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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.
    Long-term increase in quality of nursing documentation: Effects of a comprehensive intervention2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 1, p. 34-42Article in journal (Refereed)
  • 2.
    Eriksson, Henrik
    et al.
    Mälardalens University, School of Health, Care and Social Welfare, Eskilstuna.
    Salzmann-Erikson, Martin
    Department of Acute Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål, Oslo.
    Supporting a caring fatherhood in cyberspace: an analysis of communication about caring within an online forum for fathers2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 63-69Article in journal (Refereed)
    Abstract [en]

    Background:  Today’s parents seek out social support on the Internet. A key motivation behind the choice to go online is the need for more experience based information. In recent years, new fathers have increasingly taken on an active parental role. Men’s support for their caring activities for infants on the Internet needs attention.

    Aim:  The aim was to describe communication about caring activities for infants among men who visited an Internet-based forum for fathers and elaborate on the dimensions of support available in the forum.

    Method:  An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online: “nethnography”. A total of 1203 pages of data from an Internet forum for fathers were gathered and analysed.

    Result:  Support for a caring fatherhood in cyberspace can be understood as fathers’ communicating encouragement, confirmation and advice. The findings show that important ways of providing support through the forum included a reciprocal sharing of concerns – how to be a better father – in relation to caring for an infant. Concerns for their child’s well-being and shared feelings of joy and distress in everyday life were recurrent supportive themes in the communication. Information gained from contacting others in similar situations is one important reason for the fathers’ use of the Internet.

    Discussion:  Support offered in this kind of forum can be considered as a complement to formal support. Professionals can use it to provide choices for fathers who are developing themselves as caregivers without downplaying the parental support offered by formal health care regimes.

    Further research:  Online support will probably be one of the main supporting strategies for fathers in Scandinavia. Caring and nursing researchers need to closely monitor support activities that develop, and over time, as these ill likely become an important source of support for people.

  • 3.
    Friman, Anne
    et al.
    Karolinska Institutet.
    Klang, Birgitta
    Red Cross University College of Nursing.
    Ebbeskog, Britt
    Karolinska Institutet.
    Wound care by district nurses at primary healthcare centres: A challenging task without authority or resources2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 426-434Article in journal (Refereed)
  • 4.
    Gransjön Craftman, Åsa
    et al.
    Sophiahemmet University and Aging Research Center (ARC), Karolinska Institutet and Stockholm University.
    Westerbotn, Margareta
    Sophiahemmet University and Division of Nursing, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet.
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Public Health and Medicine. Aging Research Center (ARC), Karolinska Institutet and Stockholm University .
    Hillerås, Pernilla
    Sophiahemmet University and Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Marmstål Hammar, Lena
    School of Health, Care, and Social Welfare, Mälardalen University.
    Older people's experience of utilisation and administration of medicines in a health- and social care context.2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 760-768Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.

    AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.

    DESIGN: A qualitative descriptive study.

    METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.

    FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.

    CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.

    RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

  • 5.
    Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing. Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Division of Geriatric Medicine, Karolinska Institutet, Stockholm.
    Grafström, Margareta
    Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Division of Geriatric Medicine, Karolinska Institutet, Stockholm.
    Conditions for rehabilitation of older patients with dementia and hip fracture: – the perspective of their next of kin2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 2, p. 151-158Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the conditions for rehabilitation of older patients with dementia and hip fracture from the perspective of their next of kin. Twenty patients at orthopaedic wards were examined postfracture using a short cognitive test. The same number of next of kin answered four open-ended questions about rehabilitation as well as about the patient’s physical function. Qualitative content analysis was used to identify categories. The findings indicate that the conditions for rehabilitation of older patients with dementia and hip fracture are related to the patients’ competence, specific needs of support in the light of competence, environmental factors and classification of the rehabilitation activities. The study confirms that the conditions for rehabilitation are related to symptoms of dementia disease and arise from a decline in competence making the patient unable to cope with the environmental pressure and to perform rehabilitation activities. Because of difficulties in assessing competence, patients with dementia are being judged as incapable of managing rehabilitation. A supportive strategy is necessary to encourage the recovery process.

  • 6.
    Hellström, Ingrid
    et al.
    Linköpings Universitet.
    Håkansson, Cecilia
    Ersta Sköndahl Högskola; Karolinska Institutet.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Nursing and Care.
    Sandberg, Jonas
    Jönköpings Universitet.
    Development of older men’s caregiving roles for wives with dementia2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 957-964Article in journal (Refereed)
    Abstract [en]

    This secondary analysis of qualitative interviews describes how older Swedish men approach the caregiver role for a wife with dementia, over time. An increasing number of male caregivers will become primary caregivers for partners living with dementia at home, and they will likely be caregivers for an extended period of time. It has been stated that caregiving experiences influence how older men think of themselves. The theoretical starting point is a constructivist position, offering an understanding of older caregiving men’s constructions and reconstructions of themselves and their caregiver roles. Seven men, who were cohabiting with their wives, were interviewed on up to five occasions at home during a 5- to 6-year period. The findings comprise three themes; me and it, me despite it, it is me, depict how these men gradually take on and normalise the caregiving tasks, and how they develop and internalise a language based on their caring activities. The results provide understanding about the relationship between men as caregivers and how this influences them as individuals. By careful attention to each caregiving man’s individual needs rather than making gendered assumptions about men and caring, the aim of the caregiver support for men might best target men’s own meaning to the caring in their the everyday practices.

  • 7.
    Hertzberg, Annika
    et al.
    Red Cross University College of Nursing. Karolinska Institute.
    Ekman, Sirkka-Liisa
    Karolinska Institute.
    How the relatives of elderly patients in institutional care perceive the staff1996In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 10, no 4, p. 205-211Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is to describe how relatives in the next generation to elderly patients in institutional care perceive the staff. The study was carried out using unstructured interviews lasting 60/90 min, followed by a semi-structured interview lasting about 30 min for each participant. The interviews were analysed by thematic content analysis. The findings gave a picture of how seven relatives perceived the staff. On the whole, they were content with the physical care given, but they had some doubts about the psychological care. Some were worried about what to do during visiting time. Communication between relatives and staff was on a superficial level and concerned mostly practical matters, and it was the relative who had to take the initiative in interactions. The relatives found it very difficult to express criticism. The environment and the possibilities of being out of doors were of importance to the relatives, since they were aware that the nursing home was their parents' last home. The results of this study provide the impetus for further research on topics relating to relative/staff interaction.

  • 8.
    Holmgren, Jessica
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Emami, Azita
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Eriksson, Lars E.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm.
    Eriksson, Henrik
    Red Cross University College of Nursing.
    Being perceived as a ‘visitor’ in the nursing staff’s working arena: the involvement of relatives in daily caring activities in nursing homes in an urban community in Sweden2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 677-685Article in journal (Refereed)
    Abstract [en]

    Background

    It is both complex and difficult for relatives when a loved one moves into a nursing home and many relatives are not prepared for the realities these new situations entail. Little attention has been paid to scrutinising the involvement of relatives in patient care, particularly in relation to the structures and routines of nursing homes or to the staff's reasoning concerning their involvement.

    Aim

    To describe, from a gender perspective, how nursing staff's routines and reasoning act to condition the involvement of relatives in nursing homes.

    Methods

    Focused ethnographic fieldwork was conducted in a medium-sized urban community in central Sweden in three different nursing homes.

    Results

    The nursing staff assigns a certain code of conduct to all relatives they perceived as ‘visitors’ in their working arena. This code of conduct was related to the routines and subcultures existing among the nursing staff and stemmed from a division of labour; the underlying concept of ‘visitor’ predetermined the potential for relatives' involvement. This involvement is explicitly related to the general gendered characteristics that exist in the nursing staff's perception of the relatives.

    Discussion

    The study's limitations are primarily concerned with shortcomings associated with a research presence during the fieldwork. The discussion focuses on the dimensions of power structures observed in the nursing home routines and the staff's reasoning based on their gendered assumptions. We argue that it is important to develop mechanisms that provide opportunities for nursing staff in elderly care to reflect on these structures without downplaying the excellent care they provide. We stress the importance of further exploring these issues concerning relatives and their involvement in nursing homes to facilitate the transition from informal caregiver to ‘visitor’.

  • 9.
    Klang, Birgitta
    et al.
    Red Cross University College of Nursing. Karolinska Institutet.
    Markström, Agneta
    National Respiratory Center, Division of Anaesthesiology and Intensive Care, Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
    Sundell, Kerstin
    National Respiratory Center, Division of Anaesthesiology and Intensive Care, Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
    Barle, Hans
    National Respiratory Center, Division of Anaesthesiology and Intensive Care, Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
    Gillis-Haegerstrand, Caroline
    National Respiratory Center, Division of Anaesthesiology and Intensive Care, Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
    Hypoventilation does not explain the impaired quality of sleep in postpolio patients ventilated noninvasively vs. invasively2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 2, p. 236-240Article in journal (Refereed)
    Abstract [en]

    In a previous study, it was found that patients treated with noninvasive ventilation (NIV) reported larger dysfunctions in sleep-related parameters as assessed with the Sickness Impact Profile (SIP) and Health Index questionnaires than those treated with tracheostomy. The aim of the current study was to further evaluate these sleep limitations and relate these limitations to blood gas analyses in the groups to investigate, if the differences could be related to differences in the efficacy of ventilation. We compared postpolio patients treated with tracheostomy (PPT, n = 17), NIV (PPN, n = 14) and patients with neuromuscular disorders treated with NIV (NMN, n = 15). Significantly fewer patients in the PPT group scored large dysfunctions in the SIP sleep (SIP score >10 points) compared with the PPN and NMN patients. The PPT patients scored significantly higher regarding quality of sleep and less sense of tiredness than the PPN and NMN patients. No differences were found between the groups regarding blood gas parameters neither before nor during or after the study period. In conclusion, postpolio patients treated with invasive home mechanical ventilation seem to experience better sleep and less sense of tiredness than patients on NIV. These differences cannot be explained by differences in alveolar ventilation as assessed with blood gas analyses.

  • 10.
    Langius-Eklöf, Ann
    et al.
    Örebro University.
    Samuelsson, Mats
    Red Cross University College of Nursing. Karolinska Institutet.
    Sense of coherence and psychiatric morbidity in terms of anxiety and depression in patients with major depression before and after electric convulsive treatment2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2, p. 375-379Article in journal (Refereed)
  • 11.
    Lewen, Hanna
    et al.
    The Emergency Department, Karolinska University Hospital, Solna, Sweden.
    Gardulf, Ann
    Red Cross University College of Nursing. The Department of Laboratory Medicine, Section of Clinical Immunology, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden.
    Nilsson, Jan
    Red Cross University College of Nursing. Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden.
    Documented assessments and treatments of patients seeking emergency care because of pain2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 764-771Article in journal (Refereed)
    Abstract [en]

    Study rationale: Pain is one of the most frequent symptoms for which people seek emergency care. Studies show that pain management in emergency clinics is insufficient. No previous studies regarding pain documentation at emergency clinics in the Nordic countries have been undertaken. Objectives: The main purpose was to investigate the extent to which pain assessment, pain treatment and pain relief were documented in patient records. Design: Patient records were reviewed using a study-specific protocol. Setting: Emergency unit at a Swedish university hospital. Participants: A total of 698 patient records randomly selected were reviewed using a study-specific protocol. According to Swedish law and the university hospital's quality and safety guidelines, there should be a note in each patient record regarding whether or not the patient was in pain on arrival. The guideline stresses the importance of using patient self-assessment by a visual analogue scale (VAS). Results: In 361/698 (52%) records, there was a note by a doctor or a nurse as to whether or not the patient had been experiencing pain on arrival. In 319 of these 361 records 88%), a full pain assessment had been documented. In 15/319 (5%) cases, the pain assessment included patient VAS assessment. In 54/319 (17%) patient records, a note regarding pain treatment was found. Significantly more notes regarding pain treatment were found in the records with an initial documented pain assessment, when compared with the records without any such assessment (p < 0.01). In the 54 records with notes regarding pain treatment, 10 (19%) included documentation regarding the effect of the treatment. Conclusions: The results show an alarming lack of documentation regarding pain assessments, pain treatments and follow-ups. This is in marked contrast to Swedish law, which clearly stipulates the responsibility of health care staff to document information relevant to providing safe care. Prompt action to improve pain documentation is warranted.

  • 12.
    Lindh, Marianne
    et al.
    Ersta Sköndal University College, Department of Health Care Science, Stockholm.
    Kihlgren, Annica
    Örebro University, Department of Health Science, Örebro.
    Perseius, Kent-Inge
    Ersta Sköndal University College, Department of Health Care Science, Stockholm.
    Factors influencing compliance to hygiene routines in community care: the viewpoint of medically responsible nurses in Sweden2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 224-230Article in journal (Refereed)
    Abstract [en]

    Aims and objectives:  The aim of the study was to describe factors influencing compliance to hygiene routines in community care in Swedish municipalities from the perspective of medically responsible nurses (MRN).

    Method:  A web-based questionnaire was sent to all MRNs in Swedish municipalities, N = 268. Beside demographical background data, the questionnaire contained two core open-ended questions generating free text data. Data were analysed with descriptive statistics and qualitative content analysis.

    Result:  Four categories of factors were found: resources, management, staff and external factors. All four categories contained subcategories.

    Conclusion:  To some extent, the challenges to uphold adequate compliance to hygiene routines seem different in community care than in hospitals. Resources regarding equipment and supplies seem as an uncertain asset and uneven distributed among municipalities. Home likeness was seen as a major obstacle for upholding adequate hygiene routines. To uphold sufficient hygiene routines in a person’s home or in a home-like environment might be one of the major challenges for community health care in the future. The MRN’s narratives suggest that Registered Nurses have a key role in upholding sufficient hygiene in community care. This report might contribute in providing them with more knowledge to take on this urgent task.

  • 13.
    Löfmark, Anna
    et al.
    University of Gävle.
    Thorell-Ekstrand, Ingrid
    Red Cross University College of Nursing. Karolinska Institute.
    Evaluation by nurses and students of a new assessment form for clinical nursing education2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 2, p. 89-96Article in journal (Refereed)
    Abstract [en]

    An assessment form, was developed, based on Swedish higher education regulations and international guidelines for nursing education, to be used during clinical education regardless of the level of the programme or clinical speciality. Nurses who acted as supervisors for students used the form for continuous and formal assessment, and students used it for self-assessment. Once developed, the assessment form covered 18 professional and academic areas. After one semester nurses (n = 323) and students (n = 154) from two university colleges evaluated their experiences of using the form by answering a questionnaire. In addition, the completed assessment forms filled in by the nurses were reviewed and analysed. The evaluation showed that the nurses and the students considered the assessment form highly valuable. Both groups believed that the form highlighted the requirements for clinical education and was useful in assessing the students' development. Almost all 18 factors were found to be important to assess. Least important and most difficult to assess were 'the use of research and developmental work' and 'the ability to inform and teach co-workers and students'. Some areas that were regarded as difficult to assess were also marked by the nurses in the assessment form as 'not possible or relevant to assess'. The form was found to be useful in assessing students' development towards the goals of nursing education. The study also revealed that essential areas in nursing education have unclear educational demands for those involved.

  • 14.
    Mazaheri, Monir
    et al.
    The Swedish Red Cross University College, Department of Nursing and Care. Tehran University of Medical Sciences, Tehran, Iran.
    Ericson-Lidman, Eva
    Umeå University.
    Öhlén, Joakim
    Sahlgrenska Academy at the University of Gothenburg; University of Gothenburg Centre for Person-Centred Care.
    Norberg, Astrid
    Umeå University; Ersta Sköndal Bräcke University College.
    Meanings of troubled conscience and how to deal with it: expressions of Persian-speaking enrolled nurses in Sweden2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 380-388Article in journal (Refereed)
    Abstract [en]

    Introduction

    A feature of the healthcare system in Sweden, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision-making processes, the idea of conscience and the adverse effects of a troubled conscience, it is important to study the concepts of conscience and troubled conscience in culturally diverse populations. There is no published study regarding troubled conscience among immigrant populations that includes enrolled nurses.

    Aim

    To illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care for Persian-speaking people with dementia who have emigrated from Iran.

    Method

    The study was conducted with a phenomenological hermeneutic design. Ten enrolled nurses with an Iranian background, with at least one year's experience of taking care of older people with dementia, were interviewed. The study was reviewed by the Regional Ethical Review Board for ethical vetting of research involving humans. Appropriate measures were taken to ensure confidentiality and voluntary participation.

    Results

    The meanings of having a troubled conscience for the participants comprise not being a good person, including being an uncaring person, not acting according to one's values and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations by being a responsible caregiver.

    Conclusions

    The enrolled nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values. The findings should be interpreted in the given specific context.

  • 15.
    Müllersdorf, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Zander, Viktoria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Eriksson, Henrik
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås.
    The magnitud of reciprocity in chronic pain management: experiences of dispersed ethnic populations of Muslim women2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 4, p. 637-645Article in journal (Refereed)
    Abstract [en]

    Dispersed ethnic populations believe their health to be worse than the ethnic majority group in Sweden. Most studies in rehabilitation exclude dispersed ethnic populations who can not read or speak the national language although this group seems to be in need of rehabilitation to a larger extent than privileged majority groups. The aim of the study was to examine the experience of living with musculoskeletal pain and experience of health care among dispersed ethnic populations of Muslim women. The method used was inspired by Grounded Theory in this study. Interviews were made with five first-generation Muslim immigrant women who had come to Sweden via Iraq as refugees. Two interviews were performed with interpreters. A preliminary core category ‘The magnitude of reciprocity’ based on three categories emerged from the analysis: (1) Impact of pain, (2) Managing pain and (3) Facing health care. Chronic pain limited the informants physically and emotionally, as well as impacting on their everyday life. Informants managed their pain primarily through medicine and physical activity, which gave at least temporary relief. Health care providers were perceived as doing their best but experiences of bad meetings were also witnessed. The factors important in achieving a good meeting in this study appeared to be; time, dialogue, honesty and understanding. Communication skills, feelings of being taken seriously and a sense of security were additional factors. Not being properly examined, or offered optimal treatment, not being believed or understood, were all seen as signs of dismissal within health care. The limitations of this study are primarily concerned with language difficulties resulting in various shortcomings. Reciprocal recognition and support connected to the specific life experiences of women that come with forced resettlement from the Muslim world to the European diaspora is a vital part of a holistic approach to pain management.

  • 16.
    Müllersdorf, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Zuccato, Linda Martinson
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Nimborg, Jennie
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Eriksson, Henrik
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Maintaining professional confidence–monitoring work with obese schoolchildren with support of an action plan.2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 1, p. 131-138Article in journal (Refereed)
    Abstract [en]

    School nurses meet obese children in their everyday work. Although school nurses acknowledge the importance of getting hold of school children's obesity, they seem to lack strategies enabling them to handle the delicacy of the problem. The aim of this study was to describe how school nurses perceive their work with obese children with support of an action plan. Qualitative in-depth interviews were performed with six school nurses working in a municipality, where an action plan for the work with obese school-age children had been implemented. The transcribed data was analysed by a manifest content analysis. The results showed that the informants perceived having a key role in the obesity work, which they experienced as meaningful, but full of pitfalls. They found themselves suitable for the task, but perceived lacking deeper knowledge about specific modes of work such as motivational conversation. As the task was considered delicate, there were great demands for guidelines, education and cooperation. The action plan served as support for maintaining professional confidence throughout the process, but there was room for improvements.

  • 17.
    Nahlen Bose, Catarina
    et al.
    Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet / Sophiahemmet University.
    Elfström, Magnus L.
    Academy of Health, Care and Social Welfare, Mälardalen University.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Nursing and Care. Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet.
    Persson, Hans
    Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet.
    Saboonchi, Fredrik
    Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet.
    Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 4, p. 704-713Article in journal (Refereed)
    Abstract [en]

    Introduction: Emotional distress in patients with chronic heart failure (CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite.

    Aim: This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF.

    Method: Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression.

    Results: Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression.

    Conclusions: Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness.

  • 18.
    Perseius, Kent-Inge
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Andersson, Eva
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Åsberg, Marie
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Samuelsson, Mats
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Health-related quality of life in women patients with borderline personality disorder2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 302-307Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aims of the study were to: (i) test the reliability of a health-related quality of life (HRQOL) instrument [Swedish Health-Related Quality of Life Survey (SWED-QUAL)] on women patients with borderline personality disorder (BPD); (ii) compare their HRQOL to a normal population group comparable in age; and (iii) test for subgroup differences in HRQOL considering psychiatric DSM axis-I comorbidity. METHOD: The study was conducted in connection to a randomized, controlled trial of psychotherapy for women BPD patients. Seventy-five women with BPD diagnosis were administered the SWED-QUAL. Statistic reliability was evaluated with inter-item correlations, total-item correlations and internal consistency criterions. The BPD patients' SWED-QUAL results were compared with data extracted from a published study and subgroup differences due to axis-I comorbidity were analysed. RESULTS AND CONCLUSIONS: SWED-QUAL could be considered as an instrument with acceptable reliability when assessing HRQOL in BPD patients. The BPD patients suffered significant impairments in HRQOL overall health dimensions compared to normal population. There were no subgroup differences due to axis-I comorbidity, which indicate that BPD in itself might be a predictor of substantial HRQOL impairment.

  • 19.
    Petersson, Lena-Marie
    et al.
    Karolinska Institutet.
    Vaez, Marjan
    Karolinska Institutet.
    Nilsson, Marie I.
    Karolinska Institutet / Karolinska University Hospital.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet / Stockholm University.
    Alexanderson, Kristina
    Karolinska Institutet.
    Olsson, Mariann
    Karolinska Institutet.
    Wennman-Larsen, Agneta
    Karolinska Institutet / Sophiahemmet University.
    Sickness absence following breast cancer surgery: a two-year follow-up cohort study2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 715-724Article in journal (Refereed)
    Abstract [en]

    RATIONALE AND AIM: Most women of working ages with limited breast cancer (BC) have returned to work within the first year after diagnosis. However, little is known about what is happening during this year regarding sickness absence and return to work. Also, the knowledge is very limited about the occurrence of part-time sickness absence after BC diagnosis. Therefore, the aim of this study was to describe occurrence, extent and length of SA during a two-year follow-up after BC surgery and to analyse the association between being SA and type of cancer treatment.

    METHODS: In this prospective cohort study, 497 women responded to questionnaires about different aspects of sickness absence at six occasions during two years after primary BC surgery (at baseline and after 4, 8, 12, 18 and 24 months). Treatment information was obtained from the National breast cancer register. Multinomial logistic regression was used to calculate odds ratios (OR) for likelihood of being sickness absent more than once.

    RESULTS: Two-thirds of the women were sickness absent at baseline; this proportion decreased, especially during the first eight months. At 24 months, 13% were sickness absent. Of all women, 27% never reported sickness absence and 14% were sickness absent at most of the six survey times. At eight months, many had shifted from full- to part-time sickness absence. Women with chemotherapy and/or advanced BC surgery had higher ORs for being sickness absent at most of the follow-ups.

    CONCLUSIONS: Most women returned to work within the first eight months after BC surgery and of those sickness absent after that, most had been part-time sickness absent. Thus, it is important to differentiate between part- and full-time sickness absence in future studies. Special attention should be paid to the impact of chemotherapy and type of surgery on the likelihood of being sickness absent.

  • 20.
    Rydholm Hedman, Ann-Marie
    et al.
    Red Cross University College of Nursing. Division of Nursing, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm.
    Strömberg, Lars
    Red Cross University College of Nursing. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
    Grafström, Margareta
    Division of Nursing, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm.
    Heikkilä, Kristina
    Linnaeus University, School of Health and Caring Sciences, Växjö.
    Hip fracture patients’ cognitive state affects family members’ experiences: a diary study of the hip fracture recovery2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 451-458Article in journal (Refereed)
    Abstract [en]

    Background:  Many patients with hip fractures suffer from dementia disease, which has shown to affect the outcome of recovery strongly, as well as care and treatment. As most hip fracture patients are discharged home early after surgery, caregiving often falls on family members – spouses, daughters, sons, or even neighbours become informal carers.

    Aim:  To explore how hip fracture patients’ cognitive state affect family members’ experiences during the recovery period.

    Methods:  Eleven diaries written by family members’ of hip fracture patients were analysed by means of qualitative content analysis.

    Findings:  The analysis generated two main categories with four categories. The first main category was; ‘Being a family member of a cognitively impaired patient’ with the categories ‘Dissatisfaction with lack of support’ and ‘Emotional distress due to the patient’s suffering’. The second main category was ‘Being a family member of a cognitively intact patient’ with the categories ‘Satisfaction with a relative’s successful recovery’ and ‘Strain due to their caring responsibilities’. Being a family member of a patient with cognitive impairment and a hip fracture meant being solely responsible for protecting the interests of the patient; in regard to care, rehabilitation and resources. The family members were also burdened with feelings of powerlessness and sadness due to the patients’ suffering. On the contrary, family members of cognitively intact hip fracture patients had positive experiences. The family members expressed pleasure from seeing their close ones make progress. However, when the healing process was delayed this led to strain on the family members.

    Conclusions:  The findings suggest the hip fracture patient’s cognitive state is more decisive than the hip fracture itself for the family members’ experiences.

  • 21.
    Saboonchi, Fredrik
    et al.
    Red Cross University College of Nursing. Stress Research Institute, University of Stockholm, Stockholm.
    Perski, Aleksander
    Stress Research Institute, University of Stockholm, Stockholm.
    Grossi, Giorgio
    Stress Research Institute, University of Stockholm, Stockholm.
    Validation of Karolinska Exhaustion Scale: psychometric properties of a measure of exhaustion syndrome2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 1010-1017Article in journal (Refereed)
    Abstract [en]

    Background

    The syndrome of exhaustion is currently a medical diagnosis in Sweden. The description of the syndrome largely corresponds to the suggested core component of burnout, that is exhaustion. Karolinska Exhaustion Scale (KES) has been constructed to provide specific assessment of exhaustion in clinical and research settings.

    Aim

    The purpose of the present study was to examine the psychometric properties of this scale in its original and revised versions by examining the factorial structure and measures of convergent and discriminant validity.

    Methods

    Data gathered from two independent samples (n1 = 358 & n2 = 403) consisting of patients diagnosed with ‘reaction to severe stress, and adjustment disorder’ were subjected to confirmatory factor analysis. The study's instruments were Karolinska Exhaustion Scale and Shirom Melam Burnout Measure. Correlation analyses were employed to follow up the established factorial structure of the scale. The study was ethically approved by Karolinska Institute regional ethic committee.

    Results

    The findings demonstrated adequate fit of the data to the measurement model provided by the revised version of KES Limitations: The main limitation of the present study is the lack of a gold standard of exhaustion for direct comparison with KES. (KES-26) and partially supported convergent validity and discriminant validity of the scale.

    Conclusion

    The demonstrated psychometric properties of KES-26 indicate sound construct validity for this scale encouraging use of this scale in assessment of exhaustion. The factorial structure of KES-26 may also be used to provide information concerning possible different clinical profiles.

  • 22.
    Sund-Levander, M
    et al.
    University of Linköping.
    Forsberg, Christina
    Red Cross University College of Nursing. Karolinska Institute.
    Wahren, L K
    University of Linköping.
    Normal oral, rectal, tympanic and axillary body temperature in adult men and women: a systematic literature review2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 2, p. 122-128Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate normal body temperature in adult men and women. A systematic review of data was performed. Searches were carried out in MEDLINE, CINAHL, and manually from identified articles reference lists. Studies from 1935 to 1999 were included. Articles were classified as (1) strong, (2) fairly strong and (3) weak evidence. When summarizing studies with strong or fairly strong evidence the range for oral temperature was 33.2-38.2 degreesC, rectal: 34.4-37.8 degreesC, tympanic: 35.4-37.8 degreesC and axillary: 35.5-37.0 degreesC. The range in oral temperature for men and women, respectively, was 35.7-37.7 and 33.2-38.1 degreesC, in rectal 36.7-37.5 and 36.8-37.1 degreesC, and in tympanic 35.5-37.5 and 35.7-37.5 degreesC. The ranges of normal body temperature need to be adjusted, especially for the lower values. When assessing body temperature it is important to take place of measurement and gender into consideration. Studies with random samples are needed to confirm the range of normal body temperature with respect to gender and age.

  • 23.
    Turunen Olsson, Pernilla
    et al.
    Karolinska University Hospital, Huddinge.
    Petersson, Helena
    National Board of Health and Welfare, Stockholm.
    Willman, Ania
    Blekinge Institute of Technology.
    Gardulf, Ann
    Red Cross University College of Nursing. National Board of Health and Welfare, Stockholm / Karolinska University Hospital, Huddinge.
    Standardized care plans in Swedish health care: their quality and the extent to which they are used2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 4, p. 820-825Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the quality of standardized care plans and the extent to which they are used within Swedish in-hospital somatic care. Further, to examine the quality of the knowledge summaries on which existing standardized care plans were supposed to be based. Design: Submitted documents were reviewed with study-specific protocols. Setting: A national survey, based on a structured selection of Swedish hospitals. Participants: A total of 25 Swedish hospitals participated, and were asked to submit all documents in use that were labelled standardized care plan. Results: Only 4% (34 out of 782) of the reviewed documents fulfilled the criteria for being a standardized care plan. None of the 34 knowledge summaries (an accompanying document with a compilation of scientific facts and reliable experience) was evidence-based. Conclusions: There is a lack of knowledge regarding what a standardized care plan is, and how such a document should emanate from evidence-based knowledge. Our results raise the question of how recent developments in research are used to create standardized care plans for the best possible care. In the process of developing standardized care plans it is important to acknowledge that staff who develop these plans need scientific training and experience. Standardized care plans are in the early stages of development, and at this stage it seems appropriate to initiate a discussion regarding possible cooperation at national level when developing standardized care plans for certain large groups of patients suffering from specific diseases, or undergoing the same treatment.

  • 24.
    Uwe, Nicolay
    et al.
    Unit of Clinical Nursing Research and Research in Immunotherapy and Immunology, Section of Clinical Immunology at the Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge.
    Östblom, Eva
    Department of Clinical Research and Education, Södersjukhuset, Karolinska Institutet, Stockholm.
    Egmar, Ann-Charlotte
    Red Cross University College of Nursing.
    Nordström, Gun
    Department of Nursing, Faculty of Life and Social Sciences, Karlstad University, Karlstad.
    Gardulf, Ann
    Unit of Clinical Nursing Research and Research in Immunotherapy and Immunology, Section of Clinical Immunology at the Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge.
    Validation of a Disease-Specific Questionnaire for Measuring Parent-Reported Health-Related Quality of Life in Children with Allergies2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, p. 679-687Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate the properties and suitability of a disease-specific questionnaire to assess parent-reported health-related quality of life (HRQL) of children and parents of children suffering from food hypersensitivity (FHS) or allergy to furred pets (AFP).

    Methods: The parents of 202 children with FHS and of 131 children with AFP filled in questionnaires comprising the CHQ-PF28 and the Food-Pet-Allergy in Children (FPAC) Questionnaire. Psychometric properties of the FPAC questionnaire were evaluated separately for FHS and AFP.

    Results: Analyses resulted in five proposed scales: Limitations of Family/Child Activities (I), Parents’ Distress (II), Child’s Emotions (III), Child in School (IV) and Family Conflicts (V). Convergent/discriminant validity for scales I, II and III of both questionnaires was high; for scale IV it was moderate. All five FHS and four AFP scales were able to distinguish significantly between children with and without clinical allergy symptoms (known-group validity). Internal consistency reliability was good for scales I, II and III, but poor for scale IV.

    Conclusion: Three valid scales were determined for both FHS and AFP (Limitations of Family/Child Activities, Parents’ Distress and Child’s Emotions) and can be used in clinical research.

  • 25.
    Östlund, Britt
    Department of Design Sciences, Lund University.
    Watching television in later life: a deeper understanding of TV viewing in the homes of old people and in geriatric care contexts.2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 233-43Article in journal (Refereed)
    Abstract [en]

    A secret among staff at nursing homes is that they are often ambivalent about old residents spending more time in watching TV as it is a common cultural perception that it makes the viewer passive. The purpose of this paper is to highlight the importance of reflecting on the TV viewing habits that old people bring with them when they move into geriatric care. The findings are based on a study involving qualitative interviews and observations in two nursing home settings - urban and rural - of 20 persons between 82 and 100 years of age. The results confirm that TV viewing is far from a passive activity. Instead, it contributes to structuring daily life, to satisfying old peoples' needs for reflection and contemplation and to remain socially integrated. As such, TV viewing makes a significant contribution to their capacity to cope with disengagement in old age and can be used as a way of promoting communication and well-being in geriatric care.

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