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  • 1.
    Arvidsson, Barbro
    Malmö School of education, Malmö, Sweden.
    Clinical supervision: a study of how psychiatric nurses experience group supervision2000Book (Refereed)
  • 2.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Malmö School of Education, Malmö, Sweden.
    Group supervision in nursing care: a longitudinal study of psychiatric nurses' experiences and conceptions2000Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The purpose of group supervision in nursing care is to understand nurses’ experiences from real care settings and to structure these in a professional and personal context. An interventional and longitudinal method of research was chosen in this study of group supervision in nursing care. The overall aim of the present study was to examine and investigate how psychiatric nurses’ professional competence changed over time as a result of group supervision in nursing care. The sample consisted of two groups (N=12) of nurses, who received clinical supervision over a period of two years. The study is composed of three interim studies. The aim of Interim study 1 was to describe how psychiatric nurses experienced group supervision in nursing care. A questionnaire was constructed to investigate if, and to what degree, the participants experienced safety, trust and learning during the supervision sessions. The questions asked focused on the concepts ‘a feeling of friendship’, ‘allowing atmosphere’, ‘understanding’ and ‘competence’. Data was analysed using descriptive statistics, and the informants’ comments were categorised. Dairy notes were presented as a background to the ratings, words and quotations. The supervision process was analysed based on theories on supervision, including Maslow’s need theory. The results showed that the supervision climate was, to a high degree, characterised by safety, trust and learning regardless of when the rating was made. The theoretical basis of the interim study and the most common words and expressions appearing in the results were used to design a general model of supervision. The aim of Interim studies 2 and 3 was to investigate the influence of supervision in nursing care, after one and after two years of ongoing supervision as well as four years after completed supervision, on the psychiatric nurses’ professional competence. Data consisted in answers provided during interviews with the informants. Data was analysed according to the phenomenographical method. Interim studies 2 and 3 resulted in four description categories: ‘a feeling of job satisfaction’, ‘gaining knowledge and competence’, ‘gaining a sense of security in nursing situations’ and ‘a feeling of personal development’. In Interim study 3, an additional two description categories emerged: ‘realising the value of supervision’ and ‘a sense of professional solidarity’. The findings gave valuable proof that group supervision in nursing care has a lasting influence on nurses’ professional competence in the form of a distinct professional identity and an integrated nursing care perspective. Group supervision contributes to maintaining the participants’ strength and energy to carry on working, which makes continuing supervision necessary.

  • 3.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Grupphandledning i omvårdnad utmanar sjuksköterskans kompetens2004In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 81, no 4, p. 334-339Article in journal (Refereed)
    Abstract [sv]

    Handledning i omvårdnad startade bland sjuksköterskor inom den psykiatriska vården i England. Under 1960-talet började handledning av sjuksköterskor införas på en psykiatrisk avdelning vid Ullevåls sjukhus i Norge. Utvecklingen av handledning i omvårdnad/yrkesmässig handledning i omvårdnad har sedan dess spridits via den psykiatriska vården till den somatiska (Hermanson m.fl., 1994), och kom i slutet av 1980-talet även till Sverige.

  • 4.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Yrkesmässig handledning i omvårdnad2006In: Psykiatrisk omvårdnad: att stödja hälsofrämjande processer, Lund: Studentlitteratur, 2006, p. 139-154Chapter in book (Refereed)
    Abstract [sv]

    Boken, den första i sitt slag, har ett hälsofrämjande förhållningssätt både vad gäller att förhindra att psykisk ohälsa uppstår och att förhålla sig till personer som i någon mening drabbats av psykisk ohälsa. Syftet är att locka fram hälsofrämjande processer, att hitta hälsan i det sjuka.

    Författarna beskriver den vårdande insatsen, mötet och relationen mellan vårdare och patient/vårdtagare. Boken belyser också betydelsen av att övriga sociala relationer fungerar, såväl inom familjen som i övriga samhällslivet. Värdet av stöd till vårdarna i form av yrkesmässig handledning lyfts fram, liksom vårdmiljöns betydelse.

    Boken vänder sig till universitets- och högskolestudenter vid specialistutbildningar för sjuksköterskor inom psykiatrisk omvårdnad, vid utbildningar med inriktning mot folkhälsa samt till kliniskt verksamma inom hälso- och sjukvården.

    (Från Studentlitteratur)

  • 5.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Hellström, Elisabeth
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Persson, Ulrika
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Patients' perceptions of drug dispensing in a rheumatological in-patient unit2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 4, p. 213-223Article in journal (Refereed)
    Abstract [en]

    Introduction:

    The dispensing of drugs in medical care systems is, in most countries, strictly regulated, and nurses are responsible for distributing drugs to in-patients.

    Aim:

    To describe the perceptions of patients with rheumatic diseases regarding traditional drug dispensing during in-patient care and rehabilitation in a specialized rheumatological care unit.

    Method:

    Twenty in-patients who stayed in the Spenshult Hospital unit for 3-4 weeks and who were on continuous medication were chosen for the study. The phenomenographic approach was used for the collection and analysis of data.

    Findings:

    Three descriptive categories emerged - Relief, Active Participation and Dependence. These descriptive categories comprised: three perceptions for Relief (to experience security, to be served, to dare to bother), two for Active Participation (to rely on one's own ability, to search for knowledge) and two for Dependence (lack of independence, lack of information).

    Conclusion:

    The patients experienced relief due to the nurse assuming responsibility for the medication and its dispensation. Patients expressed a wish to be more active in the management of their medication, as they trusted their own ability. The patients articulated that they were dependent on the nurse to give them the correct medication and they also asked for more information about their medication.

  • 6.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    Department of Primary Health Care, Sahlgrenska Academy, Göteborg University, Sweden.
    Skärsäter, Ingela
    Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Göteborg University, Sweden.
    Changes in the effects of process-oriented group supervision as reported by female and male nursing students: a prospective longitudinal study2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 437-444Article in journal (Refereed)
    Abstract [en]

    The aim of this prospective longitudinal study was to perform a large-scale investigation over a longer period of time, to evaluate changes in the effects of process-oriented group supervision (PGS) as reported by female and male nursing students undergoing a 3-year nursing education. The study included nursing students (n = 183) who were followed during their 3-year study period in relation to their participation in PGS.

    Methods:

    A questionnaire consisting of three subscales: supportive (six items), educational (six items) and developmental (six items) as well as three items of a socio-demographic character (age, gender and previous experience of healthcare work) was used. Student’s t-test was conducted to compare the educational, supportive and developmental subscales between the first and third year.

    Results:

    Females had a significant increase in the educational subscale (p = 0.018) over the 3-year study period, while no such difference was found for the males (p = 0.733). The female students also exhibited an increase in the supportive subscale (p = 0.031) over the 3-year period, while there was no difference for the male students (p = 0.426). There was also an increase in the developmental subscale for the female students over the 3-year period (p = 0.047) but no significant difference for their male counterparts (p = 0.912). For the study group as a whole, an increased positive effect of supervision was observed in the educational subscale (p = 0.020).

    Conclusions:

    The findings have strengthened the argument for the use of PGS in nursing education. To achieve the goal of PGS, which is supportive, educational and developmental in nature, it is important to bear in mind that the supervision needs of women and men can differ. Further research should therefore map out the supervisees’ experiences and expectations of participating in a single sex group.

  • 7.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Franke, Anita
    Department of Education, University of Gothenburg, Gothenburg, Sweden.
    Nurses' various ways of conceiving their learning process as doctoral students: A phenomenograhic study2013In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 13, no 1, p. 53-57Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to describe variations in how doctoral students conceive their learning process to become researchers in the light of their professional background as nurses. BACKGROUND: Nursing research is an emerging discipline and the number of nurses who acquire a doctor's degree is increasing. METHOD: The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. RESULTS: Three different description categories emerged: (1) A learning process that provides a synthesis of different parts of the research process aimed at developing preparedness for action within the nursing profession. (2) A learning process where practical problems are integrated with and problematised in relation to scientific theories. (3) A learning process involving the transformation from nurse to researcher. CONCLUSIONS: The description categories revealed that the focus was on solving problems that occur in health care and synthesising them by means of research tools. Furthermore, the doctoral students explored different ways of understanding and developing their awareness of the nature of research. Focus was also on the nursing profession and practice and a shift towards the role of a researcher was evident.

  • 8.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Department of Nursing, Lund University, Lund, Sweden.
    Factors influencing nurse supervisor competence: a critical incident analysis study2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 3, p. 231-237Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to identify factors related to critical incidents that influence the competence of nurse supervisors. Nurse supervisors require considerable competence in order to help supervisees to reflect on their clinical work and to interpret the needs of the patient. A qualitative approach involving the critical incident technique was used. Critical incidents were collected by means of self-reports from 25 nurse supervisors. Two main areas emerged: a professional and a personal stance. The professional stance described the nurse supervisors’ awareness of the importance of creating a secure learning environment and facilitating reflection. The supervisors structured the material and created awareness of fundamental nursing values. The second main area, personal stance, described the nurse supervisors’ behaviour when they gave the participating nurses the opportunity to work through the experiences gained in the daily provision of nursing care. Although they experienced lack of self-assurance during the supervision session, they also expressed security regarding their own performance as nurse supervisors. Nurse supervisors need to include more nursing theory and focus on the nursing process as well as being aware of their own shortcomings and resources. One way for the supervisior to scrutinize his/her actions is to discuss and examine them with a more experienced nurse supervisor colleague.

  • 9.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hedelin, Birgitta
    Institutt for sykepleie, Högskolan i Gjøvik, Norge.
    Johansson, Inger
    Institutionen för Hälsa och Vård, Karlstads Universitet, Karlstad.
    Uppsatsarbete på kandidatnivå inom omvårdnad: peer-review som kvalitetssäkring2006In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 26, no 1, p. 56-59Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe degree projects on a bachelor level in nursing where peer review was used as quality assurance. Two student groups, 45 nursing students and seven registered nurses, participated. This case study describes quality assurance through collaboration between examiners. The results are focused on students´, supervisors´ and examiners` experiences during the degree process from the examiners perspective. Time disposal and criteria for a passing grade constituted factors associated with obstacles for students as well for supervisors and examiners. Peer review between two universities created opportunities for increasing awareness and validation of the quality of degree project and increased reliability for the examiner’s assessment. The study highlighted the need for collaboration between supervisors and examiners throughout the work process with student’s degree project. A model of group supervision e.g. with eight students, two supervisors and one examiner with regularly utilisation of peer-review for quality assurance is a further development to reach quality assurance in a degree project.

  • 10.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Löfgren, H.
    Department of Educational and Psychological Research, School of Education, Malmö University, Malmö, Sweden .
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence: a 4-year follow-up study2001In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 9, no 3, p. 161-171Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to describe, after 4 years, psychiatric nurses' conceptions of how a 2-year group supervision programme within nursing care had influenced their professional competence.

    BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.

    METHODS: Ten psychiatric nurses participated in a 2-year group supervision programme. They were interviewed 4 years after the group supervision was ended. Data were analysed according to the phenomenographic method.

    FINDINGS: Six description categories emerged: a feeling of job satisfaction; gaining knowledge and competence; gaining a sense of security in nursing situations; a feeling of personal development; realizing the value of supervision; and a sense of professional solidarity.

    CONCLUSIONS: The findings of the 4-year follow-up showed that a group supervision programme in nursing care had lasting influences on the psychiatric nurses' professional competence in the form of a pronounced professional identity and an integrated nursing care perspective. Group supervision contributes to maintaining the strength and energy needed to carry on working, which makes continuing supervision necessary.

    IMPLICATIONS: An important research implication could be to investigate the type of knowledge that ought to be developed within group supervision in nursing care.

    © 2001 Blackwell Science Ltd.

  • 11.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Löfgren, H.
    Department of Educational and Psychological Research, School of Education, Malmö University, Malmö, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychiatric nurses' conceptions of how group supervision in nursing care influences their professional competence2000In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 8, no 3, p. 175-185Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to describe, after 1 and 2 years respectively, psychiatric nurses' conceptions of how group supervision within nursing care influenced their professional competence.

    BACKGROUND: The intention of group supervision in nursing care is to understand nurses' experiences within real care settings and to structure these in a professional and personal context.

    THE STUDY: Ten psychiatric nurses participated in the group supervision. They were interviewed on two occasions: after 1 and 2 years, respectively.

    FINDINGS: The data analysis was influenced by the phenomenographic approach and provided four description categories: a feeling of job satisfaction; acquiring knowledge and competence; gaining a sense of security in nursing situations; and a feeling of personal development.

    CONCLUSIONS: In supervision, practice and theory are integrated, resulting in enhanced nursing competence among the participants. Supervision should be an integrated part of nursing work and regarded as a means of quality assurance. A long-term follow-up could give valuable proof that group supervision in nursing care has a lasting effect on nurses' professional competence.

  • 12.
    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.

  • 13.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, IngelaHögskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Psykiatrisk omvårdnad: att stödja hälsofrämjande processer2006Collection (editor) (Other (popular science, discussion, etc.))
    Abstract [sv]

    oken, den första i sitt slag, har ett hälsofrämjande förhållningssätt både vad gäller att förhindra att psykisk ohälsa uppstår och att förhålla sig till personer som i någon mening drabbats av psykisk ohälsa. Syftet är att locka fram hälsofrämjande processer, att hitta hälsan i det sjuka. Författarna beskriver den vårdande insatsen, mötet och relationen mellan vårdare och patient/vårdtagare. Boken belyser också betydelsen av att övriga sociala relationer fungerar, såväl inom familjen som i övriga samhällslivet.

    (Beskrivning från förlaget)

  • 14.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    The Sahlgrenska Academy at Göteborg University, Department of Primary Health Care, Göteborg, Sweden.
    Fridlund, Bengt
    The Sahlgrenska Academy at Göteborg University, Department of Primary Health Care, Göteborg, Sweden.
    The development of a questionnaire for evaluating process-oriented group supervision during nursing education2008In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 8, no 2, p. 88-93Article in journal (Refereed)
    Abstract [en]

    The benefits of process-oriented group supervision are difficult to evaluate, as the validity and reliability of the existing instruments have been questioned. The aim was to develop and test the psychometric properties of a questionnaire in order to evaluate the effects of process-oriented group supervision on nursing students during their three-year nursing education. A 55-item Process-oriented Group Supervision Questionnaire (PGSQ) with a developmental design was formulated on the basis of a literature review and the expectations of nursing students who participated in a three-year nursing education programme (N = 176). Construct validity and internal consistency reliability were tested at the end of each study year: year 1 (T1), year 2 (T2), and year 3 (T3) by means of exploratory factor analysis and Cronbach’s coefficient. An adequate explorative factor analysis (principal component analysis, varimax rotation) with an Eigenvalue >1.0 and factor loadings >0.40, reduced the questionnaire to 18 items comprising three factors labelled educative, supportive and developmental, which explained 60.2% at T1, 71.8% at T2, and 69.3% at T3 of the total cumulative variance. The corresponding Cronbach’s coefficient figures were 0.89 (T1), 0.94 (T2) and 0.93 (T3). The 18-item PGSQ is considered to be a short and useful tool due to its satisfactory validity and reliability figures.

  • 15.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Science, Göteborg, Sweden.
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Sweden.
    Svensson, Marie-Louise
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    The Sahlgrenska Academy at Göteborg University, Department of Primary Health Care, Göteborg, Sweden.
    Effects of process-oriented group supervision as reported by nursing students: a pilot study2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 1, p. 26-29Article in journal (Refereed)
    Abstract [en]

    One method to ensure that nursing students are better prepared for their future professional role can be to offer them process-oriented group supervision. The aim of this prospective, longitudinal pilot study was to evaluate the effects of a process-oriented group supervision programme (PGSP) comprising educational, supportive and developmental areas based on reports by nursing students undergoing a 3-year nursing education. The students (N=61) evaluated their experiences of the PGSP by means of a questionnaire, which they filled in after each study year. An independent t-test was conducted to compare the educational, supportive, and developmental areas after the first (2002), second (2003) and third year (2004) as well as over the whole 3-year study period. The result showed no significant difference in scores in the educational area. However, there was a significant increase in the supportive area (p=.03) over the 3-year period, which was especially noticeable during the first year (p=.013). There was also an increase in the developmental area over the 3-year period (p=.021) as well as during the first year (p=.024). Thus, PGSP seems to develop nursing students in their professional identity and personal growth. However, as this was a pilot study, a research implication is to perform a large-scale study over a longer period of time.

  • 16.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Science, Göteborg, Sweden.
    Öijervall, Jörgen
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Process-oriented group supervision implemented during nursing education: nurses’ conceptions 1 year after their nursing degree2008In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 16, no 7, p. 868-875Article in journal (Refereed)
    Abstract [en]

    AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS: for Nursing Management Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.

  • 17.
    Arvidsson, Susann
    et al.
    Department of Research and Development, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Bergman, Stefan
    Department of Research and Development, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Chronic musculoskeletal pain and sleep disturbances as predictors for lower vitality measured by the short form 36 (SF-36) - A eight-year follow up study2006In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 65, no Suppl. 2, p. 656-656Article in journal (Other academic)
    Abstract [en]

    Background: Subjects with chronic musculoskeletal pain or sleep disturbances have been shown to have a poor healthstatus as measured by the SF-36 health survey. Fatigue is commonly reported by subjects with chronic musculoskeletal pain and sleep disturbances. There is little known about the temporal relationship between chronic pain, sleep disturbances and changes of vitality.

    Objectives: The aim of this study was to evaluate the predictive value of chronic musculoskeletal pain and sleep disturbances with regard to changes in vitality as measured by SF-36 over an eight year period.

    Method: An eight year follow up of 2 425 subjects aged 20-74 from the general population that in 1995 answered the same postal questionnaire. The questionnaire assessed chronic musculoskeletal pain, sleep disturbances, and included the SF-36 health survey. Pain was considered "chronic" if persistent for three months or more. Sleep disturbances assessed were difficulty in falling asleep, frequent awakenings, early awakenings and not feeling rested. Main outcome measure was change of vitality as measured by SF-36 in those that at baseline reported vitality over the median value. Statistical analyses were done with use of logistic regression. Besides the studied variables, the logistic regression analyses also controlled for gender, age, socio-economic group, and the use of analgesics and sleeping pills.

    Results: At baseline 1212 subjects reported a vitality score on SF-36 above the median score of 75. There were 943 subjects (78%) responding at the eight-year follow up. Chronic pain at baseline predicted (OR=1,64, 95% CI 1,14-2,36%, p=0,01) worsening of vitality over time. Loss of vitality was also predicted by moderate problems with falling asleep (OR=2,17, 95% CI 1,31-3,60%, p<0,01), and problems with not feeling rested (moderate problems OR=2,08, 95% CI 1,23-3,50%, p=0,01, and major problems OR=4,76, 95% CI 1,53-14,78%, p=0,01).

    Conclusion: Loss of vitality in SF-36 over an eight-year period was predicted by chronic musculoskeletal pain, problems with falling asleep and problems with not feeling rested. Problems with frequent awakenings and early awakenings did not predict lower value of vitality over an eight-year period. It could thus be important to attend to sleeping problems and especially the feeling of not being rested in subjects with chronic musculoskeletal pain.

  • 18.
    Arvidsson, Susann
    et al.
    FoU Centrum, Spenshult, Halmstad, Sverige & Hälsohögskolan, Jönköping, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Hälsohögskolan, Jönköping, Sverige.
    Bergman, Stefan
    FoU Centrum, Spenshult, Halmstad, Sverige.
    Factors promoting health-related quality of life in patients with rheumatic diseases 12 months after rehabilitation2010In: Svenska Läkaresällskapets Riksstämma 2010: Program: Reumatologi, 2010, p. 3-3Conference paper (Refereed)
    Abstract [en]

    Rheumatic diseases have significant adverse impact on the individual from physical, mental and social aspects, resulting in a low estimation of health-related quality of life (HRQL). Patients with rheumatoid arthritis who receive a multi-disciplinary team-based care in a rheumatology clinic could get improved HRQL. Several factors can be supposed to promote health in patients with rheumatic diseases and in health-promoting work within the clinical practice it would be valuable to identify health factors that affect HRQL in a positive direction.

    This is a longitudinal cohort study in 185 patients with rheumatic diseases with test one week and 12 months after rehabilitation on a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors (chronic musculoskeletal pain, sleep quality, food habits, exercise habits, leisure habits, sexual lust, sense of coherence (SOC), social support and socio-demographic variables). The association between SF-36 subscales and suggested health factors were estimated by OR and 95 % CI calculated by multivariable logistic regressions.

    Factors predicting better outcome in HRQL in one or several SF-36 subscales were being of younger ages or middle-ages, feeling painless, having good sleep structure, feeling rested after sleep, doing low effort of exercise more than twice a week, having strong SOC, having emotional support and practical assistance, having higher educational level, and having working capacity. The most important factors were having strong SOC, feeling rested after sleep, having working capacity, being of younger ages or middle-ages, and having no/small problem with sleep structure.

    The most important factors promoting HRQL in patients with rheumatic diseases 12 months after rehabilitation were having strong SOC, feeling rested after sleep, having working capacity, being of younger ages or middle-ages, and having no/small problem with sleep structure. These health factors are important to address in clinical work with rheumatic diseases to optimise treatment strategies.

  • 19.
    Arvidsson, Susann
    et al.
    Research and Development Centre Spenshult, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Research and Development Centre Spenshult, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Factors promoting health-related quality of life in people with rheumatic diseases: a 12 month longitudinal study2011In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 12, article id 102Article in journal (Refereed)
    Abstract [en]

    Background: Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL). There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases.

    Methods: A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions.

    Results: Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC), emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure.

    Conclusions: This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies. © 2011 Arvidsson et al; licensee BioMed Central Ltd.

  • 20.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Feeling rested predicts good health in subjects with and without chronic musculoskeletal pain2008In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 67, no Suppl. II, p. 552-552Article in journal (Refereed)
    Abstract [en]

    Background: Musculoskeletal pain is a public health problem and a common cause for people to seek health care. It has also been shown that people with musculoskeletal pain estimates their health-related quality of life very low compared to a pain free population. Earlier studies have primarily looked at risk factors and there are little known about health predicting factors in a general population.

    Objectives: To investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain.

    Methods: A longitudinal study in a Swedish general population (N=1 849) with a postal questionnaire at baseline 1995 and at a follow up 2003. Subjects were divided into two groups, according to their response about chronic musculoskeletal pain at baseline. Health-related quality of life was assessed by the SF-36 together with suggested health factors. The associations between the dependent variables (SF-36 subscales) and the independent variables (i.e. the suggested health factors; socioeconomic status, immigrant status, emotional support, regularly exercise, sleep structure, feeling rested, smoking and alcohol habits) were estimated by OR and 95% CI calculated by multivariable logistic regressions, with adjustment for all health factors, age, sex and baseline SF-36 values.

    Results: The most consistent finding for subjects with and without chronic musculoskeletal pain at baseline and in the eight-year follow up was a statistical significant (p<0.05) better health outcome in SF-36 subscales for subjects that were feeling rested at baseline. At baseline feeling rested was associated with having a health status better than the mean score in seven SF-36 subscales for both subjects with chronic pain (OR 1.5 (95% CI 1.0-2.3) – OR 4.4 (95% CI 2.9-6.6)) and subjects without chronic pain (OR 2.6 (95% CI 1.6-4.1) – OR 4.4 (95% CI 3.0-6.5)). At the follow up feeling rested predicted a better outcome in five subscales for subjects with chronic pain (OR 1.6 (95% CI 1.0-2.4) – OR 2.2 (95% CI 1.4-3.6)) and in six subscales for subjects without chronic pain (OR 1.6 (95% CI 1.0-2.5) – OR 2.7 (95% CI 1.8-4.1)). Other factors that in some aspects predicted a better outcome were belonging to higher socioeconomic group, being an inborn Swede, having emotional support, having good sleep structure, never being or being a former smoker, and regularly drinking alcohol.

    Conclusion: ''Feeling rested'' was the most consistent factor predicting a good health outcome, both in subjects with and without chronic musculoskeletal pain, and should be attended to in health promotion work. Emotional support, sleep structure, smoking and alcoholic habits also appears to be important health factors to take into account.

  • 21.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Feeling rested predicts good health in subjects with and without chronic musculoskeletal pain2008Conference paper (Refereed)
  • 22.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain2008In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 6, article id 98Article in journal (Refereed)
    Abstract [en]

    Background: Many factors are proposed to be associated with health-related quality of life. Knowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work. The aim of this study was to investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain in a cohort from a general population.

    Methods: The study was designed as a longitudinal study in a Swedish general population (N = 1 849) with a postal questionnaire at baseline 1995 and at follow up 2003. Subjects were divided into two groups, according to their response about chronic musculoskeletal pain at baseline. Health-related quality of life was assessed by the SF-36 together with suggested health factors. The associations between SF-36 subscales and suggested health factors were estimated by OR and 95% CI calculated by multivariable logistic regressions, with adjustment for all health factors, age, sex and baseline SF-36 values.

    Results: Although subjects without chronic musculoskeletal pain reported better health-related quality of life than subjects with chronic pain, similar health factors were found to be associated to higher scores in SF-36 at baseline and predicted a better outcome in the eight-year follow up. The most consistent finding was a better health outcome in the eight-year follow up for subjects that were feeling rested after sleep. Other factors that in some aspects predicted a better outcome were belonging to higher socioeconomic group, being a native Swede, having emotional support, having good sleep structure, never being or being a former smoker, and regularly drinking alcohol.

    Conclusion: The most important health factor in subjects with and without chronic musculoskeletal pain was feeling rested after sleep, but also emotional support, sleep structure, smoking and alcoholic habits appears to be important components. These health factors could be important to address in clinical work with painful musculoskeletal disorders. Since several health factors are common in both subjects with and without pain there could be a common strategy to be formed in public health programmes.

  • 23.
    Arvidsson, Susann
    et al.
    Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Experiences of health-promoting self-care in people living with rheumatic diseases2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 6, p. 1264-1272Article in journal (Refereed)
    Abstract [en]

    Aim: This paper is a report of a study that explores and describes the meaning of the phenomenon of health-promoting self-care as experienced by people living with rheumatic diseases.

    Background: People with rheumatic diseases estimate health status as low and health belief and health status influence self-care behaviours. Several self-care behaviours are used in the efforts to mitigate the diseases.

    Method: The study had a descriptive phenomenological approach based on a reflective life-world perspective. Data were gathered in 2007 by unstructured open-ended interviews with 12 individuals living with rheumatic diseases.

    Findings: The meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care takes place against a background of continual hope and belief to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three inter-related constituents elucidated their experiences: dialogue, power struggle and choice. Self-care was experienced as dialogues with the body and with the immediate environment. In order to respond to signals from the body, power struggles were required to be entered into when fighting the diseases. Choices were required to be made and things that were beneficial for the body were prioritized.

    Conclusion: In this study, the meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care was a way of life. This meant to be ready to understand and respond to signals from the body. Self-care required dialogues, power struggles and choices. © 2011 Blackwell Publishing Ltd.

  • 24.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    People with Rheumatic Diseases Experiences of Health-Promoting Self-Care2010In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 69, no Suppl. 3, p. 743-743Article in journal (Refereed)
    Abstract [en]

    Background: People with rheumatic diseases estimate their health status low. The health status and health belief are influencing the choice of self-care behaviours. Self-care behaviours are common and could prevent loss of valued life activities and health. Little is known of how people with rheumatic diseases experience self-care.

    Objectives: To describe people with rheumatic diseases experiences of health-promoting self-care.

    Methods: The study had a phenomenological approach based on a reflective life-world perspective. Data were gathered by unstructured and open-ended interviews with 12 individuals with various diagnoses of rheumatic diseases.

    Results: For people with rheumatic diseases, self-care was a way of life and implied being ready at all times to understand and respond to signals from the lived body. Self-care was experienced as an internal dialogue within the lived body but also as an external dialogue with the immediate environment. Self-care could also be described as a power struggle where the individuals strived and forced themselves to fight the diseases and its concrete consequences. The self-care also required that choices were made. Crucial for the choices were trust in oneself and belief in one's own ability to chosen health-promoting self-care. The individual prioritised self-care that was experienced as a beneficial and/or a reward for the lived body.

    Conclusion: People with rheumatic diseases experienced self-care as a way of life and that it meant to be ready at all times to understand and respond to signals that the lived body sends out. Self-care required dialogue, power struggle and choice. This knowledge ads to a fuller understanding of factors that from a patient perspective are important for health when living with a chronic rheumatic disease.

    Disclosure of Interest: None declared

  • 25.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    People with Rheumatic Diseases Experiences of Health-Promoting Self-Care2010In: QMSH 10: 6th Nordic Interdisciplinary Conference on Qualitative Methods in the Service of Health: May 2-4, 2010 • Uppsala, Sweden: Program and Abstracts, Uppsala: Uppsala universitet, 2010, p. 67-67Conference paper (Refereed)
  • 26.
    Arvidsson, Susann
    et al.
    FoU Centrum, Spenshult, Halmstad, Sverige & Hälsohögskolan, Jönköping, Sverige.
    Bergman, Stefan
    FoU Centrum, Spenshult, Halmstad, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Gjøvik, Norge.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    Upplevelse av hälsobefrämjande egenvård vid reumatisk sjukdom2009Conference paper (Refereed)
    Abstract [en]

    Bakgrund

    Personer med reumatiska sjukdomar skattar sitt hälsostatus lågt. Hälsostatus och tron på den egna förmågan att kunna påverka hälsan påverkar i sin tur valet av egenvårdsbeteenden. Egenvårdsbeteenden är vanliga och kan förhindra försämrad hälsa och förlust av värdefull fysisk och psykisk aktivitet. Kunskaperna är små om hur personer med reumatiska sjukdomar upplever att utföra egenvård. Syftet är därmed att beskriva hur personer med reumatiska sjukdomar erfar att utföra egenvård för att nå hälsa.

    Metod

    Studien har en kvalitativ design med en fenomenlogisk ansats och en livsvärldsteoretisk grund. Data har samlats in genom ostrukturerade och öppna intervjuer med 12 personer med olika diagnostiserade reumatiska sjukdomar.

    Resultat

    Personer med reumatiska sjukdomar upplever att egenvård är ett sätt att leva och att det innebär att ständigt vara redo för att förstå och reagera på signaler från den levda kroppen. Egenvård upplevs som en inre dialog inom den levda kroppen, men också en yttre dialog med närmiljön. Egenvård beskrivs också som en maktkamp där personen strävar efter och tvingar sig att kämpa mot sjukdomen och dess konkreta konsekvenser. Egenvården kräver också att val görs. Avgörande för valet är att personen har tillit till sig själv och tror på sin egen förmåga att välja hälsobefrämjande egenvård. Personer med reumatiska sjukdomar prioriterar egenvård som upplevs som positiv och/eller ger en belöning till den levda kroppen.

    Sammanfattning

    Personer med reumatiska sjukdomar upplever egenvård som ett sätt att leva och det innebär att vara i beredskap för att förstå och reagera på signaler som den levda kroppen sänder ut. Egenvård kräver dialog, maktkamp och val. Denna kunskap bidrar till en mer fullständig förståelse av faktorer som från ett patientperspektiv är viktiga för hälsan vid kronisk reumatisk sjukdom.

  • 27.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Tingström, Pia
    The Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, p. 1500-1514Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the effects of a self-care promoting problem-based learning programme for people with rheumatic diseases in terms of health-related quality of life, empowerment, and self-care ability.

    Background: Individuals with rheumatoid arthritis express a great need for education and support in adapting to the disease, but the average qualities of studies about patient education interventions are not high. There is no evidence of long-term benefits of patient education.

    Design: Randomized controlled trial.

    Methods: A randomized controlled design was selected with test at baseline, 1-week and 6-month post-interventions after completed the 1-year programme. The tests consisted of validity and reliability tested instruments. The participants were randomly assigned in spring 2009 to either the experimental group (n = 54) or the control group (n = 148). The programme was running alongside the standard care the participants received at a rheumatology unit. Parametric and non-parametric tests were used in the analyses.

    Results: The participants in the experimental group had statistically significant stronger empowerment after participation in the self-care promoting problem-based learning programme compared with the control group, at the 6-month post-intervention. Approximately, two-thirds of the participants in the experimental group stated that they had implemented lifestyle changes due to the programme.

    Conclusion: The self-care promoting problem-based learning programme enabled people with rheumatic diseases to improve their empowerment compared with the control group. It is important to continue to develop problem-based learning in patient education to find the very best way to use this pedagogical method in rheumatology care. © 2012 Blackwell Publishing Ltd.

  • 28.
    Arvidsson, Susann
    et al.
    FoU Centrum, Spenshult, Halmstad, Sverige & Hälsohögskolan, Jönköping, Sverige.
    Bergman, Stefan
    FoU Centrum, Spenshult, Halmstad, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Gjøvik, Norge.
    Fridlund, Bengt
    Hälsohögskolan, Jönköping, Sverige.
    Tingström, Pia
    Linköpings universitet, Linköping, Sverige.
    Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-232010In: Svenska Läkaresällskapets Riksstämma 2010: Program: Reumatologi, 2010, p. 3-3Conference paper (Refereed)
    Abstract [en]

    Empowerment is a central concept in a patient-focused rheumatology care. WHO describes empowerment as a process in which the person receives more control over decisions and actions that affect the own life and health. Today there is no Swedish empowerment instrument for rheumatic diseases created or transl[...]

    The already existing questionnaire, Swedish Diabetes Empowerment Scale (SWE-DES-23), was adapted for use in patients with rheumatic diseases by exchanging the word diabetes with rheumatic disease in all the questions. No items were added or removed. The adapted questionnaire was called SWE-RES-23. In 2009, 260 patients with rheumatic diseases from a rheumatology unit in the southwest of Sweden completed the questionnaire.

    In order to establish discriminant validity, a question about self-perceived health from SF-36 was used in addition to SWE-RES-23.

    Construct validity was tested by using exploratory factor analysis. In order to determine unidimensionality of the empowerment subscales, inter-item correlations were calculated. Internal consistency reliability was tested by the use of the Cronbach-α coefficient.

    The exploratory factor analysis resulted in five factors (empowerment subscales) with Eigenvalues >1 explaining 64.1% of the variance. The five empowerment subscales were: Goal achievement and overcoming barriers to goal achievement, Self-awareness, Managing stress, Assessing dissatisfaction and readiness to change, and Support for caring. The Cronbach-α values ranged from 0.59 to 0.91 and for the total score 0.92. All inter-item correlations were significant. Patients with very good and good self-reported health scored significantly higher on three empowerment subscales (Goal achievement, Self-awareness and Managing stress). The same patterns were seen in the other two empowerment subscales (Readiness to change and Support for change), but did not reach significance.

    The SWE-RES-23 was a first step in developing a questionnaire for assessment of empowerment of patients with rheumatic diseases. The questionnaire possesses acceptable validity and reliability. To fully validate the SWE-RES-23 further studies are needed, but the instrument is even now possible to use in empowerment education programmes for patients with rheumatic diseases.

  • 29.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Tingström, Pia
    Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-232012In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, no 2, p. 101-109Article in journal (Refereed)
    Abstract [en]

    Introduction. Empowerment is a central concept in both rheumatology and diabetes care. A Swedish empower- ment instrument for patients with rheumatic diseases has not been created before now. The aim of the present study was to determine the psychometric properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-23, such as construct validity, internal consistency reliability, inter-item correlations and discriminant validity.

    Methods. The already existing instrument, the Swedish Diabetes Empowerment Scale (SWE-DES-23), was adapted for use in patients with rheumatic diseases. The adapted instrument was called the SWE-RES-23. In 2009, 260 patients with rheumatic diseases from a rheumatology unit in Sweden completed the instrument. Construct validity was tested by using exploratory factor analysis. Internal consistency reliability was tested by the use of Cronbach’s a-coefficient. In order to determine unidimensionality of the empowerment subscales, inter-item correlations were calculated. To establish discrim- inant validity, an item about self-perceived health from the Short Form (SF) 36 was used in addition to the SWE-RES-23.

    Results. The exploratory factor analysis resulted in five factors (empowerment subscales) with eigenvalues >1, explaining 64.1% of the total variance: Goal achievement and overcoming barriers to goal achievement; Self- knowledge; Managing stress; Assessing dissatisfaction and readiness to change; and Support for caring. Cronbach’s a values ranged from 0.59 to 0.91, and the value for the total score was 0.92.

    Conclusion. The results support the possibility of adapting the SWE-DES-23 for use in patients with rheumatic diseases. The SWE-RES-23 shows acceptable psychometric properties, in terms of construct validity and internal consistency reliability. To validate the SWE-RES-23 fully, further studies are needed, with a focus on test-retest correlations. Copyright © 2012 John Wiley & Sons, Ltd.

  • 30.
    Bergseth Bogsti, Wenche
    et al.
    Högskolan i Gjövik.
    Solvik, Elisabeth
    Högskolan i Gjövik.
    Engelien, Ragna Ingeborg
    Högskolan i Gjövik.
    Larsen Moen, Øyfrid
    Högskolan i Gjövik.
    Sønsteby Nordhagen, Siv
    Högskolan i Gjövik.
    Struksnes, Solveig
    Högskolan i Gjövik.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Styrket veiledning i sykepleierutdanningens praksisperioder2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 1, p. 56-60Article in journal (Refereed)
    Abstract [en]

    Background: A more complex and knowledge-based society has resulted in increasing specialization and greater demands on employees in the fields of practice. At Gjøvik University College, a new supervision model was tested for nursing students in practice. The main elements were: daily supervisors were given increased responsibility for assessing the students, while at the same time participating in three group counseling meetings. A portfolio contained the student’s work requirements. A weekly reflection hour was formalized. Purpose: The purpose was to elucidate how the supervision model influenced the student’s learning situation. Method: The SVIP model was evaluated by the use of focus group interviews. The data were analyzed using qualitative content analysis. Findings: Three categories: structure, inclusion and self-confidence describe the students’ need for clear guidelines and objectives, as well as their need to be included and to be seen. Conclusion: Various aspects of clinical practice, including daily supervision are important for student learning. Counseling meetings where the supervisor role is recognized and developed through the tutor, and daily supervisor sharing of experiences and knowledge, should permeate the cooperation.

  • 31.
    Bergsten, Ulrika
    et al.
    Jonkoping Univ, Sch Hlth Sci, Jonkoping.
    Bergman, Stefan
    Spenshult Hosp, Ctr Res & Dev, Oskarstrom.
    Fridlund, Bengt
    Jonkoping Univ, Sch Hlth Sci, Jonkoping.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm.
    Berglund, Anita
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Petersson, Ingemar
    Univ Lund Hosp, Dept Rheumatol, S-22185 Lund.
    Patterns of background factors related to early RA patients conceptions of the cause of their disease2011In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 30, no 3, p. 347-352Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to identify patterns of background factors related to the early RA patients' conceptions of the cause of the disease. Conceptions from a qualitative study formed the basis for the stratification of 785 patients from the Swedish EIRA study answering a question about their own thoughts about the cause to RA. Logistic regression analyses were used to explore the associations between patients' conceptions and relevant background factors: sex, age, civil status, educational level, anti-cyclic citrullinated peptide antibody (anti-CCP) and smoking habits. The results were presented as odds ratios (OR) with 95% confidence intervals (CI). A conception of family-related strain was strongly associated with being young (OR 0.50; 95% CI 0.33-0.78 for age 58-70 vs. 17-46), female (OR 0.38; 95% CI 0.25-0.60 for male vs. female) and having a high level of education (OR 2.15; 95% CI 1.54-3.01 for university degree vs. no degree). A conception of being exposed to climate changes was associated with being male (OR 1.99; 95% CI 1.24-3.22 for male vs. female), having a low level of education (OR 0.33; 95% CI 0.18-0.58 for university degree vs. no degree) and positive Anti-CCP (OR 1.72; 95% CI 1.03-2.87 for positive vs. negative Anti-CCP). Linking patients' conceptions of the cause of their RA to background factors potentially could create new opportunities for understanding the complexity of the aetiology in RA. Furthermore, this information is important and relevant in the care of patients with early RA.

  • 32.
    Bergsten, Ulrika
    et al.
    Research and Development Centre at Spenshult Hospital, Oskarström, Swede.
    Bergman, Stefan
    Research and Development Centre at Spenshult Hospital, Oskarström, Swede.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Berglund, Anita
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Petersson, Ingemar F.
    Lund University Hospital, Lund, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients’ conceptions of the cause of their Rheumatoid Arthritis: A qualitative study2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 4, p. 243-255Article in journal (Refereed)
  • 33.
    Bergsten, Ulrika
    et al.
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Spenshult Hosp, Ctr Res & Dev, Oskarstrom, Sweden .
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    “Delivering knowledge and advice”: Healthcare providers’ experiences of their interaction with patients’ management of rheumatoid arthritis2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4, article id 8473Article in journal (Refereed)
    Abstract [en]

    Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers’ perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers’ experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers’ attitudes and patients’ responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers’ experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients’ expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.

  • 34.
    Bergsten, Ulrika
    et al.
    Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Spenshult Hospital, Oskarström, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    "Striving for a good life" - the management of reumatoid arthritis as experienced by patients2011In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 5, p. 95-101Article in journal (Refereed)
    Abstract [en]

    Aim:

    To generate a theoretical model how patients experience their management of rheumatoid arthritis (RA) in everyday life.

    Method:

    An explorative design with the grounded theory approach was used by interviewing 16 informants with RA.

    Results:

    The generated theoretical model emerged in a core category-Striving for a good life with two categories; making use of personal resources and grasping for support from others, which formed the base of managing RA. When relating these categories together, four dimensions emerged which characterised patients' different ways of managing RA: mastering, relying, struggling and being resigned.

    Discussion:

    The management of RA incorporated the use of personal resources and the grasping for support from others. Both self-management strategies and patients' need of support were highlighted as aspects that were of importance when managing RA. Patients' experiences of their need of support to manage RA give extended knowledge that is of importance for nurses and other healthcare providers. The relationship between patients and healthcare providers is always the key to a good encounter. Interventions to increase self-management in RA have to incorporate this knowledge when trying to increase patients' self-efficacy and with their experience of support.

  • 35.
    Bergsten, Ulrika
    et al.
    Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Spenshult Hospital, Halmstad, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perception of tactile massage as a complement to other forms of pain relief in rheumatic disease2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 3, p. 157-167Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate how patients with rheumatic disease perceive tactile massage as a complement to other pain alleviation methods.

    Methods: A phenomenographic approach with semi-structured interviews was employed on a strategic sample of 14 patients with various rheumatic diseases, both inflammatory and non-inflammatory, who had been admitted to Spenshult Rheumatic Hospital.

    Results: Three descriptive categories with a total of nine conceptions emerged. The descriptive categories were: experiencing alleviation, experiencing trust, and gaining insight. Experiencing alleviation described how patients experience relaxation, pleasure and respite. Experiencing trust described how patients experience a sense of security, confirmation and inner peace. Gaining insight described how patients get to know themselves, see possibilities, and experience wholeness.

    Conclusions: When caring for patients who have a chronic illness involving considerable changes to their lives, it is important for health professionals not only to be aware of their physical needs but also to take account of the whole person. This study demonstrates the importance of offering patients a complement to conventional treatment. Tactile massage is a method that promotes a holistic view of patients with chronic pain as well as allowing them to find a new focus in terms of the disease and how they cope with it in their daily lives.

  • 36.
    Bremander, Ann
    et al.
    Spenshult Hosp Rheumat Dis, Ctr Res & Dev, S-31392 Oskarström, Sweden .
    Bergman, Stefan
    Spenshult Hosp Rheumat Dis, Ctr Res & Dev, Oskarström, Sweden .
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Perception of multimodal cognitive treatment for people with chronic widespread pain: changing one's life plan2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 24, p. 1996-2004Article in journal (Refereed)
    Abstract [en]

    Purpose.

    The aim of this study was to gain a deeper understanding of chronic widespread pain patients' perception of a multimodal treatment with a cognitive approach.

    Methods.

    A reformulated grounded theory study based on interviews with 16 participants in the programme was conducted at the end of a 6-month treatment period.

    Results.

    The result describes a conceptual model of the informants' perception of the treatment. The core category 'changing one's life plan' comprised of three categories: 'changing one's perception of life', 'depending on support' and 'managing one's life'. Changing one's perception of life could be deep and overwhelming 'overall life changes' or more superficial 'life adjustments'. Support by health professionals and the patient group were of importance. At the end of the rehabilitation program managing one's life was perceived as either 'reorientation' or 'stagnation'. The informants who experienced overall life changes achieved reorientation with support by others, while those who experienced life adjustments did not change their way of managing one's life to any great extent.

    Conclusion.

    The core category changing one's life plan included the categories; changing one's perception of life, depending on support and managing one's life. Informants experiencing overall life changes were more likely to achieve reorientation than those who experienced life adjustments

  • 37.
    Franke, Anita
    et al.
    Department of Education, Pedagogen B, University of Gothenburg, Läroverksgatan 15, Box 300, SE 405 30, Göteborg, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Research supervisors’ different ways of experiencing supervision of doctoral students2011In: Studies in Higher Education, ISSN 0307-5079, E-ISSN 1470-174X, Vol. 36, no 1, p. 7-19Article in journal (Refereed)
    Abstract [en]

    Research supervisors’ different ways of experiencing their supervision of doctoral students are analysed in terms of the students’ questions and problems as they relate to the supervisor’s research, and what consequences this connection, or non‐connection, to the supervisor’s research has for supervision and the role of supervisor. Thirty supervisors of doctoral students at different faculties at a university in Sweden were interviewed. The results illustrate two supervision structures, called research practice‐oriented and research relation‐oriented supervision. The principal differences between these two ways of structuring supervision consist of whether the supervisor and the doctoral student participate in a common research practice and share objects of research with the same or a related research approach, or whether the doctoral student’s research problems and research objects lack a clear connection with the supervisor’s research.

  • 38.
    Franke, Anita
    et al.
    Institutionen för pedagogik och didaktik, Göteborgs universitet, Göteborg, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Gustafsson, Bertil
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Högskolepedagogisk handledning: Erfarenheter av pedagogisk förnyelse vid Högskolan i Halmstad2007Book (Other academic)
    Abstract [sv]

    Upprinnelsen till denna arbetsrapport är erfarenheter av ett pedagogiskt utvecklingsarbete om högskolepedagogisk handledning, finansierat av Högskoleverket, Rådet för högre utbildning. Projektet planerades och genomfördes i ett konsortium under 2003 samt avrapporterades i april 2004. Konsortiet bestod av Chalmers Lindholmen, Göteborg; Blekinge Tekniska Högskola, Karlskrona och Högskolan i Halmstad, Halmstad. Projektledare var Anita Franke, Institutionen för pedagogik och didaktik, Göteborgs universitet. Övriga projektmedarbetare var: Elsie Anderberg, Institutionen för pedagogik och didaktik, Göteborgs universitet, Erling Fjeldstad, CKK, Chalmers Tekniska Högskola, Helene Ivarsson, Christer Alvegård och Jörgen Andersson, Blekinge Tekniska Högskola samt Barbro Arvidsson och Bertil Gustafsson, Sektionen för hälsa och samhälle, Högskolan i Halmstad.

    Projektets idé om pedagogisk utveckling var att utveckla handledningskompetens hos lärare inom högskolan. Avsikten var att hos kursdeltagarna försöka åstadkomma en medvetenhet om lärande och lärprocesser i arbetet med pedagogisk handledning bland studerande och doktorander.

    Denna rapport är ett resultat av ett fortsatt samarbete kring frågor om högskolepedagogisk handledning mellan Anita Franke och Barbro Arvidsson. Medverkar i rapporten gör också Bertil Gustafsson. Vår avsikt är att visa på betydelsen av att högskolelärares kompetens i arbetet med handledning och undervisning grundas i pedagogiska teorier. Mot denna bakgrund beskrivs, analyseras, och reflekteras erfarenheter och exempel från det pedagogiska utvecklingsarbetets planering och genomförande vid Högskolan i Halmstad. Rapporten är tänkt att användas i arbetet med högskolepedagogisk utbildning och i pedagogiskt utvecklingsarbete.

  • 39.
    Hubertsson, Jenny
    et al.
    Clinical Sciences Lund, Lund University, Lund, Sweden.
    Petersson, Ingmar
    Clinical Sciences Lund, Lund University, Lund, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Thorstensson, Carina
    Clinical Sciences Lund, Lund University, Lund, Sweden.
    Sickness absence in musculoskeletal disorders: patients' experiences of interactions with the Social Insurance Agency and health care. A qualitative study2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 107Article in journal (Refereed)
    Abstract [en]

    Background:

    Sickness absence has represented a growing public health problem in many Western countries over the last decade. In Sweden disorders of the musculoskeletal system cause approximately one third of all sick leave. The Social Insurance Agency (SIA) and the health care system are important actors in handling the sickness absence process. The objective was to study how patients with personal experience of sickness absence due to musculoskeletal disorders perceived their contact with these actors and what they considered as obstructing or facilitating factors for recovery and return to work in this situation.

    Methods:

    In-depth interviews using open-ended questions were conducted with fifteen informants (aged 33-63, 11 women), all with experience of sickness absence due to musculoskeletal disorders and purposefully recruited to represent various backgrounds as regards diagnosis, length of sick leave and return to work. The interviews were audio-recorded, transcribed verbatim and analysed using content analysis.

    Results:

    The informants' perceived the interaction with the SIA and health care as ranging from coherent to fragmented. Being on sick leave was described as going through a process of adjustment in both private and working life. This process of adjustment was interactive and included not only the possibilities to adjust work demands and living conditions but also personal and emotional adjustment. The informants' experiences of fragmented interaction reflected a sense that their entire situation was not being taken into account. Coherent interaction was described as facilitating recovery and return to work, while fragmented interaction was described as obstructing this. The complex division of responsibilities within the Swedish rehabilitation system may hamper sickness absentees' possibilities of taking responsibility for their own rehabilitation.

    Conclusions:

    This study shows that people on sick leave considered the interaction with the SIA and health care as an important part of the rehabilitation process. The contact with these actors was perceived as affecting recovery and return to work. Working for a more coherent process of rehabilitation and offering professional guidance to patients on sick leave might have an empowering effect.

  • 40.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svensson, Bengt
    Lunds universitet.
    Hansson, Lars
    Lunds Universitet.
    Construct validity of a health questionnaire intended to measure the subjective experience of health among patients in mental health services2008In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 15, no 3, p. 238-245Article in journal (Refereed)
    Abstract [en]

    Mental health services have been lacking systematic health-promoting activities, and health is often perceived as the absence of disease from a biomedical perspective. It is vital to develop methods to assess perceived health among patients in a broader perspective. The aim of the study was to investigate construct validity of a newly developed health questionnaire intended to measure subjectively experienced health among patients in mental health services. A cross-sectional study, including a randomly selected sample of 139 outpatients in contact with the mental health services, was performed in order to explore the relationship between perceived health and self-reported levels of self-esteem, symptoms, empowerment, quality of life and experiences of stigmatization. Self-esteem, symptoms, empowerment and quality of life altogether accounted for 70% of the variation in overall perceived health. Overall perceived health showed positive associations to self-esteem, empowerment and quality of life and negative associations to psychiatric symptoms, discrimination and rejection experiences. The findings suggest that perceived health as measured by the health questionnaire can be a meaningful and valid construct that may be useful for measuring health in clinical mental healthcare practice and in mental health services research.

  • 41.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nurses' conceptions of how health processes are promoted in mental health nursing2003In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, E-ISSN 1365-2850, Vol. 10, no 5, p. 608-615Article in journal (Refereed)
    Abstract [en]

    The health and well-being of the individual is a central goal in nursing, and health promotion seeks to enable people to increase control over and improve their health. In mental health care, health is often described in negative terms such as the absence of mental illness, which may create hopelessness and constitute a barrier to a policy of health promotion. The aim of this study was to describe nurses' conceptions of how health processes are promoted in mental health nursing. Twelve nurses working in mental health care were interviewed and the data were analysed using a phenomeographic approach. The nurses expressed 11 different conceptions of the phenomenon, which were summarized into three descriptive categories: presence, balance of power, and focus on health. The findings show that the nurses expressed ambiguous attitudes towards meeting the patient in mental health care. It is suggested that the goal of nursing care should be clarified for nurses in practice, otherwise they may adopt the perspectives of other mental health professionals.

  • 42.
    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.

  • 43.
    Jormfeldt, Henrika
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Svensson, Bengt
    Department of Health Sciences, Lund University, Lund, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hansson, Lars
    Department of Health Sciences, Lund University, Lund, Sweden.
    Dimensions and reliability of a questionnaire for the evaluation of subjective experiences of health among patients in mental health services2008In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 29, no 1, p. 51-62Article in journal (Refereed)
    Abstract [en]

    Even though the concept of health and its importance has been widely discussed in health care during recent decades, mental health services have been criticised for adopting a biomedical perspective, which does not sufficiently consider the concept of health. The aim of the present study was to investigate the psychometric properties of the Health Questionnaire, a newly developed questionnaire to measure patients' subjective experience of health in mental health services. A cross sectional study was performed using a sample of 139 outpatients in mental health services. A principal component analysis with varimax rotation was used to test the factor structure of the questionnaire. Cronbach's alpha was employed to test internal consistency and Cohen's Kappa assessed test-retest reliability. The final scale, which contained 22 items, derived from three factors (autonomy, social involvement, and comprehensibility) and showed a good reliability in terms of internal consistency. Test-retest reliability was moderate or better for 17 out of 22 items. The Health Questionnaire may enable further empirical studies on subjectively experienced health in mental health services and serve as a measure of outcome and to monitor quality of care.

  • 44.
    Koslander, Tiburtius
    et al.
    Department of Nursing Health and Culture, University Trollhättan, Uddevalla, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    How the spiritual dimension is addressed in psychiatric patient-nurse relationships2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 51, no 6, p. 558-566Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports a study describing nurses' conceptions of how the spiritual dimension is addressed in psychiatric patient–nurse relationships.

    Background. In psychiatric care, it is essential that patient–nurse relationships be built on a holistic view. In this context, nursing research shows that there is a lack of integration of the spiritual dimension.

    Method. Twelve strategically selected psychiatric nurses were interviewed and analysed using a phenomenographic approach. The data were collected in 2003.

    Findings. The main findings were three descriptive categories: being a good carer, recognizing the spiritual dimension, and regarding the spiritual dimension as difficult to capture in patient–nurse relationships. The first descriptive category shows that nurses deal with spirituality by behaving as good carers. Those included in the second descriptive category reveal nurses who are aware of patients' spiritual needs and who deal with these needs in different ways. The third descriptive category consists of conceptions revealing lack of knowledge of patients' spiritual needs, both in abstract and real terms.

    Conclusions. Further research is needed to explore how patients describe their own spiritual needs, and how nursing staff can learn to be aware of and understand their own spirituality, thus enabling them to detect, discuss, clarify and deal with the concept of spirituality in patient–nurse relationships.

  • 45.
    Koslander, Tiburtius
    et al.
    Department of Nursing Health and Culture, West University, Vänersborg, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Patients’ conceptions of how the spiritual dimension is addressed in mental health care: a qualitative study2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 57, no 6, p. 597-604Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports a study to describe patients’ conceptions of how the spiritual dimension is addressed in mental health care.

    Background. Spirituality is a broad concept, and is highly subjective, multidimensional and difficult to define. Spirituality and religiousness are two separate concepts but have several common features. In mental health care, it is essential that nursing care be built on a holistic view, and the spiritual dimension has an important function in nursing care. The notion of spirituality is full of nuances, and in a multi-cultural society patients express their spirituality in different ways.

    Method. Data were collected by interviewing 12 strategically selected patients in mental health care and analysed according to a qualitative method inspired by the phenomenographic approach. The data were collected in 2003 in Sweden.

    Findings. Three descriptive categories emerged: patients wish to have their spiritual needs addressed; patients must see to it that their spiritual needs are addressed; patients lack confidence in nurses with regard to discussing spirituality. The findings show that patients actively sought the assistance of nurses to meet their spiritual needs. They turned their thoughts inwards and found community with other patients, while nurses often avoided addressing the spiritual dimension.

    Conclusion. Nurses should work actively to seek new knowledge about how they can address patients’ spiritual needs. It is also important that there be scope for discussing and reflecting on spiritual questions at the workplace. Additional research is needed to explore how knowledge about spirituality should be implemented in mental health care and nursing education.

  • 46.
    Larsson, Ingrid
    et al.
    Spenshult Hospital, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Patients’ dependence on a nurse for the administration of their intravenous anti-TNF therapy: A phenomenographic study2008Conference paper (Refereed)
    Abstract [en]

    Background. Pain, stiffness and functional restrictions of the joints are the main problems for many patients with inflammatory rheumatic conditions. When conventional drugs fail to delay the development of the disease the patient may require biological treatment such as anti-TNF therapy. Some biological drugs are administered in the form of intravenous infusions and thus the patient is obliged to attend a clinic in order to receive his/her medication, which can affect everyday life as well independence. Therefore, it is important that the patient perspective is focused upon in order to improve the care. Aim. To describe variations in how patients with rheumatic conditions perceive their dependence on intravenous anti-TNF therapy provided by a nurse. Method. The study has a descriptive qualitative design and a phenomenographic approach. Interviews were conducted with 20 patients suffering from rheumatoid arthritis and spondyloarthropathies who were treated by means of intravenous anti-TNF therapy. Results. Three descriptive categories and ten sub-categories emerged: Dependence that affords security (encountering continuity, encountering competence, having accessibility and obtaining information); Dependence that creates involvement (being allowed influence and being given freedom); Dependence that invigorates (obtaining relaxation, being seen as an individual, being taken care of and encountering the environment). The patients perceived that the treatment led to feelings of security and involvement and stated that regular encounters with a nurse were invigorating. The patients’ needs should constitute the basis for the nurse’s role in the provision of intravenous anti-TNF therapy in an outpatient clinic

  • 47.
    Larsson, Ingrid
    et al.
    Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden & Spenshult, R&D Ctr, Spenshult, Oskarstrom, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden.
    Teleman, A.
    Spenshult Hosp, Spenshult Hosp Rheumat Dis, Oskarstrom, Sweden.
    Bergman, Stefan
    Spenshult, R&D Ctr, Spenshult, Oskarstrom, Sweden.
    Nurse-led rheumatology clinic versus rheumatologist clinic in monitoring of biological therapy– a randomised controlled study2012In: Annals of the Rheumatic Diseases, ISSN 0003-4967, Vol. 71, no Suppl. 3, p. 121-121Article in journal (Refereed)
    Abstract [en]

    Background: Patients with rheumatic diseases treated with biological therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients with low disease activity or in remission.

    Objectives: To compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients treated with biological therapy with low disease activity or in remission.

    Methods: In a prospective controlled study 107 patients were randomised into two groups with six months follow up to a nurse-led rheumatology clinic (intervention group; n=53) or to a rheumatologist clinic (control group; n=54). Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. In the nurse-led rheumatology clinic the patients´ disease activity was assessed by examination of tender or swollen joints and laboratory tests. The rheumatology nurse also had a dialogue concerning the patient’s needs with regard to drug therapy, smoking habits and psychosocial aspects. Main outcome was disease activity measured by DAS28.

    Results: After 12 months 97 patients completed the study. The patients had mean age of 55.4 years, disease duration of 16.7 years, and DAS28 was 2.1, with no significant differences between the two groups. In change of DAS28 there were no differences (p=0.66) between the intervention group (0.14) or control group (0.20) from inclusion to 12 months. There were no differences (p>0.05) in mean change after 12 months in ESR, swollen and tender joints, global health and pain visual analogue scales (VAS) or Health Assessment Questionnaire (HAQ) between the patients followed up at the nurse-led rheumatology clinic or the rheumatologist clinic, see table.

     Table. Comparison of the two groups intervention group (Nurse-led rheumatology clinic) and control group (Rheumatologist clinic).

  • 48.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Bergman, Stefan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients’ conceptions of drug information given by a rheumatology nurse - A phenomenographic study2009In: / [ed] Svenska Läkaresällskapet, 2009Conference paper (Refereed)
    Abstract [en]

    Bakgrund Pain, stiffness and functional restriction of the joints are the main problems experienced by patients with inflammatory rheumatic conditions. The majority of patients with rheumatic diseases require several drugs every day. Adherence is highest among patients who have repeatedly been given drug information by a nurse from the start of the treatment. When developing patient information, it is essential to utilise patients' experiences. The aim of this study was to describe variations in how patients with rheumatic diseases conceive drug information given by a rheumatology nurse.

    Metod Fifteen informants who had been prescribed one or several new drugs during the period of hospitalisation were approached, agreed to take part in the study and were interviewed. Strategic sampling was carried out in order to achieve variation in conceptions of the phenomenon in terms of sex, age, marital status, education, type of rheumatic disease, disease duration and type of new drug

    Resultat Three descriptive categories comprising seven conceptions emerged and revealed how the patients conceived the information about new medication provided by a nurse. Drug information led to Autonomy, Power and Security. Autonomy was based on the patients' experiences of taking responsibility and participating. Power meant gaining knowledge and being motivated to take the drug. Security involved trust, experiencing care and access to a rheumatology nurse.

    Sammanfattning Patients with a rheumatic disease experienced that drug information from a rheumatology nurse gave them autonomy, power and security. These factors could explain why information from a nurse increases drug treatment adherence.

  • 49.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Bergman, Stefan
    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).
    Patients’ conceptions of drug information given by the rheumatology nurse2009In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 68, no Suppl. 3, p. 781-781Article in journal (Refereed)
    Abstract [en]

    Background: Pain, stiffness and functional restriction of the joints are the main problems for patients with inflammatory rheumatic conditions. The majority of patients with rheumatic diseases have a need for daily intake of several drugs. Compliance in drug treatment is higher amongst patients that have been given drug information by a nurse at repeated occasions from the start of the treatment. In the development of patient information, it is essential to take advantage of patients' experiences.

    Objectives: The purpose of this study was to describe variations in how patients with rheumatic diseases conceive drug information given by a rheumatology nurse.

    Methods: The study had a descriptive qualitative design with a phenomenographic approach. When employing such an approach, the main aim is to describe how a phenomenon is conceived by different individuals. Fifteen patients with rheumatic diseases who had received a new drug during a hospital visit were approached, agreed to take part in the study and were interviewed. Strategic sampling in terms of sex, age, marital status, education, rheumatic diseases, and illness duration, was carried out in order to achieve variation in conceptions of the phenomenon.

    Results: Three descriptive categories emerged: (1) Autonomy (own responsibility and participation), (2) Power (knowledge and motivation), (3) Security (trust, care and accessibility). Autonomy was based on the patients' experiences from taking their own responsibility and participation. Power meant to gain knowledge and motivation to take the drug. Security was to receive trust, experience care, and to have accessibility to a rheumatology nurse.

    Conclusion: Patients with rheumatic diseases experiences that drug information from a rheumatology nurse gives them autonomy, power and security. These could be essential for the patients to manage their daily life, where drug treatment is one part.

    Disclosure of Interest: None declared

  • 50.
    Larsson, Ingrid
    et al.
    Spenshult hospital, Oskarström, Sweden.
    Arvidsson, Susann
    Spenshult hospital, Oskarström, Sweden.
    Bergman, Stefan
    Spenshult hospital, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients´conceptions of drug information given by a rheumatology nurse: a phenomenographic study2010In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 8, no 1, p. 36-45Article in journal (Refereed)
    Abstract [en]

    Background:

    Pain, stiffness and functional restriction of the joints are the main problems experienced by patients with inflammatory rheumatic conditions. The majority of patients with rheumatic diseases require several drugs every day. Adherence is highest among patients who have repeatedly been given drug information by a nurse from the start of the treatment. When developing patient information, it is essential to utilize patients' experiences.

    Objectives:

    The purpose of this study was to describe variations in how patients with rheumatic diseases perceive drug information given by a rheumatology nurse.

    Methods:

    The study had a descriptive qualitative design with a phenomenographic approach. Fifteen inpatients with rheumatic diseases who had received a new drug agreed to take part in the study and were interviewed.

    Results:

    Three descriptive categories emerged: autonomy, power and security. Autonomy was based on patients' experiences of taking responsibility and participating. Power meant gaining knowledge and being motivated to take the drug. Security involved trust, experiencing care and access to a rheumatology nurse.

    Conclusions:

    For patients with a rheumatic disease, drug information from a rheumatology nurse gave them autonomy, power and security. These factors could explain why information from a nurse increases adherence to drug treatment.

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