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  • 1.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Petersson, Ann
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Nilsson, Inger
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Andersson, Britt I.
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    A nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis: A qualitative study2006In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 8, no 3, p. 133-139Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe a nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic, inflammatory disease that attacks many joints, causing considerable functional restrictions for patients. Consequently, these patients are dependent on a wide variety of health-care services. A descriptive, qualitative design inspired by phenomenography was chosen. The conceptions were collected through interviews with 16 strategically selected patients with RA. Three descriptive categories comprising eight conceptions emerged: teaching (gaining insight and receiving information), regular review (receiving security, realizing regularity, and achieving accessibility), and attention (getting a holistic assessment, receiving coordinated care, and getting sufficient time). A nurse-led rheumatology clinic can be a source for empowering patients with RA to adopt new stances to alternative actions and achieve a higher level of faith in their own abilities.

  • 2.
    Baigi, Amir
    et al.
    Department of Primary Health Care, Göteborg University, Göteborg.
    Hildingh, Cathrine
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Virdhall, Helen
    Lund University Hospital, Lund, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Sense of coherence as well as social support and network as perceived by patients with a suspected or manifest myocardial infarction: a short-term follow-up study2008In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, no 7, p. 646-652Article in journal (Refereed)
    Abstract [en]

    Objective:

    To compare sense of coherence as well as social support and network as perceived by ischaemic heart disease patients at baseline and two weeks post-discharge in terms of age, sex, educational and marital status.

    Design:

    Multicentre study with a prospective short-term follow-up design.

    Setting:

    A university hospital, a central hospital and a district hospital in southern Sweden.

    Subjects:

    Consecutive sample of 246 patients with a suspect or manifest myocardial infarction.

    Main measures:

    The Lubben Social Network Scale (LSNS-R), the Medical Outcome Study (MOS) Social Support Survey and the Sense of Coherence Scale were included in a self-administered questionnaire and answered twice, together with sociodemographic variables.

    Results:

    Bivariate analyses indicated changes in social support (practical support increased in men and decreased in women; both P= 0.003) and social network (family network increased among >65 year olds; P= 0.001, men; P= 0.013, and women; P= 0.033, those with a low; P=0.017, and intermediate; P= 0.033, educational level, as well as those cohabiting; P= 0.0001), but did not reveal any difference in sense of coherence.

    Conclusions:

    Sociodemographic variables have no influence on sense of coherence but do affect social support (i.e. practical support and social network, family). Ischaemic heart disease patients' short stay in hospital implies that the network outside the hospital has to assume responsibility, but at the same time it is important for health care professionals to have sufficient knowledge to be able to support the specific needs of patients and their family members.

  • 3.
    Broström, Anders
    et al.
    Linköping University.
    Hubbert, Laila
    Linköping University.
    Jakobsson, Per
    Linköping University.
    Johansson, Peter
    Linköping University.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Dahlström, Ulf
    Linköping University.
    Effects of Long-term Nocturnal Oxygen Treatment in Patients With Severe Heart Failure2005In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 20, no 6, p. 385-395Article in journal (Refereed)
    Abstract [en]

    Sleep-disordered breathing (SDB) is common in patients with heart failure (HF) and leads to disturbed sleep. The objective of this study was to determine the persistent effects of long-term nocturnal oxygen treatment in patients with severe HF regarding (1) objective outcomes, such as steep. SDB, cardiac function, and functional capacity; (2) subjective outcomes, such as self-assessed sleep difficulties, daytime sleepiness, and health-related quality of life (HRQOL); and (3) the relationship between objective and subjective outcomes. In this open nonrandomized experimental study, 22 patients, median age 71 years, with severe HF were studied before and after 3 months of receiving nocturnal oxygen. The measures used were overnight polysomnography, echocardiography, 6-minute walk test, self-assessed sleep difficulties (Uppsala Sleep Inventory-HF), daytime sleepiness (Epworth Sleepiness Scale), and HRQOL (36-ltem Short Form Health Survey and Minnesota Living with Heart Failure Questionnaire). SDB, with a 90% dominance of central sleep apnea, occurred in 41 % of the patients with severe HF before intervention. After intervention, functional capacity improved for both the whole group of patients with HF (P < .01) and HF patients with SDB (P < .05). No improvements regarding cardiac function, objective sleep, subjective sleep, or SDB were seen, except for a decrease of ‚â•4% desaturations (P < 05). HRQOL did not differ significantly between HF patients with and without SDB before or after intervention with nocturnal oxygen. Long-term nocturnal oxygen treatment improved functional capacity in patients with severe HF, with or without SDB. No improvements were seen regarding sleep, daytime sleepiness, SDB, cardiac function, or HRQOL.

  • 4.
    Flemme, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Edvardsson, Nils
    Sahlgrenska universitetssjukhuset, Göteborg.
    Dalman, Margareta
    Sahlgrenska universitetssjukhuset, Göteborg.
    Jinhage, Britt-Marie
    Sahlgrenska universitetssjukhuset, Göteborg.
    Hinic, Hansi
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Quality of life related to shocks in ICD-recipients: a 5-year follow-up2006In: 6th Annual Spring Meeting of the Working Group on Cardiovascular Nursing of the European Society of Cardiology and the Spring Meeting of the Norwegian National Society of Cardiovascular Nurses Bergen, Norway 5–6 May 2006, London: Sage Publications, 2006, p. S20-S20Conference paper (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to describe QoL in relation to shocks and uncertainty in ICD-recipients and to identify predictors of QoL over a 5-year period. Methods: The design was prospective and longitudinal. Thirty-five patients who had lived with the ICD for at least five years had taken part in the study. All recipients had received their ICD as a form of secondary prevention. The questionnaires Mishel Uncertainty in Illness Scale – community version (MUIS-C), Quality of Life Index – cardiac version (QLI-CV) were completed on three occasions: before implantation, at year 1 and at year 5 after implantation. Self-reported number of shocks between the implantation and year 1 and between year 1 and year 5 were described. Data were analyzed by descriptive as well as analytical statistics. Results: In general, QoL was lower at year 1 than before implantation (p = 0.033). A decrease in the socio-economic domain was observed at year 1 (p = 0.006) but improved again at year 5 (p = 0.027) although it remained below the value before implantation. ICD recipient’s satisfaction with the family domain decreased from the time before ICD implantation (p = < 0.001) and from year 1 (p = 0.039) to year 5 after implantation. A decrease in overall uncertainty was observed at year 5 in relation to year 1 (p = 0.009). The longer the ICD recipient had lived with the device, the greater the risk of receiving a shock. However, ICD recipients who received shocks reported being less troubled by them over time. Uncertainty was identified as a predictor of low QoL. Conclusion: The recipients reported a higher level of QoL at year 5 than at year 1. QoL was reasonably good 5 years after implantation and the ICD recipient felt more secure and perceived their ICD as a lifesaver.

  • 5.
    Flemme, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Edvardsson, Nils
    Division of Cardiology, Sahlgrenska University Hospital.
    Hinic, Hansi
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Jinhage, Britt-Marie
    Division of Cardiology, Sahlgrenska University Hospital.
    Dalman, Margareta
    Division of Cardiology, Sahlgrenska University Hospital.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Long-term quality of life and uncertainty in patients living with an implantable cardioverter defibrillator2005In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 34, no 6, p. 386-392Article in journal (Refereed)
    Abstract [en]

    Purpose: This study describes the quality of life (QOL) and uncertainty in patients who have an implantable cardioverter defibrillator (ICD) and predicts QOL at long-term follow-up.

    Methods: Long-term follow-up was defined as 6.9 years ± 1 year (range 4.11–8.7 years). QOL was measured with the Quality of Life Index, and uncertainty was measured with the Mishel Uncertainty in Illness Scale.

    Results: The overall QOL and health/functioning were unchanged over time. QOL in the socioeconomic (P = .002) and psychologic/spiritual domains (P = .012) decreased in the first year. From baseline to long-term follow-up, the QOL in the family domain (P = .011) and uncertainty (P = .002) decreased. Uncertainty was a predictor of low QOL.

    Conclusion: QOL was reasonably good 6.9 years post-ICD implantation. Patients felt less uncertain once they had passed the first year of their illness.

  • 6.
    Flemme, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Strömberg, Anna
    Hälsouniversitetet, Linköping.
    Living with life-saving technology: long-term follow-up of recipients with implantable cardioverter defibrillator2010Conference paper (Refereed)
    Abstract [en]

    The evidence that treatment of life-threatening arrhythmia (LTA) with an Implantable Cardioverter Defibrillator (ICD) can prolong life is convincing. Living with a lifelong heart disease will gradually influence the everyday life and encompasses some or all aspects of life. In order to influence health outcomes, the impact of the ICD must be considered in a broader context including not only the physical, but also the psychological and social functioning of the individual.The general aim of this thesis was to describe everyday life in recipients living with an ICD in a longterm perspective. The aim in Paper I was to describe changes in the life situation of recipients’ with an ICD over a period of 1 year. The aim in Paper II was to describe quality of life (QOL) and uncertainty in recipients who have an ICD and to predict QOL at long-term follow-up. Fifty-six recipients participated (I) and 35 of these recipients, who had survived at least five years, were further included (II). The Quality of Life Index-Cardiac version (I, II), Mishel Uncertainty in Illness Scale-Community version (I, II), Patient ICD Questionnaire (I) and multiple regression analysis (II) were used. Higher scores indicate higher QOL and uncertainty. The questionnaires were completed before implantation, three and twelve months after implantation (I) and also five years after implantation i.e. long-term follow up (II). At the long-term follow up, the average ICD recipient had lived with an ICD for six years and nine months (6.9 years). The results showed the overall QOL and QOL in the health/functioning domain were unchanged over time. QOL in the socio-economic (p= .002) and psychological/spiritual domains (p= .012) decreased in the first year. From baseline to long-term follow up, the QOL in the family domain (p= .011) and overall uncertainty (p= .002) decreased. Uncertainty related to the information decreased at year 1 in relation to baseline (p= .001).The aim in Paper III was to illuminate the main concern of recipients living with an ICD and how they handle this in their daily life. Sixteen recipients who had lived with an ICD between six to twenty-four months were interviewed. Data was collected and analysed in a simultaneous process according to guidelines for classical grounded theory. In the analysis, a substantive theory was generated explaining the main concern of ICD recipients and how they handle this in their daily life. The core category, labelled “Striving to resume command”, illuminates the main concern of ICD recipients. To manage this main concern, the recipients used the following strategies: Economizing resources, Distracting oneself, Submitting to one’s fate and Re-evaluating life.The aim in Paper IV was to explore relationships between OQL, coping strategies, anxiety, depression and perceived control in recipients living with an ICD and to compare those having received an ICD less or more than one year ago and those with a primary or secondary preventive indication. A cross-sectional, correlational, multicenter design was used, and 147 recipients who had lived with an ICD between six to twenty-four months completed Quality of Life Index-Cardiac version, Jalowiec Coping Scale, Hospital Anxiety and Depression Scale and Control Attitude Scale. The results showed that anxiety, depression and perceived control were predictors of QOL. Anxiety was also a predictor of coping with optimistic coping being the most used coping strategy. There was no relationship between QOL and coping. No differences were found in QOL, coping, anxiety, depression and perceived control between recipients implanted either on a primary or secondary preventive indication or having the device less or more than one year.In this thesis, it was concluded that the ICD recipients strived to resume command over their life (III) and the more control the recipients perceived the more satisfied they were with their QOL (IV) and the more symptoms of anxiety, depression and uncertainty they experienced the less satisfied they were with their QOL (II, IV). Coping strategies were used more frequently by ICD recipient perceiving more anxiety (IV). QOL was fairly good 6,9 years after implantation and ICD recipients felt less uncertain once they had passed the first year of their illness.

  • 7.
    Fridlund, Bengt
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hildebrandt, Linda
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hildingh, Cathrine
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Status and trends in Swedish dissertations in the area of cardiovascular nursing2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 1, p. 72-76Article in journal (Refereed)
    Abstract [en]

    In Europe, cardiovascular nursing (CVN) is a young branch of nursing science. The explicit knowledge contained in CVN dissertations has, so far, not been studied in Europe, and this is especially true in the case of Sweden. Accordingly, the aim of this literature study was to describe the status of and compare trends in Swedish dissertations in the area of CVN in terms of organisational structure, approach, research strategy, social orientation and socio-demographic aspects. The literature search resulted in 29 dissertations and a 26-item questionnaire that illuminated the problem areas. Most dissertations were produced in the universities of Göteborg, Halmstad and Linköping; a minority had a nurse as main supervisor; rehabilitation was the most common CVN approach; very few of the dissertations had an experimental design; and the majority was hospital-based. The main trends were (A) an increase in dissertations that were written during the last 6 years, (B) an increased number of nurses as main supervisors as well as publication in nursing journals, (C) an increase in hospital care settings while a decrease in community settings, and finally, (D) an increased number of dissertations addressing the issues of tertiary prevention as well as focusing on patients and next-of-kin as target groups. An important implication is to stimulate nurse-led interventions at all preventative levels in order to maintain or improve the cardiac health of both healthy and sick individuals, but also in order to visualize CVN and distinguish it from cardiology.

  • 8.
    Gavois, Helena
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Paulsson, Gun
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Mental health professional support in families with a member suffering from severe mental illness: a grounded theory model2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 1, p. 102-109Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to develop a model of mental health professional (MHP) support based on the needs of families with a member suffering from severe mental illness (SMI). Twelve family members were interviewed with the focus on their needs of support by MHP, then the interviews were analyzed according to the grounded theory method. The generated model of MHP support had two core categories: the family members’ process from crisis to recovery and their interaction with the MHP about mental health/illness and daily living of the person with SMI. Interaction based on ongoing contact between MHP and family members influenced the family members’ process from crisis towards recovery. Four MHP strategies – being present, listening, sharing and empowering – met the family members’ needs of support in the different stages of the crisis. Being present includes early contact, early information and protection by MHP at onset of illness or relapse. Listening includes assessing burden, maintaining contact and confirmation in daily living for the person with SMI. Sharing between MHP and family members includes co-ordination, open communication and security in daily living for the person with SMI. Finally, the MHP strategy empowering includes creating a context, counselling and encouraging development for the family members. The present model has a holistic approach and can be used as an overall guide for MHP support in clinical care of families of persons with SMI. For future studies, it is important to study the interaction of the family with SMI and the connection between hope, coping and empowerment.

  • 9.
    Hildingh, Cathrine
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Access to the world after myocardial infarction: experiences of the recovery process2006In: Rehabilitation Nursing, ISSN 0278-4807, Vol. 31, no 2, p. 63-69Article in journal (Refereed)
    Abstract [en]

    Myocardial infarction (MI) is a traumatic health event and at the same time a transition of vital importance in human life. The purpose of this study was to elucidate recovery patterns after myocardial infarction with regard to the content of patients' experiences. The study used a descriptive design and a qualitative method. Interviews with 16 men and women were performed, and data were subjected to a thematic content analysis. The recovery process had a pattern of ability, restraints, and reorientation. Through self-help and help from others, the mutual sharing of burdens, and clarifying restraints to recovery, the recovery process progressed toward reorientation. New values and motivation for change, as well as a new balance within the self and relationships were found. The MI had been integrated into life and, through the recovery process, patients' attitudes were better focused, leading to an enhanced quality of life.

  • 10.
    Hildingh, Cathrine
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Women's experiences of recovery after myocardial infarction: a meta-synthesis2007In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 36, no 6, p. 410-417Article in journal (Refereed)
    Abstract [en]

    Background: Women report lower well-being, compared with men, during recovery after myocardial infarction (MI). To support women in their recovery it is important to understand their experiences from their own perspective. However, a single study using a qualitative method does not have the potential to contribute to evidence-based nursing practice, and it is therefore important to synthesize findings from several qualitative studies. Objectives: The aim of this study was to perform a meta-synthesis of findings of women's experiences of recovery after MI. Methods: A meta-synthesis with seven qualitative studies, including a total of 70 women, was performed. Results: Recovery was characterized by subordination and superordination. The women strived to preserve their self, and at the same time they were strongly oriented toward other people. Four concepts emerged: protecting, adjusting, downgrading, and succumbing. Conclusion: Women oscillate between subordination and superordination. Protecting the matriarchy and being a victim of the patriarchy shed light on this ambivalence in the same way as adjusting to the situation and succumbing to the disease do.

  • 11.
    Johansson, Elsie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Roxberg, Åsa
    Växjö University, Växjö, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Växjö University, Växjö, Sweden.
    Nurse’s consolation: A grounded theory study2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 2, p. 19-22Article in journal (Refereed)
    Abstract [en]

    To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’ professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.

  • 12.
    Johansson, Ingrid
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hildingh, Cathrine
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Wenneberg, Stig
    Department of Health Sciences, Örebro University, Örebro, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ahlström, Gerd
    Department of Health Sciences, Örebro University, Örebro, Sweden.
    Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 5, p. 463-471Article in journal (Refereed)
    Abstract [en]

    Aim: This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area.

    Background: When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery.

    Method: Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home.

    Findings: The theoretical model was developed in 2004–2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated.

    Conclusion: This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used.

  • 13.
    Johansson, Peter
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Oleni, Magnus
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nurses' assessments and patients' perceptions: development of the night nursing care instrument (NNCI), measuring nursing care at night2005In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, no 5, p. 569-578Article in journal (Refereed)
    Abstract [en]

    Background:

    Nursing care provided at night has a different purpose and objective to that provided during the day. A review of the literature does not reveal any scientifically tested research instruments for evaluating and comparing the nurse's assessment of nursing care with the patient's perception at night.

    Aims and objectives:

    The aim of this study was to develop and test an instrument for evaluating nursing care and to compare nurses' assessments with patients' perceptions of nursing care provided at night.

    Design:

    The study was carried out in two phases; the first had an explorative design and the second an evaluative and comparative design. The Night Nursing Care Instrument (NNCI) included two questionnaires; one for nurses and one for patients. These questionnaires were developed from a nursing framework and covered the following three areas:,nursing interventions', 'medical interventions' and 'evaluation'.

    Methods:

    Nurses (n = 40) on night duty on a medical ward at a central hospital in southern Sweden were consecutively selected, to participate in the study. The patients (n = 80) were selected by means of convenience sampling. In order to achieve construct validity, factor analysis of each individual area was carried out. Reliability in terms of internal consistency was tested by Cronbach's alpha.

    Results:

    The overall NNCI had acceptable reliability and validity. There was no statistically significant difference between nurses' assessments and patients' perceptions in any of the three areas of 'nursing interventions', 'medical interventions' or 'evaluation'. The patients rated night nursing care as satisfactory for the majority of the items. Relevance to clinical practice: These findings demonstrate that it is possible to create a short instrument with acceptable reliability and validity, which is easy to use in clinical practice. The results also show that night nurses need to improve their ability to assess patients' needs during the night to increase the quality of night nursing care.

  • 14.
    Jormfeldt, Henrika
    et al.
    Department of Health Sciences, Lund University, Lund.
    Svedberg, Petra
    Department of Health Sciences, Lund University, Lund.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Perceptions of the concept of health among nurses working in mental health services: a phenomenographic study2007In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 16, no 1, p. 50-56Article in journal (Refereed)
    Abstract [en]

    A new understanding of the concept of health is needed to meet the goal of mental health nursing, which besides reducing disease is to strengthen the patient's health. The aim of the present study was to describe perceptions of the concept of health among nurses working in mental health services. Twelve Swedish nurses working in mental health services were interviewed and data were analysed with a phenomenographic approach. The nurses expressed 10 perceptions, which constituted three description categories: autonomy, process, and participation. The result showed that health was more than absence of disease. Simultaneously, perceptions were expressed indicating that health was viewed as absence of disease, which implies that the concept is not sufficiently defined. The result emphasizes the need to clarify the concept of health if it is to be used as a goal in mental health nursing and to integrate a clarified definition of health at all hierarchical levels in mental health care services.

  • 15.
    Koinberg, Inga-Lill
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Langius-Eklöf, Ann
    Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Holmberg, Lars
    Department of Surgical Sciences, Division of Surgery, Uppsala University, Uppsala, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    The usefulness of a multidisciplinary educational programme after breast cancer surgery: A prospective and comparative study2006In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 10, no 4, p. 273-282Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to compare and evaluate a multidisciplinary educational programme with traditional follow-up visits to a physician after breast cancer surgery in terms of well-being, aspects of self-care and coping ability 1 year after diagnosis. A reduction in the intensity of follow-up after breast cancer surgery is recommended. New follow-up models are being debated and could be of interest. The study design was non-randomised and comparative. Ninety-six consecutively selected women with newly diagnosed breast cancer, classified as stage I or stage II, participated in either a multidisciplinary educational programme (n = 50), or traditional follow-up by a physician (n = 46). Three questionnaires were used: Functional Assessment of Cancer Therapy-General (FACT-G), a study specific questionnaire regarding self-care aspects (SCA) and Sense of Coherence (SOC). With the exception of physical well-being at baseline there was no significant difference between the groups. The women in the multidisciplinary educational programme increased their physical and functional well-being (P < 0.01). The women in traditional follow-up by a physician increased their functional well-being while social/family well-being (P < 0.01) decreased over time. There was a statistically significant difference in SOC (P < 0.001) in the traditional follow-up by a physician between baseline (mean = 74.4, SD = 12.4) and the 1-year follow up (mean = 67.7, SD = 11.4). Thus, women in the traditional follow-up by a physician scored lower in the area of SOC 1 year after diagnosis. A multidisciplinary educational programme may be an alternative to traditional follow-up by a physician after breast cancer surgery, but more research is needed about the financial benefits and effectiveness of such a programme. (c) 2006 Elsevier Ltd. All rights reserved.

  • 16.
    Mårtensson, Jan
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Strömberg, A.
    Department of Cardiology, Heart Centre, Linköping University Hospital Linköping, Sweden.
    Dahlström, U.
    Department of Cardiology, Heart Centre, Linköping University Hospital Linköping, Sweden.
    Karlsson, J. E.
    Department of Cardiology, County Hospital Ryhov Jönköping S-551 85, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Patients with heart failure in primary health care: effects of a nurse-led intervention on health-related quality of life and depression2005In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 7, no 3, p. 393-403Article in journal (Refereed)
    Abstract [en]

    Aim:

    To determine the effects of a nurse-led intervention designed to improve self-management of patients with heart failure in a primary health care setting regarding health-related quality of life and depression.

    Methods:

    Patients at eight primary health care centres were screened by the Diagnosis Related Groups registry for the diagnosis of heart failure and eligibility for a cluster randomised study. A total of 153 patients were included (n = 78 in the intervention group, 54% males, mean age 79 years, 59% in New York Heart Association class III-IV). The intervention involved patient and family education about heart failure and self-management and monthly telephone follow-up during 12 months by a primary health care nurse.

    Results:

    The effects of the nurse-led intervention were limited. Significant differences were found in the physical dimension measured by the SF-36 health survey, and in depression measured by the Zung Self-rating Depression Scale. In comparison within groups at the 3 and 12-month follow-up, the intervention group significantly maintained their health-related quality of life measured by the SF-36 health survey, and their experience of depression measured by the Zung Self-rating Depression Scale to a greater extent than in the control group, especially among women.

    Conclusion:

    A nurse-led intervention directed toward patients with heart failure in a primary health care setting resulted in limited effects between the groups, although the physical and mental status were retained during 12 months of follow-up to a greater extent than in the control group.

  • 17.
    Pihl, Emma
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences, Jönköping University.
    Mårtensson, Jan
    School of Health Sciences, Jönköping University.
    Patients' experiences of physical limitations in daily life activities when suffering from chronic heart failure: A phenomenographic analysis2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 1, p. 3-11Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one's own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one's social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.

  • 18.
    Pihl, Emma
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Mårtensson, Jan
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Spouses' experiences of impact on daily life regarding physical limitations in the loved one with heart failure: A phenomenographic analysis2010In: Canadian Journal of Cardiovascular Nursing, ISSN 0843-6096, Vol. 20, no 3, p. 9-17Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical limitation is a great burden for patients with heart failure, but little is known about how that affects spouses. Beneficial effects of support on the prognosis for the patient with chronic heart failure may come at a psychological and physical cost to the person providing the support. PURPOSE: The aim of this study was to explore and describe how spouses conceive the physical limitations in patients with heart failure and the impact these limitations have on the daily life of the spouse. DESIGN: A qualitative design with a phenomenographic approach was chosen for the study. FINDINGS: The informants were 15 spouses of heart failure patients. The spouses perceived a variety of aspects pertaining to how they conceive the physical limitations in the loved one with heart failure and the implication this had on their daily life. The referential aspects were: Losing self-containment, Missing communality, Accommodating to the situation and Finding satisfaction in life. IMPLICATIONS AND CONCLUSIONS: Awareness must be raised among health care professionals about the profound impact heart failure in loved ones has on the spouses and explore how the spouses' needs can be appropriately met. Since spouses have an important role to play in the management of heart failure, it is of great importance that nurses identify and support spouses to manage daily life activities. Taking care of the good days in order to have a rich life and to help spouses see possibilities is necessary since it is difficult to predict the future.

  • 19.
    von Bothmer, Margareta I. K.
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students2005In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 7, no 2, p. 107-118Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate gender differences in students’ health habits and motivation for a healthy lifestyle. The sample of students comprised a probability systematic stratified sample from each department at a small university in the south-west of Sweden (n = 479). A questionnaire created for this study was used for data collection. Self-rated health was measured by number of health complaints, where good health was defined as having less than three health complaints during the last month. A healthy lifestyle index was computed on habits related to smoking, alcohol consumption, food habits, physical activity and stress. Female students had healthier habits related to alcohol consumption and nutrition but were more stressed. Male students showed a high level of overweight and obesity and were less interested in nutrition advice and health enhancing activities. The gender differences are discussed in relation to the impact of stress on female students’ health, and the risk for male students in having unhealthy nutritional habits in combination with being physically inactive and drinking too much alcohol.

  • 20.
    Ziegert, Kristina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Health in everyday life among spouses of haemodialysis patients: a content analysis2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 2, p. 223-228Article in journal (Refereed)
    Abstract [en]

    Despite the fact that haemodialysis requires that spouses support and assist their partner during the treatment period, little attention has been focused on their health. The aim of this study was to explore experiences of health in everyday life among spouses of haemodialysis patients. The study had an explorative and descriptive design based on content analysis. Thirteen participants were interviewed in their home without the presence of the patient. The results show that arduousness was experienced when that spouses' everyday life was taken up by caring for the patient at the expense of his/her own health. Spouses exhibited stamina and neglected their own health when focusing on the patient and minimising their own condition. Independence in everyday life revealed that spouses who cared about themselves and looked after their own health experienced relaxation and happiness, which protected their health. Clinical interventions should include an assessment of the spouses' health and everyday life in order to plan the care to ensure that it is directed towards increasing their independence. Instruments need to be developed that assess when and how spouses experience the greatest sense of well-being, if they have scope for relaxation and recovery, and what type of support they require in their everyday life.

  • 21.
    Ziegert, Kristina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    "Time for dialysis as time to live": Experiences of time in everyday life of the Swedish next of kin of hemodialysis patients2009In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 11, no 1, p. 45-50Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the content of time in everyday life as experienced by the next of kin of patients on hemodialysis in Sweden. Chronic renal disease often requires hemodialysis, which is a time-consuming treatment that makes it necessary to carefully plan everyday life and involves the next of kin to a large degree. This study used a descriptive design with a content analysis approach. The analysis of the data from the twenty interviews revealed the experiences of time in the everyday lives of the next of kin of a patient on hemodialysis. The content of time in everyday life can be described as follows: fragmented time, vacuous time, and uninterrupted time. The findings show how everyday life time for the next of kin is minimized and that the common life space is contracted. The next of kin must be provided with supervision in order to provide them with more of their own time in everyday life, which can benefit their health.

  • 22.
    Ziegert, Kristina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Lidell, Evy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Time in everyday life as experienced by next of kin of haemodialysis patientsManuscript (preprint) (Other academic)
    Abstract [en]

    Aim The aim of this study was to explore the content of time in everyday life as experienced by the next of kin of haemodialysis patients.

    Background Chronic renal disease often requires haemodialysis which is a time-consuming treatment that necessitates careful planning of everyday life and involves next of kin to a large degree. Next of kin's time can be severely restricted when his/her life is devoted to the needs of the haemodialysis patient.

    Method This study used explorative and descriptive design with a qualitative content analysis approach. Twenty next of kin selected purposive with the criterion of having at least one year of experience as a next of kin of a patient on haemodialysis.

    Results Analysis of data from the interviews revealed experiences of time in everyday lives of the next of kin of haemodialysis patients. Their experiences were reflected in the concepts fragmented time, vacuous time and uninterrupted time.

    Conclusion The experience of time in the everyday lives of next of kin of haemodialysis patients demonstrated that time for themselves was minimised and that common life space contracted. The next of kin were also aware of the prognosis of renal disease and the fact that haemodialysis was a life-sustaining treatment, which forced them to live in the present. They afforded wellness when they experienced a break from everyday live and could use their time for their own needs. Attention should be focused on time in the nurse's assessment of the next of kin's everyday life and whether or not next of kin have sufficient time required for the patient's care. There is need for further research that focuses on a generalisation of the fmdings by means of the development of instruments that can contribute assessment of time in everyday life among next of kin of chronically ill patients.

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