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  • 101.
    Stoltz, Peter
    et al.
    Studentlitteratur AB, SE-22100 Lund, Sweden.
    Skärsäter, Ingela
    Gothenburg Univ, Sahlgrenska Acad, Fac Hlth & Caring Sci, Inst Nursing, Gothenburg, Sweden.
    Willman, Ania
    Blekinge Inst Technol, Sch Hlth Sci, Karlskrona, Sweden.
    "Insufficient evidence of effectiveness" is not "evidence of no effectiveness": evaluating computer-based education for patients with severe mental illness2009Ingår i: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 6, nr 4, s. 190-199Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    RATIONALE: This article reports on commissioned research funded by the Swedish Council of Technology Assessment in Health Care (SBU) and the Swedish Nursing Society (SSF). The objective was to review computer-based education programs. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to a previous incident where such evidence was misunderstood by Swedish policy and health care decision makers.

    AIMS: This article highlights the concept of evidence with regard to the consequences of insufficient evidence of effectiveness being mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computer-based education program for patients suffering from severe mental illness.

    METHODS: Systematic database searches in Medline, CINAHL, PsycINFO and the Cochrane Library identified a total of 131 potentially relevant references. Thereafter, 27 references were retrieved as full-text documents, of which 5 were finally included and co-reviewed by two independent researchers.

    FINDINGS: The review found no decisive evidence of effectiveness regarding computer-based education programs designed to assist persons suffering from severe mental illness. IMPLICATIONS FOR PRACTICE AND POLICY: Failing to see the difference between insufficient evidence and evidence of no effectiveness may have unexpected consequences. As a result, practice may be misguided and treatments withheld, which at worse may have harmful consequences for patients. In the end, it is of utmost importance that researchers do good quality research by ensuring statistical power and quality of outcome measurement. For example, this review of computer-based education programs could have revealed effective ways of dealing with severe mental illness if the studies included had been conducted using more sophisticated designs.

  • 102.
    Wadell, Katheleen
    et al.
    Institute of Nursing, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Skärsäter, Ingela
    The Vårdal Institute Göteborg, The Swedish Institute for Health Sciences, and Psychiatric Services, Halland, Sweden.
    Nurses' experiences of caring for patients with a dual diagnosis of depression and alcohol abuse in a general psychiatric setting2007Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 28, nr 10, s. 1125-1140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study is to describe mental psychiatric health nurses' experiences of caring for persons with the dual disorders of major depression and alcohol abuse. The study was conducted in 2003 on three psychiatric wards located in two general hospitals in Sweden. The study group comprised 11 registered nurses with experience of caring for patients with dual disorders. The data were analyzed by means of qualitative content analysis. The findings revealed three categories: Enabling a good level of cooperation with patients; Facilitating continued care and treatment; and Understanding barriers to cooperation with patients. Building a trusting relationship in order to enable cooperation with patients was the basis for continued care and treatment. The nurses needed more training and multidisciplinary knowledge in order to meet the particular clinical needs of this patient group. Nurses have an important obligation to utilize the best available evidence, including research findings and other scientific sources.

  • 103.
    Warrén Stomberg, Margareta
    et al.
    Gothenburg University, Sahlgrenska Academy, the Institute of Health and Care Sciences, Gothenburg, Sweden.
    Knudsen, Kai
    Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Stomberg, Henrik
    Police Department in Örebro County, Örebro, Sweden.
    Skärsäter, Ingela
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Symptoms and Signs in Interpreting Gamma-hydroxybutyrate (GHB) Intoxication – An Explorative Study2014Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, artikel-id 27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Acute poisoning with gamma-hydroxybutyrate (GHB) has been a serious medical and social problem in different parts of the world including Sweden. GHB is a drug of abuse which acts primarily as central nervous system (CNS) depressants. GHB has serious toxicity, although many young users do not recognise GHB as a dangerous drug. The aim of this pilot study was to explore how symptoms with risk of failure in vital functions would be valued among professionals that encounter GHB intoxication in the emergency phase.

    Methods

    A web-based survey focusing on the assessment of vital clinical signs for possible GHB intoxication using a numeric scale was carried out during April and May 2011. The participants, n 105, are all professionals who encounter GHB intoxicated in the emergency phase, but have different levels of training in GHB intoxication, mainly Registered Nurses (RNs) in southwest Sweden, employed in pre-hospital or emergency departments at somatic and most psychiatric health care facilities, as well as police officers who in their work come into contact with drug users. Responses in the survey were scored according to risk of GHB intoxication with serious failure of vital functions. The score value was then referred to a so-called evidence based priority (EBP) scale and analysed using descriptive statistics and Fisher's exact test.

    Results

    Cardiac arrest, coma, hypoxia, general convulsions, slow respiratory and heart rate and pale skin are symptoms with the highest risk of serious failure in vital physical functions and were predominantly recognised as such.

    Conclusion

    Despite the professionals' different levels of training in GHB intoxication, all of them were relatively well aware of and in accordance regarding the most risky symptoms. The interpretation score for the less risky symptoms and signs of GHB intoxication varied depending on their degree of training. The results should be viewed cautiously, as the size of the professional groups and their general knowledge of critical symptoms of GHB poisoning varied. © 2014 Stomberg et al.; licensee BioMed Central Ltd.

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