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  • 1.
    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
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. 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 Care2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 5, nr 2, s. 380-387Artikel i tidskrift (Refereegranskat)
    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.

  • 2.
    Ehrenberg, Anna
    et al.
    Uppsala University.
    Ehnfors, Margareta
    Örebro University.
    Thorell Ekstrand, Ingrid
    Röda Korsets Högskola.
    Nursing documentation in patient records: Experience of the use of the VIPS model1996Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 24, nr 4, s. 853-867Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The VIPS model for the documentation of nursing care in patient records was scientifically developed and published in 1991, with the aim of supporting the systematic documentation of nursing care and promoting individualized care. As the model seemed to be accepted and used in many parts of Sweden, a study was conducted in order to gather further information on the validity of the model, to describe the clinical and educational experience of its use and to refine it. Experience of the use of the model was gathered from a review of the scientific papers and other reports on it, from questionnaires addressed to nurses (n = 514), from comments by key informants, and from interviews with faculty members at all the nursing schools in the country. The findings showed that an intense process of change and development was occurring regarding nursing documentation. However, there were limitations in the use of the entire nursing process, especially in the specification of patient problems and the formulation of nursing diagnoses and nursing interventions. The keywords (Swedish spelling) of the VIPS model had good content validity in different areas of nursing care. The findings also indicated the need for further elaboration and revision of some of the keywords. A revised version of the VIPS model based on these findings is presented.

  • 3.
    Georgsson, Susanne
    et al.
    Röda Korsets Högskola. Karolinska Institutet.
    Carlsson, Tommy
    Sophiahemmet University / Uppsala University.
    Pain and pain management during induced abortions: a web-based exploratory study of recollections from previous patients2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To explore recollections of pain and pain management during induced abortions.

    DESIGN: Mixed-methods exploratory study in Sweden.

    METHODS: A web-based survey was distributed between October 2017 - July 2018 via Swedish discussion boards and social media. Open-ended questions were asked about recollection of pain and pain management, followed by self-report ratings. The survey was answered by 185 participants, responses analyzed with qualitative content analysis.

    FINDINGS: Recollections of pain intensity illustrated considerable pain and a traumatic event, described in temporal aspects and likened to other painful conditions such as dysmenorrhea and childbirth. Recollections of pain management illustrated experiences of insufficient treatment of pain and dissatisfaction with pain management, including inefficient treatment and lack of professional attendance. Psychological aspects and consequences illustrated that participants related psychological distress to physical pain, felt unprepared for the physical pain and emphasized the importance of psychological support. Those who experienced intense pain described long-term psychological consequences, including fear of childbirth.

    CONCLUSION: Physical pain and psychological distress can manifest as considerable challenges during induced abortion. Abortion-related pain is a multidimensional phenomenon involving physical and psychological components that needs to be rigorously treated. When physical pain is unsuccessfully treated, women may experience long-term psychological consequences after an abortion.

    IMPACT: The results illustrate the importance of holistic abortion care where the multidimensional components of abortion-related pain are considered. Patients need to be offered sufficient preparatory information about potential physical pain and psychological distress. This study indicates that there is room for improvement in pain management. Larger studies are needed.

  • 4.
    Georgsson, Susanne
    et al.
    Röda Korsets Högskola. Karolinska Institutet.
    van der Spoel, Linde
    Uppsala University.
    Ferm, Johanna
    Uppsala University.
    Carlsson, Tommy
    Uppsala University / Sophiahemmet University.
    Quality of web pages about second-trimester medical abortion: A cross-sectional study of readability, comprehensiveness, and transparency2019Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To investigate the readability, comprehensiveness and transparency of web pages about medical abortion in the second trimester of pregnancy.

    DESIGN: A cross-sectional descriptive study of Swedish web pages.

    METHODS: Six systematic searches were performed in Google during January 2017. The first 10 hits of each search were screened, resulting in 46 included Swedish web pages. The web pages were analyzed with readability index (LIX) to investigate readability, inductive manifest content analysis to investigate comprehensiveness, and Journal of the Medical Association benchmarks to investigate transparency.

    RESULTS: Median LIX was 29.0 and the largest proportion had LIX 31-40 (N = 17), indicating moderate readability. Visual components were observed in 13 websites. Content analysis resulted in 12 categories illustrating comprehensiveness, but eight of these were only included in ≤50% web pages. With regard to transparency, 29 (63%) adhered to no benchmark, 15 (33%) adhered to one benchmark, and 2 (4%) adhered to two benchmarks. Most web pages were written or reviewed by laypersons (N = 25) and health professionals (N = 11).

    CONCLUSION: The results indicate that web pages about medical abortion have moderate readability, varied comprehensiveness and poor transparency.

    IMPACT: Health professionals need to acknowledge the risk of contact with web-based information about poor quality. There is a need for research that aims to increase the chances that patients encounter high-quality web-based information about medical abortion in the second trimester of pregnancy.

  • 5.
    Hertzberg, Annika
    et al.
    Röda Korsets Högskola. Karolinska Institute.
    Ekman, Sirkka-Liisa
    Karolinska Institute.
    'We, not them and us?' - Views an the relationships and interactions between staff and relatives of older people permanently living in nursing homes2000Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 31, nr 3, s. 614-622Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study describes relatives' and staffs' experiences of each other in their relationships and interactions in connection with the care of old people with dementia living in nursing homes. The aim was to identify obstacles and promoters concerning these interactions. A qualitative method was used. Data were collected from 27 hours of observations of group discussions about relatives' and staffs' communication, interactions and experiences. Three different groups, with eight participants, relatives, staff and a group leader in each, met six times during a period of 3 months. Findings indicate that the experiences that relatives and staff have of each other are related to issues about influence, participation, trust and measures to avoid conflicts. These conclusions build on concrete descriptions about care, activities, competence, communication and visits given by research participants. Experiences of situations were sometimes contradictory between relatives and staff. This implies that the potential for cooperation between relatives and staff in care of the elderly is not fully utilized. Suggestions for enhancing the relationships between relatives and staff are: pre-planned informal, individual conversations between relatives and staff; development of ways to give regular two-way feedback about matters concerning the resident and the relationship between staff and relatives; giving staff credit for measures taken to facilitate relatives' involvement in the nursing home care; measures to improve documentation about families' involvement; and working together with minor practical tasks.

  • 6.
    Letterstål, Anna
    et al.
    Karolinska Institute / Karolinska University Hospital.
    Sandström, Veronica
    Karolinska Instiutute / Quality ServiceExecutive, Quintiles OY, Espoo, Finland.
    Olofsson, Pär
    Karolinska Institute / Karolinska University Hospital.
    Forsberg, Christina
    Röda Korsets Högskola.
    Postoperative mobilization of patients with abdominal aortic aneurysm2004Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 48, nr 6, s. 560-568Artikel i tidskrift (Refereegranskat)
  • 7.
    Lööf, H
    et al.
    Sophiahemmet University College, Stockholm.
    Johansson, U-B
    Sophiahemmet University College, Stockholm.
    Welin Henriksson, E
    Division of Nursing, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm.
    Lindblad, S
    Rheumatology Clinic, Karolinska University Hospital, Stockholm.
    Saboonchi, Fredrik
    Sophiahemmet University College, Stockholm.
    Development and psychometric testing of the Swedish version of the Body Awareness Questionnaire2013Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, nr 7, s. 1643-1651Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    This paper is a report of the development and psychometric testing of the Swedish version of the Body Awareness Questionnaire to measure bodily focus of attention.

    Background

    The Body Awareness Questionnaire has been identified as an instrument with excellent psychometric properties within the concept of body awareness. It has been used in both research and clinical settings in different contexts. However, a validated Swedish version is not available.

    Method

    A cross-sectional design was applied for adaptation of the Body Awareness Questionnaire and psychometric validation. Data were collected between autumn 2009 and spring 2011 from 120 patients diagnosed with rheumatoid arthritis, and from 120 students. The ‘concurrent think aloud’ method was used in a pre-test to determine the usability of the questionnaire. Cronbach's alpha was used to test the internal consistency, and confirmatory factor analysis was performed to test the construct validity.

    Results

    According to the confirmatory factor analysis, neither the one-factor model nor the four-factor model tested in this study fulfilled the pre-specified criteria in accordance with the Comparative Fit Index, Standardized Root Mean Squared Residual and the Root Mean Square Error of Approximation. The value of Cronbach's alpha for the Swedish version of the Body Awareness Questionnaire was satisfactory.

    Conclusion

    Our results indicate that the two models tested in this study do not provide a good fit to the observed data. Further refinement and testing of the Swedish version of the Body Awareness Questionnaire is therefore required. The concept of body awareness may be useful in the management of chronic disease and can be addressed in nursing.

  • 8.
    Mendel, Barbro
    et al.
    Karolinska Instiutet.
    Lutzen, K
    Karolinska Institutet.
    Bergenius, J
    Karolinska Hospital.
    Björvell, H
    Karolinska Hospital.
    Living with dizziness: an explorative study1997Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 26, nr 6, s. 1134-1141Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A qualitative study was conducted for the purpose of exploring how patients with dizziness manage their daily living. Ten patients with history of dizziness were recruited from the out-patient clinic, Department of Audiology, in a hospital in Stockholm. Collection and analysis of data were inspired by the method of grounded theory. Four themes were developed that described the experience-of living with dizziness: vulnerable reactions, affirmation and non-affirmation, finding ways to carry on daily living, and expressing the need for health care support. These themes seem to conceptualize these patients' difficulties and needs in relationship to living with dizziness and, given the small sample, have implications for nursing practice and provide a framework for a broader study.

  • 9.
    Peterson, U.
    et al.
    Karolinska Institute.
    Bergström, G.
    Karolinska Institute.
    Samuelsson, M.
    Röda Korsets Högskola. Karolinska Institute.
    Åsberg, M.
    Karolinska Institutet, Danderyd Hospital.
    Nygren, Å.
    Karolinska Institutet, Danderyd Hospital.
    Reflecting peer-support groups in the prevention of stress and burnout: Randomized controlled trial2008Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 63, nr 5, s. 506-516Artikel i tidskrift (Refereegranskat)
  • 10.
    Peterson, Ulla
    et al.
    Karolinska Institute.
    Demerouti, Evangelia
    Utrecht University, Utrecht, The Netherlands.
    Bergström, Gunnar
    Karolinska Institute.
    Samuelsson, Mats
    Röda Korsets Högskola. Karolinska Institute.
    Åsberg, Marie
    Danderyd Hospital, Stockholm, Sweden.
    Nygren, Åke
    Danderyd Hospital, Stockholm, Sweden.
    Burnout and physical and mental health among Swedish healthcare workers2008Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 62, nr 1, s. 84-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim. This paper is a report of a study to investigate how burnout relates to self-reported physical and mental health, sleep disturbance, memory and lifestyle factors. Background. Previous research on the possible relationship between lifestyle factors and burnout has yielded somewhat inconsistent results. Most of the previous research on possible health implications of burnout has focused on its negative impact on mental health. Exhaustion appears to be the most obvious manifestation of burnout, which also correlates positively with workload and with other stress-related outcomes. Method. A cross-sectional study was conducted, using questionnaires sent to all employees in a Swedish County Council (N = 6118) in 2002. The overall response rate was 65% (n = 3719). A linear discriminant analysis was used to look for different patterns of health indicators and lifestyle factors in four burnout groups (non-burnout, disengaged, exhausted and burnout). Results. Self-reported depression, anxiety, sleep disturbance, memory impairment and neck- and back pain most clearly discriminated burnout and exhausted groups from disengaged and non-burnout groups. Self-reported physical exercise and alcohol consumption played a minor role in discriminating between burnout and non-burnout groups, while physical exercise discriminated the exhausted from the disengaged group. Conclusion. Employees with burnout had most symptoms, compared with those who experienced only exhaustion, disengagement from work or no burnout, and the result underlines the importance of actions taken to prevent and combat burnout.

  • 11.
    Saarnio, Lotta
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge.
    Arman, Maria
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge.
    Ekstrand, Per
    School of Health, Care and Social Welfare, Mälardalens University.
    Power relations in patient′s experiences of suffering during treatment for cancer2012Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, nr 2, s. 271-279Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim. This paper is a report of how patients who have cancer experience suffering in the context of power relations. Background. Many studies in Sweden and in other countries have detected inequality in healthcare use and resources, including unseen influences that can be connected to gender and distribution of resources. Few studies have examined how multiple relations of power - such as gender, ethnicity, age and education - influence how people with cancer experience suffering during treatment. Method. A hermeneutic design was used. Qualitative interviews were conducted with 12 women and 14 men receiving treatment for a variety of cancer diagnoses. The data collection was done at two hospitals in Sweden during 2008-2009. The interpretation of data was based on two theoretical perspectives - suffering and intersectionality. Results. The results highlight patients suffering where two or more positions of power relations interacted with each other. Three main themes were identified: the complexity of control, the vulnerable effects of body changes, and the internal battle of survival. Conclusion. A vulnerable social situation for people with cancer concretely increased their suffering. Social inequalities, seemingly linked to social hierarchy, increased the suffering of people with cancer. For example, women with cancer with a low education belonging to an ethnic minority suffered more than highly educated patients belonging to the ethnic majority.

  • 12.
    von Vogelsang, Ann-Christin
    et al.
    Department of Neurosurgery, Karolinska University Hospital, SE-171 76 Stockholm.
    Wengström, Yvonne
    Forsberg, Christina
    Patient information after ruptured intracranial aneurysm rupture2004Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 48, nr 6, s. 551-559Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim.  This paper reports an investigation into the effects of increased information for patients treated for intracranial aneurysm rupture.

    Background.  Intracranial aneurysm rupture is a grave condition that requires immediate care. It can be treated in two different ways, by surgery or by endovascular procedure. Intracranial aneurysm rupture can mean great changes in life, both for the patient and their spouse or relatives.

    Methods.  An intervention study was conducted using a quasi-experimental design. Participants were recruited consecutively over a period of 12 months and consisted of 62 patients treated for intracranial aneurysm rupture at a Swedish neurosurgical clinic. They were divided into two groups: an intervention group, who received written and oral information, and a comparison group, who received only oral information.

    Instruments.  Self-report questionnaires were sent to patients’ homes 1–3 months after the aneurysm rupture. The questionnaires consisted of one study-specific instrument with questions about understanding of the information given and the State-Trait Anxiety Inventory, which measures worry or anxiety.

    Findings.  The intervention group considered that the information that they received was somewhat easier to understand and that it corresponded more closely to their needs, compared with the comparison group. The majority of patients in both groups expressed a need for more and improved information. Levels of anxiety were high for the majority of patients, but no significant difference was evident between groups. Furthermore, the results showed that the majority of patients were given information without their spouse or relatives being present.

    Conclusion.  Increased information seems to be needed for these patients. There is a need to continue the work to improve information-giving to them and their relatives.

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