconstruction with implants and chemotherapy are some of the treatments the woman can undergo. Women have an emotional bond to their breasts that can cause emotional stress in correlation to breast cancer.  Aim: The aim was to describe the factors which can affect the mental well-being of women with breast cancer and describe the role of the health care personnel´s care in breast cancer. Method: A general literature study was conducted with 11 scientific articles with qualitative data, and analyzed with a content analysis. Result: The content analysis resulted in three main themes and nine sub-themes. The first theme was: Communication, a part of well-being, the second theme: The perceived mental feeling and the third theme: The effect of physical factors on the woman. Information was essential for the woman to be able to rely on the health care workers and physical activity was experienced as helpful during the illness. Conclusion: The conclusion shows that factors that can affect the mental well-being of women with breast cancer are the lack of information, knowledge of the disease and support from health care personnel. The authors believe that more research is needed on the topic of mental illness related to breast cancer in women, in the form of clearer guidelines, protocols and further studies from a patient perspective.

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  • 19.
    Adestam, Linda
    et al.
    Swedish Red Cross University.
    Alevad, Hanna
    Swedish Red Cross University.
    Patienters erfarenhet av självvald inläggning i psykiatrisk vård: En litteraturstudie2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: With a shift in psychiatric care where inpatient places have been reduced and the psychiatric care will increasingly take place in outpatient settings, patients are expected to take greater responsibility for their well-being. The difficulty for patients with serious and complex disease may be that they potentially be at risk of being refused admission when they seek help at an early stage. Therefore they might feel compelled to signal deterioration in one's health dramatic and in a destructive way, which can lead to compulsory psychiatric care with sometimes long periods of care.

    Aim: To explore patients experiences of the method brief admission in psychiatric care.

    Method: A literature study with 16 articles that were investigated using a qualitative approach and reviewed with thematic analysis.

    Result: The results are presented in three themes with two associated subthemes. The main finding was that the participants perceived brief admission as safe. The predictability and the increased control before and during hospitalization contributed to the participants becoming more responsible for their mental well-being, they were able to focus on their coping strategies and their recovery and experienced increased health. With increased responsibility, the care relationship changed to the nurse and became more equal.

    Conclusion: Brief admission increases participation, promotes self-care and changes the care relationship with the nurse. With Orem’s self-care theory, the nurse can promote cooperation with patients and contribute to increased quality of life.

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  • 20.
    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.

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  • 21.
    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.

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  • 22.
    Adolfsson, Sara
    et al.
    The Swedish Red Cross University College.
    Kerrén, Charlotte
    The Swedish Red Cross University College.
    Infektionssjuksköterskors upplevelser av att ta emot och initialt vårda patienter från IVA: En intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients with complex care needs, and sometimes even a need for isolation, are often transferred with short notice from the intensive care unit [ICU] to the infection ward. The limited resources of the infection ward make it difficult to meet the care needs of these patients.

    Purpose: The aim was to highlight nurses' experiences of the care of patients in connection with and 72 hours after the transfer from the ICU to the infection ward.

    Method: A qualitative interview study, with semi-structured questions, was conducted. The data collection consisted of eleven interviews. A qualitative content analysis with inductive approach was used.

    Main findings: The nurses feel lonely, stressed and anxious in caring for patients in connection with and 72 hours after transfer. Lack of time is perceived to be the dominant factor. When guidelines are lacking, care becomes dependent on the competence and experience of the receiving nurse, which affects the quality of care. Isolation care is perceived to be a part of everyday work and not to affect the quality of care.

    Conclusion: Through skills and experience develop the working environment and procedures to maintain patient safety and a better working environment.

    Future research: To investigate how the transfer process is experienced by nurses in other hospitals in the same region but also on a national level. Also to investigate how the transfer process is experienced after intermediary care places have started in the ward.

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  • 23.
    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, 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.

  • 24.
    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.

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  • 25.
    Aflaton, Mojtaba
    et al.
    Swedish Red Cross University.
    Hellman, Matilda
    Swedish Red Cross University.
    Nyutexaminerade sjuksköterskors erfarenhet av arbetsrelaterad stress: En allmän litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Work-related stress among newly graduated nurses is a problem that results in ill health for the nurses and negatively impacts patient care, risking patient safety. For newly graduated nurses to provide quality and safe nursing care despite work-related stress, it is necessary to understand their experience regarding how work-related stress affects their nursingpractice.

    Purpose: The aim was to shed light on newly graduated nurses' experiences of work-related stress.

    Method: A general literature review, including ten original articles, was analysed using Graneheim & Lundmans method of qualitative content analysis.

    Results: The results of the literature study identified two categories and five subcategories: The transition from theory to practice with the subcategories of Managing unexpected workload, Being clinically ignorant, and Fear of making mistakes. New to the team with subcategories, Adapting to the healthcare team and Meeting expectations.

    Conclusions: The experience of work-related stress among newly graduated nurses affects their nursing practice and jeopardizes patient safety. With support from experienced nurses, colleagues, and adequate preparation, the transition process can be facilitated, enabling newly graduated nurses to provide quality and safe nursing care more easily.

    Further research: A longitudinal study would enable investigation of possible patterns and trends regarding stress levels, coping strategies and their impact on nurses' well-being, with a specific focus onnursing work and patient safety.

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  • 26.
    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. 

  • 27.
    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.

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  • 28.
    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.

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  • 29.
    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.

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  • 30.
    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.

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  • 31.
    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.

  • 32.
    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.

  • 33.
    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.

  • 34.
    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.

  • 35.
    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)
  • 36.
    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.

  • 37.
    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.

  • 38. 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)
  • 39.
    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.

  • 40.
    Ahlner, Olivia
    et al.
    Swedish Red Cross University.
    Albertsson, Elin
    Swedish Red Cross University.
    Livsviktigt bemötande: hur patienter som lever med HIV beskriver sina erfarenheter av vården2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    BAKGRUND: Personer som lever med hiv har historiskt sett blivit bemötta med rädsla och negativa attityder i samhället liksom inom sjukvården sedan viruset först uppmärksammades på 1980-talet.Idag innebär en hiv-diagnos en livslång kontakt med hälso- och sjukvård men vid daglig medicinering är behandlingen är så effektiv att dessa personer kan leva ett lika långt och fullgott liv som andra och smittorisken är näst intill obefintlig. Eftersom personer som lever med hiv är i behov av kontinuerlig kontakt med hälso- och sjukvård så ställer det krav på vårdpersonal att säkerställa ett gott bemötande av dessa personer och se till att inte förlegade attityder och okunskap lever vidare. SYFTE: Att utforska hur personer som lever med hiv upplever mötet med hälso- och sjukvård för att öka kunskapen kring jämlikhet i hälsa. METOD: En litteraturöversikt med induktiv ansats där data samlats från 11 stycken kvalitativa vetenskapliga originalartiklar. Tematisk analysmetod användes vid data-analyseringen. RESULTAT: Studien resulterade i tre övergripande teman vilka var följande: Att uppleva stigmatisering, Att uppleva gott bemötande och Att hävda sin rätt. Personer som lever med hiv runt om i världen hade liknande upplevelser, positiva som negativa. SLUTSATSER: Personer som lever med hiv utsätts fortfarande för fördomar och diskriminering till följd av den okunskap som historiskt funnits. Trots kunskapen som finns till hands idag lever fördomar kvar, vilket står i vägen för att personer som lever med hiv-viruset ska känna sig trygga i sin vårdmiljö. 

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  • 41.
    Ahmad, Hashem
    et al.
    Swedish Red Cross University.
    Ümit, Parçacı
    Swedish Red Cross University.
    Att leva med typ 2-diabetes: En litteraturstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes mellitus type 2 (DMT2) is a chronic disease and is one of the most common and rapidly growing diseases globally. Treatment and self-care of the disease requires plenty of lifestyle changes. The risk for physical diseases and mental illness is higher for people living with DMT2. The quality of life can be affected from chronic diseases. Aim: The purpose of this study was to describe people's experiences of living with DMT2. Method: Literature study with a qualitative approach. The results consist of ten qualitative research articles which were analysed with thematic analysis method. Results: Three main themes and six subthemes were identified. The first main theme: To manage Emotions included Fear from disease and Acceptance/normalization of living with a disease as subthemes. Second main theme: The need of support included Family and friends, and Knowledge of disease and selfcare. Third main theme: To be faced with lifestyle changes included Restrictions: Diet and physical activity, and Medication and blood sugar controls as subthemes. Conclusion: Based on the results, people had many similar experiences globally and felt that their lives and quality of life had been affected after they had been diagnosed with DMT2.

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  • 42.
    Ahmad Hassan, Kamaran
    et al.
    The Swedish Red Cross University College.
    Safi, Hafize
    The Swedish Red Cross University College.
    Personers erfarenheter av att leva med stomi: En litteraturstudie2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: An ostomy means an artificial opening in the abdomen that is created through surgery. Ostomy surgery is performed when there is a change in the affected tissue caused by, among other things cancer and inflammatory bowel disease (IBD). In the role of the nurse, it is important to encourage people with stoma to deal with everyday problems. In addition to dealing with physiological problems, care, education and counseling as well as extensive social and psychological aspects. Aim: The purpose of the study was to describe people's experiences of living with a stoma. Method: A literature review with a thematic analysis of ten qualitative original articles. Result: Two themes and five subthemes were identified. The two themes were the impact of the stoma on life and the need for support. The results show that the person's self-image and body perception changed due to stoma was somewhat difficult to adapt to further shows how important it is that the nurse has knowledge and experience of teaching both affected people and relatives. Conclusion: The changed physical conditions have a major impact on the quality of life, which means limited daily routines such as physical activities for some people. While others considered the stoma a rescue from a previous, underlying disease and experienced an improved quality of life.

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  • 43.
    Ahmad Hassan, Kamaran
    et al.
    Swedish Red Cross University.
    Öhrn, Victoria
    Swedish Red Cross University.
    Sjuksköterskors upplevelser av att vårda vuxna patienter med intensivvårdsdelirium.: En litteraturstudie2024Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Delirium is widespread in various healthcare settings, particularly in intensive care units (ICUs). This condition can lead to several negative consequences, including prolonged stays in the ICU and the hospital. Aim: The study aimed to describe nurses' experiences of caring for adult patients with ICU delirium. Method: A literature review was conducted following Polit and Beck's nine-step model. The study was based on 18 qualitative articles analyzed using Braun and Clarke's thematic analysis. Results: The authors identified two main themes: identifying and treating delirium and facing challenges and uncertainties in caring for patients with delirium. Six sub-themes were categorized into assessment tools for identifying delirium, challenges with pharmacological treatment and nursing interventions for non-pharmacological treatment, lack of knowledge, the importance of optimizing the care environment, and communication difficulties. The conclusions drawn were that there were deficiencies in the assessment of ICU patients with delirium, partly due to time constraints and lack of knowledge. Pharmacological treatment was extensively used, leading to more monitoring and supervision instead of utilizing non-pharmacological treatment measures. Adequate knowledge about delirium was lacking, and more education was needed to increase competence in delirium care. The environment impacted the work, and modifications were made to create a safer workplace and prevent delirium.

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  • 44.
    Ahmed Ali, Amal
    et al.
    The Swedish Red Cross University College.
    Hoang, Victoria
    The Swedish Red Cross University College.
    En kartläggning av antal patienter per omvårdnadspersonal och skill mix vid svenska mellanstora akutmottagningar2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of patients per nursing staff and skill mix (the percentage of registered nurse) among nursing staff have an impact on the working environment, effects quality of care and patient safety. Aim: The aim of this study was to map the number of patients per nursing staff during a 24-hour period and to describe skill mix among nursing staff at emergency departments in medium-sized hospitals in Sweden. Method: This study is a descriptive cross-sectional study with a quantitative approach. Thirty medium-sized Swedish emergency departments participated in this study. Result: The number of patients per registered nurse varied between 0,0-11,0 patients (mean=3,3) during a 24-hour period. The number of patients per licensed practical nurse varied between 0,0-17,2 (mean=4,7). The average skill mix was 58,1% registered nurses and 41,9% licensed practical nurses for 24 hours. Conclusion: The staffing of nurses does not follow the patient flow, which results in a higher number of patients per nursing staff between 11:00 am and 11:59 pm. Further studies are needed to optimize the staffing of nurses, which can lead to an improved working environment for nurses, an improved quality of care and an increased patient safety. 

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  • 45.
    Ahmed, Tanya
    et al.
    Swedish Red Cross University.
    Casinathan, Ahrathi
    Swedish Red Cross University.
    Likvärdighet inom vården: Sjuksköterskans erfarenhet av att bemöta HBTQ-personer inom hälso- och sjukvården2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: LQBTQ-people have a higher risk of ill health compared to heterosexuals. Health differences lead to LGBTQ-people being more exposed to discrimination and harassment from society´s negative ideas about norm, gender identity and sexual orientation. Lack of knowledge among nurses regarding LGBTQ-health issues and norm is an obstacle to a good health care and equal care. Lack of knowledge creates insecurity and fear for LGBTQ-people, who end up avoiding seeking care. Aim: The aim of the study was to describe nurses experince in the health care-encounter with LGBTQ-people. Method: Literature study with a qualitative approach based on twelve scientific articles. The study used Polit and Beck`s nine-step model and was analyzed with Braun and Clarks' thematic analysis. Results: Two themes and six subthemes were identified. The theme Challenges in the care of LGBTQ-people, had sub-theme: Lack of knowledge and education, Communication and terminology and Equal care. The theme Meeting LGBTQ-people had sub-themes: Promoting and hindering attitudes, wanting to care and Uncertainty at the care meeting. Conclusion: Nurse's express a desire to offer good and equal care for everyone, but there is a need for further education and knowledge about care for LGBTQ-people. Lack of knowledge leads to poor communication and care.

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  • 46.
    Akbari, Massoud
    et al.
    Swedish Red Cross University.
    Barnö, Stig Niklas
    Swedish Red Cross University.
    Mäns erfarenheter och omvårdnadsbehov vid prostatacancer: En litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Prostate cancer is the most common form of cancer in Sweden. Early diagnosis andseveral available treatment methods mean that many can survive their cancer, however this means thatthey may have to live with the side effects of treatment and complications from the disease for alonger period of time. The study relates to the basic concepts of communication and person-centeredcare.Aim: The aim is to describe men's experiences and nursing care needs during prostate cancer.Method: A literary review with a qualitative approach. Twelve qualitative original articles wereanalyzed with thematic analysis as described by Braun and Clarke.Results: Two themes with two subthemes each is presented.Conclusion: Men with prostate cancer need support to deal with both physical and psychological sideeffects that come with illness and treatment and here both health care personnel as well as the thepeople surrounding the individual have a significant role. With person-centered care a good quality oflife throughout the healthcare process can be maintained.

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  • 47.
    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.

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  • 48.
    Akselsson, A
    et al.
    Karolinska Institutet / Sophiahemmet University.
    Lindgren, H
    Karolinska Institutet.
    Georgsson, Susanne
    The Swedish Red Cross University College. Karolinska Institutet.
    Pettersson, K
    Karolinska Institutet.
    Steineck, G
    Karolinska Institutet.
    Skokic, V
    University of Gothenburg.
    Rådestad, I
    Sophiahemmet University.
    Mindfetalness to increase women's awareness of fetal movements and pregnancy outcomes: a cluster-randomised controlled trial including 39 865 women2020In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 127, no 7, p. 829-837Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes.

    DESIGN: Cluster-randomised controlled trial.

    SETTING: Sixty-seven maternity clinics in Stockholm, Sweden.

    POPULATION: Women with singleton pregnancy with birth from 32 weeks' gestation.

    METHODS: Women registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness (n = 19 639) in comparison with routine care (n = 20 226). Data were collected from a population-based register.

    MAIN OUTCOME MEASURES: Apgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small-for-gestational-age and mode of delivery.

    RESULTS: No difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8-1.2) was found between the Mindfetalness group and the Routine care group for a 5-minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57-1.87). Mindfetalness was associated with a reduction of babies born small-for-gestational-age (RR 0.95, 95% CI 0.90-1.00), babies born after gestational week 41+6 (RR 0.91, 95% CI 0.83-0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91-0.99).

    CONCLUSIONS: Mindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small-for-gestational-age.

    TWEETABLE ABSTRACT: Introducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7.

  • 49.
    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.

  • 50.
    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, 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.

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