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  • 1.
    Almerud, Sofia
    et al.
    Växjö University, School of Health Sciences and Social Work, Vaxjo Sweden.
    Baigi, Amir
    Sahlgrenska Academy, Department of Primary Health Care, Gothenburg Sweden.
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jogre, J.
    Växjö University, Centre for Acute and Critical Care (CACC), Vaxjo Sweden.
    Lyrström, L.
    Växjö University, Centre for Acute and Critical Care (CACC), Vaxjo Sweden.
    Fridlund, Bengt
    School of Health Sciences Jonkoping, School of Health Sciences, Jonkoping Sweden.
    Acute coronary syndrome: social support and coping ability on admittance2008In: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 17, no 8, p. 527-531Article in journal (Refereed)
    Abstract [en]

    Aim: To compare social support and coping ability in acute coronary syndrome patients at the time of the cardiac event with a healthy community-based sample, with regard to age, sex, education and marital status.

    Method: The study comprised 241 patients and 316 healthy controls. The participants answered a self-administered questionnaire that included three well-established scales. Multiple logistic regression was used in the analysis to compare the health situation between the patients and controls.

    Results: Persons suffering from acute coronary syndrome rated emotional support significantly lower than the healthy controls. However, there were no differences between the two groups in terms of socio-demographic variables.

    Conclusion: This study indicates that social support may be a predictor of acute coronary syndrome.

  • 2.
    Andersson, S.
    et al.
    Länssjukhuset, Halmstad.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    The aphasic person's views of the encounter with other people: a grounded theory analysis2002In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 3, p. 285-292Article in journal (Refereed)
    Abstract [en]

    Notes that being affected by aphasia influences the total life experience. The aim of this study was to generate a theoretical model, from a nursing perspective, of what 12 aphasic persons (aged 28-92 yrs old) experience in encounters with other people. Data were collected through interviews which adopted a biophysical, socio-cultural and psychological approach and then analyzed using grounded theory method. Two main categories emerged, namely: interaction and support. Encountered experiences led to (1) a feeling of having ability, (2) a feeling of being an outsider, and (3) a feeling of dejection or uncertainty. The feeling state was dependent on whether the interaction was obstructed or secure and on whether the support resulted in strengthened or impaired self-esteem. Therefore, nurses need to give support that enhances patients self-esteem and which results in them gaining a positive and realistic view of their aphasia, as well as involving those around them in this perspective. This then will give the possibility for the patient to turn the interaction process from an obstructed into a secure one.

  • 3.
    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.

  • 4.
    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.

  • 5.
    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.

  • 6.
    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.

  • 7.
    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.

  • 8.
    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.

  • 9.
    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.

  • 10.
    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.

  • 11.
    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)
  • 12.
    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.

  • 13.
    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.

  • 14.
    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

  • 15.
    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)
  • 16.
    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.

  • 17.
    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.

  • 18.
    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.

  • 19.
    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.

  • 20.
    Baigi, Amir
    et al.
    Primary Health Care Halland, Falkenberg.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Marklund, B.
    Göteborg University.
    Oden, A.
    Statistics, Göteborg.
    Cardiovascular mortality focusing on socio-economic influence: the low-risk population of Halland compared to the population of Sweden as a whole2002In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 116, no 5, p. 285-288Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate the relationship between mortality from cardiovascular diseases (CVD) and socioeconomic status (SES) in Sweden and to estimate to what extent the difference between a province with low mortality and the rest of Sweden was dependent on socio-economic factors. A population-based retrospective study with a historical prospective approach was performed covering a 10-y period in the province of Halland, Sweden, as well as Sweden as a whole. Altogether 1654 744 men and 1592 467 women were included, of whom 45 394 men and 43 403 women were from Halland, distributed according to SES. Multivariate analysis with Poisson regression was used. Relative risks with 95% confidence intervals were calculated. Both men and women with a low SES showed a significantly higher risk of death from CVD in Sweden as a whole. The risk was 23% higher for male blue-collar workers and 44% higher for female blue-collar workers when compared to their white-collar counterparts. The level of mortality in Halland was 14% lower compared to the country as a whole when only age was taken into account. When the socio-economic variable was also included, this figure was 8%. The results show the substantial significance of social differences with respect to CVD mortality. The effect of SES seems to be more important than that of geographical conditions when the latter are isolated from socio-economic influence.

  • 21.
    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.

  • 22.
    Björklund, M.
    et al.
    Centre for Health Promotion Research, Halmstad University, Halmstad and the Ear Clinic, Nordvastra Skanes Sjukvardsdistrikt, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Cancer patients' experiences of nurses' behaviour and health promotion activities: a critical incident analysis1999In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 8, no 4, p. 204-212Article in journal (Refereed)
    Abstract [en]

    Patients with head and neck cancer report several disease- and health-related problems before, during and a long time after completed treatment. Nurses have an important role in educating/supporting these patients about/through the disease and treatment so that they can attain well-being. This study describes the cancer patients' experiences of nurses' behaviour in terms of critical incidents after nurses had given them care to promote health. The study had a qualitative, descriptive design and the method used was the critical incident technique. Twenty-one informants from the Nordic countries diagnosed with head and neck cancer were strategically selected. It was explained to the informants what a critical incident implies before the interviews took place; this was defined as a major event of great importance, an incident, which the informants still remember, due to its great importance for the outcome of their health and well-being. The nurses' behaviour was examined, and critical incidents were involved in 208 cases-150 positive and 58 negative ones-the number of incidents varying between three and 20 per informant. The nurses' health promotion activities or lack of such activities based on the patients' disease, treatment and symptoms, consisted of informing and instructing the patients as well as enabling their participation. Personal consideration and the nurses' cognisance, knowledge, competence, solicitude, demeanour and statements of understanding were found to be important. Continuous health promotion nursing interventions were of considerable value for the majority of this group of cancer patients. Oncology nurses could reconfirm and update the care of head and neck cancer patients by including health promotion activities in individual care plans. By more frequent use of health promotion models, such as the empowerment model, the nurses could identify and focus on those individuals who needed to alter their Life-style as well as tailor their approach towards these patient by setting goals for well-being and a healthy life-style.

  • 23.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Hamilton, Glenys
    University of Oslo, Center for Shared Decision Making and Nursing Research, Norway.
    Flanagan, Jane
    University of Massachusetts-Lowell, Lowell, MA, USA.
    Caroll, Diane L.
    Massachusetts General Hospital, Boston, MA, USA.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ways of experiencing the life situation among United States patients with an implantable cardioverter-defibrillator: a qualitative study2005In: Progress in Cardiovascular Nursing, ISSN 0889-7204, E-ISSN 1751-7117, Vol. 20, no 1, p. 4-10Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is to describe how a selected group of United States patients with an implantable cardioverter-defibrillator perceived their life situation. A qualitative design based on the phenomenographic approach was chosen to describe the patients' conceptions of their life situation. Fourteen patients-eight men and six women, aged 21-84-were strategically selected to obtain as broad a variation as possible. The descriptive categories to emerge from the analysis of the interviews were trust, adaptability, and empowerment. The category labeled trust describes how patients trusted in the organization around them. The category labeled adaptability describes how patients adapted to living with an implantable cardioverter-defibrillator device. The category entitled empowerment describes how patients considered that they received support from family and friends as well as from health care professionals. This study suggests the need for a holistic intervention program comprising family, work, and leisure, focusing on patients' future life situation.

  • 24.
    Boström, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Hinic, Hansi
    Halmstad University, School of Social and Health Sciences (HOS).
    Lundberg, Dag
    Dept. of Anaesthiol./Intensive Care, Lund University, Lund, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Pain and health-related quality of life among cancer patients in final stage of life: a comparison between two palliative care teams2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 3, p. 189-196Article in journal (Refereed)
    Abstract [en]

    A two-centred descriptive study was performed in order to describe and compare pain and health-related quality of life (HRQOL) among cancer patients, in their final stage of life. The patients were cared for by either a nurse-led palliative care team I (PCT I) or a physician-led palliative care team II (PCT II). Forty-six consecutive, stratified patients (PCT I, n = 21 and PCT II, n = 25) participated. The medical outcomes study short form 36 (SF-36) was used for evaluating HRQOL and the Pain-O-Meter for assessing pain. Patients' pain intensity, pain quality and HRQOL showed no significant difference between the two groups PCT I and PCT II. The patients from PCT I had significantly longer survival time (P = 0.017) than those from PCT II. The different composition of the teams being led by nurses or physicians is worth further research; both from the patient's and staff's viewpoint, there may also be cost-benefits worth examining.

  • 25.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Lund University, University Hospital, Lund, Sweden.
    Fridlund, Bengt
    Lund University, University Hospital, Lund, Sweden; Department of Nursing, Lund University, Lund, Sweden.
    A comparison of pain and health-related quality of life between two groups of cancer patients with differing average levels of pain2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 5, p. 726-735Article in journal (Refereed)
    Abstract [en]

    A study was performed to describe and compare pain and Health-Related Quality of Life (HRQOL) in two groups of cancer patients in palliative care as well as to describe the correlation between pain and HRQOL. ○ Forty-seven patients with mild average pain [Visual Analogue Scale (VAS) < 3] and 28 patients with moderate to severe average pain (VAS > 3) were included. Medical Outcomes Study Short Form (SF-36) was used to evaluate HRQOL, pain intensity levels were measured with the VAS on Pain-O-Meter. ○ Compared to patients with mild pain, patients with moderate to severe pain had statistically significant, higher pain intensity for the items 'pain at time of interview', 'worst pain in the past 24 hours' and 'pain interrupting sleep.' They also had the lowest scores of the SF-36 dimensions: physical functioning, role-physical, and bodily pain. Patients with moderate to severe pain had statistically significant, fewer months of survival. There were statistically significant positive correlations between pain items and negative correlation between pain and SF-36 dimensions. ○ The conclusion is that pain has a negative impact on HRQOL, especially on physical health and that pain increases towards the final stages of life. Even if patients have to endure symptoms such as fatigue and anxiety during their short survival time, dealing with pain is an unnecessary burden, which can be prevented.

  • 26.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer patients' experiences of care related to pain management before and after palliative care referral2004In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 13, no 3, p. 238-245Article in journal (Refereed)
    Abstract [en]

    Pain is the main problem for patients with cancer referred to palliative care (PC). Pain management in PC requires a multidimensional approach. A questionnaire was used to determine cancer patients' experiences of care related to pain management, before and after being referred to PC, and to also discover possible correlations between pain control and other aspects of care. Seventy-five consecutive patients from two PC teams were included in the study. The patients had experienced a statistically significant (P < 0.01) improvement in care after being referred to PC, despite the fact that pain control had not been optimized. Patients' description of 'pain control' after being referred to PC had a statistically significant correlation with their 'feeling of security' and 'continuity of care' throughout the same period. The conclusion is that care provided in PC is vital to successful pain management. Pain control depends not only on analgesics but also on many other aspects of care provided by the nurse. Continuity of care and the opportunity to talk increases the patients' feeling of security, which is also of utmost importance to successful pain management.

  • 27.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer-related pain in palliative care: patients' perceptions of pain management2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 45, no 4, p. 410-419Article in journal (Refereed)
    Abstract [en]

    Background: Pain is still a significant problem for many patients with cancer, despite numerous, clear and concise guidelines for the treatment of cancer-related pain. The impact of pain cognition on patients' experiences of cancer-related pain remains relatively unexplored. Aim: The aim of this study was to describe how patients with cancer-related pain in palliative care perceive the management of their pain. Method: Thirty patients were strategically selected for interviews with open-ended questions, designed to explore the pain and pain management related to their cancer. The interviews were analysed using a phenomenographic approach. Findings: Patients described 10 different perceptions of pain and pain management summarized in the three categories: communication, planning and trust. In terms of communication, patients expressed a need for an open and honest dialogue with health care professionals about all problems concerning pain. Patients expressed an urgent need for planning of their pain treatment including all caring activities around them. When they felt trust in the health care organization as a whole, and in nurses and physicians in particular, they described improved ability and willingness to participate in pain management. While the findings are limited to patients in palliative care, questions are raised about others with cancer-related pain without access to a palliative care team. Conclusion: The opportunity for patients to discuss pain and its treatment seems to have occurred late in the course of disease, mostly not until coming in contact with a palliative care team. They expressed a wish to be pain-free, or attain as much pain relief as possible, with as few side effects as possible.

  • 28.
    Broström, Anders
    et al.
    Linköping University, Linköping, Sweden.
    Strömberg, Anna
    Linköping University, Linköping, Sweden.
    Dahlström, Ulf
    Linköping University, Linköping, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Congestive heart failure, spouses' support and the couple's sleep situation: a critical incident technique analysis2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 2, p. 223-233Article in journal (Refereed)
    Abstract [en]

    Sleep related breathing disorders are common as well as a poor prognostic sign associated with higher mortality in patients with congestive heart failure (CHF). These patients often have a shorter total duration of sleep, disturbed sleep structure and increased daytime sleepiness, which can negatively affect all dimensions of the life situation. The spouse has an important role in supporting the patient in relation to sleep disorders, but this role may be adversely affected by the sleep situation of the couple. The aim of this study was to describe decisive situations that influence spouses' support to patients with CHF in relation to the couple's sleep situation. A qualitative descriptive design using critical incident technique was employed. Incidents were collected by means of interviews with 25 spouses of patients with CHF, strategically selected from two hospital-based specialist clinics in southern Sweden. Two main areas emerged in the analysis: support stimulating situations and support inhibiting situations. Support stimulating situations described how spouses' support was positively affected by their own adaptation in psychosocial or practical situations, and receiving help from others. Support inhibiting situations described how the spouses' support was negatively affected by sleep disturbances as a result of the patient's symptoms, anxiety in relation to the disease, limitations as a result of the sleeping habits, dissatisfaction with care related to the sleep situation, and being left to cope alone with the problems. An increased understanding of the stimulating and inhibiting situations influencing spouses' support for patients with CHF can guide health care personnel in deciding if an intervention is needed to improve the sleep situation for patient and spouse.

  • 29.
    Cider, Asa
    et al.
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Mårtensson, Jan
    Jönköping University, Jönköping, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Strömberg, Anna
    Linköping University, Linköping, Sweden.
    Pihl, Emma
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Response to 'Exercise programmes and quality of life in the elderly important facts'2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no 1, p. 128-128Article in journal (Refereed)
  • 30.
    Flemme, Inger
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hinic, Hansi
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Dalman, Margareta
    Kardiologkliniken, Sahlgrenska Universitetssjukhuset, Göteborg, Sverige.
    Jinhage, Britt-Marie
    Kardiologkliniken, Sahlgrenska Universitetssjukhuset, Göteborg, Sverige.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Edvardsson, Nils
    Kardiologkliniken, Sahlgrenska Universitetssjukhuset, Göteborg, Sverige.
    Livskvalitet och upplevda chocker under ICD-behandling: en 5-års uppföljning2004Conference paper (Refereed)
    Abstract [sv]

    ICD–behandling ökar överlevnaden hos patienter (pat), som har överlevt en malign ventrikulär tachyarytmi. Pats livskvalitet (QoL) har angivits variera betydande och långtidseffekterna är ännu mindre väl kända. Vi följde ett antal konsekutiva pat under minst 5 år med avseende på livskvaliteten.

    Metod.   Pat undersöktes med MUIS-C (Mishel Uncertainty in Illness Scale – community version) och QLI-CV (Quality of Life Index – cardiac version) och multipel regressionsanalys användes hos 35 patienter. Formulären fylldes i vid tre tillfällen: före implantationen, efter 1 och 5 år. Pats egen uppfattning om antalet upplevda chocker oavsett anledning noterades.

    Patienter. Ur en grupp pat, som tidigare undersöktes efter 1 år, hade 39 pat överlevt med sin ICD i minst 5 år. Av dessa avböjde tre deltagande i uppföljningen utan orsak och en pga cancer. Alla pat hade fått sin ICD på indikationen sekundär prevention.  

    Resultat.  Under det första året rapporterade 13 pat totalt 79 chocker och 22 pat ingen chock. Tio pat hade ingen chock vare sig efter 1 eller 5 år, och deras QoL var likvärdig med dem som hade haft ≤5 chocker. Tre pat rapporterade ≥6 chocker och hade sänkt QoL. Mellan år 1 och 5 rapporterade 20 pat 94 shocker och 15 pat ingen shock. Det var ingen skillnad mellan pat med eller utan chocker i deras QoL år 5 vs. år 1. Pat med chocker blev mindre besvärade med tiden.

    QoL var generellt sänkt år 1 vs baseline. En försämring i den socio-ekonomiska domänen sågs år 1 men var förbättrad år 5. En försämring i familjedomänen var oförändrad vid 1 och 5 år vs. baseline. En förbättring av otrygghet noterades vid 5 år vs år 1.

    Konklusioner. Pat med ICD mådde bättre år 5 än år 1 efter implantationen.  Livskvaliteten var rimligt god 5 år efter implantationen och pat kände sig mer trygga och upplevde sin ICD som en livräddare. Pat med många chocker under det första året mådde sämre än övriga. Under resten av observationsperioden var chocktätheten lägre, möjligen delvis pga farmakologisk behandling, och pat upplevde mindre besvär av chockerna. 

  • 31.
    Folke, Solgun
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Paulsson, Gun
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Söderfeldt, Björn
    Malmö University, Sweden.
    The subjective meaning of xerostomia: an aggravating misery2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 4, p. 245-255Article in journal (Refereed)
    Abstract [en]

    Xerostomia, the subjective sensation of dry mouth, is associated with qualitative and quantitative changes of saliva. Poor health, certain medications and radiation therapy constitute major risk factors. To gain further understanding of this condition the present study explored the main concern of xerostomia expressed by affl icted adults. Qualitative interviews were conducted with 15 participants and analysed according to the grounded theory method. An aggravating misery was identi-fi ed as the core category, meaning that the main concern of xerostomia is its devastating and debilitating impact on multiple domains of well-being. Professional consultation, search for affi rmation and social withdrawal were strategies of management. The fi ndings reveal that xerostomia is not a trivial condition for those suffering. Oral impairment as well as physical and psychosocial consequences of xerostomia has a negative impact on quality of life. There is an obvious need to enhance professional competence to improve the compassion for and the support of individuals affl icted by xerostomia

  • 32.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI). Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    The case study as a research strategy1997In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 11, no 1, p. 3-4Article in journal (Refereed)
    Abstract [en]

    A research strategy seldom used in the caring sciences is the case study. A case study is an empirical in-depth inquiry about an individual, family, group or organization. It is preferable when 'how' and 'why' questions are asked. The case study is mainly used to explain those causal links in real-life intervention that are too complex for either the survey or experimental strategies. Like other research strategies, its design includes questions or propositions, units of analysis, the logic linking the data to the questions or propositions, and the interpretations of the outcomes. A case study can be reported as a single case or as a compilation of a series of cases. In conclusion a case study is a simple and excellent way for a care professional to present him or herself to the scientific world.

  • 33.
    Fridlund, Bengt
    et al.
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Baigi, Amir
    Primary Health Care R&D Unit, County Council Halland, Falkenberg, Sweden.
    Hildingh, Cathrine
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Developing and testing the psychometric properties of a short-form questionnaire regarding the psychosocial condition after a cardiac event2010In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 30, no 2, p. 29-32Article in journal (Refereed)
    Abstract [en]

    Psychosocial difficulties in patients after a cardiac event is well-known concept yet no systematic or routine assessment with focus on their psychosocial condition with regard to coping, social support and sense of coherence is established. Accordingly the aim of this pilot study was to develop and test the psychometric properties of a short-form questionnaire regarding patients’ psychosocial condition after a cardiac event to be used in every day clinical practice. This pilot study, which had a methodological design, used selected sample of 30 participants to answer a questionnaire built on 37 items in order to determine face, content and construct validity and homogeneity reliability. Five factors built on 18 items emerged, all with good values for the psychometric tests chosen, and labelled according to their theoretical belongings: closeness, belongingness, availability, concordance and outlook. This short-form questionnaire measuring the psychosocial condition after a cardiac event useful in every day clinical practice seems appropriate but needs further psychometric development carried out in large scale studies with regard to cultural-socio-demographics and diagnoses.

  • 34.
    Fridlund, Bengt
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Billing, Ewa
    Karolinska Institutet.
    Cardiac rehabilitation and psychosocial gender differences2002In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 22, no 3, p. 48-51Article in journal (Refereed)
    Abstract [en]

    Tertiary prevention comprising treatment, care and rehabilitation of patients with heart disease is an important task for nurses and other health care professionals. This is achieved through a combination of medico-physical and psychosocial interventions, related to the male or female patient's personal, expressed problems and the personnel's know ledge. Therefore, the aim of this literature study was to highlight the comprehensiveness of the cardiac rehabilitation concept from a Nordic perspective and with focus on psychosocial gender differences. The Nordic examples of cardiac rehabilitation programmes, involving a multidisciplinary team and comprising health education, physical exercise and stress management, include no specific efforts for women. However, the efficacy of out-patient programmes is still poorly documented and there is a need to increase the attendance of eligible patients, particularly women, in these programmes. There are differences between the genders concerning the need for support from personnel and laymen in order to better reach patient's compliance. Taking the psychosocial characteristics specific to women into account, could be the first step towards increased attendance rates for women as well as reaching the proximal and distal targets with regards to cardiac rehabilitation.

  • 35.
    Fridlund, Bengt
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Mårtensson, Jan
    Halmstad University, School of Social and Health Sciences (HOS).
    Cardiovascular nursing in RN and higher education in Swedish universities: A national survey2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 3, p. 255-259Article in journal (Refereed)
    Abstract [en]

    Cardiovascular nursing (CVN) is rapidly developing and has accumulated a large amount of evidence to support interventions aimed at reducing suffering and hastening recovery. However, knowledge of the extent and content of CVN training in Sweden is lacking. The aim of this study was therefore to identify and describe CVN in the Swedish RN education as well as in higher education, with reference to type of course and credits, content, area and target group. A nationwide survey was carried out in Sweden at all university level nursing schools (N=26) by means of a 25-item questionnaire, which was analysed by descriptive statistics. The findings show that 69% and 23% of the schools awarded 0–1 credits [0–1.5 European Credit Transfer and Accumulation System (ECTS)] and 2–3 credits (3–4.5 ECTS), respectively for cardiology/CVN in the RN education. Target areas outside the hospital setting reported by 23% and 19% of nursing schools were primary health care and community care, respectively. Special target groups in addition to the general public were the elderly (42%) and women (58%). Advanced courses in CVN comprising 10–40 credits (15–60 ECTS) were held by 27% of nursing schools, but no school had a specialist or Master level education. Important educational implications from the study of the RN education are the establishment of a minimum credit figure and to reach out into primary health care.

  • 36.
    Haraldsson, Katarina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Aamir
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Lydell, Marie C.
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Marklund, B.
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Evaluation of a school-based adolescent health promotion programme with focus on well-being related to stress2008In: Proc. European Conference on Public Health: ”Health and innovation in Europe”, Centro Congressos de Lisboa 5-8 November 2008, 2008Conference paper (Refereed)
  • 37.
    Haraldsson, Katarina
    et al.
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Lindgren, Eva-Carin
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Baigi, Amir
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Lydell, Marie C.
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Marklund, Bertil
    Department of Public Health and Community Medicine, Göteborg University, Göteborg, Sweden.
    Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress2008In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, no 1, p. 25-33Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress.

    Study design: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden.

    Methods: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment.

    Results: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls’ sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls’ sense of well-being was maintained in two areas and deteriorated in four areas.

    Conclusion: Massage and mental training helped to maintain adolescents’ very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.

  • 38.
    Haraldsson, Katarina
    et al.
    Research and Development Unit, General Practice and Public Health, Halland County Council, Falkenberg.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Mattsson, Bengt
    Sahlgrenska School of Public Health and Community Medicine, Göteborg University.
    Fridlund, Bengt
    Sahlgrenska School of Public Health and Community Medicine, Göteborg University.
    Marklund, Bertil
    Research and Development Unit, General Practice and Public Health, Halland County Council, Falkenberg.
    Adolescent Girls' Experiences of Underlying Social Processes Triggering Stress in Their Everyday Life: A grounded theory study2011In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 27, no 2, p. E61-E70Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to generate a theoretical model of underlying social processes that trigger stress in adolescent girls’ everyday life. In-depth interviews regarding the experiences of stress at home, school and during leisure time were conducted with 14 17-year-old schoolgirls. Data were analysed by means of the grounded theory method. Stress was triggered in the interaction between responsibility and the way in which the girls were encountered. Triggered emotional reactions took the form of four dimensions of stress included ambivalence, frustration, despair and downheartedness. These reactions were dependent on whether the girls voluntary assumed responsibility for various situations or whether they were forced, or felt they were being forced, to assume responsibility in interaction with an encounter characterized by closeness or distance. These forms of stress reactions could appear in one dimension and subsequently shift to another. From the public health perspective, the generated stress model can be used in the planning and implementation of future actions to prevent stress and promote well-being related to stress in adolescent girls.

  • 39.
    Hildingh, Cathrine
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Candidate, D.
    Segesten, K.
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Elderly persons' social network and need for social support after their first myocardial infarction1997In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 11, no 1, p. 5-11Article in journal (Refereed)
    Abstract [en]

    Social network and social support are phenomena suggested to be of importance to successful recovery from myocardial infarction. However, Very few studies have been carried out, especially among the elderly, focusing on their social network and its ability to provide adequate support after myocardial infarction. The aim of this study was to examine elderly persons' social network and need for social support three months after their first myocardial infarction. The sample consisted of 128 persons between 65 and 94 years of age who answered a questionnaire. The results showed that the subjects, even the oldest ones, had an available social network and that they were satisfied with the support it provided. There was an increased need for social support after the myocardial infarction, especially for emotional support and appraisal, but also for instrumental aid and information. Despite these positive results indicating that elderly persons with myocardial infarction have a social network, whose members provide them with support, there may be a need for support also from persons outside this network. Assessment of social network characteristics and the need for social support as well as the provision of adequate information about additional support networks are important tasks for all health professionals.

  • 40.
    Hildingh, Cathrine
    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.
    A 3-year follow-up of participation in peer support groups after a cardiac event2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 4, p. 315-320Article in journal (Refereed)
    Abstract [en]

    Secondary prevention is an important component of a structured rehabilitation programme following a cardiac event. Comprehensive programmes have been developed in many European countries, the vast majority of which are hospital based. In Sweden, all patients with cardiac disease are also given the opportunity to participate in secondary prevention activities arranged by the National Association for Heart and Lung Patients [The Heart & Lung School (HL)]. The aim of this 3-year longitudinal study was to compare persons who attended the HL after a cardiac event and those who declined participation, with regard to health aspects, life situation, social network and support, clinical data, rehospitalisation and mortality. Totally 220 patients were included in the study. The patients were asked to fill in a questionnaire on four occasions, in addition to visiting a health care center for physical examination. After 3 years, 160 persons were still participating, 35 of whom attended the HL. The results show that persons who participated in the HL exercised more regularly, smoked less and had a denser network as well as more social support from nonfamily members than the comparison groups. This study contributes to increased knowledge among healthcare professionals, politicians and decision makers about peer support groups as a support strategy after a cardiac event.

  • 41.
    hildingh, cathrine
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of nursing, Lund University, Lund, Sweden.
    A 3-year follow-up of participation in the Heart & Lung School after a cardiac event2004Conference paper (Refereed)
  • 42.
    hildingh, cathrine
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Medicine and Care, Faculty of Health Science, Linköping University, Linköping, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Medicine and Care, Faculty of Health Science, Linköping University, Linköping, Sweden.
    Peer support groups after a cardiac event, a 12-month follow-up2002Conference paper (Refereed)
  • 43.
    Hildingh, Cathrine
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Baigi, Amir
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Sense of coherence and experiences of social support and mastery in the early discharge period after an acute cardiac event2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 10, p. 1303-1311Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: The aim of this study was to examine sense of coherence and experiences of change in social support and mastery from a short-term perspective in patients who had been admitted to hospital with a suspected myocardial infarction.

    Background: The early discharge period after an acute cardiac event can be a stressful and vulnerable time when psychosocial resources are of the utmost importance. A positive outcome in an encounter with a stressor is thought to be linked to a strong sense of coherence, social support and mastery.

    Design: A multi-centre survey was conducted in three hospitals in southern Sweden.

    Methods: The sample was 300, 241 of whom completed the questionnaires; while in hospital and two weeks postdischarge.

    Results: In the early discharge period a low sense of coherence was found in over 60% of the sample. There was an association between social support and mastery and between sense of coherence and mastery. Differences in social support ratings, with lower ratings two weeks postdischarge, were found among women and persons over 65 years of age.

    Conclusions: This study adds knowledge about experiences in the early discharge period. Changes in ratings of social support but not in ratings of mastery were found between baseline and two weeks postdischarge.

    Relevance to clinical practice: Healthcare professionals need to be sensitive to patients’ sense of coherence, mastery and need for social support during the early discharge period. They can help patients to identify adequate support strategies and prevent future potential complications. However, to routinely assess sense of coherence, social support and mastery, there is a need for a simple and useful instrument in clinical practice.

  • 44.
    Isaksson, R.
    et al.
    Cent Hosp, Halmstad, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Paulsson, Gun
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nederfors, T.
    Cent Hosp, Halmstad, Sweden.
    Evaluation of an oral health programme for nursing personnel in special housing facilities for the elderly. Part II: Clinical aspects.2000In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 79, no 5, p. 1291-1291Article in journal (Other academic)
  • 45.
    Jacobsson, Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Pihl, Emma
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Mårtensson, Jan
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Emotions, the meaning of food and heart failure: a grounded theory study2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 46, no 5, p. 514-522Article in journal (Refereed)
    Abstract [en]

    Background:

    Many patients with heart failure have generalized wasting, referred to as cardiac cachexia. This leads to skeletal muscle wasting, impaired mobility, reduced functional capacity and poor prognosis. Patients with heart failure have symptoms that can affect their food intake, for example breathing difficulties, fatigue, nausea, loss of appetite, early feeling of fullness and ascites. These dietary problems and patients' nutritional status, can be significantly improved by means of simple nursing interventions.

    Aim:

    This paper reports a grounded theory study which developed a theoretical model of experiences of food and food intake among patients with heart failure.

    Methods:

    A descriptive and exploratory design, with a grounded theory analysis, was used. Data were collected in 2002 through interviews with 11 patients with heart failure. Findings. Two core categories emerged: emotions and the meaning of food. Psychosocial meaning could be associated with positive feelings of well-being, or negative feelings of sorrow. Physiological meaning could be associated with positive feelings of comfort or negative feelings of burden. Patients' experiences of food and eating changed during the development of the disease. Feelings of fatigue and lack of appetite gave rise to a feeling of deprivation because of missing both eating and the related social environment. This could lead to a loss of personal identity.

    Discussion:

    Although the findings of a qualitative study cannot be generalized, they raise important clinical nursing issues. With increasingly shorter hospital stays, these problems will need to be addressed by community healthcare staff and family carers. Therefore, all healthcare professionals need knowledge about heart disease and information techniques if they are to be able to give appropriate care to this group.

    Conclusion:

    Ignorance about food and eating can easily lead to malnourishment, with an increased risk of the patients falling into a vicious circle. Implications of the study for health care practice and research are identified.

  • 46.
    Jacobsson, Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Pihl-Lindgren, Emma
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Malnutrition in patients suffering from chronic heart failure; the nurse's care2001In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 3, no 4, p. 449-456Article in journal (Refereed)
    Abstract [en]

    Chronic heart failure is associated with a bad prognosis with considerably shortened survival and repeated hospitalisations. Patients suffering from heart failure also have symptoms that can affect their food intake, for example, tiredness when strained, breathing difficulties and gastrointestinal symptoms like nausea, loss of appetite and ascites. Pharmacological therapy can lead to a loss of appetite, which will make the intake of food inadequate to fill the required energy and nutritional needs. The nurse's interest in and knowledge of diet issues can improve these patients' nutritional status, The aim of this literature review was to describe the nurse's interventions regarding malnutrition in patients suffering from chronic heart failure. The literature search gave 13 articles, which were analysed, and sentences whose content was related to the aim were identified. Three areas of content appeared; drug treatment and consequences, gastrointestinal effects, and information and education. The results show that the nutritional status of these patients can be significantly improved by means of simple nursing interventions. Future research should focus on controlled experimental studies to evaluate differences in body weight, body mass index and quality of life between patients suffering from chronic heart failure, who are taking part in a fully enriched nutrition intervention, and patients suffering from chronic heart failure, who are eating their normal diet.

  • 47.
    Johansson, Elsie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Roxberg, Åsa
    School of Health Sciences and Social Work, Växjö University.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nurses' consolation: a grounded theory study2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 2, p. 19-22Article in journal (Refereed)
    Abstract [en]

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

  • 48.
    Johansson, Ingrid
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Coping strategies of relatives when an adult next-of-kin is recovering at home following critical illness2004In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 20, no 5, p. 281-291Article in journal (Refereed)
    Abstract [en]

    The trend within the Swedish healthcare system is to reduce the duration of hospital care. This means that a patient who is discharged to their home after critical illness is highly likely to be functionally impaired, and therefore, requires care-giving assistance from a family member. The aim of this study was to generate a theoretical model with regard to relatives’ coping when faced with the situation of having an adult next-of-kin recovering at home after critical illness. The design incorporated grounded theory methodology. Four coping strategies exhibiting different characteristics were identified: volunteering, accepting, modulating and sacrificing. Factors determining the choice of coping strategy were the physical and psychological status of the relative, previous experience of ICU-care and the psychological status of the patient. The theoretical model described in this article can contribute to expanding healthcare professionals’ understanding of the coping strategies of relatives during recovery, but also provide inspiration for social action to be taken.

  • 49.
    Koinberg, Inga Lill
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Holmberg, Lars H.
    Department of Surgical Sciences, Division of Surgery, Uppsala University, Uppsala, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Breast cancer patients' satisfaction with a spontaneous system of check-up visits to a specialist nurse2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 209-215Article in journal (Refereed)
    Abstract [en]

    Aim: To describe breast cancer patients' satisfaction with a spontaneous system of check-up visits to a specialist nurse. Background: There is little evidence that routine follow-up visits after breast cancer surgery influence survival or patient satisfaction. Consequently, there is a need to evaluate alternative follow-up programmes. Sample: A strategic sample of 19 breast cancer patients, who were not involved in a routine follow-up system but who had the possibility of contacting a specialist nurse when necessary, were interviewed. Method: A qualitative descriptive design inspired by the method of phenomenographic analysis was used. Findings: Five description categories and 606 statements showing similarities and differences in conceptions were obtained. The patients satisfaction with the knowledgeable and professional skills of the nurses was high. Confirmation and trust were important and necessary in order for the women with breast cancer to feel secure. Patients had a need for information and self-care education. Accessibility and early assessment by professional personnel or an oncology nurse were essential in a system without routine follow-ups. Discussion: This study identifies key issues in a specialist nurse-led check-up system. The findings can be used for developing an education programme for women who have undergone breast cancer surgery. Additionally, the findings emphasize the need to introduce more flexible solutions to the follow-up programmes, one alternative being specialist nurse-led check-ups.

  • 50.
    Kristofferzon, Marja-Leena
    et al.
    Department of Caring Science and Sociology, University of Gävle.
    Johansson, Ingela
    Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Brännström, Margareta
    Department of Nursing, Umeå University, Umeå, Sweden.
    Arenhall, Eva
    Department of Cardiology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Baigi, Amir
    General Practice and Public Health, Halland County Council, Falkenberg, Sweden.
    Brunt, David
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Fridlund, Bengt
    Shool of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Nilsson, Ulrica
    Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Persson, Sylvi
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Rask, Mikael
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Wieslander, Inger
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Lund University Hospital and Lund University, Lund, Sweden.
    Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: a pilot study2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required.

    AIMS: The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.

    METHODS: A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.

    RESULTS: Two separate factor analyses each revealed a two-factor structure on both occasions: "Sexual appetite" and "Sexual expectations" with gender-neutral questions and "Sexual sensitiveness" and "Sexual ability" with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test-retest values for all but one question exceeded 0.70.

    CONCLUSIONS: The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.

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