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  • 1.
    Björvell, C.
    et al.
    Karolinska Institutet / Karolinska Hospital.
    Wredling, R.
    Karolinska Institutet.
    Thorell-Ekstrand, Ingrid
    Red Cross University College of Nursing. Karolinska Institutet.
    Prerequisites and consequences of nursing documentation in patient records as perceived by a group of registered nurses2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 2, p. 206-214Article in journal (Refereed)
  • 2.
    Craftman, Åsa G
    et al.
    Sophiahemmet University College.
    von Strauss, Eva
    The Swedish Red Cross University College. Aging Research Center (ARC), Karolinska Institutet.
    Lundell Rudberg, Susanne
    Sophiahemmet University College.
    Westerbotn, Margareta
    Sophiahemmet University College.
    District nurses’ perceptions of the concept of delegating administration of medication to home care aides working in the municipality: A discrepancy between legal regulations and practice2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 3-4, p. 569-578Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  To describe district nurses’ perceptions of the concept of delegating medication management to unlicensed personnel working in municipal social care.

    Background.  The delegation of medical tasks involves responsibility and is regulated by law to avoid damage and injuries and to protect the patient. The delegation of the administration of medication is a multifaceted task. The delegating district nurse is responsible for the outcome and should also follow up the delegated task.

    Design.  A descriptive qualitative study, involving semi-structured interviews and content analysis.

    Methods.  Twenty district nurses were interviewed. The interviews were audio taped. The data were collected from April 2009–August 2010 and analysed using content analysis.

    Results.  The findings revealed that the statutes of delegation appear to be incompatible with practice, however, mostly due to lack of time. Communication between district nurses and home care aides, as well as tutoring, was regarded as important. The district nurses found it imperative to be available to the home care aides and made an effort to create a trusting atmosphere.

    Conclusions.  District nurses cannot manage their workload without delegating the administration of medication in the present organisational model of health care and social care. The statutes regarding delegating medicine tasks are also cumbersome and difficult to incorporate for district nurses who are responsible for the delegation.

    Relevance to clinical practice.  The findings elucidate the current situation as regards district nurses and the need to delegate the administration of medication. Health care and social care for home-dwelling older patients, as well as statutes, needs to be evaluated and updated to meet and be prepared for the increasing demands of care.

  • 3.
    Eriksson, Julia
    et al.
    Sophiahemmet University / Karolinska University Hospital.
    Gellerstedt, Linda
    Danderyd Hospital, Karolinska Institutet / Sophiahemmet University.
    Hillerås, Pernilla
    Sophiahemmet University.
    Craftman, Åsa Gransjön
    Sophiahemmet University.
    Registered nurses' perceptions of safe care in overcrowded emergency departments2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. e1061-e1067Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVE: To explore registered nurses' perceptions of safe practice in care for patients with an extended length of stay in the emergency department.

    BACKGROUND: Extended length of stay and overcrowding in emergency departments are described internationally as one of the most comprehensive challenges of modern emergency care. An emergency department is not designed, equipped or staffed to provide care for prolonged periods of time. This context, combined with a high workload, poses a risk to patient safety, with additional medical errors and an increased number of adverse events. From this perspective, it is important to extend our knowledge and to describe registered nurses' experiences of safe practice.

    DESIGN: A qualitative, inductive and descriptive study.

    METHODS: Qualitative interview study carried out in five emergency departments. Data were analysed using a qualitative content analysis with a latent approach.

    RESULTS: Patient safety meets obstacles in the clinical environment involving experiencing deficiencies regarding patient safety in the clinical setting and the impact of working procedures and routines. Moreover, nurses are challenged in their professional responsibilities involving balancing essential nursing care and actual workload; it is common to experience emotional reactions based on feelings of loss of control.

    CONCLUSIONS: From the nurses' perspective, a prolonged stay in the emergency department may lead to negative consequences for both patient safety and care as well as registered nurses' psychosocial experiences. An extended length of stay significantly reduces the level of nursing and caring that registered nurses can perform in the emergency department. This article is protected by copyright. All rights reserved.

  • 4.
    Fallahi Khoshknab, Masoud
    et al.
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Mazaheri, Monir
    Faculty of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran; Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Maddah, Sadat Seyed Bagher
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Rahgozar, Mehdi
    Department of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Validation and reliability test of Persian version of The Spirituality and Spiritual Care Rating Scale (SSCRS)2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 19-20, p. 2939-2941Article in journal (Refereed)
  • 5.
    Grundberg, Åke
    et al.
    Sophiahemmet Högskola.
    Hansson, Anna
    Sophiahemmet Högskola.
    Hillerås, Pernilla
    Sophiahemmet Högskola / Karolinska Institutet.
    Religa, Dorota
    Karolinska Institutet.
    District nurses' perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 17-18, p. 2590-2599Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To describe district nurses' perspectives on detecting mental health problems and promoting mental health among homebound older people with multimorbidity.

    BACKGROUND:

    Mental health problems among older people with multiple chronic conditions, that is, multimorbidity, are challenging issues. These patients' homes often serve as arenas in which district nurses can promote health. Mental health promotion must be studied in greater depth within primary care because older people with multimorbidity are particularly prone to developing poor mental health, which can go undetected and untreated.

    DESIGN:

    A descriptive, qualitative study using semi-structured interviews and content analysis.

    METHODS:

    Twenty-five district nurses completed individual or focus group interviews. Data were analysed using qualitative content analysis.

    RESULTS:

    Most district nurses stated that detecting mental health problems and promoting mental health were important tasks but that they typically focused on more practical home health care tasks. The findings revealed that district nurses focused on assessment, collaboration and social support as means of detecting mental health problems and promoting mental health.

    CONCLUSIONS:

    The district nurses described various factors and actions that appeared to be important prerequisites for their involvement in primary mental health care. Nevertheless, there were no established goals for mental health promotion, and district nurses often seemed to depend on their collaboration with other actors. Our findings indicated that district nurses cannot bear the primary responsibility for the early detection of mental health problems and early interventions to promote mental health within this population.

    RELEVANCE TO CLINICAL PRACTICE:

    The findings of this study indicated that workforce training and collaboration between different care providers are important elements in the future development of this field. Early detection and early treatment of mental health-related issues should also be stated as explicit objectives in the provision of care to community-dwelling older people with multimorbidity.

  • 6.
    Hertzberg, Annika
    et al.
    Red Cross University College of Nursing. Karolinska Institute.
    Ekman, Sirkka-Liisa
    Karolinska Institute / Blekinge Institute of Technology, .
    Axelsson, Karin
    Luleå University of Technology.
    'Relatives are a resource, but ...': Registered Nurses' views and experiences of relatives of residents in nursing homes2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 3, p. 431-441Article in journal (Refereed)
    Abstract [en]

    Registered Nurses (RNs) working in nursing homes in Sweden have obligations towards the residents' relatives, besides the care of residents. Relatives' involvement and satisfaction with the care partly depend on their contacts and communication with the staff. This study aimed to explore and describe RNs' views and experiences of relatives of residents who live in nursing homes. Open interviews were conducted with 19 RNs at three nursing homes. The verbatim-transcribed interviews were subjected to qualitative content analysis. Relatives were seen as a resource (with some restrictions) and nice, although demanding. The RNs saw relatives as part of their work - a part that could be time-consuming and had low priority. Interviewees noticed a difference between young and old relatives, and between female and male relatives. A large proportion of accounts could be related to issues about communication and interpersonal relationships with relatives. Building a trusting relationship with relatives may result in them being involved in residents' care and thus giving the nurses time rather than consuming time.

  • 7.
    Hertzberg, Annika
    et al.
    Red Cross University College of Nursing.
    Ekman, Sirkka-Liisa
    University of Karlskrona/Ronneby.
    Axelsson, Karin
    Luleå University of Technology / Karolinska Instiute.
    Staff activities and behaviour are the source of many feelings: relatives' interactions and relationships with staff in nursing homes2001In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 3, p. 380-388Article in journal (Refereed)
    Abstract [en]

    Family members do not give up their involvement in the life of their older relatives when they move to an institution. Relatives feel that it is they who take the initiative to establish a working relationship with the staff at the nursing home. Relatives want more spontaneous information from staff, particularly about residents' dairy fives, and there is a need for relatives to have opportunities to talk with staff under relaxed conditions. Staff behaviour and activities towards residents and relatives are a source of many feelings for relatives. Relatives' understandings of the challenges faced by staff are not communicated to staff, nor are positive or negative experiences explicitly passed on to staff.

  • 8.
    Holmér Pettersson, Pia
    et al.
    Red Cross University College of Nursing. Karolinska Institutet, Department of Molecular Medicine and Surgery.
    Wengström, Yvonne
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm.
    Acupuncture prior to surgery to minimise postoperative nausea and vomiting: A systematic review2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, ISSN 0962-1067, Vol. 21, no 13/14, p. 1799-1805Article, review/survey (Refereed)
    Abstract [en]

    Aims and objectives: The aim of this systematic review was to assess the outcome of acupuncture treatment prior to surgery in order to avoid or minimise postoperative nausea and vomiting.

    Background: The symptoms of nausea and/or vomiting remain a huge problem for many patients after surgery. There is much debate around the best treatment for nausea and/or vomiting, and the most beneficial solution has yet to be found. Postoperative nausea and vomiting is not a life-threatening symptom, but many patients express great distress and dissatisfaction with the existing treatment. Many patients rate their nausea similar to or worse than pain. Historically, treatments often include drug therapy, but not other non-pharmacologic therapies, such as acupuncture or acupressure, which can have beneficial effects on nausea.

    Design: A systematic literature review.

    Methods: The review was undertaken using key words and electronic databases and included 21 papers from the years November 1996 until August 2009.

    Results: The results indicate that the application of acupuncture reduced the incidence of nausea but not vomiting when compared with the use of antiemetic prophylaxis alone.

    Conclusions: The results show that there is a lack of knowledge of the best treatment to minimise postoperative nausea and vomiting prior to surgery. Relevance to clinical practice. The overall results of this review conclude that all kinds of AP stimulation, both non-invasive and invasive, seem to prevent PONV with minimal side effects. The findings from this study can be used to inform future research to evaluate the effects of preoperative treatment with acupuncture vs. sham procedure before surgery to avoid PONV

  • 9.
    Jäghult, Susanna
    et al.
    Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital.
    Saboonchi, Fredrik
    Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    Johansson, Unn-Britt
    Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    Wredling, Regina
    Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    Kapraali, Marjo
    Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm.
    Identifying predictors of low health-related quality of life among patients with inflammatory bowel disease: comparison between Crohn's disease and ulcerative colitis with disease duration2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, ISSN 0962-1067, Vol. 20, no 11/12, p. 1578-1587Article in journal (Refereed)
    Abstract [en]

    To identify predictors of low health-related quality of life among patients with inflammatory bowel disease and make a comparison between Crohn's disease and ulcerative colitis with disease duration. Studies have shown that patients with inflammatory bowel disease rate their health-related quality of life lower, as compared with a general population. Survey. In this study, 197 patients in remission were included and divided into a Crohn's disease group and an ulcerative colitis group. Each group was also divided into separate groups whether the patients had short disease duration or long disease duration. Generic instruments, combined with disease-specific questionnaires, were used for measuring health-related quality of life. The analysis showed a non-significant effect for diagnosis, but a significant effect for disease duration showing that the patients with short disease duration had lower scores of health-related quality of life compared with patients with long disease duration. A significant interaction between diagnosis and disease duration was also revealed. Patients with longer disease duration experienced a better health-related quality of life than patients with short disease duration. Patients with Crohn's disease and short disease duration have the lowest health-related quality of life and are in greatest need of education and support. It is important to identify which patients' are in the greatest need of education and support.

  • 10.
    Kajermo, K N
    et al.
    Karolinska Institute.
    Nordström, G
    Karolinska Institute.
    Krusebrant, Åsa
    Red Cross University College of Nursing.
    Lutzen, K
    Ersta Sköndal University College,.
    Nurses' experiences of research utilization within the framework of an educational programme2001In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 5, p. 671-681Article in journal (Refereed)
    Abstract [en]

    This paper explores nurses' reflections on their experiences of disseminating and implementing research findings in clinical practice within the framework of an educational programme. Ten registered nurses, all in clinical practice, participated in a research-orientated educational programme with the aim of facilitating the dissemination and implementation of research findings in clinical practice. Thus, the programme contained different activities designed to disseminate and implement research findings in the participants' wards. . Focus groups were used to collect data and a qualitative content analysis was performed. The main themes that were developed were: organizational and leadership issues; acquiring a new role; responses and reactions by others; and orientation to research. Organizational and leadership issues, nurses' interest in research, nurses' reading habits, and support and feedback from their head nurses and other managers and from their nursing colleagues and physicians were seen as important. This study confirms that research utilization and the change to research-based nursing practice are complex issues which require both organizational and educational efforts.

  • 11.
    Löfvenmark, C
    et al.
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Saboonchi, Fredrik
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Edner, M
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Billing, E
    Department of Medical Sciences, Uppsala University, Uppsala.
    Mattiasson, A.-C
    Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.
    Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 1-2, p. 115-126Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  To evaluate the effect of a group-based multi-professional educational programme for family members of patients with chronic heart failure with regard to quality of life, depression and anxiety. The secondary aim was to investigate the impact of social support and sense of coherence on changes in quality of life, anxiety and depression during the period of the study.

    Background.  When a person is diagnosed with heart failure, the daily life of the family members is also affected.

    Design.  Randomised controlled trial.

    Methods.  A total of 128 family members were randomly assigned to participate in a multi-professional educational programme or a control group. Analysis of variance and regression analysis were used.

    Results.  There were no significant differences in anxiety, depression or quality of life between the intervention group and control group. Adequacy of social network was the only independent variable that explained levels of anxiety and depression after 12 months beyond baseline levels of anxiety (p < 0·001, R2 = 0·35) and depression (p = 0·021, R2 = 0·37). Younger family members were found to have a higher quality of life (p < 0·01).

    Conclusion.  Improved disease-related knowledge may need to be combined with other target variables to induce desired effects on depression, anxiety and quality of life of family members. Antecedents of depression and anxiety, such as sense of control, may need to be specifically targeted. Our results also suggest that intervention aimed at enhancing social support may be beneficial for family members.

    Relevance to clinical practice.  Anxiety and depression did not decrease nor did quality of life improve after the intervention. An educational programme for family members with a component specifically targeting anxiety, depression and quality of life warrants testing. Furthermore, it is important that health care providers understand the influence of social support on anxiety, depression and quality of life when interacting with family members.

  • 12.
    Mazaheri, Monir
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet; School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
    Eriksson, Lars E
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Heikkilä, Kristiina
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Nasrabadi, Alireza Nikbakht
    School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
    Ekman, Sirkka-Liisa
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Sunvisson, Helena
    School of Health and Medical Sciences, Örebro University.
    Experiences of living with dementia: qualitative content analysis of semi-structured interviews2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 21/22, p. 3032-3041Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To describe people's experiences of living with dementia in Iran.

    BACKGROUND:

    A knowledge gap exists regarding the experiences of living with dementia in nonWestern contexts. This gap may be especially apparent within the Iranian context, where dementia research is relatively new. Deeper understanding about context-related experiences of dementia is a prerequisite for nurses' ability to provide adequate and meaningful care.

    DESIGN:

    Qualitative, cross-sectional design.

    METHODS:

    Qualitative content analysis of semi-structured interviews with people living with dementia in urban Iran (six women and nine men; 60-87 years old).

    RESULTS:

    The participants experienced their condition as a state of forgetfulness that was accompanied by losses and dependency on others. They wanted to feel good about themselves and feel important, but they continually struggled with matters such as a loss of accountability, feelings of futility and the frustration of others. Economic dependency and a lack of economic resources were sources of feelings of futility.

    CONCLUSION:

    Experiences of living with dementia in Iran included a substantial struggle to stay connected to the social world and to deal with dramatic life changes, aspects of living with dementia that seem to be universal. However, the feelings of financial burden and the experience of being nagged for their shortfalls by family members have seldom been described in other studies and seem to represent a cultural aspect of their experience.

    RELEVANCE TO CLINICAL PRACTICE:

    The results of the study call for further nursing efforts in supporting people living with dementia in their struggle with their altered lives and in retaining their connections to everyday life. Furthermore, their family members might benefit from specific nursing interventions including information about dementia and advice on how to help the family members with dementia to interact with others while exercising their individual strengths.

  • 13.
    Rahmqvist Linnarsson, Josefin
    et al.
    Red Cross University College of Nursing.
    Bubini, Jennifer
    Jakobsbergs Hospital, Stockholm County Council, Järfälla.
    Perseius, Kent-Inge
    Ersta Sköndal University College, Stockholm.
    Review: a meta-synthesis of qualitative research into needs and experiences of significant others to critically ill or injured patients2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 21-22, p. 3102-3111Article, review/survey (Refereed)
    Abstract [en]

    Aims and objectives.  This study aimed to describe the significant others’ experiences and needs when a person is critically ill or injured in an acute care setting.

    Background.  Being a significant other to a hospitalised critically ill or injured patient is a heavily distressing life event. Addressing significant others’ needs adequately has been shown to be essential to mitigate the psychological consequences of such distressing events.

    Design.  A systematic review of qualitative research.

    Methods.  Meta-ethnographic synthesis was used for analysis.

    Results.  The key findings are described in five major themes: uncertainty and emotional ‘roller coaster’; information – balancing hope and reality; to guard and to protect the loved one; alliance with caregivers – crucial support; and social network – support and disequilibrium.

    Conclusions.  The study can provide a broader understanding of the significant others’ situation. They are facing an overwhelming and emotionally challenging situation and need to be seen and heard.

    Relevance to clinical practice.  The results point towards the nurses’ key position in handling the needs of the significant others. This kind of description might be helpful in taking on this delicate task and might also serve as a body of knowledge to influence clinical practice guidelines and nursing interventions in this field.

  • 14.
    Rydeman, IngBritt
    et al.
    Neurotec Department, Center for Family and Community Medicine, Karolinska Institutet; Center for Family and Community Medicine, Stockholm.
    Törnkvist, Lena
    Neurotec Department, Center for Family and Community Medicine, Karolinska Institutet.
    The patient’s vulnerability, dependence and exposed situation in the discharge process: Experiences of district nurses, geriatric nurses and social workers2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 10, p. 1299-1307Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of the study was to obtain a deeper understanding of the experiences of the discharge process among different professionals. Background. An optimal discharge process for hospitalized elderly to other forms of care is of crucial importance, especially since health and medical policies encourages shorter hospital stays and increased healthcare service in outpatient care. Methods. Nurses and social workers from inpatient care, outpatient care, municipal care and social services were interviewed. Eight focus-group interviews with a total of 31 persons were conducted. The subsequent analyses followed a phenomenological approach. Results. The findings revealed three themes, Framework, Basic Values and Patient Resources, which influenced the professionals’ actions in the discharge process. The overall emerging structure comprised the patient’s vulnerability, dependence and exposed situation in the discharge process. Conclusion. In conclusion some factors are of special importance for the co-operation and the actions of professionals involved in the discharge process. Firstly, a distinct and common framework, with conscious and organizationally based values. Secondly the need to take the patient resources into consideration. Together these factors could contribute to secure the patients involvement in the discharge process and to design an optimal, safe and good care. Relevance to clinical practice: Collaborative approaches among a range of professionals within a variety of organizations are common, especially in the care of the elderly. The role and support of both the organizations and the educational units are decisive factors in this area.

  • 15.
    Rydholm Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing.
    Fonad, Edit
    Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm.
    Sandmark, Hélène
    School of Health, Mälardalen University, Care and Social Welfare, Public Health Sciences, Västerås.
    Older people living at home: associations between falls and health complaints in men and women2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 19-20, p. 2945-2952Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To investigate the associations between self-reported falls and health complaints, among persons aged 75 years and older living at home, and to investigate gender differences in the associations.

    Background

    There are several studies concerned with risk factors for falling, and others related to health complaints, but not many with associations between falls and health complaints. There are some inconsistent data of incidence and gender-related differences in falling.

    Design

    Case–control community-based study.

    Methods

    In total, 1243 persons living in two municipal districts in Sweden answered a questionnaire. Odds ratios (OR) and regression models with 95% confidence interval (CI) were used to determine the associations between self-reported falls and different health complaints.

    Results

    The adjusted (multivariate) linear regression showed that urinary incontinence, self-rated health and tiredness were significantly associated with falls for both men and women living at home. The gender-related differences in falling were associated with the variables such as self-rated health for men and tiredness and pain in the hands, elbows, legs or knees for women.

    Conclusion

    An association is evident between falls and urinary incontinence, poor self-rated health and tiredness for older persons living at home. Gender differences in falls show an association with poor self-rated health, tiredness and pain in the hands, elbows, legs or knees.

    Relevance to clinical practice

    As older people are expected to live in their own homes as long as possible, more knowledge is required about what determines the risk of falling. Nurses in community care are recommended to use assessment tools that include urinary incontinence in order to detect the risk of falling.

  • 16.
    von Vogelsang, Ann-Christin
    et al.
    Karolinska Instsitutet / Karolinska Univ Hospital.
    Milton, Camilla
    Danderyd Hospital.
    Ericsson, Ingrid
    Handen Geriatrics, Praktikertjänst NÄRA.
    Strömberg, Lars
    The Swedish Red Cross University College, Department of Nursing and Care.
    'Wouldn't it be easier if you continued to be a guy?' - a qualitative interview study of transsexual persons' experiences of encounters with healthcare professionals2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 23-24, p. 3577-3588Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To describe transsexual persons' experiences of encounters with healthcare professionals during the sex reassignment process. Background. Transsexual persons are individuals who use varying means to alter their natal sex via hormones and/or surgery. Transsexual persons may experience stigma, which increases the risk of psychological distress. Mistreatments by healthcare professionals are common. Qualitative studies addressing transsexual persons' experiences of healthcare are scarce. Design. Qualitative descriptive design. Methods. A Swedish non-clinical convenience sample was used, consisting of six persons who had been diagnosed as transsexual, gone through sex reassignment surgery or were at the time of the interview awaiting surgery. Semi-structured interviews were undertaken, and data were analysed using manifest qualitative content analysis. Results. Three categories and 15 subcategories were identified. The encounters were perceived as good when healthcare professionals showed respect and preserved the transsexual person's integrity, acted in a professional manner and were responsive and built trust and confidence. However, the participants experienced that healthcare professionals varied in their level of knowledge, exploited their position of power, withheld information, expressed gender stereotypical attitudes and often used the wrong name. They felt vulnerable by having a condescending view of themselves, and they could not choose not to be transsexual. They felt dependent on healthcare professionals, and that the external demands were high. Conclusions. Transsexual persons are in a vulnerable position during the sex reassignment surgery process. The encounters in healthcare could be negatively affected if healthcare professionals show inadequate knowledge, exploit their position of power or express gender stereotypical attitudes. A good encounter is characterised by preserved integrity, respect, responsiveness and trust. Relevance to clinical practice. Improved education on transgender issues in nursing and medical education is warranted. Healthcare professionals should be aware of how their attitudes and their level of knowledge affect the care given during the sex reassignment surgery process.

  • 17.
    von Vogelsang, Ann-Christin
    et al.
    Red Cross University College of Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Wengström, Yvonne
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Svensson, Mikael
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Forsberg, Christina
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Transitional experiences in patients following intracranial aneurysm rupture2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 9-10, p. 1263-1273Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To describe changes and transitions in everyday life in the first two years following an intracranial aneurysm rupture.

    Background

    An intracranial aneurysm rupture causes a haemorrhagic stroke, and the physical and mental consequences of this condition are numerous and complex. In Sweden, some, but not all, patients receive rehabilitation for this condition. Patients with this type of stroke are not included in the national stroke registry; thus, information on the recovery period for these particular patients is lacking.

    Design

    A longitudinal mixed methods study design was used.

    Methods

    The sample was consecutive and consisted of 88 patients (84·6% of 104 eligible), acutely admitted to a neurosurgical clinic in Stockholm for intracranial aneurysm rupture. Data were collected through a postal study-specific questionnaire at 6 months, 1 year and 2 years postaneurysm rupture. Intramethod mixing was used in the data collection, and quantitative and qualitative data were analysed parallel with statistical and qualitative content analysis.

    Results

    A majority of participants perceived changes in their everyday lives during the first two years following aneurysm rupture, and the changes were ongoing with little differences reported between 6 months and 2 years after the onset. Internal changes, or transitions, were revealed within changes in personality, changed social roles and relationships and changed abilities and behaviour.

    Conclusions

    Recovering from an intracranial aneurysm rupture involves a period of intense changes and transitions, a vulnerable period for many people that may be made easier to manage by the intervention of nurses.

    Relevance to clinical practice

    Patients experiencing transitions in the recovery period after intracranial aneurysm rupture may benefit from nursing interventions that support them through the transitional process. Nurse-led follow-up care by a specialist nurse from the neurosurgical clinic may be a possible way to provide support.

  • 18.
    Westerbotn, Margareta
    et al.
    Sophiahemmet högskola / Karolinska Institutet / Äldrecentrum.
    Fahlström, Elin
    Sophiahemmet.
    Fastbom, Johan
    Karolinska Institutet / Äldrecentrum.
    Agüero-Torres, Hedda
    Karolinska Institutet / Äldrecentrum.
    Hillerås, Pernilla
    Sophiahemmet / Karolinska Institutet / Äldrecentrum.
    How do older people experience their management of medicines?2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 5a, p. 106-115Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective.

    Background. Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes.

    Methods. This qualitative study involved audiotaped interviews with 25 very old persons. Inclusion criteria: aged ≥85 years, mini‐mental state examination ≥24, living at home, taking medicines regularly. Data collected May–June 2005, analysed using content analysis.

    Design. Descriptive study.

    Results. Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up.

    Conclusion. Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes.

    Relevance to clinical practice. Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health‐care resource use.

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