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  • 1.
    Amin, M. Ridwanul
    et al.
    Karolinska Institutet.
    Helgesson, M.
    Karolinska Institutet.
    Runeson, B.
    Karolinska Institutet.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences.
    Mehlum, L.
    National Centre for Suicide Research and Prevention, Oslo, Norway.
    Holmes, E.
    Karolinska Institutet.
    Mittendorfer-Rutz, E.
    Karolinska Institutet.
    The risk of suicidal behaviour in refugees and other immigrants to Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl. 4, p. 191-191Article in journal (Other academic)
  • 2.
    Amin, Ridwanul
    et al.
    Karolinska Institutet.
    Helgesson, Magnus
    Karolinska Institutet.
    Runeson, Bo
    Karolinska Institutet.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences.
    Mehlum, Lars
    University of Oslo, Oslo, Norway.
    Qin, Ping
    University of Oslo, Oslo, Norway.
    Holmes, Emily A
    Karolinska Institutet / Uppsala universitet.
    Mittendorfer-Rutz, Ellenor
    Karolinska Institutet.
    Suicide attempt and suicide in refugees in Sweden - a nationwide population-based cohort study2019In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, p. 1-10Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 3.
    Anderberg, Peter
    et al.
    Blekinge Institute of Technology.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institute.
    Stjernberg, Louise
    The Swedish Red Cross University College. Region of Blekinge.
    Bohman, Doris
    Blekinge Institute of Technology.
    Analyzing Nursing Students' Relation to Electronic Health and Technology as Individuals and Students and in Their Future Career (the eNursEd Study): Protocol for a Longitudinal Study2019In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 8, no 10, article id e14643Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students' internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study.

    OBJECTIVE: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students' knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge?

    METHODS: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study.

    RESULTS: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019.

    CONCLUSIONS: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students' attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students' knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14643.

  • 4.
    Antoniadou, Irini
    et al.
    Karolinska universitetssjukhuset.
    Soltannia, Marjan
    Karolinska universitetssjukhuset.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Care Sciences and Society, Sweden.
    Mattsson, Janet
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska universitetssjukhuset.
    Moving from Participation towards Partnership in Nursing Care2019In: Anaesthesia & Surgery Open Access Journal, Vol. 1, no 3, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Background: Meeting with health care gets short before and after the operation. The difficulty at the day surgery is that preparation and information take place in close proximity to the operation. Health professionals must not only take care of the child during the medical visit, but also of the accompanying parent, too. Parents’ participation in the perioperative care, sometimes unable to attend.

    Aim: This study aims to investigate how parental involvement in the perioperative a process can be facilitated.

    Method: A qualitative design based on observations and interviews with semi structured questions with open answers. Results: The results conveyed involvement in the child’s perioperative process in diverse ways and to a different depth. This is highlighted in the theme Allowed with the under themes Security and Being accepted. However, the theme Exclusion with the under-theme Rejection revealed a non-caring approach where no caring relation could be established. Quotes from the transcribed material are used to highlight the results.

    Conclusion: The study’s findings confirm earlier studies in the perspective that information is of central importance in enabling parents to be involved in the perioperative process. The results showed that parents’ involvement in the perioperative process is a prerequisite for creating safety in the child and reducing concerns in connection with the operation. Parental involvement may be hindered by a conventional approach that does not include the child’s perspective.

  • 5. Barkestad, Eva
    et al.
    Andersson, Ingrid
    Gustafsson, Ingrid
    Hyllienmark, Petra
    Mattsson, Janet
    The Swedish Red Cross University College, Department of Health Sciences.
    Stevens, Lena
    The Swedish Red Cross University College, Department of Health Sciences.
    Säkra kunskap och kvalitet: utmaningar för framtidens anestesi och intensivvårdssjuksköterska2017In: Ventilen, ISSN 0348-6257, no 4, p. 16-18Article in journal (Other (popular science, discussion, etc.))
  • 6.
    Bexelius, T.
    et al.
    Karolinska Institutet.
    Lachmann, Hanna
    The Swedish Red Cross University College, Department of Health Sciences.
    Järnbert-Pettersson, H.
    Karolinska Institutet.
    Kalén, S.
    Karolinska Institutet.
    Möller, R.
    Karolinska Institutet.
    Ponzer, S.
    Karolinska Institutet.
    Stress among medical students during clinical courses: a longitudinal study using contextual activity sampling system2019In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 10, p. 68-74Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate medical students’ experiences of stress and other emotions related to their professional roles, as defined by the CanMEDS framework, by using the Contextual Activity Sampling System (CASS).

    Methods: Ninety-eight medical students agreed to participate of whom 74 completed this longitudinal cohort study. Data was collected between 6th and 8th term via CASS methodology: A questionnaire was e-mailed to the participants every 3rd week (21questionnaires/measurements) during clinical rotations and scientific project work term. Emotions were measured by a 7-point Likert scale (e.g., maximum stress = 7). Answers were registered through mobile technology. We used a linear mixed-model regression approach to study the association between stress over time in relation to socio-demographic and learning activities related to CanMEDS roles.

    Results: Participants completed 1390 questionnaires. Mean stress level over all time points was 3.6. Stress was reported as highest during the scientific project term. Learning activities related to ‘Communicator,’ ‘Collaborator,’ ‘Scholar,’ ‘Manager’ and ‘Professional’ were associated with increased stress, e.g. ’Scholar’ increased stress with 0.5 points (t=3.91, p<0.001). A reduced level of stress was associated with ’Health Advocate’ of 0.39 points (t=-2.15, p=0.03). No association between perceived stress and demographic factors, such as gender or age was found.

    Conclusions: An association between different learning activities related to CanMEDS Roles and feelings of stress were noted. The CASS methodology was found to be useful when observing learning experiences and might support educational development by identifying course activities linked to stress.

  • 7.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Material Wear of Medical Technical Products: Impact on patient safety2018Conference paper (Refereed)
    Abstract [en]

    The use of a central venous catheters (CVC) always involves an increased risk of infection and thrombotic complications, subsequently increasing patient suffering, prolonged care and health care related costs. One contributing cause of infection is that the surface of the catheter is quickly colonized by bacteria, forming a biofilm, hard to reach by and/or resistant to antibiotics and the patient’s immune defense system. Catheter related thrombosis may also promote colonization of microbes on the fibrin sheet at the surface, and at the same time impact on CVC functionality by lumen occlusion or, in a rare worst-case scenario – cause life threatening embolic events. Coatings with silver or metal alloys can reduce the risk for complications. Our research group have previously identified a correlation between material degradation in medical devices used in patients and exposure time and infections. This talk will discuss the impact of material degradation of different types of CVCs used for patients undergoing chemotherapy against breast cancer.  The results from an evaluation study of a anti infectious noble metal alloy coated CVC compared with an uncoated CVC for tolerability (Adverse Events, AEs), performance and noble metal durability on the surface will also be discussed.

  • 8.
    Björling, Gunilla
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. KI.
    Fossum, Maren
    NTNU.
    Aune, Ragnhild
    NTNU.
    Cytostatika-inducerad materialnedbrytning av subkutana venportar: En preliminär jämförande in-vitro och in-vivostudie2017Conference paper (Refereed)
  • 9.
    Björling, Gunilla
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Johansson, Dorota
    Bactiguard, Stockholm.
    Bergström, Linda
    Bactiguard, Stockholm.
    Strekalovsky, Anton
    Karolinska University Hospital.
    Sanchez, Javier
    Karolinska Institutet / Bactiguard, Stockholm.
    Frostell, Claes
    Karolinska Institutet.
    Kalman, Sigridur
    Karolinska University Hospital / Karolinska Institutet.
    Evaluation of central venous catheters coated with a noble metal alloy - A randomized clinical pilot study of coating durability, performance and tolerability2018In: Journal of Biomedical Materials Research. Part B - Applied biomaterials, ISSN 1552-4973, E-ISSN 1552-4981, Vol. 106, no 6, p. 2337-2344Article in journal (Refereed)
    Abstract [en]

    The use of Central Venous Catheters (CVCs) commonly results in complications. Coatings with silver or metal alloys can reduce the risk associated with the use of CVC. We have evaluated the durability of a noble metal coated CVC (the Bactiguard Infectious Protection, BIP CVC) and compared with an uncoated CVC for clinical tolerability (Adverse Events, AEs) and performance, in order to create a baseline for a large future study. Patients undergoing major surgery, randomised at a 2:1 ratio to BIP CVC (n = 22) or standard CVC (n = 12), were catheterized 9 - 12 days, respectively. Adverse events, microbial colonization and metal release were measured.

    FINDINGS: There were no AEs in the BIP CVC-group, but 5 AEs occurred in 4 patients (1 patient had 2 AEs) in the standard CVC-group, p = 0.011 (whereof 3 were catheter related). The BIP CVC showed an initial release of coating metals in blood (gold, silver and palladium), which rapidly decreased and were far below Permitted Paily Exposure (PDE) for chronical use. The levels of silver concentration were far below those needed to develop microbial resistance. The performance was equal, and there was no difference concerning microbial colonization, for the two CVCs.

    CONCLUSION: In this pilot study the BIP CVC had significantly lower AEs and showed a comparable performance to the standard CVC. The coating was durable throughout the study length (up to 16 days) and toxicological evaluation showed good safety margins. Larger studies are needed.

  • 10.
    Björling, Gunilla
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Johansson, Dorota
    Bactiguard.
    Sanchez, Javier
    Karolinska Institutet / Bactiguard.
    Frostell, Claes
    Karolinska Institutet.
    Bergström, Linda
    Bactiguard.
    Kalman, Sigridur
    Karolinska Institutet.
    Evaluation of Tolerability and Performance of BIP Central Venous Catheter with a noble metal alloy coating: A Clinical Tolerability Study2017Conference paper (Refereed)
  • 11.
    Bränström, Richard
    et al.
    Yale School of Public Health, New Haven, USA / Karolinska Institutet.
    Hatzenbuehler, Mark L
    Columbia University, New York, USA.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Pachankis, John E
    Yale School of Public Health, New Haven, USA.
    Sexual orientation differences in outpatient psychiatric treatment and antidepressant usage: evidence from a population-based study of siblings2018In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 33, no 6, p. 591-599Article in journal (Refereed)
    Abstract [en]

    In the past two decades, population-based health surveys have begun including measures of sexual orientation, permitting estimates of sexual orientation disparities in psychiatric morbidity and differences in treatment utilization. The present study takes advantage of the high-quality, comprehensive nationwide health registry data available in Sweden to examine whether psychiatric outpatient treatment for various diagnoses and antidepressant medication usage are greater in sexual minority individuals compared to their siblings. A longitudinal cohort study design was used with a representative random population-based sample in Stockholm, Sweden. Registry-based health record data on all specialized outpatient health care visits and prescription drug use was linked to a sample of 1154 sexual minority individuals from the Stockholm Public Health Cohort and their siblings. The main outcomes were treatment due to psychiatric diagnoses retrieved from nationwide registry-based health records. In analyses accounting for dependency between siblings, gay men/lesbians had a greater likelihood of being treated for mood disorder [adjusted odds ratio (AOR) 1.77; 99% confidence intervals (CI) 1.00, 3.16] and being prescribed antidepressants (AOR 1.51; 99% CI 1.10, 2.07) compared to their siblings. Further, bisexual individuals had a greater likelihood of any outpatient psychiatric treatment (AOR 1.69; 99% CI 1.17, 2.45) and being prescribed antidepressants (AOR 1.48; 99% CI 1.07, 2.05) as well as a greater likelihood of being treated for a mood disorder (AOR 1.98; 99% CI 1.33, 2.95) compared to their siblings. No difference in anxiety or substance use disorder treatment was found between any sexual minority subgroup and their siblings. The potential role of familial confounding in psychiatric disorder treatment was not supported for more than half of the outcomes that were examined. Results suggest that sexual minority individuals are significantly more likely to be treated for certain psychiatric disorders compared to their siblings. Future research is needed to understand mechanisms other than familial factors that might cause the substantial treatment differences based on sexual orientation reported here.

  • 12.
    Burström, Åsa
    et al.
    Karolinska Institutet / Astrid Lindgren Children's Hospital.
    Acuna Mora, Mariela
    University of Gothenburg / KU Leuven, Department of Public Health and Primary Care, Leuven, Belgium.
    Öjmyr-Joelsson, Maria
    Karolinska Institutet / Astrid Lindgren Children's Hospital.
    Sparud-Lundin, Carina
    University of Gothenburg.
    Rydberg, Annika
    Umeå University.
    Hanseus, Katarina
    Skåne University Hospital.
    Frenckner, Björn
    Karolinska Institutet / Astrid Lindgren Children's Hospital.
    Nisell, Margret
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Moons, Philip
    University of Gothenburg / KU Leuven, Department of Public Health and Primary Care, Leuven, Belgium.
    Bratt, Ewa-Lena
    University of Gothenburg / The Queen Silvia Children's Hospital.
    Parental Uncertainty About Transferring Their Adolescent with Congenital Heart Disease to Adult Care2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 5, no 2, p. 380-387Article in journal (Refereed)
    Abstract [en]

    AIMS: To study parent's levels of uncertainty related to the transfer from pediatric to adult care in adolescents with Congenital Heart Disease (CHD) and to identify potentially correlating factors.

    BACKGROUND: Parents acknowledge that during transition they struggle with finding ways of feeling secure in handing over the responsibility and letting go of control. Well-prepared and informed parents who feel secure are most likely better skilled to support their adolescent and to hand over the responsibility.

    DESIGN: A cross-sectional study.

    METHODS: Overall, 351 parents were included (35% response rate). Parental uncertainty was assessed using a Linear Analogue Scale (0-100). Data was collected between January - August 2016. Potential correlates were assessed using the readiness for transition questionnaire and sociodemographic data.

    RESULTS: The mean parental uncertainty score was 42.5. Twenty-four percent of the parents had a very low level of uncertainty (score 0-10) and 7% had a very high level (score 91-100). Overall, 26% of the mothers and 36% of the fathers indicated that they had not started thinking of the transfer yet. The level of uncertainty was negatively associated with the level of perceived overall readiness. Adolescents' age, sex, CHD complexity and parental age were not related to uncertainty.

    CONCLUSION: A wide range in the levels of uncertainty was found. Parents who were less involved in the care, or perceived their adolescent as readier for the transition, felt less uncertain. Still, thirty percent of the parents had not started to think about the transfer to adult care. This article is protected by copyright. All rights reserved.

  • 13.
    Burström, Åsa
    et al.
    Karolinska Institutet / Astrid Lindgren Children’s Hospital.
    Acuña Mora, Mariela
    University of Gothenburg.
    Öjmyr-Joelsson, Maria
    Karolinska Institutet / Astrid Lindgren Children’s Hospital.
    Sparud-Lundin, Carina
    University of Gothenburg.
    Rydberg, Annika
    Umeå University.
    Hanseus, Katarina
    Skåne University Hospital.
    Frenckner, Björn
    Karolinska Institutet / Astrid Lindgren Children’s Hospital.
    Nisell, Margret
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Moons, Philip
    University of Gothenburg / KU Leuven, Belgium.
    Bratt, Ewa-Lena
    Universisty of Gothenburg / The Queen Silvia Children’s Hospital.
    Ready for Transfer to Adult Care? A Triadic Evaluation of Transition Readiness in Adolescents With Congenital Heart Disease and Their Parents2019In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 25, no 3, p. 447-468Article in journal (Refereed)
    Abstract [en]

    Transfer to adult care for adolescents with chronic conditions ought to be determined by transition readiness. The aims of this study were (a) to describe the level of readiness for transition in adolescents with congenital heart disease, (b) to compare adolescents' assessment of transition readiness with their parents' assessments, and (c) to study potential correlates of transition readiness. A total of 157 triads of adolescents aged 14 to 18 years and their parents completed the Readiness for Transition Questionnaire. Adolescents scored higher on overall readiness than their parents. Multivariable analyses revealed that higher levels of adolescents' overall readiness were associated with a less threatening view of the illness, a higher level of empowerment, and with higher mothers' and fathers' overall readiness scores. Adolescents' responsibility scores were positively associated with age and parental adolescent responsibility scores. Parental involvement scores were negatively associated with adolescents' age and positively with the mothers' parental involvement scores. By using a triadic evaluation, the results of the present study significantly extend what is currently known about this population.

  • 14.
    Chatchumni, Manaporn
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. School of Nursing at Rangsit University, Thailand.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Mazaheri, Monir
    The Swedish Red Cross University College, Department of Health Sciences.
    Towards person-centered pain management in surgical care: Addressing the overlapping pain management systems in nursing education to enhance practice2019In: Global Nursing Education Conference: Nursing Education, Canada, 2019Conference paper (Refereed)
    Abstract [en]

    Since nurses’ work is knowledge-based an ineffective pain management may be the nurse’s perceptions of the patient in pain, which are a barrier of communication between nurses and patients’ pain within individual contexts. The purpose was to explore nurses’ post-operative pain management practices. A qualitative triangulation design was used, applying numerous qualitative methods: observations in a postoperative pain management setting (100 hours); in-depth interviews (12 nurses), three focus group discussions (18 nurses), and narratives relating to 69 critical incidents gathered during recurrent visits over a period of ten weeks (9 nurses). Content analysis, as outlined in grounded theory, was applied.

    The findings revealed the complex communication system that were nurses affirmed patient’s pain by using double- and triple-control methods to document and record it. As a consequence, they were managing pain by administrative prescription when the patients had requested rather than being proactive in providing pain relief. Mainly of ineffective succeed of communication tasks and information about the patients’ pain in post-operative pain that was available analgesics as causes delayed for pain relief.

    From the findings the complex communication system was discuss within the responding to and addressing patients’ postoperative pain system model, it was most helpful in creating a meaningful way of communicating education can prepare students for effective communication in a complex understanding about pain management, it must seek opportunities to challenge and change the way nurses think address how pain management within different interacting structures in practice and are create new and important ways of communicating with patients.

  • 15.
    Chatchumni, Manaporn
    et al.
    Rangsit University, Pathumthani, Thailand.
    Namvongprom, Ampaporn
    Rangsit University, Pathumthani, Thailand.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Mazaheri, Monir
    The Swedish Red Cross University College, Department of Health Sciences. Tehran University of Medical Sciences, Tehran, Iran.
    Engagement and availability in shaping nurses’ management of postoperative pain: a qualitative study2018In: Electronic Physician, ISSN 2008-5842, Vol. 10, no 8, p. 7235-7242Article in journal (Refereed)
    Abstract [en]

    Background: Studies reporting inadequate nursing care for patients indicate that nurses are negatively affected in such situations, and research is needed to study nursing care in postoperative situations. Objective: To describe situations of postoperative pain management in a surgical ward in Thailand. Methods: A qualitative approach using the Critical Incident Technique was chosen to investigate situations of postoperative pain management from the perspective of surgical nurses in Thailand. Data were collected through multiple semi-structured interviews with nine nurses over a five-week period. Results: The situations of surgical nurses described three elements that heavily influenced the quality of postoperative pain management: engagement in a trustful nurse-patient relationship, availability of pain medication and nursing care when needed, and imbalance between meeting the patient’s needs and completing routine nursing duties. Conclusion: The results help to expand our understanding of how Thai nurses manage pain in postoperative situations and indicate areas that could be improved in terms of how nurses respond to patients’ pain. Nurses challenge existing guidelines and facilitate development of new nursing guidelines and/or policies in pain management.

  • 16.
    Chatchumni, Manaporn
    et al.
    The Swedish Red Cross University College. Rangsit University, Pathumthani, Thailand.
    Namvongprom, Ampaporn
    Rangsit University, Pathumthani, Thailand.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Mazaheri, Monir
    The Swedish Red Cross University College, Department of Health Sciences.
    Exploring the different management structures in nurses responses and treating of patients’ postoperative pain: A qualitative triangulation study2019In: Electronic Physician, ISSN 2008-5842, Vol. 11, no 2, p. 7536--7543Article in journal (Refereed)
    Abstract [en]

    Background: Nurses’ roles are an important aspect of their approaches to pain management and monitoring in the post-operative phase of recovery in a surgical ward. A barrier to successful pain management may be the nurse’s perceptions of the patient in pain, which are confounded by the patterns of communication within individual contexts. We need to study, grasp and understand the complexities of the pain management practice within the context of the surgical ward in order to be able to improve the practices and design appropriate interventions to help patients in need. Objective: The purpose of this study was to explore nurses’ postoperative pain management practices. Methods: This qualitative triangulation study was conducted in a surgical ward at a public hospital in Bangkok (Thailand) from 2012 to 2015. We applied four qualitative methods in the study: 1) observations in a postoperative pain management setting (100 hours); 2) in-depth interviews (12 nurses), 3) three focus group discussions (18 nurses), and 4) narratives relating to 69 critical incidents gathered during recurrent visits over a period of ten weeks (9 nurses). Content analysis, as outlined in grounded theory, was applied. Results: The 40 nursing staff made their observations of the participants by conducting go-along interviews while they worked in the surgical field. The group of nurses comprised of 20 females and 4 males, age-ranged between 21-49 years of age, and their nursing experience ranged from 1-28 years. From our analysis, nurses verified patients’ pain by using double- and triple-control methods to document and record it, thus managing pain by administrative procedures rather than being proactive in providing pain relief. Therefore, communication and information about the patients’ pain and subsequent treatment of postoperative pain caused delays that may hamper the adequate use of available analgesics for pain relief. Levels of experience in communicating between nurses, other professionals, and patients were a main cause of delays in treating and managing pain. Conclusion: The complex communication system that would improve the communication ways leads to better standards of practice and quality of care.

  • 17.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    A Review of International Nursing-related Vocational and Educational Training on the issue of integrated teaching2019Conference paper (Refereed)
    Abstract [en]

    Background: The review focus was to systematize, describe and critically analyze previous international research on school-based integrated teaching for vocational knowing in nursing-related education in upper secondary and higher-level education. The review questions were: a) What kind of integration was conducted within a school context in nursing-related education? b) What in terms of vocational knowing was highlighted as a result in the studies through integrated teaching? c) What was the relation between study aim and analytical method for the vocational knowing that was highlighted?

    Summary of Work: Searches were conducted in two databases, EbscoHost, and ProQuest Social Sciences. Search terms ‘integrated teaching’, ‘vocational knowing’ and ‘nursing’, retrieved from the databases, were combined with “AND”. Search area was expanded by terms ‘education’, ‘curriculum’, ‘vocational’, and specified with ‘thematical integration’. Delimitations comprised admitted approaches of integration (Case Method, Problem-based Learning), and were set to scholarly, peer-reviewed articles. The first sorting comprised assessment of abstracts, while the second sorting comprised whole articles. Reference-lists of included studies were assessed for inclusion. Altogether, 14 studies were included and assessed for quality and coherence with Grade CerQual.

    Summary of Results:The results showed three types of integrated teaching, integration through embeddedness or streaks, problem-based learning, and between school and workplace; vocational knowing related to a professional and academic context; and there was a methodological significance for the type of vocational knowing highlighted in the studies.

    Discussion and Conclusions: Integrated teaching with professional connection was stressed as significant for vocational knowing, because of authenticity and meaningfulness. Vocational knowing of academic character required a professional contextualization for meaningfulness. The primary studies highlighted quantitative methodology as quality measure and by passed epistemological (constructivism and positivism) aspects. A quantitative method of approach was shown as the quality measure in primary studies. The notion of quality requires expansion with more qualitative studies, that focus on minor student groups and specific didactic situations for an in-depth understanding of integrated teaching and vocational knowing in nursing.

    Take-home Messages: Integrated teaching is an admitted didactical approach but highly significant for vocational knowing.

  • 18.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences. Stockholm University.
    Integrated teaching for vocational knowing: A systematic review of research on nursing-related vocational education and training2019In: Nordic Journal of Vocational Education and Training, ISSN 2242-458X, E-ISSN 2242-458X, Vol. 9, no 2, p. 19-50Article in journal (Refereed)
    Abstract [en]

    The aim for this review was to systematize, describe and critically analyse previous research concerning school-based integrated teaching for vocational knowing in nursingrelated training in upper secondary and in higher level education. Searches were conducted in four databases, two specifically for Swedish hits, and two for international hits. Also, search was made in a Nordic journal on vocational education and training. References in included studies were also assessed for further inclusion of studies. Altogether, 14 studies were included and assessed for quality and coherence with GRADE CERQual. Review findings comprised three types of integrated teaching, through embeddedness or streaks, problem-based learning, and between school and workplace; vocational knowing relating to a professional and academic context; and methodological significance for the vocational knowing highlighted in the studies. In conclusion, the methodological approach typically used in the primary studies related to a quantitative approach, which was also discerned as quality measure. The primary studies brought forward a partial understanding of integrated teaching and vocational knowing, which is dependent on the methodological approach. In order to enhance understanding about the research topic, there is a need for more studies on integrated teaching utilizing a qualitative approach.

  • 19.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    Mötet med patienten2019In: Bettfysiologi: orofacial smärta och käkfunktion / [ed] Nikolaos Christidis, Stockholm: Gothia Fortbildning , 2019, p. 173-189Chapter in book (Other academic)
    Abstract [sv]

    Kapitlet behandlar mötet med patienten och framhäver dels kommunikativa aspekter och dels etiska aspekter såsom integritet och medbestämmande.  Avslutningsvis behandlas upptaget av anamnes och status för behandling av patienten. 

  • 20.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    Teaching Communication in Nursing Assistants Training on a Swedish Upper Secondary Health and Social Care Program2018Conference paper (Other academic)
  • 21.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    Teaching communication in nursing assistants training on a Swedish upper secondary Health and Social Care Program2019Conference paper (Refereed)
  • 22.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences. Stockholm University.
    Tools for subject integrated teaching and the formation of vocational knowledge in one Swedish Health and Social Care Program2014Conference paper (Refereed)
    Abstract [en]

    The aim of the main study was to investigate subject integrated teaching in an upper-secondary Health and Social Care program and the vocational knowledge that was shaped in teaching. The aim of this presentation is to highlight a teacher-constructed case report as a tool for subject integration, the use of the tool for integration and the kind of vocational knowledge that is shaped through the use of the tool.

    The material was collected ethnographically and comprised of observation on teaching, with the case report as a base, during a theme unit called “Professional language”. The material further comprised of field-notes on teaching, interviews and informal discussions, sound-recording of teaching and material handed out during teaching. The material was analysed according to Activity-Theoretical concepts of actions, goals and tools.

    The results identifiedthat the case report had a vocational origin but had been modified to an educational context. This qualified the case report as a boundary object. It was used by a teacher of core-subjects in teaching to highlight content related to Swedish and to vocational subjects, but also content that related to the theme unit.

    In conclusion, the use of the teacher-constructed case report in subject integrated teaching helped shape additional vocational knowledge compared to subject-specific teaching.

  • 23.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    Two Swedish PhD-programmes in Vocational Pedagogy  : Background, Aims and Strategies2014Conference paper (Other academic)
  • 24.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences. Stockholm University.
    Vocational knowing in subject integrated teaching: A case study in a Swedish upper secondary health and social care program2019In: Learning, Culture and Social Interaction, ISSN 2210-6561, E-ISSN 2210-657X, Vol. 21, p. 21-33Article in journal (Refereed)
    Abstract [en]

    The aim of this case study was to investigate what vocational knowing was made available in subject-integrated teaching of four vocational subjects in a Swedish Health and Social Care Program (HSCP). The study was composed of two separate data collections, both ethnographic. The first data collection was performed in autumn 2012 on a theme unit called VIPS, with a group of students (16+), in a Swedish HSCP. Data comprised observations, field notes, and audio recordings of planning and teaching of the theme unit, informal discussions with teachers and students, handouts, a theme booklet, and student assignments. The second data collection was performed during spring 2018 in which life-history interviews focused on documentation were conducted with the teachers involved in the theme unit from 2012. Data comprised audio recordings and time lines. A theoretical framework and analytical work were performed with concepts from Cultural Historical Activity Theory, and from New Literacy Studies. The results indicate that the object in the teaching activity comprised vocational knowing in three areas: psychosis, ethics, and communication, and vocational literacy. Vocational contextualization of teaching was a necessary component that made available vocational knowing that contributed to the students' professional development.

  • 25.
    Christidis, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    Vocational knowledge in a Subject Integrated Form of Teaching at two Swedish Health and Social care Program2014Conference paper (Other academic)
  • 26.
    Christidis, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Lindberg, Viveca
    Göteborgs universitet.
    Lärares samverkan för yrkeskunnande: Engl. translation: Teachers’ Cooperation for Vocational Knowing2017In: Yrkesdidaktikens mångfald / [ed] Andreas Fejes, Viveca Lindberg, Gun-Britt Wärvik, Stockholm: Lärarförlaget , 2017, 1Chapter in book (Other (popular science, discussion, etc.))
    Abstract [en]

    Based on a study of curriculum integration in Swedish upper secondary education, at a Health and Social Care Programme (Christidis, 2014), the issue of this chapter is how general subjects can contribute to vocational knowing in the interaction between teachers and students. Inspired by an ethnographic approach, classroom observations, interviews and documents formed the data, and for the analysis concepts from activity theory were used. Main results were that teachers’ and students’ experiences used in teaching focused three actors’ perspectives: those of nurse-assistants’, patients’ and relatives’. These were expressed in subject specific as well as interdisciplinary teaching of general and vocational subjects. Using subject integration made it possible for both teachers and students to explore connections between the subjects. Furthermore, subject integration contributed to one of the main goals of the Health and Social Care Programme: to develop a holistic view of the human being.

  • 27.
    Christidis, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Stockholm University.
    Lindberg, Viveca
    Stockholm University.
    Subject-Integrated Teaching for Expanded Vocational Knowing and Everyday Situations in a Swedish Upper Secondary Health and Social Care Program2019In: Vocations and Learning, ISSN 1874-785X, E-ISSN 1874-7868, Vol. 12, no 3, p. 479-498Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore what subject-integrated teaching of vocational subjects, ethics and health care, contributed with in terms of vocational knowing. The case study was ethnographically inspired and followed a group of students (16 +) and their teachers in a Swedish Health and Social Care Program while they worked with a theme unit called Death for two weeks in autumn 2012. Data comprised observations, field notes, and audio recordings of the planning and teaching of the theme unit, informal discussions with teachers and students, handouts, a theme booklet, and student assignments. Analysis was based on concepts related to cultural historical activity theory, especially emphasizing rules, tools, actions, operations, and contradictions. Results showed three major objects emphasized in the teacher–student interaction and the tools chosen to support the subject-integrated teaching activity: vocational knowing related to vocational ethics, to everyday ethics, and argumentative skills. Manifestations of contradictions in the form of dilemmas related to the examples that teachers copied from a textbook. As these examples were mainly contextualized in everyday situations, and there are no formal ethical guidelines for nursing assistants on which teachers could rely on, teachers’ narratives were used to complement these examples. Students’ argumentative skills were emphasized and related to personal situations, in which ethical arguments for justification in vocationally relevant situations were made unclear.

  • 28.
    Christidis, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Lindberg, Viveca
    Göteborgs universitet.
    Vocational Literacy as means for Vocational Knowing related to Ethics in a Swedish Upper Secondary Health and Social Care Program2017Conference paper (Other academic)
    Abstract [en]

    The issue of this paper is to explore what vocational knowing is made available for students in Swedish upper secondary vocational education (16+) within the Health and Social Care program, with a specific focus on literacy-related vocational knowing framed by contextualized teaching (previously integration of subjects). A case study of contextualized teaching in a Swedish upper secondary school was followed ethnographically during autumn 2012 in the Health and Social Care program (year 2 of 3). Cultural-historical activity theory was used for analyzing what vocational knowing was made available and what literacy aspects that contributed to this. Teachers constructed a theme, Death, in order to work with ethical content relevant for nurse assistants. Ethical dilemmas and literacy practices (writing notes, reading aloud) were used as tools for enhancing sharing of different perspectives. The object of learning was identified as the ability to change perspectives and taking the other’s perspective in a dilemmatic situation related to caring.

  • 29.
    Crafoord, Marie-Therese
    et al.
    Södersjukhuset, Karolinska Institutet.
    Mattsson, Janet
    The Swedish Red Cross University College, Department of Health Sciences.
    Fagerdahl, Ann-Mari
    Södersjukhuset, Karolinska Institutet.
    Operating Room Nurses’ Perceptions of the Clinical Learning Environment: A Survey Study2018In: Journal of Continuing Education in Nursing: Continuing Competence for the Future, ISSN 0022-0124, E-ISSN 1938-2472, Vol. 49, no 9, p. 416-423Article in journal (Refereed)
    Abstract [en]

    Background: Authors commonly agree that the clinical learning environment significantly affects student learning. Studies of how operating room nurses perceive the clinical learning environment during their specialist studies are sparse. 

    Method: This study aimed to examine newly graduated operating room nurses’ perceptions of the clinical learning environment during their specialist education. Fifty newly graduated operating room nurses answered a questionnaire gaging their perceptions of clinical education. 

    Results: Most participants perceived the clinical learning environment as good and highly associated with the supervisor’s ability to supervise, enjoy supervision, and show interest in the participants’ degree project. The management at the clinical setting, which was perceived to emphasize the importance of supervision, time allocated especially for supervision, and perceived cooperation between the University and hospital, also had an impact. 

    Conclusion: Social interactions and structures within the operating room affect how the clinical learning environment is perceived. 

  • 30.
    Dyar, Anna
    et al.
    Karolinska Institutet.
    Lachmann, Hanna
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Stenfors, Terese
    Karolinska Institutet.
    Kiessling, Anna
    Karolinska Institutet.
    The learning environment on a student ward: an observational study2019In: Perspectives on medical education, ISSN 2212-2761, Vol. 8, no 5, p. 276-283Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Worldwide, a growing number of healthcare students require clinical environments for learning. Some wards have become adapted 'student wards' to meet this demand. Benefits have been reported from the students', supervisors' and patients' perspectives. There is no definition of a student ward, and little research on what the term means. A deeper understanding of the characteristics of student wards is needed to support their use. The aim of this study is to describe what characterises the learning environment on one student ward.

    METHODS: An ethnographic approach was used for an observational study on a student ward in a hospital in Sweden. Student nurses, supervisors and others on the ward were observed. Field notes were thematically analysed.

    RESULTS: Four themes were identified: 'Student-led learning' described students learning by actively performing clinical tasks and taking responsibility for patients and for their own learning. 'Learning together' described peer learning and supervision. 'Staff's approach to learning' described personalised relationships between the students and staff and the build-up of trust, the unified inter-professional approach to teaching, and the supervisors' motivation for teaching and for their own learning. 'Student-dedicated space' described the effect of the student room on the learning environment.

    DISCUSSION AND CONCLUSIONS: This study describes the characteristics of a student ward that centred around a community of practice that shared a view of learning as a priority, allowing staff to provide clinical care without compromising students' learning. This qualitative study at a single centre lays the groundwork for future research into other student wards.

  • 31.
    Díaz, Miguel
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Manchester Metropolitan University, UK.
    Avila, A
    Manchester Metropolitan University, UK / KU Leuven, Belgium.
    Degens, H
    Manchester Metropolitan University, UK / Lithuanian Sports University, Lithuania.
    Coeckelberghs, E
    KU Leuven, Belgium.
    Vanhees, L
    KU Leuven, Belgium.
    Cornelissen, V
    KU Leuven, Belgium.
    Azzawi, M
    Manchester Metropolitan University, UK.
    Acute resveratrol supplementation in coronary artery disease: towards patient stratification2019In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, p. 1-20Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Resveratrol (RV) is a polyphenol with antioxidant, anti-inflammatory and cardio-protective properties. Our objective was to investigate whether acute supplementation with high doses of RV would improve flow-mediated dilation (FMD) and oxygen consumption (VO2) kinetics in older coronary artery disease (CAD) patients.

    DESIGN: We employed a placebo-controlled, single-blind, crossover design in which ten participants (aged 66.6 ± 7.8 years) received either RV or placebo (330 mg, 3x day-1) during three consecutive days plus additional 330 mg in the morning of the fourth day with a seven-day wash-out period in-between. On the fourth day, FMD of the brachial artery and VO2 on-kinetics were determined. Results; RV improved FMD in patients who had undergone coronary artery bypass grafting (CABG; -1.4 vs. 5.0%; p = 0.004), but not in those who had undergone percutaneous coronary intervention (PCI; 4.2 vs. -0.2%; NS).

    CONCLUSION: Acute high dose supplementation with RV improved FMD in patients after CABG surgery but impaired FMD in patients who underwent PCI. The revascularization method-related differential effects of RV may be due to its direct effects on endothelial-dependent dilator responses. Our findings have important implications for personalized treatment and stratification of older CAD patients.

  • 32.
    Díaz, Miguel
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Manchester Metropolitan University, Manchester, UK.
    Parikh, Vijay
    Manchester Metropolitan University, Manchester, UK.
    Ismail, Saira
    Manchester Metropolitan University, Manchester, UK.
    Maxamed, Raja
    Manchester Metropolitan University, Manchester, UK.
    Tye, Emily
    Manchester Metropolitan University, Manchester, UK.
    Austin, Clare
    Edge Hill University, Lancashire, UK.
    Dew, Tristan
    Manchester Metropolitan University, Manchester, UK.
    Graf, Brigitte A
    Manchester Metropolitan University, Manchester, UK.
    Vanhees, Luc
    University Leuven, Leuven, Belgium.
    Degens, Hans
    Manchester Metropolitan University, Manchester, UK / Lithuanian Sports University, Kaunas, Lithuania / University of Medicine and Pharmacy of Targu Mures, Romania..
    Azzawi, May
    Manchester Metropolitan University, Manchester, UK.
    Differential effects of resveratrol on the dilator responses of femoral arteries, ex vivo2019In: Nitric oxide, ISSN 1089-8603, E-ISSN 1089-8611, Vol. 92, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Resveratrol is a plant-derived phytoalexin with antioxidant, anti-inflammatory and cardio-protective properties and may be a promising therapeutic intervention strategy in cardiovascular disease. Here, we investigated the acute direct effects of trans-resveratrol (RV), on acetylcholine (ACh)-induced and flow-mediated dilation (FMD) of isolated pressurized femoral arteries of young (4-month-old) and old (26-month-old) mice. Vessel exposure to RV enhanced ACh (0.01-1.0 mM)-induced dilation (p < 0.05), but not FMD (@ 5-10 μL⋅min-1) (p < 0.05) in both young and old mice. After RV incubation, acute nitric oxide (NO) production by cultured endothelial cells was increased in response to 0.01 mM ACh, but reduced by flow (5-10 μL⋅min-1; p < 0.05). In isolated femoral arteries from endothelial nitric oxide synthase knockout (eNOS-/-) mice, RV had no overall effect on flow mediated dilation, but potentiated ACh induced dilation, that was completely abolished by potassium channel blockers, Apamin and Tram 34 (p < 0.01). We demonstrate that the non-metabolised form of RV stimulates ACh-induced dilation via the NO and EDHF pathways, but not FMD by interaction with the cyclo-oxygenase pathway. Our findings have important implications in the use of RV (for both young and aged) under 'normal' non-diseased physiological states.

  • 33.
    Eckerström, Joachim
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet, Stockholm County Council.
    Allenius, Emelie
    Stockholm County Council.
    Helleman, Marjolein
    Hanze University of Applied Sciences, Groningen, Netherlands.
    Flyckt, Lena
    Karolinska Institutet.
    Perseius, Kent-Inge
    The Swedish Red Cross University College. Karolinska Institutet.
    Omerov, Pernilla
    Ersta Sköndal Bräcke University College.
    Brief admission (BA) for patients with emotional instability and self-harm: nurses’ perspectives - person-centred care in clinical practice2019In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, no 1, article id 1667133Article in journal (Refereed)
    Abstract [en]

    Purpose: Emotional instability and self-harm pose major problems for society and health care. There are effective interventions in outpatient care, but when patients need inpatient care, nurses often struggle meeting their patient’s needs. Brief admission (BA) is a newly implemented crisis intervention and novel form of inpatient care. The aim of this study is to describe nurses’ experiences working with BA related to patients with emotional instability and self-harm.

    Methods: Eight nurses were interviewed according to a semi-structured interview guide. The data was analysed using qualitative content analysis.

    Results: Four main categories emerged regarding nurses’ experiences with BA: provides security and continuity, fosters caring relationships, shifts focus towards patient’s health and empowers the patient. The nurse’s role shifted from “handling problems” to establishing caring relationships with a focus on the person’s health and possibilities for recovering instead of psychiatric symptoms.

    Conclusions: Previous studies on patients’ perspective of BA describe positive experiences such as increased autonomy and participation in the healthcare process. This study supports those findings, albeit from the perspective of nurses. Our findings suggest that BA may reduce work-related stress experienced by nurses while caring for persons with emotional instability and self-harm. BA may also support nurses in their ability to provide more meaningful and constructive psychiatric inpatient care.

  • 34.
    Ekstrand, Per
    The Swedish Red Cross University College, Department of Health Sciences.
    Att  vara  eller  arbeta som  sjuksköterska: ett gränsöverskridande yrke2017In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg och Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 87-105Chapter in book (Other academic)
  • 35.
    Ekstrand, Per
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Saarnio, Lotta
    Karolinska Institutet, Ersta Sköndal Bräcke högskola.
    Makt och vanmakt hos patienter med svår sjukdom2017In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg och Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 169-184Chapter in book (Other academic)
  • 36.
    Eriksson, Catrin
    et al.
    Sophiahemmet University.
    Skinstad, Matilda
    Sophiahemmet University.
    Georgsson, Susanne
    The Swedish Red Cross University College. Karolinska Institutet.
    Carlsson, Tommy
    The Swedish Red Cross University College, Department of Health Sciences. Sophiahemmet University / Uppsala University.
    Quality of websites about long-acting reversible contraception: a descriptive cross-sectional study2019In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 16, no 1, article id 172Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Today, there are various short- and long-acting contraceptive alternatives available for those who wish to prevent unintended pregnancy. Long-acting reversible contraception are considered effective methods with a high user satisfaction. High-quality information about contraception is essential in order to empower individuals to reach informed decisions based on sufficient knowledge. Use of the Web for information about contraception is widespread, and there is a risk that those who use it for this purpose could come in contact with sources of low quality.

    OBJECTIVE: The overarching aim was to investigate the quality of websites about long-acting reversible contraception.

    METHODS: Swedish client-oriented websites were identified through searches in Google (n = 46 included websites). Reliability and information about long-acting reversible contraceptive choices were assessed by two assessors with the DISCERN instrument, transparency was analyzed with the Journal of the American Medical Association benchmarks, completeness was assessed with inductive content analysis and readability was analyzed with Readability Index.

    RESULTS: The mean DISCERN was 44.1/80 (SD 7.7) for total score, 19.7/40 (SD 3.7) for reliability, 22.1/35 (SD 4.1) for information about long-acting reversible contraceptive choices, and 2.3/5 (SD 1.1) for overall quality. A majority of the included websites had low quality with regard to what sources were used to compile the information (n = 41/46, 89%), when the information was produced (n = 40/46, 87%), and if it provided additional sources of support and information (n = 30/46, 65%). Less than half of the websites adhered to any of the JAMA benchmarks. We identified 23 categories of comprehensiveness. The most frequent was contraceptive mechanism (n = 39/46, 85%) and the least frequent was when contraception may be initiated following an abortion (n = 3/46, 7%). The mean Readability Index was 42.5 (SD 6.3, Range 29-55) indicating moderate to difficult readability levels, corresponding to a grade level of 9.

    CONCLUSIONS: The quality of client-oriented websites about long-acting reversible contraception is poor. There is an undeniable need to support and guide laypersons that intend to use web-based sources about contraceptive alternatives, so that they may reach informed decisions based on sufficient knowledge.

  • 37.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Det subversiva arvet: Global Omvårdnad och relationer till vetenskapliga doktriner – en personlig betraktelse2018Conference paper (Other academic)
  • 38.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Förutsättningar för omvårdnad: genus2019In: Omvårdnadens grunder: perspektiv och förhållningsätt / [ed] Febe Friberg & Joakim Öhlén, Lund: Studentlitteratur AB, 2019, 3, p. 337-357Chapter in book (Other academic)
  • 39.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Intimitetens villkor i vårdandet2017In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg & Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 71-86Chapter in book (Other academic)
  • 40.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    Omvårdnad i ett historiskt perspektiv: framväxt2019In: Omvårdnadens grunder: perspektiv och förhållningsätt / [ed] Febe Friberg & Joakim Öhlén, Lund: Studentlitteratur AB, 2019, 3, p. 33-60Chapter in book (Other academic)
  • 41.
    Eriksson, Henrik
    The Swedish Red Cross University College, Department of Health Sciences.
    What is nursing? Nursing as the science of human life in a postmodern era: Clues from the past to understand the road ahead2018In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 3, p. 117-118Article in journal (Other academic)
  • 42.
    Eriksson, Henrik
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Dahlborg-Lyckhage, Elisabeth
    Högskolan Väst.
    Om Genus - introduktion2017In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg och Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 15-30Chapter in book (Other academic)
  • 43.
    Eriksson, Henrik
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Sandberg, Jonas
    Jönköping University.
    Röster från sidlinjen - former och normer i anhörigspelet2017In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg & Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 149-166-Chapter in book (Other academic)
  • 44.
    Eriksson, Henrik
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Strömberg, HelénUmeå Universitet.
    Genusperspektiv på vård och omvårdnad2017Collection (editor) (Other academic)
    Abstract [sv]

    Det som vanligen benämns genusfrågor är inte bara en angelägenhet för akademin och forskare, utan begreppet diskuteras i såväl politisk som populärvetenskaplig debatt.

    Genusrelaterade, feministiska  och/eller jämställdhetsfrågor är viktiga för samhället och för individer i många olika sammanhang. Men vad är egentligen genus och vad menas med att ha ett genusperspektiv? På vilket sätt kan genus vara en utgångspunkt när det talas om vård och omvårdnad som sträcker sig bortom dagsaktuella politiska utfästelser och olika myndigheters pågående jämställdhetsarbete?

    Genusperspektiv på vård och omvårdnad problematiserar vårdandet, dess handlingar, relationer och processer samt hälso-och sjukvårdens institutioner ur olika genusteoretiska perspektiv.

  • 45.
    Ernstsson, Olivia
    et al.
    Karolinska Institutet.
    Tinghög, Petter
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Alexanderson, Kristina
    Karolinska Institutet.
    Hillert, Jan
    Karolinska Institutet.
    Burström, Kristina
    Karolinska Institutet / Stockholm County Council.
    The External Validity of Mapping MSIS-29 on EQ-5D Among Individuals With Multiple Sclerosis in Sweden2017In: Medical Decision Making Policy & Practice, ISSN 2381-4683, Vol. 2, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Mapping can be performed to predict utility values from condition-specific measures when preference-based measures are absent. A previously developed algorithm that predicts EQ-5D-3L index values from the Multiple Sclerosis Impact Scale (MSIS-29) has not yet been externally validated. Aim: To examine the external validity of a previously developed mapping algorithm by testing the accuracy of predicting EQ-5D-3L index values from MSIS-29 among multiple sclerosis (MS) patients in Sweden. Methods: Cross-sectional individual-level data were collected from population-based Swedish registers between 2011 and 2014. Health-related quality of life was assessed through MSIS-29 and EQ-5D-3L at one point in time among 767 individuals with known disability level of MS. A previously developed mapping algorithm was applied to predict EQ-5D index values from MSIS-29 items, and the predictive accuracy was assessed through mean absolute error and root mean square error. Results: When applying the algorithm, the predicted mean EQ-5D-3L index value was 0.77 compared to the observed mean index value of 0.75. Prediction error was higher for individuals reporting EQ-5D values <0.5 compared to individuals reporting EQ-5D values ≥0.5. Mean absolute error (0.12) and root mean square error (0.18) were smaller or equal to the prediction errors found in the original mapping study. Conclusion: The mapping algorithm had similar predictive accuracy in the two independent samples although results showed that the highest predictive performance was found in groups with better health. Varied predictive accuracy in subgroups is consistent with previous studies and strategies to deal with this are warranted.

  • 46.
    Faag, Carina
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Örebro University.
    Bergenius, Johan
    Karolinska Institutet / Karolinska University Hospital.
    Forsberg, Christina
    Karolinska Institutet.
    Langius-Eklöf, Ann
    Karolinska Institutet.
    Feasibility and Effects of a Nursing Intervention for Patients with Peripheral Vestibular Disorders2017In: Rehabilitation Nursing, ISSN 0278-4807, Vol. 42, no 5, p. 274-281Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore the feasibility and possible outcomes of a nursing intervention in patients with peripheral vestibular disorders. Design: A randomized controlled trial (RCT). Methods: Thirty-six patients participated in the study: the intervention group (n = 18), who received the intervention, and patients in a control group (n = 18), who received standard care. The intervention includes patient education and individualized nursing support during a 6-month rehabilitation period. Outcomes were symptoms, well-being, sense of coherence, and self-care measured at baseline before randomization and at 6 and 9 months later. Findings: At the 9-month follow up, the patients who received the intervention rated significantly fewer vertigo-related symptoms and a higher sense of coherence than the control group. Conclusion: The intervention was feasible and seems to support the patients to manage symptoms, but confirmative studies are warranted. Clinical Relevance: Patient education in combination with individual support may be beneficial to help patients with peripheral disorders during their rehabilitation.

  • 47.
    Farrants, Kristin
    et al.
    Karolinska Institutet.
    Friberg, Emilie
    Karolinska Institutet.
    Sjölund, Sara
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Alexanderson, Kristina
    Karolinska Institutet.
    Trajectories of future sickness absence and disability pension days among individuals with a new sickness absence spell due to osteoarthritis diagnosis ≥21 days: a prospective cohort study with 13-month follow-up2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 8, article id e030054Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Osteoarthritis is one of the most common types of musculoskeletal diagnoses also among working-age populations, and often leads to long-term sickness absence (SA) spells or even disability pension (DP).

    THE AIM: was to identify future trajectories of days of SA and/or DP among people with a new SA spell due to osteoarthritis that became ≥21 long, and to investigate sociodemographic and morbidity characteristics of individuals in identified trajectories.

    METHODS: tests and multinomial logistic regression.

    RESULTS: We identified five trajectories of SA/DP days: 'fast decrease' (36% of the cohort), 'medium fast decrease' (29%), 'slow decrease' (15%), 'fluctuating' (12%) and 'late decrease' (8%). Individuals in the two trajectories who still had SA/DP days at end of follow-up (late decrease and fluctuating) were more likely to be older, born outside the EU and have indicators of more severe morbidity than those in the other trajectories.

    CONCLUSION: Five trajectories of future SA/DP days were identified; 80% of the cohort belonged to trajectories with no SA/DP by the end of follow-up. Identifying trajectories of future SA/DP provides new insights regarding the developments of SA/DP over time among people on SA due to osteoarthritis; not only days in the initial SA spell but also in new spells during follow-up need to be included for a better understanding.

  • 48.
    Forsner, Maria
    et al.
    Karolinska University Hospital.
    Mattsson, Janet
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet, Karolinska University Hospital.
    Caring for Dying Children in the Pediatric Intensive Care Unit, Nurses and Parent’s Perspective2019In: Online Journal of Complimentary & Alternative Medicine, Vol. 1, no 2, p. 1-7, article id 000510Article in journal (Refereed)
    Abstract [en]

    Caring for dying children is complex and requires coordination of all resources. In PICU the main objective is to save lives and ensure vital functions in critically ill children. However due to the child’s critical and life-threatening condition, there is always the possibility the child will not survive. The acuity and technical nature of the intensive care context can provide an obstacle in the transition to palliative care and furthermore conflict with the affected families’ needs. The study aim was to enlightening caring as it is represented in caring situations of dying children at PICU. An Interpretative Phenomenological design was applied. The data collection was performed at three PICU in Sweden in two different occasions at 2011 and 2016 [1,2]. Caring situations of a total of 18 children were observed, of these five cases were estimated as end of life care or lifethreatening conditions. Additionally, nurses and parents were interviewed in direct connection to the observation. Results showed that for nurses, it was a challenge to change perspective from curative to palliative care. Furthermore, medical examinations and treatment was experienced to disturb the dying child thus causing unnecessary suffering. Parents found it difficult to leave their dying children even just for a moment. At the same time the space in PICU usually did not support closeness and parenting but rather separated the dying child from her/his family. In conclusion, since it isn´t possible to always care for dying children in specialized palliative care units these results illuminate the importance of guidelines and training in palliative care in PICU and other acute pediatric care units. Children and their family ought to have the best care possibly when affected by life-limiting or life-threatening illness.

  • 49.
    Fossum, Maren
    et al.
    Norwegian University of Science and Technology, Trondheim, Norway.
    Tunc, Zozan
    KTH.
    Strömberg, Emma
    KTH.
    Frostell, Claes
    Karolinska Institutet.
    Liljegren, Annelie
    Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Aune, Ragnhild
    Norwegian University of Science and Technology, Trondheim, Norway.
    In-vitro and In-vivo Exposure of Intravascular Catheters to Cytostatic Drugs2018Conference paper (Refereed)
  • 50.
    Gedin, F
    et al.
    Karolinska Institutet / Scandinavian College of Chiropractic.
    Dansk, V
    Scandinavian College of Chiropractic.
    Egmar, Ann-Charlotte
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Sundberg, T
    Karolinska Institutet.
    Burström, K
    Karolinska Institutet / Stockholm County Council.
    Patient-reported improvements of pain, disability, and health-related quality of life following chiropractic care for back pain - A national observational study in Sweden2019In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 23, no 2, p. 241-246Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chiropractic care is a common but not often investigated treatment option for back pain in Sweden. The aim of this study was to explore patient-reported outcomes (PRO) for patients with back pain seeking chiropractic care in Sweden.

    METHODS: Prospective observational study. Patients 18 years and older, with non-specific back pain of any duration, seeking care at 23 chiropractic clinics throughout Sweden were invited to answer PRO questionnaires at baseline with the main follow-up after four weeks targeting the following outcomes: Numerical Rating Scale for back pain intensity (NRS), Oswestry Disability Index for back pain disability (ODI), health-related quality of life (EQ-5D index) and a visual analogue scale for self-rated health (EQ VAS).

    RESULTS: 246 back pain patients answered baseline questionnaires and 138 (56%) completed follow-up after four weeks. Statistically significant improvements over the four weeks were reported for all PRO by acute back pain patients (n = 81), mean change scores: NRS -2.98 (p < 0.001), ODI -13.58 (p < 0.001), EQ VAS 9.63 (p < 0.001), EQ-5D index 0.22 (p < 0.001); and for three out of four PRO for patients with chronic back pain (n = 57), mean change scores: NRS -0.90 (p = 0.002), ODI -2.88 (p = 0.010), EQ VAS 3.77 (p = 0.164), EQ-5D index 0.04 (p = 0.022).

    CONCLUSIONS: Patients with acute and chronic back pain reported statistically significant improvements in PRO four weeks after initiated chiropractic care. Albeit the observational study design limits causal inference, the relatively rapid improvements of PRO scores warrant further clinical investigations.

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