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  • 1.
    Ahmadi, Nasser S.
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Månsson, Jörgen
    University of Gothenburg, Gothenburg, Sweden.
    Lindblad, Ulf
    University of Gothenburg, Gothenburg, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Breathlessness in everyday life from a patient perspective: A qualitative study using diaries2014Inngår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 12, nr 3, s. 189-194Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Breathlessness is a subjective symptom, which makes it difficult to define and understand. The aim of the present study was to illuminate how patients suffering from breathlessness experience their everyday life. Method: The study was a qualitative study, and the focus of the analysis was the patients' descriptions of their experiences of breathlessness using a diary with two unstructured questions for a period of 7 consecutive days. Sixteen participants: 7 men, mean age 65 ± 7 (range 55-73 years old), and 9 women, mean age 65 ± 9 (range 50-72 years old) participated in the study. Results: Two themes emerged from the analysis: 1) Impaired quality of life and 2) symptom tolerance and adaptation. The theme "impaired quality of life" included the categories limited physical ability, psychological burdens, and social life barriers. The theme "symptom tolerance and adaptation" included importance of health care, social support, hobbies and leisure activities, and coping strategies. Significance of results: The findings in our study showed that patients, in spite of considerable difficulties with shortness of breath, found relief in several types of activities, in addition to drug therapy. The result indicates that the "biopsychosocial model" is an appealing approach that should be discussed further to gain a better understanding of breathlessness. Copyright © Cambridge University Press 2013.

  • 2.
    Ali, Lilas
    et al.
    Sahlgrenska Academy, Gothenburg University, Institute of Health and Care Science, Sweden.
    Krevers, Barbro
    Linköping University, Department of Medical and Health Sciences, Sweden.
    Sjöström, Nils
    Sahlgrenska Academy, Gothenburg University, Institute of Health and Care Science, Sweden.
    Skärsäter, Ingela
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Effectiveness of web-based versus folder support interventions for young informal carers of persons with mental illness: a randomized controlled trial2014Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, nr 3, s. 362-371Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness. 

    Methods: This study was a randomized control trial, following the CONSORT statements, which compared the impact of two interventions. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N = 241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires, comparing the two interventions and also to detect changes. 

    Results: The stress levels were high in both groups at baseline, but decreased in the folder group. The folder group had improvement in their caring situation (also different from the web group), general self-efficacy, well-being, and quality of life. The web group showed increase in well-being. 

    Conclusion: Young informal carers who take on the responsibility for people close to them; suffer consequences on their own health. They live in a life-situation characterized by high stress and low wellbeing. This signals a need for support. 

    Practice implications: The non-significant differences show that each intervention can be effective, and that it depends upon the individual's preferences. This highlights the importance of adopting person-centered approach, in which young persons can themselves choose support strategy. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

  • 3.
    Bengtsson, Margareta
    et al.
    Hallands Sjukhus, Halmstad.
    Kvarnhäll, Jennie
    Hallands Sjukhus, Halmstad.
    Svedberg, Petra
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svenska sjuksköterskors upplevelse av handledningsprocessen vid sjuksköterskestudenters verksamhetsförlagda utbildning2011Inngår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 31, nr 4, s. 47-51Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A central part of the nursing profession is the supervision in clinical practice of nursing students and a consequence of this is that the nurse needs to be prepared and have sufficient knowledge to support student's learning process. The aim of this study was to gain a deeper understanding of nurses' experiences of the supervision of nursing students in clinical practice. Fifteen nurses with experience of being supervisor were interviewed and the data material was analyzed with a Grounded Theory approach. The results comprise a core category “supervision was perceived as developing and stimulation” and four categories; to have sufficient with time, to have a working co-operation, to have sufficient knowledge and to get confirmation. These categories formed a conceptual model explaining the nurse’s experiences of the process of supervision and their needs of time, co-operation, knowledge and confirmation if the supervision should be perceived as developing and stimulating. More research needs to be conducted to expand the perspective on how supervision education and opportunities for reflection during the clinical education contribute to the student's learning process.

  • 4.
    Bramsved, Rebecka
    et al.
    Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Mehlig, K.
    Section for Epidemiology and Social Medicine, Institute of Medicine, University of Gothenburg, Sweden.
    Novak, D.
    Department of Pediatrics, Shalgrenska Academy, University of Gotehburg, Sweden.
    Lissner, L.
    Section for Epidemiology and Social Medicine, Institute of Medicine, University of Gothenburg, Sweden.
    Mårild, S.
    Department of Pediatrics, Shalgrenska Academy, University of Gotehburg, Sweden.
    Parental education and income: independent and combined effects on children's growth and weight status2016Konferansepaper (Fagfellevurdert)
  • 5.
    Brobeck, Elisabeth
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd. Department of Research, Development and Education, Halmstad, Sweden & School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bergh, Håkan
    Department of Research Development and Education, Varberg, Sweden.
    Odencrants, Sigrid
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education?2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 1, s. 118-125Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change. © 2014 Nordic College of Caring Science.

  • 6.
    Brobeck, Elisabeth
    et al.
    Department of Research, Development and Education, Halmstad, Sweden & School of Health and Medical Sciences Örebro University, Örebro, Sweden.
    Odencrants, Sigrid
    School of Health and Medical Sciences Örebro University, Örebro, Sweden.
    Bergh, Håkan
    Department of Research, Development and Education, Varberg, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Patients' experiences of lifestyle discussions based on motivational interviewing: a qualitative study2014Inngår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, nr 1, artikkel-id 13Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: According to World Health Organization about 75% of cardiovascular diseases and type 2 diabetes and 40% of all cases of cancer could be prevented if the risk factors tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol could be eliminated. Patients often need help in monitoring themselves to make the proper lifestyle changes and it is important that adequate support is provided to enable the patients to take control over their health. Motivational interviewing is a framework that can help to facilitate this movement. The aim of this study was to describe how patients in primary health care settings experience lifestyle discussions based on motivational interviewing.

    Methods: This study has a descriptive design and qualitative content analysis was used as the method. Sixteen patients who had each visited a registered nurse for lifestyle discussions were interviewed.

    Results: The results show that the lifestyle discussions could enable self-determination in the process of lifestyle change but that certain conditions were required. Mutual interaction between the patient and the nurse that contributes to a sense of well-being in the patients was a necessary condition for the lifestyle discussion to be helpful. When the discussion resulted in a new way of thinking about lifestyle and when patient initiative was encouraged, the discussion could contribute to change. The patient’s free will to make a lifestyle change and the nurse’s sensitivity in the discussions created fertile soil for change.

    Conclusions: This study focuses on MI-based discussions, and the result shows that a subset of patients, who self-reported that they are motivated and aware of their role in making lifestyle changes, appreciate these strategies. However, it is not known whether discussions would be experienced in the same way if RNs used another method or if patients who were less motivated, engaged, or aware of their role in making lifestyle changes were interviewed. © 2014 Brobeck et al.; licensee BioMed Central Ltd.

  • 7.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Being in a safe and thus secure place, the core of the early labour: A secondary analysis in a Swedish context2016Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikkel-id 30230Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Early labour is the very first phase of the labour process and is considered to be a period of time when no professional attendance is needed. However there is a high frequency of women who seek care at the delivery wards during this phase. When a woman is admitted to the delivery ward, one role for midwives is to determine whether the woman is in established labour or not. If the woman is assessed as being in early labour she will probably then be advised to return home. This recommendation is made due to past research that found that the longer a woman is in hospital the higher the risk for complications for her and her child. Women have described how this situation leaves them in a vulnerable situation where their preferences are not always met and where they are not always included in the decision-making process.

    Aim: The aim of this study was to generate a theory based on where a woman chooses to be during the early labour process and to increase our understanding about how experiences can differ from place to place.

    Methods: The method was a secondary analysis with grounded theory. The data used in the analysis was from two qualitative interview studies and 37 transcripts.

    Conclusion: The findings revealed a substantive theory that women needed to be in a safe and thus secure place during early labour. This theory also describes the interplay between how women ascribed their meaning of childbirth as either a natural live event or a medical one, how this influenced where they wanted to be during early labour, and how that chosen place influenced their experiences of labour and birth.

  • 8.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Institutionen för Kvinnors och Barns Hälsa, Karolinska Institutet, Stockholm, Sverige.
    The movement towards birth: A study of women's childbirth self-efficacy and early labour2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Aim: The overall aim of this thesis was to increase the understanding of early labour, the latency phase of labour, based on women’s experiences and ability to handle the situation. Furthermore, the aim was to perform a psychometric testing of an instrument measuring childbirth self-efficacy and to explore the relationships to women´s well-being and number of obstetric interventions and birth outcomes.

    Methods: In study I, a grounded theory method was used to obtain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour. The same method, grounded theory was used in study II, but in this study, the aim was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset before admission to maternity ward. In both these studies (I & II) interviews were used to collect data. Study III and IV were cross sectional studies with a  consecutive data collection. In study III, a forward-backward translation was used to translate the childbirth self-efficacy inventory (CBSEI) into a Swedish version. An explorative factor analysis with principal component analysis was used to test the psychometric properties of the inventory and reliability tests with Cronbach's alpha and inter item total correlation was performed. In study IV, chi-2 test, Fisher's exact test and student's t-test for independent samples was performed between women´s estimated childbirth self-efficacy and demographics, obstetric interventions and birth outcomes. Correlations were also performed between different scales measuring well-being during pregnancy and childbirth self-efficacy. Finally a logistic regression analysis was performed to predict the probability for low or high childbirth self-efficacy.

    Findings: Being in a safe place is essential for the women in the early labour process. But a safe place has different meanings for different women, depending on how they assess their own ability to handle their impending labour. For some women, the hospital is a secure place, a place where somebody else can take over the responsibility for themselves, the labour process or their child’s well-being. Some women choose to remain in their homes, which they consider as a kind of base camp which they can leave and go back to whenever they please. There is also a difference in how women ascribe ability to their own bodies and women´s belief in their own ability to cope and deal with the impending birth, their self-efficacy. These differences together with the women´s choice of seeking care or not, during the early labour process, affect the women´s experience of the labour process. The women's experience during the early labour process varies from feeling powerful and strong, to perceiving themselves as victims and feeling totally powerless. Women with high self-efficacy as measured by CBSEI had less previous mental illness and had more often been told their sister´s birth story. During the labour process, women with a higher childbirth self-efficacy have a lower frequency of epidural analgesia than women with low childbirth self-efficacy.

    Conclusion: Women´s belief in their childbirth self-efficacy affects their choice of place to be, during the early labour process. The place in turn, affects the women´s experiences and the way they handle the early labour process. The early labour process is a sensitive period that requires attention and should not be neglected. Through increased knowledge and understanding of the problematic issues related to the early labour process, the birth preparation and antenatal obstetric care, as well as the care during labour can be improved.

  • 9.
    Carlsson, Ing-Marie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Hallberg, Lillemor R.-M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Odberg Pettersson, Karen
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Swedish women's experiences of seeking care and being admitted during the latent phase of labour: A grounded theory study2007Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, nr 2, s. 172-180Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: to gain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour.

    Design: a qualitative interview study using the grounded theory approach.

    Setting: the study was conducted at a hospital in the southwestern part of Sweden with a range of 1600-1700 deliveries per year. The interviews took place in the women's homes two to six weeks after birth.

    Participant: eighteen Swedish women, aged 22-36, who were admitted to the tabour ward while they were stilt in the latent phase of tabour.

    Findings: 'Handing over responsibility' to professional caregivers emerged as the core category or the central theme in the data. The core category and five additional categories formed a conceptual model explaining what it meant to women being admitted in the early stage of tabour and their experiences of the Latent phase of tabour. The categories, which all related to the core category, were labelled: (1) 'longing to complete the pregnancy,' (2) 'having difficulty managing the uncertainty,' (3) 'having difficulty enduring the stow progress,' (4) 'suffering from pain to no avail' and (5) 'oscillating between powerfulness and powerlessness.'

    Conclusions and implications for practice: findings indicate that women being admitted to the tabour ward in the latent phase of tabour experienced a need for handing over responsibility for the tabour, the welt-being of the unborn baby, and for themselves. Midwives have an important role in assisting women with coping during the latent phase of tabour, and in giving the women opportunity to hand over responsibility. This care should include validation of experienced pain and confirmation of the normality of the slow process, information and support. © 2007 Elsevier Ltd. All rights reserved.

  • 10.
    Carlsson, Ing-Marie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Department of Women's and Children's health, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. School of Social and Health Sciences, Örebro University, Örebro, Sweden.
    Nissen, Eva
    Department of Women's and Children's health, Karolinska Institutet, Stockholm, Sweden.
    Psychometric properties of the Swedish Child-Birth Self-efficacy Inventory (Swe-CBSEI)2014Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, nr 1, artikkel-id 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Previous research has reported that women who are admitted to delivery wards in early labour process before an active stage of labour has started run an increased risk of instrumental deliveries. Therefore, it is essential to focus on factors such as self-efficacy that can enhance a woman's own ability to cope with the first stage of labour. However, there was no Swedish instrument measuring childbirth self-efficacy available. Thus, the aim of the study was to translate the Childbirth Self-efficacy Inventory and to psychometrically test the Swedish version on first- time mothers within the Swedish culture.

    METHODS: The method included a forward-backward translation with face and content validity. The psychometric properties were evaluated using a Principal Component Analysis and by using Cronbach's alpha coefficient and inter-item correlations. Descriptive statistics and non-parametric tests were used to describe and compare the scales. All data were collected from January 2011 to June 2012, from 406 pregnant women during the gestational week 35-42.

    RESULTS: The Swedish version of the Childbirth Self-Efficacy Inventory indicated good reliability and the Principal Component Analysis showed a three-component structure. The Wilcoxon Signed-Ranks Test indicated that the women could differentiate between the concepts outcome expectancy and self-efficacy expectatancy and between the two labour stages, active stage and the second stage of labour.

    CONCLUSIONS: The Swedish version of Childbirth Self-efficacy Inventory is a reliable and valid instrument. The inventory can act as a tool to identify those women who need extra support and to evaluate the efforts of improving women's self-efficacy during pregnancy. © 2014 Carlsson et al.; licensee BioMed Central Ltd.

  • 11.
    Carlsson, Ing-Marie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Halland Hospital Halmstad, Halmstad, Sweden & Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Nissen, Eva
    Karolinska Institutet, Stockholm, Sweden.
    The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes2015Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, nr 10, s. 1000-1007Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors.

    DESIGN: a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records.

    SETTING: data were recruited from antenatal health-care clinics in Halland, Sweden.

    PARTICIPANTS: a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42.

    MEASUREMENTS: five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States.

    FINDINGS: results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy.

    KEY CONCLUSIONS: this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. © 2015 Elsevier Ltd.

  • 12.
    Carlsson, Ing-Marie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Sahlberg-Blom, Eva
    Hälsoakademin, Örebro University, Örebro, Sweden.
    Nissen, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Maintaining power: Women's experiences from labour onset before admittance to maternity ward2011Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, nr 1, s. 86-92Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: in Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward. Method: interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used. Findings: 'Maintaining power' was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: to share the experience with another', to listen to the rhythm of the body', to distract oneself and to be encased in a glass vessel', explained how the women coped and thereby maintained power. Conclusions: the first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process. © 2010 Elsevier Ltd.

  • 13.
    Dahlqvist Jönsson, Patrik
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd. Department of Research, Development and Education (FoUU), Region of Halland, Halmstad, Sweden.
    Nunstedt, Håkan
    Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Johansson Berglund, Inger
    Skaraborg Hospital, Skövde, Sweden.
    Hedman Ahlström, Britt
    Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Hedelin, Birgitta
    Department of Nursing, Gjøvik University College, Gjøvik, Norway.
    Skärsäter, Ingela
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Problematization of perspectives on health promotion and empowerment in mental health nursing – within the research network “MeHNuRse” and the Horatio conference, 20122014Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, nr 1, artikkel-id 22945Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Mental illness is increasing worldwide, while a trend towards an ever more specialized health care takes place. This development creates great demands on nurses to work from a holistic perspective of nursing. The health perspective emphasizes cooperation and communication with those who suffer from long-term mental illness, focusing on their independence and health. From a health perspective, every human being is an actor in his/her own life with an inherent ability to make their own choices. However, persons who suffer from long-term mental illness are at risk of losing power and control over areas of their lives and their health. Mental health nurses are in position to support these persons in promoting health and to regain control over their lives. The emphasis of this paper is thus to discuss mental health nurses responsibility to provide health promoting nursing care, through interpretation of the concepts of empowerment, emancipation, self-efficacy and self-management how can mental health nurses work from a health-promoting perspective in relation to these concepts. The focus of this paper is the challenge of real health promotion in mental health nursing discussed at a workshop at the European Horatio festival in Stockholm 2012 with over 600 participating mental health nurses and researchers from European countries. © 2014 P. D. Jönsson et al.

  • 14.
    Dahlqvist Jönsson, Patrik
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Research, Development and Education (FoUU), Region of Halland, Halmstad, Sweden.
    Schön, Ulla-Karin
    School of Health and Social Work, Dalarna University, Falun, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Sandlund, Mikael
    Umeå University, Umeå, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Service users’ experiences of participation in decision making in mental health services2015Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 22, nr 9, s. 688-697Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a ‘struggle to be perceived as a competent and equal person’ while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions. © 2015 John Wiley & Sons Ltd.

  • 15.
    Einberg, Eva-Lena
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    "Genom mina ögon": Barn med erfarenhet av cancer beskriver genom egna fotografier vad som främjar deras hälsa2014Inngår i: FoUU-dagen 2014: En upptäcktsfärd genom hallänningens liv, Halmstad: Region Halland , 2014, s. 29-29Konferansepaper (Fagfellevurdert)
  • 16.
    Einberg, Eva-Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Kadrija, Ibadete
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Brunt, David
    Institutionen för Hälsa och Vårdvetenskap, Linnéuniversitetet, Växjö, Sweden.
    Nygren, Jens M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Psychometric evaluation of a Swedish version of Minneapolis-Manchester quality of life-youth form and adolescent form2013Inngår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, artikkel-id 79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: It has become important to measure long-term effects and quality of life in survivors of childhood cancer. The Minneapolis- Manchester Quality of Life (MMQL) instrument has been proven to better capture the quality of life (QoL) perspective of health than other instruments. The instrument has age appropriate versions and is therefore favourable for longitudinal studies of QoL of children surviving from cancer. The aim of this study was to evaluate the psychometric properties of the Swedish version of MMQL-Youth Form and the Adolescent Form focusing on: 1) face and content validity 2) the internal consistency and 3) the test-retest reliability. Methods: The sample consisted of 950 pupils (11–16years old) from 7 schools in the western Sweden who completed the questionnaire. For the test-retest evaluation 230 respondents completed the questionnaire two weeks later. Results: Face and content validity was supported and internal consistency was found to be acceptable for the total scale for both the MMQL-Youth Form (8–12years of age) and the Adolescent Form (13–20years of age). Test-retest reliability for the MMQL-Youth Form was moderate for 50% of the items and good for the remaining. For the MMQL-Adolescent Form the test-retest showed moderate or good agreement for 80% of the items and fair for 20%. Conclusions: The result indicated that the Swedish version of the MMQLYouth Form and Adolescent Form was valid and reliable in a sample of healthy children in a Swedish context. It is recommended to test the instrument among diverse samples of children such as survivors of childhood cancer in order to validate its usefulness in research and clinical settings. © 2013 Einberg et al.; licensee BioMed Central Ltd.

  • 17.
    Einberg, Eva-Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Lidell, Evy
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Clausson, Eva K.
    Kristianstad University, Kristianstad, Sweden.
    Awareness of demands and unfairness and the importance of connectedness and security: Teenage girls’ lived experiences of their everyday lives2015Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, artikkel-id 27653Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In recent years, a number of studies have demonstrated that stress and mental health problems have increased among adolescents and especially among girls, although little is still known concerning what girls experience in their everyday lives. The aim of this study was to describe the phenomenon of teenage girls’ everyday lives, as experienced by the girls themselves. A phenomenological approach of reflective lifeworld research was used, and the findings are based on eight qualitative interviews with girls aged 13–16 years. The essence of teenage girls’ everyday lives as experienced by the girls themselves can be described as consciousness regarding demands and unfairness and regarding the importance of connectedness and security. The girls are aware of the demands of appearance and success, and they are conscious of the gender differences in school and in the media that affect them. The girls are also conscious about the meaning of connectedness with friends and family, as well as the importance of the security of their confidence in friends and feeling safe where they stay. If teenage girls feel connected and secure, protective factors in the form of manageability and meaningfulness can act as a counterweight to the demands and unfairness of everyday life. For professionals who work with teenage girls, the results from this study can be important in their work to support these girls.

  • 18.
    Einberg, Eva-Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Nygren, Jens M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Enskär, Karin
    Jönköping University, Jönköping, Sweden.
    'Through my eyes': children with experience of cancer describing through photography what promotes their health2014Inngår i: Health Promotion Research - An International Forum <<Next Health>>, August 25-27,  2014, Trondheim, Norway, Trondheim: Senter for helsefremmende forskning HiST/NTNU , 2014, s. 33-33Konferansepaper (Fagfellevurdert)
  • 19.
    Einberg, Eva-Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Enskär, Karin
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    ‘Through my eyes’: health-promoting factors described by photographs taken by children with experience of cancer treatment2016Inngår i: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 42, nr 1, s. 76-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Health promotion for children with cancer should be based on the children's own needs and desires. Because there is a lack of knowledge in this area, the aim of this study was to explore what promotes health from the perspective of children with experience of cancer treatment.

    Methods

    Fifteen children between 8 and 12 years of age participated in focus groups with three children in each group. The children were given a camera and instructions to photograph subjects that promote their health. Focus group discussions were based on the photographs and the children's own description of those photographs. The analysis of focus group discussions and photographs was conducted using inductive content analysis.

    Results

    According to the children, health-promoting factors are defined as meaningful relationships, recreational activities and a trustful environment. Meaningful relationships include togetherness within the family, affection for pets and friendship with peers. Recreational activities include engagement in play and leisure, withdrawal for relaxation and feeling enjoyment. Trustful environment includes confidence in significant others and feeling safe.

    Conclusions

    Knowledge from this study can contribute to health promotion interventions and quality improvements in the health care of children with experience of cancer treatment. Children's experiences with what promotes health in their everyday lives provide a better understanding of the type of support children prefer when promoting their own health. © 2015 John Wiley & Sons Ltd.

  • 20.
    Einberg, Eva-Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Enskär, Karin
    Hälsohögskolan i Jönköping, Jönköping, Sweden.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Friendship from the perspective of children with experience of cancer: A focus group study2013Inngår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, nr suppl. 3, s. 43-43Artikkel i tidsskrift (Fagfellevurdert)
  • 21.
    Einberg, Eva-Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Enskär, Karin
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nygren, Jens M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Friendship Relations From the Perspective of Children With Experience of Cancer Treatment: A Focus Group Study With a Salutogenic Approach2015Inngår i: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 32, nr 3, s. 153-164Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Friendships are significant to child development and health but diseases such as cancer can interrupt the contact with friends. The purpose of this study was to describe perceptions of friendship from the perspective of children undergoing cancer treatment, in order to build knowledge that can be used in a health promotion intervention for these children. Fifteen children between 8 and 12 years of age participated in focus groups, where a mixture of informative and creative techniques were used. The focus group discussions were analyzed using qualitative content analysis. The analysis resulted in three generic categories, “Common interests and experiences,” “Mutual empathic actions.” and “Mutual trust and understanding,” incorporating seven subcategories. Based on children’s descriptions from a salutogenic perspective, friendship emerged as An equal and mutual commitment that evolves over time and with interactions face-to-face and digitally, a child perspective on friendship should be central to the development of health promotion interventions designed to support friendship relations of children treated for cancer. © 2014 by Association of Pediatric Hematology/Oncology Nurses

  • 22.
    Elf, Mikael
    et al.
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Rystedt, Hans
    Department of Education, Communication and Learning, University of Gothenburg, Gothenburg, Sweden.
    Skärsäter, Ingela
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden.
    Krevers, Barbro
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    An Investigation of Intended and Real Use of a Research Web Health Portal and Its Implementation2014Inngår i: Electronic Journal of Health Informatics, ISSN 1446-4381, E-ISSN 1446-4381, Vol. 8, nr 1, artikkel-id e8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Participatory design (PD) projects involve prospective users as co-designers in a process where the design object emerges through several iterations. However, the result of such a process can only partly anticipate how the future real users will use the designed object. For this reason, its actual use needs to be investigated. The present study investigated the relationship between intended use and real use in two web-based health support systems in order to explore the conditions for redesign. The dependency between intended use and real use was found to be weak. Rather, the real use was dependent on 1) the context of use and 2) the needs or interest of the users. We conclude that redesign should be based on continuous use of web metrics collected in natural settings and by involving users on a recurring basis. While a web health portal must have an agenda it is important to adapt thing design to use design, why redesign in essence will become an adaptation to user needs. ©Copyright of articles originally published in www.eJHI.net under the Creative Commons Attribution 3.0 License is retained by the authors.

  • 23.
    Fluur, Christina
    et al.
    Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden.
    Bolse, Kärstin
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Strömberg, Anna
    Division of Nursing Sciences, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Thylen, Ingela
    Division of Nursing Sciences, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Spouses’ reflections on Implantable Cardioverter Defibrillator treatment with focus on the future and the end-of-life: a qualitative content analysis2014Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, nr 8, s. 1758-1769Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. To explore future reflections of spouses living with an implantable cardioverter defibrillator recipient with focus on the end-of-life phase in an anticipated palliative phase.

    Background. A history of or risk for life-threatening arrhythmias may require an implantable cardioverter defibrillator. Despite the life-saving capacity of the device, eventually life will come to an end. As discussion about preferences of shock therapy at end-of-life phase seldom takes place in advance, the implantable cardioverter defibrillator recipients may face defibrillating shocks in the final weeks of their lives, adding to stress and anxiety in patients and their families.

    Design. Qualitative study with in-depth interviews analysed with a content analysis.

    Methods. Interviews were performed with 18 spouses of medically stable implantable cardioverter defibrillator recipients during 2011–2012.

    Results. The spouses described how they dealt with changes in life and an uncertain future following the implantable cardioverter defibrillator implantation. Six subcategories conceptualized the spouses' concerns: Aspiring for involvement; Managing an altered relationship; Being attentive to warning signs; Worries for deterioration in the partner's health; Waiting for the defibrillating shock; and Death is veiled in silence.

    Conclusion. Despite the partner's serious state of health; terminal illness or death and the role of the device was seldom discussed with healthcare professionals or the implantable cardioverter defibrillator recipient. Open and honest communication was requested as important to support coping with an unpredictable life situation and to reduce worries and uncertainty about the future and end-of-life. © 2013 John Wiley & Sons Ltd.

  • 24.
    Forsberg, Elenita
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Fors, Uno
    Stockholm University, Stockholm, Sweden.
    Educational impacts of changed action of using VPs in postgraduate nurse education2015Konferansepaper (Fagfellevurdert)
    Abstract [en]

    A meta-analysis of a thesis project entitled Virtual Patients (VPs) for Assessment of Clinical Reasoning has been performed.  VPs are interactive computer simulations of real-life clinical scenarios for the purpose of healthcare education and assessment. To teach and learn clinical reasoning (CR) can be hard because its complexity and difficulty to make it visible for students. VPs have been found to improve learning and be superior to traditional teaching methods for training CR.  Most VP systems have the potential to track all interactions of the user and therefore recommended for assessment.

    The aim of the meta-analysis, which is based on the research project’s four studies, was to reach a deeper understanding of the educational impact of using VPs in postgraduate pediatric nurse education.  Data was collected during 2008-2013. The first study evaluated the applicability and students’ acceptance of VP-based exams. Through thinking aloud the second study identified how clinically experienced nurses solved complex VP cases which was a base for the third study; evaluating a new scoring model for VP-based exams. Finally the last study explored if formative VP-based assessments in connection with self-evaluations had an impact on student’s development of CR and if they could detect their progression.

    For the meta-analysis, concepts of challenge, skills, novice and expert have been applied. The findings shows that VP-based assessments have high educational impacts: for example even if the students were novices in the domain of Child health care, the early exposure for formative VP-based assessments gave them an insight about what is required to work at such a unit as well as a stimulation to develop CR in this field. They became aware of what to focus on in literature and clinical practice. The students reported a perceived progression of CR ability from uncertainty about the competence, to self-efficacy.

  • 25.
    Forsberg, Elenita
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Hult, Håkan
    Dept. of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Fors, Uno
    Dept. of Computer and Systems Sciences (DSV), Stockholm University, Kista, Sweden.
    Assessing progression of clinical reasoning through virtual patients: An exploratory study2016Inngår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 16, nr 1, s. 97-103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To avoid test-driven learning, there have been discussions regarding the use of more formative assessments in health care education to promote students' deep learning. Feedback is important in formative assessment, but many students ignore it; therefore, interventions should be introduced which stimulate them to reflect on the new knowledge.

    The aim for this study was to explore if Virtual Patient (VP)-based formative assessments, in connection with self-evaluations, had an impact on postgraduate pediatric nursing students' development of clinical reasoning abilities. Students' self-evaluations served as the basis for measuring progress. Data was analysed using deductive content analysis.

    The findings showed a clear progression of the clinical reasoning ability of the students. After the first assessment, the students described feelings of uncertainty and that their knowledge gaps were exposed. At the mid-course assessment the awareness of improved clinical reasoning was obvious and the students were more certain of knowing how to solve the VP cases. In the final assessment, self-efficacy was expressed.

    VP-based assessments, in connection with self-evaluations, early in the education resulted in a gain of students' own identification of the concept of clinical reasoning, awareness of what to focus on during clinical practice and visualised expected clinical competence. © 2015 Elsevier Ltd. All rights reserved.

  • 26.
    Garell, Cecilia
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Lagutrymmet för hälsofrämjande e-tjänster i förhållande till hälso- och sjukvården2014Rapport (Annet vitenskapelig)
  • 27.
    Gilljam, Britt-Mari
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Arvidsson, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Involving Children with Juvenile Idiopathic Arthritis in Health-Related Research – Why and How?2015Inngår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, nr Suppl. 2, s. 1312-1312Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Children with severe Juvenile idiopathic arthritis (JIA) are exposed to care situations and harsh treatments such as intra-articular corticosteroid injections (1). In order for these children to feel confidence, it is important they understand and feel they have control over the situation. To support the wellbeing of these children and their involvement in care, it is important to investigate their views of the care process and their everyday life (2).

    Objectives: The purpose of this study is to describe our experiences of using different activities and techniques during interviews with children with JIA.

    Methods: Children (n=23) from two rheumatic pediatric clinics in Sweden, age 8 - 17, diagnosed with JIA since at least two years were interviewed individually or in focus groups. All interviews focused on experiences and preferences of participating in care situations. Among the younger children, age 8 - 12, we used activities such as sentence completion, to express three wishes, draw and tell, and role-play with Barbie dolls. Among the older ones, age 13 – 17, we used sentence completion, to express three wishes and post-IT tabs for brainstorming and subsequent discussion. During all interviews we used open-ended questions.

    Results: Sentence completion and three wishes were two weak techniques for most of the children regardless of age. The younger children often responded to these techniques with silence or responses like “I don't know”. The older children responded with intense reflection and thinking, and predominately came up with one wish only. Techniques that were powerful in activating discussions were draw and tell and role-play with Barbie dolls for the younger children. Using Post-IT tabs and discussions was a good starter for discussions for the older children in focus groups.

    Conclusions: There is reason to reflect on what techniques researchers use when interviewing children, as the prospects of capturing children's perspectives in research is largely dependent on the researcher's ability to engage children in the interview situation. Different interview methods should be used depending on the age of the informants, the purpose of the investigation, and the capabilities, such as the health status, of the child. In this study, we experienced that the participants ability to express their experiences and preferences can be facilitated with practical techniques, like drawing and role-play with Barbie dolls for younger children and Post-IT tabs for children in older age groups.

    References:

    Bertilsson L. Andersson-Gäre B. Fasth A. Forsblad-d'Elia H. A 5-year prospective population-based study of juvenile chronic arthritis: onset, disease process, and outcome. Scandinavian journal of rheumatology 2012; 41(5): 379-382.

    Coyne I. Hayes E. Gallagher P. Regan G. Giving children a voice: investigation of children's experiences of participation in consultation and decision-making in Irish hospitals. Office of the Minister for Children 2006; 3576.

    Acknowledgements: Thanks to: The Swedish Rheumatic Foundation, Stig Thunes Foundation and Norrbacka Eugenia Foundation.

    Disclosure of Interest: None declared

  • 28.
    Gilljam, Britt-Mari
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Arvidsson, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Promoting participation in healthcare situations for children with JIA: a grounded theory study2016Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikkel-id 30518Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Children’s right to participate in their own healthcare has increasingly become highlighted in national and international research as well as in government regulations. Nevertheless, children’s participation in healthcare is unsatisfactorily applied in praxis. There is a growing body of research regarding children’s participation, but research from the children’s own perspective is scarce. The aim of this study was thus to explore the experiences and preferences for participation in healthcare situations among children with juvenile idiopathic arthritis (JIA) as a foundation for creating strategies to promote their participation in pediatric healthcare. Twenty children, aged 8 to 17 years, with JIA were interviewed individually and in focus groups. In order to increase the children’s opportunities to express their own experiences, different interview techniques were used, such as draw-and-tell and role play with dolls. The analysis was conducted with a constructivist grounded theory. The result explores children’s perspective of influencing processes promoting their participation in healthcare situations. The core category that emerged was, “Releasing fear and uncertainty opens up for confidence and participation,” and the categories related to the core category are, “surrounded by a sense of security and comfort,” and “strengthened and supported to become involved.” In conclusion, the knowledge gained in this study offers new insights from the perspective of children themselves, and can constitute a valuable contribution to the understanding of necessary conditions for the development of specific interventions that promote participation among children in healthcare situations.

  • 29.
    Grim, Katarina
    et al.
    Dalarna University, Falun, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Shared decision-making in mental health care – A user perspective on decisional needs in community-based services2016Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikkel-id 30563Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

    Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

    Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.

    Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

    Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

  • 30.
    Göransson, Carina
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Örebro University, Örebro, Sweden.
    The elderly persons´ experiences of reporting health status in an ICT-platform2015Inngår i: Abstracts: 19th International Philosophy of Nursing Society (IPONS) conference: August 24-26, 2015 Karolinska Institutet, Stockholm, Sweden: Technology, Health Care and Person-centeredness: Beyond Utopia and Dystopia. Thinking the Future, Stockholm: Karolinska Institutet , 2015, s. 19-20Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background

    More and more elderly persons are living in their own home and with support from home care due to health deterioration. This puts demands on society and especially health care to support health and self-care for the elderly persons. Therefore its essential to develop new innovative solutions which both enhance communication between the elderly person and the nurse and also increase the elderly persons´ involvement in their everyday care. An information- and communication technology (ICT)-platform was developed with content from the perspective from elderly persons, health care professionals and the literature. The platform is developed in collaboration with a Swedish company specialized in health care management consulting and new innovative care (Health Navigator). The aim with the project is to describe experiences an ICT-platform with focus on user friendly and acceptability by elderly persons living in own homes with assistance of home care nurses.

    Method

    The study has a mixed methods approach advocated for the evaluation of new technologies within health care. The design is underpinned by the Medical Research Council´s complex intervention framework.

    Elderly persons > 65 years, living in own homes, with assistance from home care nurses have regularly reported health status for three months. They have also access to evidence-based self-care advice with links to web-based pages and graph on reported health status. The home care nurse receive an alarm according to a risk assessment model and can instant  contact the elderly persons for discussion the health concerns.

    Individual interviews with the elderly persons are conducted after the intervention on the experience of using the ICT-platform, with focus on user friendly and acceptability .

    Results

    Preliminary results will be presented of the elderly persons experiences with focus on user friendly and acceptability of using an ICT-platform from reporting health status, using self-care advice and graph of reported health status.

  • 31.
    Göransson, Carina
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden & Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Blomberg, Karin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Increased well-being and participatory care for older adults with support of an interactive web-based platform2014Inngår i: Book of Abstracts: Nobel Day Festivities 10th of December 2014, 2014, s. 12-12Konferansepaper (Fagfellevurdert)
  • 32.
    Göransson, Carina
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Wengström, Yvonne
    Karolinska institutet, Huddinge, Sweden.
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Örebro University, Örebro, Sweden.
    Feasibility and acceptability of an interactive ICT-platform in older adults for participatory care2015Inngår i: ACENDIO 2015: eHealth and Nursing: Knowledge for Patient Care / [ed] Fintan Sheerin, Walter Sermeus & Anna Ehrenberg, Dublin: Association for Common European Nursing Diagnoses, Interventions and Outcomes , 2015, s. 328-330Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background

    The increasing ageing population puts demands on society and particularly on health care system to promote a health related qualityof life. Thus, it is necessary to develop strategies that promote self-care among older adults that enable them to live in their own homes as long as possible and to make them feel safe and involved in their care. In order to encourage their participationin their care, new innovative solutions are needed. The market of information-and communication technology (ICT)-based platforms directed to the health care arena has exploded during recent years. Despite the large range of products few are developed withinteractive components. In collaboration within a multicenter research group and a Swedish health care company (Health Navigator) an ICT-platform is developed for use in a mobile phone or tablet that includes an interactive mobile application for reporting problems and concerns. This platform is unique through the real-time communication enabling rapid management of early-detected problems.

    Aim

    The aim with the project is to evaluate an ICT-platform by older adults living in own homes with assistance from home care nurses in a community in Sweden.

    Method

    The study is prospective and has a mixed methods approach advocated for the evaluation of new technologies within healthcare. This includes a quantitative approach to evaluate effects, qualitative methods such as interviews and focus group discussions to evaluate how patients and health care professionals perceive the intervention. The design is underpinned by the Medical Research Council’s complex intervention evaluation framework. Thirty older adults >65 years or above, living in their own homes, with assistance from home care nurses have through an application in a tablet reported health status twice a week and when needed during three months. They have continuous access to evidence based self-care advice directly related to their reported problems and concerns. The risk assessment model sends alarms to involved nurses via text messaging (SMS). This initiates an interaction between the nurse and the older adult who is contacted by telephone to discuss the reported problems. Furthermore, the nurses in charge can also log into a web-interface and view the reports of the participants. Individually interviews with the older adults and focus groups interviews with nurses are conducted after the study period. Questionnaires are given to the older adults before intervention, after the study ́s completed and after six months with primarily main outcomes as self-care, health literacy and well-being. A control group with older adults 65 years and above is used as a comparison.

    Results

    Preliminary results will be presented with focus on feasibility, acceptability and benefit of the ICT-platform from the perspective of older adults and home care nurses. Additional logged data on the frequency of symptom reports, alerts, and page views will also be presented.

    Summary

    An interactive ICT-platform is developed and used by older adults to report problems and concerns which enabling rapid management of early-detected problems. This study aims to evaluate the ICT-platform by thirty older adults living in own home with assistance from home care nurses.

  • 33.
    Göransson, Carina
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Wengström, Yvonne
    Sektionen för omvårdnad, Institutionen för neurobiologi, vårdvetenskap och samhälle, Karolinska Institutet, Stockholm, Sverige & Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Kihlgren, Annica
    Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Blomberg, Karin
    Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Ökat välbefinnande och delaktighet hos äldre personer via en interaktiv webbaserad plattform2014Inngår i: De ska va gôtt å leva: Vårdforskningens dag: 16 oktober 2014, 2014, s. 18-18Konferansepaper (Fagfellevurdert)
  • 34.
    Göransson, Carina
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Wengström, Yvonne
    Örebro universitet, Örebro, Sverige & Karolinska Institutet, Stockholm, Sverige.
    Kihlgren, Annica
    Örebro universitet, Örebro, Sverige.
    Blomberg, Karin
    Örebro universitet, Örebro, Sverige.
    Ökat välbefinnande och delaktighet hos äldre personer via interaktiv webbaserad plattform2014Inngår i: FoUU-dagen 2014: En upptäcktsfärd genom hallänningens liv, 2014, s. 21-21Konferansepaper (Fagfellevurdert)
  • 35.
    Haglund, Emma
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS). Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden.
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin. Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden.
    Bergman, Stefan
    Lund University, Lund, Sweden; Spenshult Research and Development Center, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Larsson, Ingrid
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Spenshult Research and Development Center, Halmstad, Sweden.
    Patient Education in Spondyloarthritis Should be Guiding, Reliable and Available and Presented in Varied Formats2015Inngår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 67, nr Suppl. S10, artikkel-id 1196Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background/Purpose:

    The treatment target for axial spondyloarthritis (SpA) is to maximize health-related quality of life (HRQoL) by controlling disease activity and improving functioning. The treatment cornerstones are a combination of patient education, pharmacological and non-pharmacological treatment. Health professionals are familiar with providing patient education but the knowledge is scarce concerning how this education is experienced by the patients.

    The aim was to describe patients’ experiences of education in SpA management.

    Methods:

    The study had a descriptive design with a qualitative conventional content analysis approach performed in seven steps in accordance with Graneheim & Lundman (1). The analysis aimed to describe and preserve contextual meanings. After coding and subgrouping meaningful parts of the text were merged into categories. Eleven interviews were conducted between 2014-2015 in patients with SpA based on a strategic sampling in order to achieve variation with regard to sex (7 men, 4 women), age (38-66 years), subdiagnoses (5 patients with AS, 6 with USpA), quality of life (EQ5D 0.29-1.0), disease activity (BASDAI 1-6), physical function (BASFI 0-5), and global health (BASG 0-7) .

    Results:

    Three categories representing patients’ experiences of patient education in disease management emerged; guiding education, reliable education and available education. Guiding education comprised SpA management including disease knowledge such as symptoms, prognosis, treatment, self-management, climate impact, heredity, and assisting devices. Reliable education meant how and by whom the education was communicated and was considered reliable if it was based on science and communicated by specialists, for example by physician, nurse, PT, dietician and senior patients with experience of rheumatic diseases. The patients experienced difficulties in assessing the large flow of education coming from various sources. Individualized education also increased the reliability. Available education meant that the education can and should be presented in varied formats, and that the amount of information could be chosen. The education could be given orally (through meetings, videos, lectures), in writing (by pamphlets, e-mails, journals, webpages) or obtained through own personal experiences. There were requests to utilize newer media like skype, video and chat forums. Furthermore, individual contacts with healthcare professionals when needed were of importance.

    Conclusion:

    This study highlights the importance of obtaining a guiding, reliable and available patient education for management of SpA. Health care professionals need to consider the importance of presenting varied formats of education based on patients’ experiences and expectations.

    References:

    1.Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today 2004;24(2):105-12.

  • 36.
    Hansson, Lars
    et al.
    Lunds Universitet.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svensson, Bengt
    Lunds Universitet.
    Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness?2011Inngår i: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: Studies investigating mental health professionals' attitudes towards people with mental illness are scarce and there is a lack of comparative studies including both patients' and mental health professionals' attitudes. The aim of the present study was to investigate mental health staff's attitudes towards people with mental illness and compare these with the attitudes of patients in contact with mental health services. A further aim was to relate staff attitudes to demographic and work characteristics.

    METHODS: A cross-sectional study was performed including 140 staff and 141 patients. The study included a random sample of outpatients in contact with mental health services in the southern part of Sweden and staff working in these services. Attitudes were investigated using a questionnaire covering beliefs of devaluation and discrimination of people with a mental illness.

    RESULTS: Negative attitudes were prevalent among staff. Most negative attitudes concerned whether an employer would accept an application for work, willingness to date a person who had been hospitalized, and hiring a patient to take care of children. Staff treating patients with a psychosis or working in inpatient settings had the most negative attitudes. Patient attitudes were overall similar to staff attitudes and there were significant differences in only three out of 12 dimensions. Patients' most negative attitudes were in the same area as the staff's.

    CONCLUSIONS: This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff-patient relationship.

  • 37.
    Hutton, Katrin
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Affecta Psychiatric clinic, Halmstad, Sweden.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Nyholm, Maria
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Idrott, hälsa och fysisk aktivitet.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Low self-rated mental health among Swedish adolescent boys and its relationship to socioeconomic factors2013Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background

    Adolescents mental health is a major public health concern and studies have shown that socioeconomic factors contribute to the experienced health of adolescents. Girls’ mental health, more than boys’ mental health, is often discussed. Therefore, the aim of this study was to investigate the association between self-rated mental health and socioeconomic factors among boys and we hypothesized that household wealth influences the association.

    Methods

    In 2011, a cross-sectional study was conducted at seven junior high schools in a medium sized town in south western Sweden. The data collected was based on a self-administrated questionnaire regarding socioeconomic factors, household wealth and health related quality of life (Minnesota Minneapolis Quality of Life Instrument (MMQL). In all, 235 boys between 11-13 years old and 254 boys between 14-16 years participated. The items from MMQL were summarized into a total score and dichotomized by the median and low self-rated mental health was defined as below median. Logistic regression analysis was used.

    Results

    Among younger boys no association between low self-rated mental health and socioeconomic factors were seen. Among older boys with divorced parents, an increased risk of low mental health rating was seen OR: 1.83 (95%CI, 1.04;3.23), however when adjusting for household wealth the association disappeared (OR;1.76, CI 0.98;3.15). Also, having one or two parents born outside Sweden implied increased risk of a low self-rated mental health OR: 2.0 (CI; 1.15;3.47), which remained when adjusting for household wealth variables (OR; 2.16 CI; 1.17;3.99). Furthermore, having two or more negative socioeconomic variables increased the risk of low rated mental health (OR;2.60, CI 1.15;5.90) the association remained after adjusting for household wealth (OR;2.38, CI 1.03;5.33).

    Conclusions

    Boys with divorced parents, boys from migrant backgrounds and boys with several negative socioeconomic factors constituted the identified subgroups at risk. More research in public health is essential to meet the special needs of different age groups and backgrounds among adolescent boys.

    Key messages

    • Among older boys (14-16 years old) with divorced parents, an increased risk of low mental health rating was seen, however when adjusting for household wealth the association disappeared.
    • Among older boys (14-16 years old) having two or more negative socioeconomic variables increased the risk of low rated mental health, the association remained after adjusting for household wealth.

    © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  • 38.
    Hutton, Katrin
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Affecta psychiatric out-patients clinic, Halmstad, Sweden.
    Nyholm, Maria
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Idrott, hälsa och fysisk aktivitet.
    Nygren, Jens
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Kadrija, Ibadete ()
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Self-rated mental health and socio-economic background: a study of adolescents in Sweden2014Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, nr 1, artikkel-id 394Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Adolescents' mental health is a major public health issue. Previous research has shown that socio-economic factors contribute to the health status of adolescents. The present study explores the association between socio-economic status and self-rated mental health among adolescents.

    Methods: Cross sectional data from the Halmstad Youth Quality of Life cohort was collected in a town in Sweden. In all, 948 adolescents (11-13 younger age group and 14-16 older age group) participated. Information on self-rated mental health was collected from the subscale Psychological functioning in the Minneapolis Manchester Quality of Life instrument. The items were summarized into a total score and dichotomized by the mean. Indicators measuring socio-economic status (SES) were collected in a questionnaire using the Family Affluence Scale (FAS) and additional factors regarding parents' marital status and migration were added. Logistic models were used to analyze the data.

    Results: Girls were more likely to rate their mental health below the mean compared to boys. With regard to FAS (high, medium, low), there was a significantly increased risk of self-rated mental health below the mean among younger boys in the medium FAS score OR; 2.68 (95% CI 1.35;5.33) and among older boys in the low FAS score OR; 2.37 (1.02;5.52) compared to boys in the high FAS score. No such trend was seen among girls. For younger girls there was a significant protective association between having parents born abroad and self-rated mental health below mean OR: 0.47 (0.24;0.91).

    Conclusions: A complex pattern of associations between SES and self-rated mental health, divergent between age and gender groups, was shown. The total FAS score was only associated with boys' self-rated mental health in both age groups, whereas parents' migratory status influenced only the girls' self-rated mental health. Because of the different association for girls' and boys' self-rated mental health and SES, other factors than SES should also be considered when investigating and exploring the mental health of adolescents in affluent communities. © 2014 Hutton et al.; licensee BioMed Central Ltd.

  • 39.
    Jenholt Nolbris, Margaretha
    et al.
    Centrum for Children's Right, Queen Silvia's Children's Hospital Sahlgrenska University, Gothenburg, Sweden.
    Wee Sævig, B. I.
    The Norwegian Cancer Society, Bergen, Norway.
    Challinor, J.
    Department of Physiological Nursing, University of California, San Francisco, USA.
    Skärsäter, Ingela
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    Abramovitz, L. Z.
    UCSF Medical Center, University of California, San Francisco, USA.
    A Global Web-based Programme about Cancer in Language Specific for Staff, a Sick Child and Their Family2013Inngår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, nr Suppl. 3, s. 185-185, artikkel-id P-0565Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose/Objective: To have expert paediatric oncology nurses to inform and explain childhood cancer diagnoses, treatments, side effects, situations and feelings, by developing a web-based programme.

    Materials and Methods: The programme will be developed and tested in three steps. Step 1 is to develop a web portal with animated pictures of cancer themes based on the ’See Hear Do’ programme in Sweden and Norway. Step 2 is to add text and audio in several languages for each theme (such as Arabic, English, Spanish). Step 3 is to develop two informational sections on the web portal: one section for staff and for the patient and family. The staff, children and families will evaluate each section as appropriate before the programme is published on the web portal. A participatory design method is going to be used. The programme will also be offered to nurses in the International Society of Paediatric Oncology and nursing working group of the Pediatric Oncology in Developing Countries committee for translation into their native languages.

    Results: Expected result is that the web portal can easily be downloaded via computer, iPad or mobile and can be used twofold. Staff can use this programme for self-education and for working with the child and family. The child and family can use the web programme in various situations during the child’s cancer treatment, e.g., explaining the diagnosis to family members, schoolmates, families’ networks, during phone calls using an interpreter or for persons with a visual or auditory disability.

    Conclusions: Goal of the project is to globalize childhood cancer education and information with a web-based programme including pictures, text and audio in various languages. The programme is designed to consider the professional’s information and the child and family’s needs and participation. The active role of all stakeholders to ensure cultural relevance is key to this project.

  • 40.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University, Stockholm, Sweden & Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Lilja Andersson, Petra
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Larsson, Maria
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Ahlner-Elmqvist, Marianne
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Use of a National Clinical Final Examination in a Bachelor´s Programme in Nursing to Assess Clinical Competence-Students´, Lecturers´and Nurses´Perceptions2014Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 7, s. 501-511Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The objective of this study was to evaluate the perceptions of students, lecturers, nurses and clinical lecturers regarding the ability of the National Clinical Final Examination (NCFE) to assess clinical competence, and whether the assessment was consistent with the qualifications for a Bachelor of Science in Nursing as outlined by the Swedish Higher Education Authority. The NCFE is divided into two parts (written and bedside) and aims to evaluate third-year nursing students’ clinical competence. Methods: Data were collected at 10 universities using study-specific questionnaires. The total response rate was 84% (n = 1652). Results: The clinical lecturers indicated that there was a need for improvement in the written part of the examination in order to adequately assess clinical competence. Regarding the bedside part the clinical lecturers, nurses and students perceived that the bedside part of the examination assessed whether the student had the clinical competence required by a newly registered nurse. Conclusion: The two-part examination described in this study was perceived as useful for assessing clinical competence and for the qualification requirements for a Bachelor of Science in Nursing as outlined by the Swedish Higher Education Authority. However, especially the written part requires further development. The model and form of assessment ought to be applicable to graduate nursing programme internationally.

  • 41.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Perspectives on health and well-being in human vulnerability2016Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikkel-id 31477Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    As a guest editor of the special edition of the International Journal of Qualitative Studies on Health and Well-being I would like to present seven designated articles. The current thematic cluster represents qualitative research illustrating the challenges in supporting the central aspects of health and wellbeing for individuals in various situations linked to human vulnerability. This theme cluster will provide the reader with a new and greater understanding of the inner meaning of vulnerability and greater insights into how health and well-being, achieved through different forms of support and care, can enhance empowerment in spite of obstacles such as illness, disease, impairment, old or young age, or gender. Different kinds of qualitative methodologies have been used to elucidate the phenomenon of vulnerability. Data collection procedures vary from qualitative interviews and diaries to focus group interviews. Qualitative content analysis, phenomenographical approach, and grounded theory are used to analyse the data in the different studies. The common denominator for the included articles is the commitment of the authors to impart knowledge in terms of greater understanding of the core aspects of health and well-being among humans in different vulnerable situations. © 2016 H. Jormfeldt.

  • 42.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Perspectives on health and well-being in nursing2014Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, nr 1, artikkel-id 23026Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    As a Guest Editor of the International Journal of Qualitative Studies on Health and Well-being’s special edition on perspectives on health and well-being in nursing, it is my wish to present four original articles embracing some essential core aspects of nursing science irrespective of their specialization. They represent different aspects of qualitative research that focus on; the challenge of integrating core concepts of health into mental health nursing praxis, the experiences in psychiatric rehabilitation from the perspective of both patients and their relatives, and the nurses’ experiences of giving support to patients during the transition to hospital-bound hemodialysis. The common basis for the articles is the authors’ ambition to generate nursing knowledge in terms of core elements for the provision of health and well-being among individuals with a need for nursing care.

  • 43.
    Jormfeldt, Henrika
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Hallén, Malin
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Wigforss-gruppen.
    Experiences of housing support in everyday life for persons with schizophrenia and the role of the media from a societal perspective2016Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikkel-id 30571Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The mental health-care system in Sweden, as in many other counties, has its main focus on the reduction of psychiatric symptoms and the prevention of relapses. People diagnosed with schizophrenia often have significant health issues and experience reduced well-being in everyday life. The social imaginary of mental illness as an imbalance of the brain has implications concerning general attitudes in society. The news media are an important source of information on psychiatric disorders and have an important role in cultivating public perceptions and stigma. News media can contribute to the mental illness stigma and place individuals with mental illnesses at risk of not receiving adequate care and support.

    The aim of this preliminary study was to describe users’ experiences of housing support in everyday life.

    Results: The results revealed three themes of housing support, which were needed, but frequently insufficiently fulfilled in the municipality. The three themes were: ‘‘Support to Practice Healthy Routines in Daily Life,’’ ‘‘Support to Shape Meaningful Contents in Everyday Life,’’ and ‘‘Support to Meet Needs of Integrity and Respect.’’

    Conclusions: The findings support previous studies arguing that current health care and housing support fails to meet basic needs and may lead to significant and unnecessary health risks. Further investigation is needed regarding the links between attitudes to mental illness in society and political and financial principles for health care and housing support for persons with schizophrenia. Further research is needed regarding the role of the media in policymaking concerning health promotion interventions for people diagnosed with schizophrenia. © 2016 H. Jormfeldt & M. Hallén.

  • 44.
    Jormfeldt, Henrika
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Svensson, Bengt
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hansson, Lars
    Department of Health Sciences, Lund University, Lund, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Clients’ experiences of the Boston Psychiatric Rehabilitation Approach: A qualitative study2014Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, nr 1, artikkel-id 22916Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Boston Psychiatric Rehabilitation Approach (PR) has been described as neither being a particular technique nor a single intervention but a service model within the mental health system aiming to promote recovery and the achievement of a meaningful life, rather than simply supporting adaptation or survival in the community. A qualitative approach was used to describe clients’ experiences of a BR implementation project in a county in Sweden. The findings from the interviews could be summarized in the theme “The process of rehabilitation” consisting of three categories: Structure, Participation and Relationship. The results suggest that clients do not often realize nor are able to verbalize their goals before they have been given the possibility to reflect their thoughts in collaboration with a trusted person. It is thus important that PR schedules its special structure to secure client participation by giving the clients opportunity to get their thoughts reflected to be able to participate in decision making regarding their own care. © 2014 H. Jormfeldt et al.

  • 45.
    Jormfeldt, Henrika
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Wigforss-gruppen.
    Svensson, Bengt
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hansson, Lars
    Department of Health Sciences, Lund University, Lund, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Relatives’ experiences of the Boston Psychiatric Rehabilitation Approach: A qualitative study2014Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, nr 1, artikkel-id 22918Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Boston Psychiatric Rehabilitation approach (BPR) is individualized and characterized by being based entirely on the individual´s unique needs and preferences in the areas of working, learning, social contacts, and living environment. Relatives of clients in mental health services influence the client’s possibilities to recovery by their everyday relationship. Nonetheless traditionally relatives have had a subordinated role in the care of their mentally ill family member. The perspective of relatives is an importance aspect in the development of new approaches to psychiatric rehabilitation. Thus the purpose of the present study was to describe and explore relatives’ experiences of the Boston Psychiatric Rehabilitation Approach. Ten relatives to clients in mental health services approached with the BPR were interviewed. The interviews were transcribed and analyzed with a qualitative content analysis method to explore relatives’ experiences of the BPR intervention in a county of Sweden. The findings from the interviews could be summarized in the theme “To meet the clients’ needs” consisting of three categories: “Dependence in staffs’ competence”, “Responsibility of participation and self-determination” and “The necessity of coordination between authorities and care-givers”.  The findings suggest that relatives may contribute with important information about clients’ needs related to outcome of care. Relatives’ perspectives may be of importance in further development of BPR. Further research about relatives’ role in psychiatric rehabilitation is needed as well as studies comparing different kinds of psychiatric rehabilitation from the perspective of relatives.

  • 46.
    Kihlgren, Annica
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Sunvisson, Helena
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Mamhidir, Anna-Greta
    Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden & Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Referrals to Emergency Departments: The Process and Factors That Influence Decision-Making among Community Nurses2014Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 5, s. 366-374Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNs in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme “Shared responsibilities in the best interests of the older person reduce feelings of insufficiency”. The content was formulated, which revealed the RNs’ feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person’s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the “inner circle” were crucial for the nurses’ confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the “outer circle”, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs’ and staff members’ competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons’ health.

  • 47.
    Kristén, Lars
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Idrott, hälsa och fysisk aktivitet.
    Ivarsson, Andreas
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Idrott, hälsa och fysisk aktivitet.
    Parker, James
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Idrott, hälsa och fysisk aktivitet.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Future challenges for intervention research in health and lifestyle research: A systematic meta-literature review2015Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, artikkel-id 27326Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The overall aim of this systematic meta-literature review was to (1) summarize the findings of review studies focusing on health determinants, (2) give an overview of intervention studies that have been used to facilitate health and lifestyle, and (3) provide recommendations for future studies in health promotion. A literature review, using a meta-method, was conducted to identify health and lifestyle research based on research articles related to health changes. The search yielded a total of 561 unique citations and finally 24 citations remained. Of those, 11 studies focused on health determinants, whereas 13 focused on interventions for health promotion. Results from this meta-synthesis led to four recommendations for the design of future intervention studies. (1) To increase the likelihood of capturing different biopsychosocial aspects of health, researchers from different scientific disciplines should collaborate in the design, implementation, and evaluation of the study. (2) It is recommended to use theoretical frameworks that focus on health determinants in longitudinal studies with a repeated measures design. (3) Studies should involve behavioral interventions. (4) Design face-to-face intervention studies where the participant can interact with other persons.

  • 48.
    Källstrand-Ericson, Jeanette
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Baigi, amir
    Region Halland, Halmstad, Sweden.
    Buer, Nina
    Örebro universitet, Örebro, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Perceived functional  visual impairment and risk of falling in a non-institutional elderly population in Sweden2012Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, nr Suppl. 2, s. 106-106Artikkel i tidsskrift (Fagfellevurdert)
  • 49.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. FoU Spenshult, Halmstad, Sweden.
    Bergman, Stefan
    FoU Spenshult, Halmstad, Sweden; Lund University, Lund, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin. FoU Spenshult, Halmstad, Sweden & Lund University, Lund, Sweden.
    Person-Centred Care Can Help Patients to Become More Effective Consumers in the Use of Health Information than Regular Care – an RCT in Patients with Arthritis Undergoing Biological Therapy2015Inngår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 67, nr Suppl. S10, artikkel-id 1495Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background/Purpose:

    Person-centred care (PCC) is a holistic approach with respectful and individualized care allowing negotiation of care where persons with health problems are empowered to be involved in health decisions. Patients’ illness narratives constitute a starting point for building a collaboration with health care professionals and to empower them to play an active role in their health care. Little is known of the impact of PCC vs. regular care on patients’ skills as health care consumers. The aim was to study the impact on effective consumers’ skills over 6 and 12 months as measured by the Effective Consumer Scale (EC17) in patients undergoing biological therapy and randomly assigned to either a nurse-led rheumatology clinic (NLC) based on PCC or to a rheumatologist-led clinic (RLC) based on regular care.

    Methods:

    A 12 month RCT in 107 patients with chronic inflammatory arthritis1. Inclusion criteria were ongoing biological therapy and a DAS28 ≤3.2. All patients met a rheumatologist at inclusion and after 12 months, while the 6 month follow-up was randomized to either at an NLC (PCC) or at an RLC (regular care). Outcome measure was the EC17, developed and endorsed by the OMERACT, including five subscales; 1. Use of health information, 2. Clarifying personal priorities, 3. Communicating with others, 4. Negotiating roles and 5. Deciding and taking action. EC17 total score ranges from 0-100, worse to best. Differences between and within NLC and RLC were analyzed with Friedmans’ test or Mann Whitney U-test.

    Results:

    After 12 months 97 patients completed the RCT (NLC n=47, RLC n=50), mean (SD) age 55.4 (12.7) years, disease duration 16.7 (11.5) years, DAS28 2.1 (0.7), HAQ 0.54 (0.38), global health 20.4 (17.1), pain 21.1 (18.0) and 56% were women. There were no statistically significant differences within or between the two intervention groups at baseline nor in EC17 total score mean (SD) at baseline (NLC 83.5 (9.4) vs. RLC 83.2 (10.8), 6 months (NLC 85.4 (10.4) vs. RLC 82.9 (10.9) and 12 months (NLC 85.3 (11.1) vs. RLC 82.3 (10.9)). However, in NLC there was a statistically significant improvement in EC17 subscale “1. Use of health information” at both 6 and 12 months (p=0.041 and p=0.004 respectively).

    Conclusion:

    Replacing just one of three visits over 12 months to an NLC based on PCC instead of an RLC based on regular care resulted in more effective consumers concerning the use of health information. Larger studies over longer time frames focusing on PCC are needed to better understand its full impact on effective consumer skills measured by EC17.

    References:

    1. Larsson I, et al. Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs 2014;70:164-75.

  • 50.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Teleman, Annika
    R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Bergman, Stefan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic2014Inngår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, Suppl. 3, s. 139-140Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patients with chronic inflammatory arthritis (CIA) treated with biological therapy are usually monitored by rheumatologists. Research shows that a nurse-led rheumatology clinic is safe and effective in monitoring biological therapy (1) and contributed added value in patients within rheumatology care, because the encounter with the nurse led to a sense of security, familiarity and participation (2).

    Objectives: To compare the cost of monitoring biological therapy in a nurse-led rheumatology clinic with those of a rheumatologist-led clinic in patients with low disease activity or in remission.

    Methods: Cost comparison was based on data from a 12 month randomised controlled trial (1). A total of 107 patients were randomly assigned to either a rheumatologist-led clinic or to a nurse-led rheumatology clinic. The purpose of the intervention was to replace one of two annual monitoring visits at the rheumatologist-led clinic (control group; n=54) by a visit to a nurse-led rheumatology clinic (intervention group; n=53), based on person-centred care. Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. All outpatient visits, team rehabilitation and all the telephone advice at the Rheumatology Clinic were registered for the patients who participated in the trial. Main outcome measures were direct costs related to rheumatology care during the 12 month follow-up period.

    Results: After 12 months 97 patients completed the study. At the inclusion the patients had mean age of 55.4 years, disease duration of 16.7 years, and DAS28 was 2.1, with no significant differences between the two groups. There was no mean difference in changes in clinical outcome between the two groups (DAS28 -0.06; p=0.66). The total annual cost of team rehabilitation in rheumatology care, per patient monitored by the nurse-led rheumatology clinic was €580 compared with €1278 for monitoring by a rheumatologist-led clinic, translating in a €698 (55%) lower annual cost. The annual cost of just the outpatient rheumatology care provided by rheumatologist and rheumatology nurse, per patient was €457 for monitoring by the nurse-led rheumatology clinic compared with €598 for monitoring by a rheumatologist-led clinic, translating in a €141 (24%) lower annual cost.

    Conclusions: Patients with stable CIA undergoing biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic compared to a rheumatologist-led clinic, with no difference in clinical outcome as measured by DAS28.

    References

    1. Larsson et al. (2014). Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs, 70(1): 164-175.
    2. Larsson et al. (2012). Patients’ experiences of a nurse-led rheumatology clinic in Sweden – a qualitative study in patients undergoing biological therapy. Nurs Health Sci, 14(4): 501-507.
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