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  • 151. Berggren, Ulf
    et al.
    Hägglin, Catharina
    Hallberg, Ulrika
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hallberg, Lillemor R.-M.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychological and Quality of Life Aspects of Edentulousness and Treatment with Dental Implants2005In: The osseointegration book: from calvarium to calcaneus, Berlin: Quintessence Publishing , 2005, p. 157-172Chapter in book (Refereed)
  • 152.
    Bergh, Susanne
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Skogman, Eva
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Tideman, Magnus
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Vågar lite mer: Studerandes erfarenheter av längre folkhögskolekurser riktade till personer med utvecklingsstörning2010Report (Other academic)
    Abstract [sv]

    Specialpedagogiska skolmyndighetens (SPSM) övergripande uppdrag är att alla ska få möjlighet att nå målen för sina studier och för sin utbildning. Myndigheten arbetar med olika insatser och stöd för att fullgöra detta uppdrag. Den här rapporten handlar om folkhögskolor som får vissa statsbidrag från myndigheten, för att ge stöd till att personer med funktionsnedsättning ska kunna studera där. Myndigheten har till uppgift att följa upp och utvärdera effekter av de statsbidrag som ges.

    Den här rapporten handlar om betydelsen av studier på folkhögskola för personer med utvecklingsstörning. Det är deltagarnas egna erfarenheter och bedömningar av kursernas påverkan på kunskapsutvecklingen, sociala relationer, personlig utveckling och effekter för sysselsättningen som är i fokus. Intervjuer har genomförts med personer som studerar och med personer som tidigare har studerat på folkhögskola.

    I rapportens inledning redogörs för folkbildningens och folkhögskolornas grundläggande karaktär och uppdrag. Några slutsatser som studien visar på är att de studerande är nöjda med sina studier och att den personliga och sociala utvecklingen är i centrum. De flesta har sysselsättning inom daglig verksamhet efter genomförda studier. En slutsats som redovisas i studien är att folkbildningen har betydelse för att öka förutsättningar till ett aktivt liv i gemenskap med andra. Studien pekar även på behov av ökade och fördjupade studier av folkhögskolors betydelse för personer med utvecklingsstörning.

     

  • 153.
    Berglund, Jenny
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Haraldsson, Caisa
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Högt tryck på hälsan: En metasyntes om hur glaukom påverkar livet2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Glaucoma is a progressive chronic disease that slowly decreases visual perception. In order to optimize and individualize the care to people living with glaucoma, the ophthalmic nurse needs to understand the impact glaucoma has on daily life. The aim of this metha-synthesis is to present a synthesis of current research concerning experiences of living with glaucoma. The results of this metha-synthesis indicates that the feelings and experiences of living with glaucoma are coherent internationally. Glaucoma has both an emotional impact and an effect of the perceived autonomy. The treatment and regularly contacts with healthcare providers disturbs daily life. In order to improve the perceived health, persons with glaucoma need knowledge, how to cope with the different dimensions of the disease and the treatment. If the ophthalmic nurse, more efficiently could identify the areas in need of care, health promoted, check-up intervals prolonged, and the costs of healthcare reduced. Further research is needed concerning what persons living with glaucoma would prefer the healthcare to focus on, as well as the socioeconomic impact of their preferences.

  • 154.
    Bergman, Bodil
    et al.
    Department of Psychology, Göteborg University, Göteborg, Sweden.
    Hallberg, Lillemor R.-M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Moving away from facades: in-depth interviews with subjectively healthy women diagnosed with distress2005In: Qualitative Research in Psychology, ISSN 1478-0887, E-ISSN 1478-0895, Vol. 2, no 2, p. 169-183Article in journal (Refereed)
    Abstract [en]

    Objectives:

    To gain a deeper understanding of why women, diagnosed with mental distress, reported good physical and mental health. What could the reason be and how did they feel four to five years later?

    Method:

    In-depth interviews were conducted with seven women; age 33 to 52, who worked in a Swedish male-dominated industry. The methodological approach relied on grounded theory.

    Results:

    A conceptual model was generated in the analysis, describing a temporal process of change in the women's self-image. Three core concepts illuminated this process:(1) maintaining an ideal self-image, (2) waking up/reappraising health and (3) struggling for a realistic self. The women were moving away from facades of meeting social expectations and pleasing others toward trusting and setting boundaries for themselves. Moving away from symptoms such asasthma, migraine and infections, as well as family problems, they felt and hoped that they had more control over their lives.

    Conclusions:

    A conceptual model was proposed to illustrate a temporal change in women's self-image related to their changing perception of health. Women's newway of life challenges the support system within organizations and society.

  • 155.
    Bergseth Bogsti, Wenche
    et al.
    Högskolan i Gjövik.
    Solvik, Elisabeth
    Högskolan i Gjövik.
    Engelien, Ragna Ingeborg
    Högskolan i Gjövik.
    Larsen Moen, Øyfrid
    Högskolan i Gjövik.
    Sønsteby Nordhagen, Siv
    Högskolan i Gjövik.
    Struksnes, Solveig
    Högskolan i Gjövik.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Styrket veiledning i sykepleierutdanningens praksisperioder2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 1, p. 56-60Article in journal (Refereed)
    Abstract [en]

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

  • 156.
    Bergsten, Ulrika
    et al.
    Jonkoping Univ, Sch Hlth Sci, Jonkoping.
    Bergman, Stefan
    Spenshult Hosp, Ctr Res & Dev, Oskarstrom.
    Fridlund, Bengt
    Jonkoping Univ, Sch Hlth Sci, Jonkoping.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm.
    Berglund, Anita
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Petersson, Ingemar
    Univ Lund Hosp, Dept Rheumatol, S-22185 Lund.
    Patterns of background factors related to early RA patients conceptions of the cause of their disease2011In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 30, no 3, p. 347-352Article in journal (Refereed)
    Abstract [en]

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

  • 157.
    Bergsten, Ulrika
    et al.
    Research and Development Centre at Spenshult Hospital, Oskarström, Swede.
    Bergman, Stefan
    Research and Development Centre at Spenshult Hospital, Oskarström, Swede.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Berglund, Anita
    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Petersson, Ingemar F.
    Lund University Hospital, Lund, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patients’ conceptions of the cause of their Rheumatoid Arthritis: A qualitative study2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 4, p. 243-255Article in journal (Refereed)
  • 158.
    Bergsten, Ulrika
    et al.
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Spenshult Hosp, Ctr Res & Dev, Oskarstrom, Sweden .
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    “Delivering knowledge and advice”: Healthcare providers’ experiences of their interaction with patients’ management of rheumatoid arthritis2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4, article id 8473Article in journal (Refereed)
    Abstract [en]

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

  • 159.
    Bergsten, Ulrika
    et al.
    Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Spenshult Hospital, Oskarström, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    "Striving for a good life" - the management of reumatoid arthritis as experienced by patients2011In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 5, p. 95-101Article in journal (Refereed)
    Abstract [en]

    Aim:

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

    Method:

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

    Results:

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

    Discussion:

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

  • 160.
    Bergsten, Ulrika
    et al.
    Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Spenshult Hospital, Halmstad, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perception of tactile massage as a complement to other forms of pain relief in rheumatic disease2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 3, p. 157-167Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 161.
    Bergström-Wuolo, Maya
    et al.
    Public Health Center, Norrbotten County Council, Luleå, Sweden.
    Dahlström, Josefin
    Health Counselor in Luleå, Luleå, Sweden.
    Hertting, Krister
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Kostenius, Catrine
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    My heart has no hurt: The health of young immigrants2018In: International Journal of Migration, Health and Social Care, ISSN 1747-9894, E-ISSN 2042-8650, Vol. 14, no 3, p. 290-304Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to explore health from the perspective of young immigrants in Sweden.

    Design/methodology/approach: A total of 25 newly arrived young immigrants attending Swedish language classes in northern Sweden participated by drawing and writing open letters. They continued the open-ended sentence “Now I’ll draw and describe a day when I was feeling good, that was […].”

    Findings: The phenomenological analysis resulted in three themes: longing to be in control for a better life, searching for power in the good and the bad, and striving for a sense of belonging in the new society. The findings illuminate young immigrants’ perspectives of a health-promoting everyday life consisting of agency, reflection and a sense of community. The findings also highlight the young immigrants’ experiences when health-promoting aspects are lacking, characterized by disillusionment, anxiety and loneliness. The findings are discussed with health promotion, health literacy and young immigrants in mind.

    Practical implications: According to young immigrants, meeting basic needs such as food, sleep and housing is health promoting but easily taken for granted. Being able to have a say in matters concerning everyday life, social inclusion and finding power in memories – positive and negative – can promote health in young immigrants.

    Originality/value: The young immigrants were able to communicate via drawings and words to overcome language barriers. © 2018, Emerald Publishing Limited.

  • 162.
    Bernhard, Dörte
    et al.
    Linköping University, Linköping, Sweden.
    Barow, Thomas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Die Reform der "Gymnasiesärskola" in Schweden2015In: Die UN-Behindertenrechtskonvention und ihre Umsetzung: Beiträge zur Interkulturellen und International vergleichenden Heil- und Sonderpädagogik / [ed] Annette Leonhardt, Katharina Müller & Tilly Truckenbrodt, Bad Heilbrunn: Verlag Julius Klinkhardt, 2015, p. 258-265Chapter in book (Refereed)
    Abstract [de]

    Im Zuge der schwedischen Gymnasialreform wird derzeit auch die so genannte „Gymnasiesärskola“, die gymnasiale Sonderschule für Jugendliche mit geistiger Behinderung umgestaltet. Diese Schulform soll stärker mit der allgemeinen gymnasialen Stufe zusammenarbeiten. Auch sollen mehr Berührungs­punkte zwischen Schule und Arbeitsleben geschaffen werden, um den Übergang der Jugendlichen in die Berufswelt zu erleichtern. Im Beitrag wird die Schulreform diskutiert, wobei eine stärkere Betonung der Qualifizierungsfunktion von Bildung deutlich wird.

  • 163.
    Bernhard, Dörte
    et al.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Barow, Thomas
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Stand und Perspektiven des Krankenhausunterrichts in Schweden2013In: Sonderpädagogische Förderung heute, ISSN 1866-9344, Vol. 58, no 3, p. 323-326Article in journal (Other academic)
  • 164.
    Bernhardsdottir, Johanna
    et al.
    Department of Nursing University of Iceland Reykjavik Iceland & Landspitali-The National University Hospital of Iceland Reykjavik Iceland .
    Dimmit Champion, Jane
    School of Nursing The University of Texas at Austin Austin, TX USA .
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). The Institute of Health and Care Science Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden.
    The experience of participation in a brief cognitive behavioural group therapy for psychologically distressed female university students2014In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 21, no 8, p. 679-686Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the experience of participation in four sessions of cognitive behavioural group therapy for psychological distress for female university students' (n = 19), aged 22–45 years. Data were gathered with semi-structured interviews during March and April 2008 and analysed according to thematic content analysis. The results identified four themes: ‘Gaining knowledge and understanding’, ‘Becoming more balanced and positive in thinking’, ‘Feeling more self-confident and in control’ and ‘Opportunities for practice and in-depth reflections’. Future recommendations include an increase in sessions from four to five, with one booster session to follow-up on newly acquired skills. © 2013 John Wiley & Sons Ltd.

  • 165.
    Bernson, Jenny M.
    et al.
    Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hallberg, Lillemor R.-M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Elfstrom, Magnus L.
    Department of Psychology, School of Sustainable Development of Society and Technology, Mälardalen University, Eskilstuna, Sweden.
    Hakeberg, Magnus
    Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    'Making dental care possible - a mutual affair'. A grounded theory relating to adult patients with dental fear and regular dental treatment2011In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 119, no 5, p. 373-380Article in journal (Refereed)
    Abstract [en]

    Dental fear is a common and widespread problem, which can cause severe stress. Even so, most patients with dental fear undergo regular dental treatment in spite of their fear and many enjoy good oral health. The aim of this study was to obtain a deeper understanding of how patients with dental fear manage to undergo dental treatment. Fourteen patients with dental fear, who undergo regular dental care, were interviewed. Qualitative analysis of the transcribed interviews was performed according to the principles of grounded theory. A conceptual framework was generated, and the main concern was identified as 'making dental care possible - a mutual affair'. Four additional categories explained how patients handled their dental fear and how dental care became possible. The strategies were labelled 'taking part in a mental wrestling match', 'trust-filled interaction with dental staff', 'striving for control' and 'seeking and/or receiving social support'. The results showed that making dental care possible for patients with dental fear is a mutual challenge that requires interplay between dental staff and patients, involving verbal and non-verbal communication reflecting respect, attention, and empathy. Moreover, a balance between nearness and distance and between professional and personal treatment is required.

  • 166.
    Berntsson, Tommy
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Den prehospitala vårdrelationen ur ambulanssjuksköterskors perspektiv2010In: Forskningsseminarium 11 november 2010 Kunskapscentrum Prehospen, Högskolan i Borås.: Vårdande möten-möjligheter och hinder, 2010Conference paper (Other academic)
  • 167.
    Berntsson, Tommy
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Den prehospitala vårdrelationens sakaspekt -skapar förutsättningar för att förstå och tillgodose personens behov2013In: PreHospen 2013: Prehospital vård för att värna om patientens hälsa, 2013Conference paper (Other academic)
    Abstract [en]

    Background: To be able to further develop the pre-hospital emergency care from a nursing perspective, both in the clinical setting and in the educational setting, it is important to get a better understanding and clarification of the pre-hospital nurse-patient relationship. Therefore, a study was conducted (Berntsson and Hildingh, 2012) to explore how the phases of the pre-hospital nurse–patient relationship described by Suserud (Dahlberg et al., 2003), emerge in 17 specialist ambulance nursing students (SANs) descriptions of ambulance missions. 

    Methods: The study has a descriptive design and uses a qualitative research method. An analysis method, qualitative content analysis with a directed approach, was used. A directed approach means that the analysis is based on existing theory or prior research (Hsieh and Shannon, 2005). In this study we decided to use Suserud’s description (Dahlberg et al., 2003) of the phases of the prehospital nurse–patient relationship to govern the analysis and the identification of categories. 

    Results: In the orientation phase of the pre-hospital nurse–patient relationship, there was an ongoing analysis process in which the SANSs were seeking to obtain an initial picture of the situation, this was made by: understand the situation with support from the EMD team, from a collegial discussion, from one’s own first assessment, from the patients and relatives or witnesses description, from the colleague’s actions, from some other health-care professional’s assessments and actions. 

    In the identification phase of the nurse–patient relationship, the SANSs made an extended assessment of the situation to understand the patient’s current needs, this was made by; assess the airway, the breathing, the circulation, the consciousness, the level and experience of pain, perform a head to toe assessment, collecting the patients’ health history and note aggravating environmental factors for care and transfer. 

    In the exploitation phase of the pre-hospital nurse–patient relationships, the SANSs focus was on the hands-on care of the patient, this was made by; provide care by managing ABC problems, assessing the cause for the disability problem, managing head-to toe problem, performing actions to prevent hypothermia, creating an intravenous access, managing pain problems, transferring the patient to the stretcher and the ambulance, assessing the patient’s vital signs and by selecting appropriate driving speed.

    In the resolution phase the SANSs targeted their attention towards the receiving care unit and the forthcoming care, this was made by; pre-warn or speak with the receiving unit, inform the patient about the continuing care in the receiving care unit, transfer the patient from the ambulance stretcher on the receiving unit, report to the receiving care unit, finish the nurse–patient relationship and follow up the patient’s condition.

    Conclusion: The results of the study show that the phases in the nurse–patient relationship, as described by Suserud (Dahlberg et al., 2003), appeared in the SANSs descriptions of ambulance missions. Furthermore, the study reveals that each phase of pre-hospital nurse–patient relationship includes several parts; these findings extend Suserud’s (Dahlberg et al., 2003) description.

  • 168.
    Berntsson, Tommy
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The nurse-patient relationship in pre-hospital emergency care: form the perspective of Swedish specialist ambulance nursing students2013In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 21, no 4, p. 257-263Article in journal (Refereed)
    Abstract [en]

    The development of the Swedish ambulance service has resulted in three different competence levels in Swedish ambulance teams: specialist ambulance nurses, registered nurses and emergency medical technicians. A nursing scientific model developed by Peplau (Peplau, H., 1991. Interpersonal Relations in Nursing. Springer Publishing Company, New York.) breaks down the nurse-patient relationship into a number of phases: an orientation, an identification, an exploitation and a resolution phase. This model has then been adapted to the pre-hospital emergency care by Suserud (Dahlberg, K., Segesten, K., Nyström, M., Suserud, B.-O., Fagerberg, I., 2003. Att förstå vårdvetenskap [To Understand Caring Science]. Studentlitteratur, Lund.). The purpose of this study was to explore, by direct content analysis, how the phases of the pre-hospital nurse-patient relationship described by Suserud (Dahlberg et al., 2003), emerge in 17 specialist ambulance nursing students descriptions of ambulance missions. The results show that the four phases of the pre-hospital nurse-patient relationship could be identified and each phase includes several different parts. Furthermore, the results show that the parts of each phase can vary depending on the patient's condition and the environmental circumstances of the ambulance mission. This improved understanding of the four phases of the pre-hospital nurse-patient relationship, and their parts, could be used by ambulance team members as a support during the pre-hospital caring process in ambulance missions. This new knowledge could also be used in education. © 2012 Elsevier Ltd.

  • 169.
    Berntsson, Tommy
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wallinvirta, Eivor
    Arcada högskola Helsingfors, Helsingfors, Finland.
    Nyström, Patrik
    Arcada högskola Helsingfors, Helsingfors, Finland.
    Patientsäkerhet och vårdandets etik2013In: PreHospen 2013: Prehospital vård för att värna om patientens hälsa, 2013Conference paper (Other academic)
    Abstract [en]

    Background: An international collaborative project has been ongoing since 2009 between the Ambulance training program in Nursing at the University of Halmstad and the program in Emergency Care at Arcada University of Applied Sciences. The purpose is to jointly develop knowledge about patient safety and caring ethics, through participation in experiential skills development in innovative environments. The focus areas of collaboration are: 1) To learn safety by preventing and creating resistance to human errors and malpractices in health care 2) To become aware of the outer and inner ethics, as a basis of use of the self 3) To create conditions for inner leadership and personal responsibility in health care. The course content planning is guided by an integrative pedagogy, which contains an active simulation exercise.

    Methods: Simulation exercises are given to interdisciplinary student teams at a one week exchange program in Helsinki in spring and in Halmstad in autumn. The assessment is a written work, and the student deepens understanding in evidence-based research.

    Results: Simulation has given students opportunities for an active and motivational approach to learning, where a high degree of knowledge, creativity and reflection co-exist. Students have expressed that they have learned to think and act in terms of patient safety and ethics. The concepts have been concrete and visibly demonstrated by simulating everyday prehospital emergency situations: e.g. a situation in which the patient refuses to be transported. The simulation exercises have explained theory and built bridges to practice.

    Conclusions: The discussions of reflection in interdisciplinary groups and after the simulations have been fruitful, due to students´ different experiences, but also because of awareness of cultural similarities and differences. Students have adopted permanent values of concrete models for how to act safely and ethically at the individual, community and organizational level.

  • 170.
    Billsten, Johan
    et al.
    Department of Psychology, Linnaeus University, Sweden.
    Fridell, Mats
    Department of Psychology, Lund University, Sweden.
    Holmberg, Robert
    Department of Psychology, Lund University, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study2018In: Journal of Substance Abuse Treatment, ISSN 0740-5472, E-ISSN 1873-6483, Vol. 84, p. 9-16Article in journal (Refereed)
    Abstract [en]

    Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. Aim The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. Design and recruitment The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Statistics Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. Results A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α = 0.67 to α = 0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α = 0.64), institutional resources (α = 0.52), staff attributes (α = 0.76), and organizational climate (α = 0.74). An LPA analysis of the four factors with their three distinct profiles provided the best data fit: Profile 3 (n = 614), Profile 2 (n = 934), and Profile 1 (n = 246). Respondents with the most favorable ORC scores (Profile 3) used significantly more instruments and more treatment methods and had a better collaborating network in 2011 as well as in 2013 compared to members in Profile 1, the least successful profile. Conclusion In a large sample of social work and healthcare professionals, ORC scores reflecting higher institutional resources, staff attributes and organizational climate and lower motivational readiness for change were associated with a successful implementation of good practice guidelines for the care and treatment of substance users in Sweden. Low motivational readiness as a construct may indicate satisfaction with the present situation. As ORC proved to be an indicator of successful dissemination of evidence-based guidelines into routine and specialist healthcare, it can be used to tailor interventions to individual employees or services and to improve the dissemination of and compliance with guidelines for the treatment of substance users. © 2017

  • 171.
    Bjurling-Sjöberg, Petronella
    et al.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Sect Caring Sci, Uppsala, Sweden.;Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden..
    Jansson, Inger
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wadensten, Barbro
    Uppsala Univ, Sect Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Engström, Gabriella
    Florida Atlantic Univ, Christine E Lynn Coll Nursing, Boca Raton, FL 33431 USA..
    Pöder, Ulrika
    Uppsala Univ, Sect Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey2014In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 20, no 1, p. 48-57Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectivesTo identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents. MethodsA descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted. ResultsCPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied. ConclusionsProgress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high-quality, interprofessional and evidence-based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed.

  • 172.
    Björklund, M.
    et al.
    Centre for Health Promotion Research, Halmstad University, Halmstad and the Ear Clinic, Nordvastra Skanes Sjukvardsdistrikt, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Cancer patients' experiences of nurses' behaviour and health promotion activities: a critical incident analysis1999In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 8, no 4, p. 204-212Article in journal (Refereed)
    Abstract [en]

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

  • 173.
    Blank, J.
    et al.
    Department of Public Health and Community Health, Göteborg University, Sweden;.
    Nordin, P.
    Skaraborg Institute, Skövde, Sweden.
    Toivonen, Henri
    Children Health Care, Skaraborg, Sweden.
    Lindblad, Ulf
    Department of Public Health and Community Health, Göteborg University, Sweden.
    Nyholm, Maria
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Prevalence of overweight and obesity among preschool children between 2004 and 2008, in a rural area of Sweden: The Skaraborg Evaluation Child Obesity Prevention Project (SECOPP)2010In: Special Issue: Abstracts of the 11th International Congress on Obesity, 11-15 July 2010, Stockholm, Sweden, Chichester, England: Wiley-Blackwell, 2010, p. 73-74Conference paper (Refereed)
    Abstract [en]

    Background: Childhood obesity is considered a serious public health problem and it has increased over the last two decades. The aim of this paper was to report 5-year change in prevalence of overweight and obesity among preschool children in a rural area of Sweden. Material and Method: Body height and weight were obtained in 2004, 2006 and 2008. A total of 1914 children (1014 boys and 900 girls), aged 4 years ± 4 months and were examined at Child Welfare Clinics in two municipalities in the Skaraborg area in Region of Västra Götaland, Sweden were included in the study. Body mass index (BMI) was calculated and categorized according to the International Obesity Task Force (IOTF) and WHO cut-off as reference methods in defining overweight and obesity, and GLM methods were used to estimate the change with age as a covariate. Result: Between 2004 and 2008, overweight increased in boys according to IOTF 2.0% (P = 0.048), whereas no such trend was seen when using WHO cut-offs. In girls, overweight increased significant according to the both definitions IOTF 9.1% (P < 0.001) and WHO 2.8% (P = 0.010). Obesity has decreased in both boys and girls, however not significant. According to IOTF obesity decreased with 1.1% in boys and 1.9% in girls, and WHO with 2.1% in boys and 1.5% in girls. Conclusion: This study shows that overweight has increased in both sexes and obesity rates remained rather steady. However, public health strategies targeting the whole population is still needed.

  • 174.
    Blomqvist, Marjut
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Experiences of data collection issues in qualitative studies involving people diagnosed with schizophrenia2016In: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016, 2016, p. 41-41Conference paper (Refereed)
    Abstract [en]

    Background: The viewpoint and special needs of individuals with severe mental illness are crucial for the development of mental health nursing. In-depth knowledge of the perspectives of people with schizophrenia is primarily established in dialogue with individuals with experience of the phenomenon investigated. Attaining trustworthiness in the findings in qualitative studies is of great importance and the interview approach used should assure trustworthiness in the data collection at different levels with regard to the perspectives of the individual, which is essential for developing nursing research and practice.

    Aim: The aim of the paper was to describe and discuss the issues related to data collection in qualitative studies involving people diagnosed with schizophrenia.

    Method: Six qualitative interview studies regarding experiences of different aspects of life among people diagnosed with schizophrenia were reflected on and discussed in terms of issues related to data collection involving people with severe mental illness such as schizophrenia (N=75).

    Results: The discussions that generated the results revealed three topics in qualitative studies involving individuals diagnosed with schizophrenia: 1) Selection of research context with respect to participants’ different aspects of life, 2) Sampling issues with regard to judgements of participants’ ability to contribute with information and 3) Choice of data collection methods to meet the aim of the enquiry.

    Conclusion: Three crucial areas in data collection in qualitative studies with individuals diagnosed with schizophrenia were revealed. Further studies regarding sampling procedures and analysis of collected data are needed to ensure trustworthiness of findings regarding interviews involving people with severe mental illness.

  • 175.
    Blomqvist, Marjut
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandgren, Anna
    Linneaus University, Växjö, Sweden.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    How to facilitate healthy living described by persons with persistent psychiatric disorders in psychiatric out-patient settings – challenging health care professionals2016In: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016, 2016, p. 13-13Conference paper (Refereed)
    Abstract [en]

    Background: Over the previous decades, scientific research has demonstrated that people with persistent mental illness like schizophrenia and other psychotic disorders have a reduced life expectancy and have a higher risk of being affected of preventable physical illnesses such as developing metabolic syndrome, cardiovascular disease and type 2 diabetes. Additionally it have made evident for lower quality of life as well. These risk factors make health promoting essential in the care providing and therefore it ́s important for the health professionals to have a deeper knowledge about the facilitating factors to healthy living described by persons themselves.

    Aim: The aim of this qualitative study was to describe the experiences of persons affected by persistent mental illness such as schizophrenia or other psychotic disorders what facilitates healthy living in their everyday life. The presentation has the focus on the facilitative factors applying health professionals when providing care for persons in psychiatric out-patient settings.

    Method: The study was carried out in three different psychiatric out-patient settings in the southern Sweden. The data was collected through qualitative interviews (N= 16) and analyses by qualitative, inductive approach abased on Granheim and Lundmans ́ conceptualization of content analysis.

    Results: First, it is essential for persons with persistent and severe mental illness that they get support to bring out their needs to healthier living by having a dialogue about the issues of healthy living in their everyday life. In this dialog they may also need support to reflect and find out their own motivating factors to healthier living. Additionally, in this dialogue it is important to be aware of that they will be regarded as a whole person and include many areas of life like daily structure and social life. The professionals should show a truly involvement and active interest to persons when increasing healthy living.

    Conclusion: Many persons with persistent mental illness need practical support in their everyday life to maintaining healthier living. This requires the close cooperation between psychiatric out-patient settings, the housing support professionals from municipalities and the social services.

  • 176.
    Blomqvist, Marjut
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandgren, Anna
    Linnaeus University, Center for Collaborative Palliative Care , Department of Health and Caring Sciences, Växjö, Sweden.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Health Risks among People with Severe Mental Illness in Psychiatric Outpatient Settings2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 585-591Article in journal (Refereed)
    Abstract [en]

    Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital. © 2018 Taylor & Francis Group, LLC

  • 177.
    Blomqvist, Marjut
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Experiences of methodological issues in qualitative studies involving people with severe mental illness such as schizophrenia2016In: Programme: Second Nordic Conference in Nursing Research, 2016, p. 60-60Conference paper (Refereed)
    Abstract [en]

    Background: The viewpoint and special needs of individuals with severe mental illness is crucial in development of mental health nursing. In-depth knowledge of the perspectives of people with severe mental illness is primarily established in dialog with individuals experienced in the phenomenon investigated. To reach trustworthiness of findings in qualitative studies is central and the interview approach used should assure trustworthiness in data collection regarding perspectives of the individual essential in developing nursing research and practice.

    Aim: The aim of the paper was to describe and discuss methodological issues related to research interviews involving people with severe and persistent mental illness.

    Method: Five qualitative interview studies regarding experiences of different aspects of life among people with severe mental illness were reflected and discussed regarding methodological issues related to the interview situation involving people with severe and persistent mental illness (N=51).

    Results: The discussions forming the results revealed three crucial topics in qualitative interview studies with individuals with severe mental illness. Use previous experiences of interactions with persons with mental disabilities with an open mind without prejudices. Balance the interviewee’s need of support and encouragement during the interview without manipulating contents of statements. Comprehend the essential meaning in the interviewee’s statements even when statements are short and narrow.

    Discussion: Three crucial topics in qualitative interview studies with individuals with severe mental illness were revealed. Further studies regarding sampling procedures and analysis of collected data are needed to ensure trustworthiness of findings regarding interviews involving people with severe mental illness.

  • 178.
    Blomqvist, Marjut
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Sandgren, Anna
    Linneaus University, Växjö, Sweden.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 236-246Article in journal (Refereed)
    Abstract [en]

    It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness. © 2017 Australian College of Mental Health Nurses Inc.

  • 179.
    Blomqvist, Marjut
    et al.
    Department of Psychiatry, Central County Hospital Halmstad, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    "Family in the waiting room": A Swedish study of nurses' conceptions of family participation in acute psychiatric in-patient setting2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, p. 185-194Article in journal (Refereed)
    Abstract [en]

    Family plays an important role in the care provided for patients in all areas of nursing. However, relatively few studies deal with the focus of the present study: the ways that nurses experience family participation in acute psychiatric inpatient settings. Data were collected by interviewing 18 nurses who had experience working in such settings. A phenomenographical approach was used to analyse the interviews. Three descriptive categories were found: family participation as a part of the caring process, barriers to family participation, and nurses' resources in family participation. The findings show that the nurses' conceptions of family participation varied, and that the family was not always a priority in this caring context. The implementation of family participation was often only based on the nurses' own interests and insights. This could mean that family participation differed substantially, depending on which nurse a family encountered, and which unit the patient was admitted at. Finally, nurses had little professional autonomy, and organizational support and education were also lacking.

  • 180.
    Boberg, Andreas
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Persson, Jonathan
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Andersson, Mattias
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Klubba och Boll är allt som behövs för att ha skoj: En studie om kommunikationens och kommunikationskulturensbetydelse i ett elitsatsande ungdomsinnebandylag2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract: When playing in teams, communication is important, not just communication with words but also non-verbal communication such as gestures and body languish. The purpose with this study is to see how there is a co-op among communicating players , between leaders and players and to examine what meaning communication and culture got  in a youth team. The ambition with this study was to increase our knowledge about communication and communicationculture in the youth floorball team. This study is qualitative and was inspired by an ethnographical method so we got the information from observations of a youth floorball team, totally we made four observations. The result were analyzed and categorized from our observation papers. The results where categorized into four headlines, One and two-way communication, Artifacts, The communicationculture of the youth team and actions. The leader got a very important role as communicator and pedagogical leader for the communicationculture that the individual of the group wants to be used in order to promote the development in the team. In the future, more teams needs to be studied to get a more reliable source of information that can be used on a greater populace.

  • 181.
    Bolse, Kärstin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Caring for Patients with an Implantable Cardioverter Defibrillator Experiences of Patients and Healthcare Professionals2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: An Implantable Cardioverter Defibrillator (ICD) is a technical device used in the treatment of ventricular arrhythmias. After the implantation of an ICD the entire life situation can be affected with psychological and social consequences for the patient and his/her next of kin. The healthcare professionals play a vital role in providing educational information, support, and technical follow-up of the device. During recent years more and more hospitals have introduced a more team based organisation where the physicians collaborate with specialised ICD nurses.

    Aim: The overall aim of the thesis was to explore how patients with an ICD experienced their life situation and howhealthcare professionals described their experiences of delivering care to ICD patients.

    Methods: The design was descriptive, combining both quantitative and qualitative approaches, and the data was collected from Sweden and the USA. The Uncertainty of Illness Scale (MUIS-C) and Quality of life Index (QLI) instruments were used to determine the level of uncertainty and satisfaction with life (I), in-depth interviews with a phenomenographic approach was used to describe how Swedish and US patients living with an ICD conceived their life situation (II, III) and how healthcare professionals’ experienced delivering care to patients with an ICD, (IV). Finally, to explore clinical aspects of ICD care in Sweden, the Delivery of ICD Questionnaire (DOIQ) was used to describe the healthcare professionals’ experiences and a content analysis was used to describe the written educational information material provided to patients (V).

    Results: There were no differences in uncertainty between pre and post ICD implantation either in Swedish or the US patients. Satisfaction with life was significantly higher among US patients compared to Swedish patients both before and after ICD implantation within the health-functioning, socio-economic and psychological-spiritual domains. The Swedish ICD patients experienced a significantly higher satisfaction with life within the socioeconomic domain after 3 months. (I). The patients felt safe in having an ICD implanted, but the conceptions varied from seeing the device as a life saver to being worried about what could happen. Gratitude at having an ICD varied from happiness at being alive to something that was alien and disturbed the patient. Being more or less dependent included how patient experienced feelings from well-being to grief. Having a network varied from having sufficient support to loneliness. Having a belief in the future ranged from having confidence to look forward to resignation. Gaining awareness described patients’ adaptation to living with an ICD and limitations due to the ICD (II). The patients also underwent a transition from becoming aware of the restriction in the life situation through a process of adaption and having trust in the ICD. This phase was followed by a reorientation phase where they adapted to their life situation and the patient and his/her family regained of their lives (III). The healthcare professionals strove to provide competent and individualised care and infuse confirmation to the patients in form of information, education and support. They gave the patients tools to handle their life situation, through existential support and mediating security (IV). Half of the hospitals had nurse-based clinic and others planned to introduce them. Three hospitals performed follow-up in the form of remote home monitoring. The nurse had specific ICD education from ICD companies and/or various university courses. In the educational information material the biophysical dimensions dominated while the emotional dimension was scarcely described, and the spiritual-existential was not referred to at all (V).

    Conclusions: This thesis offers a further contribution to the scholarly discussion about the relationship between technology and human existence and how to cope with this transition. Our studies revealed that the embodiment of the ICD reflects a merger of experiences about its presence and potential from both patients’ and healthcare professionals’ perspective. This research hopefully encourages healthcare professionals to carefully reflect on what it is like to live with an ICD and to consider practice improvement for the patients’ and the next of kin.

  • 182.
    Bolse, Kärstin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Linköpings Universitet, Linköping, Sweden.
    Living with an implantable cardioverter defibrillator: Swedish and US patients' experiences of their life situation2004Licentiate thesis, comprehensive summary (Other academic)
  • 183.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Flemme, Inger
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ivarsson, Anita
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Jinhage, Britt-Marie
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Carroll, Diane
    Massachusetts General Hospital, Boston.
    Edvardsson, Nils
    Sahlgrenska University Hospital, Gothenburg.
    Hamilton, Glenys A.
    Massachusetts General Hospital, Boston.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Life situation related to the ICD implantation: self-reported uncertainty and satisfaction in Swedish and US samples2002In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, no 4, p. 243-251Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe changes in the life situation related to the ICD implantation of Swedish and US samples with regard to uncertainty and satisfaction. The life situation was measured by reference to the uncertainty caused by the condition and satisfaction with the life situation. Inferential statistics were used to analyse changes within and between the Swedish and US samples. Uncertainty showed a statistically significant difference between the Swedish and US samples before as well as after the ICD implantation. A higher level of uncertainty was indicated for the US sample prior to the ICD implantation and for the Swedish sample following the implantation. In the Swedish sample, satisfaction with life showed a statistically significant difference within the socio-economic domain, indicating a higher degree of satisfaction 3 months after implantation. Satisfaction within the domains of health and functioning, socio-economics and psychological-spiritual showed a statistically significant difference between the Swedish and US samples both before and after ICD implantation, indicating a higher degree of satisfaction in the US sample. The previous study shows that the ICD-patient's life situation is changed after the implantation and that it is necessary to provide the patient with information and education based on their own preconditions. The fact that US sample was investigated at a later stage after ICD implantation than the Swedish sample may have influenced the results of the study.

  • 184.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Hamilton, Glenys
    University of Oslo, Center for Shared Decision Making and Nursing Research, Norway.
    Flanagan, Jane
    University of Massachusetts-Lowell, Lowell, MA, USA.
    Caroll, Diane L.
    Massachusetts General Hospital, Boston, MA, USA.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ways of experiencing the life situation among United States patients with an implantable cardioverter-defibrillator: a qualitative study2005In: Progress in Cardiovascular Nursing, ISSN 0889-7204, E-ISSN 1751-7117, Vol. 20, no 1, p. 4-10Article in journal (Refereed)
    Abstract [en]

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

  • 185.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Johansson, I.
    Linköping University Hospital.
    Strömberg, Anna
    Linkoping University Hospital.
    Organisation of care for Swedish patients with an Implantable Cardioverter Defibrillator, a national survey2010In: European Heart Journal, Supplement, ISSN 1520-765X, E-ISSN 1554-2815, Vol. 31, no Supplement 1, p. 236-236Article in journal (Refereed)
    Abstract [en]

    Background:

    ICD implantations have developed rapidly in recent years and is now an established arrhythmia treatment. The expanding indication for ICD implantation demands new competencies and resources in the ICD team members.

    Objectives:

    To describe the clinical aspects of Implantable Cardioverter Defibrillators (ICD) care in Sweden with focus on organisation, the role and education of nurses, patient information and education, and areas in need of improvement.

    Methods:

    Participants were recruited among physicians and nurses in all of the hospitals implanting ICDs (N=16). Data was collected by a questionnaire. The questionnaire was constructed based on a systematic literature review and then guided by an expert group with clinical and research expertise within the ICD area. The format was inspired by existing questionnaires on heart failure care. The questionnaire comprised of 23 questions, including both multiple choice questions and open questions. Additionally, all written educational materials provided to patients pre- and post-ICD implant were collected from all 16 hospitals. Deductive content analysis using Sarvimäki and Stenbock-Hult's five holistic dimensions was employed to ascertain how information was provided in brochures and information materials.

    Results:

    This study revealed variations in the organisation and follow-up of ICD patients between the different centres in Sweden. Half of the hospitals (n=8) had nurse-based outpatient clinics and several others planned to introduce them. Three hospitals carried out distance follow-ups by means of tele-monitoring. The nurses had received specific ICD education from ICD companies and/or various university courses. In all hospitals, ICD patients received verbal and written information both before and after implantation. The biophysical dimension dominated in the information material while the emotional, intellectual, and socio-cultural dimensions were scarcely described, and the spiritual- existential was not referred to at all. The majority of the ICD teams were in favour of the development of research and quality assurance by means of check lists, guidelines and the ICD-registry.

    Conclusion:

    Holistic care of ICD patients can be achieved by means of a multi-disciplinary ICD team and more patient-centred educational strategies. In Sweden, the organisation of ICD care and follow-up is developing towards more nurse-based clinics. The content of the written educational materials need to be more holistic, rather than mainly focusing on the biophysical and technical aspects of living with an ICD.

  • 186.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Johansson, Ingela
    Department of Medicine and Health Sciences, Division of Nursing Science, Linköping University.
    Strömberg, Anna
    Department of Medicine and Health Sciences, Division of Nursing Science, Linköping University.
    Experiences of delivering care to patients with an Implantable Cardioverter Defibrillator from the perspective of health care professionals2009Manuscript (preprint) (Other (popular science, discussion, etc.))
    Abstract [en]

    Objective: To describe healthcare professionals’ experiences of delivering care to patients with an Implantable Cardioverter Defibrillator (ICD).

    Methods: A qualitative, descriptive design based on a phenomenographic approach. Data was collected between October and December 2007 through interviews with 24 healthcare professionals representing all 16 implanting ICD centres in Sweden.

    Results: Two descriptive categories comprising seven subcategories emerged. Striving to provide competent care comprised: providing access to care, improving one’s quantifications, individualising care and Striving to infuse confirmation involved: promoting independence providing existential support, mediating security and comprising needs of next of kin.

    Conclusion: The healthcare professional striving to provide competent and confirming care based on a holistic perspective. The results describe a variation of how healthcare professionals’ strive to be professional in clinical care in order to give the patient tools to handle their life situation.

    Practice Implications: The findings from healthcare professionals’ experiences can complement studies from the patients’ perspective and are important when improving care or ICD patients. This study can serve as a base for developing and redefining holistic follow-up programmes for ICD patients.

  • 187.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Johansson, Ingela
    Department of Medicine and Health Sciences, Division of Nursing Science, Linköping University.
    Strömberg, Anna
    Department of Medicine and Health Sciences, Division of Nursing Science, Linköping University.
    Organisation of care for Swedish patients with an Implantable Cardioverter Defibrillator, a national survey2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 17-18, p. 2600-2608Article in journal (Refereed)
    Abstract [en]

    Aim.

    To describe the clinical aspects of implantable cardioverter defibrillators care in Sweden with focus on organisation, the role and education of nurses, patient information and education and areas in need of improvement.

    Background.

    Implantable cardioverter defibrillators implantations have developed rapidly in recent years and are now an established arrhythmia treatment. The expanding indication for implantable cardioverter defibrillators implantation demands new competencies and resources in the implantable cardioverter defibrillators team members.

    Methods.

    Participants were recruited among physicians and nurses in all of the hospitals implanting implantable cardioverter defibrillators (n = 16). Data were collected by a questionnaire. Additionally, all written educational materials provided to patients pre- and postimplant were collected from all 16 hospitals. Deductive content analysis using Sarvimäki and Stenbock-Hult's five holistic dimensions was employed to ascertain how information was provided in brochures and information materials.

    Results.

    Half of the hospitals (n = 8) had nurse-based outpatient clinics and several others planned to introduce them. Three hospitals carried out distance follow-ups by means of tele-monitoring. The nurses had received specific implantable cardioverter defibrillators education from implantable cardioverter defibrillators companies and/or various university courses. The biophysical dimension dominated in the information material, while the emotional, intellectual and socio-cultural dimensions were scarcely described, and the spiritual-existential was not referred to at all.

    Conclusion.

    Holistic care of implantable cardioverter defibrillators patients can be achieved by means of a multidisciplinary implantable cardioverter defibrillators team and more patient-centred educational strategies. In Sweden, the organisation of implantable cardioverter defibrillators care and follow-up is developing towards more nurse-based clinics.

    Relevance to clinical practice.

    Development and implementation of structured care programmes with a more holistic approach can improve future implantable cardioverter defibrillators care. The content of the written educational materials need to be more holistic, rather than mainly focusing on the biophysical and technical aspects of living with an implantable cardioverter defibrillators.

  • 188.
    Bolse, Kärstin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Thylen, Ingela
    Department of Medical and Health Sciences, Linköping University, Linköping Sweden.
    Strömberg, Anna
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Healthcare professionals' experiences of delivering care to patients with an implantable cardioverter defibrillator2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 4, p. 346-352Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An implantable cardioverter defibrillator (ICD) is a technical device used in the treatment of ventricular arrhythmias. After an ICD implantation, the entire life situation of the patient their next of kin can be affected psychologically and socially. Healthcare professionals play a vital role in providing educational counselling, support and technical follow-up of the device, but little is known about their experiences.

    AIM: This paper describes the experiences of Swedish healthcare professionals in delivering care to patients with an ICD.

    METHODS: A qualitative, descriptive design based on a phenomenographic approach was used. Data were collected through interviews with 12 specialist ICD nurses and 12 physicians, representing 16 ICD implantation centres in Sweden.

    FINDINGS: Two descriptive categories comprising seven subcategories emerged. Striving to provide competent care comprised the subcategories: providing access to care, improving one's qualifications and individualising care. Striving to infuse confirmation incorporated the subcategories: promoting independence, providing existential support, mediating security and comprising needs of next of kin.

    CONCLUSIONS: The healthcare professionals described how they wished to develop the care further. Both nurses and physicians were consistent in wanting to provide competent and confirming care based on a holistic perspective with high accessibility to the ICD team. The findings describe how healthcare professionals strive to provide professional clinical care in order to give the patients tools to handle their life situation. They suggested that more structured education and counselling according to guidelines should be provided. They also highlighted the need to increase their own competence by improving their knowledge and skills.

  • 189.
    Bonhomme, Justin
    et al.
    School of Human Kinetics, Laurentian University, Sudbury, Canada.
    Seanor, Michelle
    Human Studies Program, Laurentian University, Sudbury, Canada.
    Schinke, Robert J.
    School of Human Kinetics, Laurentian University, Sudbury, Canada.
    Stambulova, Natalia
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The career trajectories of two world champion boxers: interpretive thematic analysis of media stories2018In: Sport in Society: Cultures, Media, Politics, Commerce, ISSN 1743-0437, E-ISSN 1743-0445Article in journal (Refereed)
    Abstract [en]

    Athlete development can be described through transitions that mark turning phases throughout athletes’ careers. Our authors explored media data to unpack the career developments of two prominent world champion boxers from their early lives to world championship status. Employing thematic analysis, five themes were identified: (1) weathering hardships of early life (subthemes: the rough life of an innercity kid; abject poverty in war-torn Philippines), (2) entry into sport (subthemes: groomed to fight; boxing to escape poverty), (3) amateur experience (subthemes: Olympic medallist en route to the pros; struggling amateur with dreams of greatness), (4) launching a professional career (impressive American prospect; a charismatic unpolished slugger) and (5) capturing a world title (subthemes: the much-anticipated world champion; the unexpected world champion). This exploration augments our understanding of how two worldrenowned boxers’ career developments were represented through sport media and interpreted by the researchers, suggesting parallel pathways for future career boxers and those who work with them. © 2018 Informa UK Limited, trading as Taylor & Francis Group

  • 190.
    Book, Robert T.
    et al.
    Southern Denmark University, Odense, Denmark.
    Henriksen, Kristoffer
    University of Southern Denmark, Odense, Denmark.
    Stambulova, Natalia
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Towards investigating athletic talent developmentenvironments in underserved communities in the United States2018In: The Science and Practice of Racket Sport for Improved Performance and Health: Special Focus on Table Tennis: Book of Abstracts / [ed] Urban Johnson, Lars Kristén, Miran Kondrič, Halmstad: Halmstad University , 2018, p. 69-70Conference paper (Refereed)
    Abstract [en]

    Introduction: This presentation will focus on the content of PhD project of the first author who has had extensive experiences of working in American schools within underserved (i.e., poor) communities. In spite of lacking resources, some of these schools are able to contribute into developing high performance athletes in various sports (including racket sports) and empowering them to achieve the success against the odds. These real life examples served as an inspiration to investigate such athletes’ career pathways and environments in which they had grown up.

    Aim and theoretical framework: The aim of this project is to acquire knowledge regarding the challenges and barriers faced by athletic talent development environments in underserved communities (UATDEs) and how successful UATDEs manage to help athletes achieve athletic and personal success against the odds. The study is based on the holistic ecological approach (Henriksen, 2010; Henriksen & Stambulova, 2017), and particularly on the athletic talent development environment (ATDE) model. The model was previously applied to study ATDEs in Scandinavia with its high social and economic equality. Conversely, in the United States, with its large income gap, many underserved communities struggle to produce elite athletes, and little investigation has been conducted surrounding such environments.

    Project design and method: The project will consist of three studies. Study 1will focus on exploring career pathways to athletic success and related environmental and personal factors in American athletes with low SES background through a series of interviews. Another series of interviews will be used in Study 2 to examine key stakeholders' perspectives on challenges faced and strategies implemented in UATDEs. In Study 3, the case study approach will be used to investigate two successful UATDEs within American communities and identify shared features responsible for their talent development success.

    Expected results: It is expected that Study 1 will reveal that athletes at the UATDEs were forced to deal with hardship and overcome a number of challenges that made them more resilient compared to those from affluent circumstances. From Study 2 it is expected to identify a spectrum of complicated issues (e.g., lack of funding, less access to practice time, lower moral, high stress and low levels of communication and support) that the UATDEs deal with. The anticipated results from Study 3 are that successful UATDEs have unique but also shared features that may form the basis for developing UATDE frameworks as an expansion of the holistic ecological approach.

  • 191.
    Boström, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Acute postoperative and cancer-related pain management: Patients experiences and perceptions in relation to health-related quality of life and the multidimensionality of pain2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis describes patients in acute postoperative pain as well as patients with acute cancer-related pain in palliative care, and their experiences and perceptions of pain management in relation to HRQOL and the multidimensionality of pain. A combination of qualitative and quantitative methods was chosen. Data were collected using interviews and questionnaires; APS, SF:36 and a new developed questionnaire PC-PPQ measuring care related to pain management in palliative care. For assessing pain VAS and Pain-o-Meter were used. The study group consisted of 100 patients on their second postoperative day, and of 75 patients with cancer-related pain from two palliative care teams. The result showed that at the time of the interview 29 of the patients with postoperative pain reported a pain > 3 on VAS and 79 reported VAS > 3 as worst pain past 24 hours. The higher the intensity of pain the less satisfied the postoperative patients were with the nurses´ way of treating their pain. Thirty-three patients stated that they had received information regarding the importance of pain relief. Patients with postoperative pain as well as patients with cancer-related pain had been prescribed analgesics mostly a combination of Paracetamol, NSAID and opioid. Of the 75 patients with cancer-related pain and in palliative care 22 patients reported pain >3 on POM-VAS and 47 patients reported >3 on POM-VAS as worst pain past 24 hours. Twenty-eight patients reported an average pain > 3 on POM-VAS past 24 hours. Twenty-four patients used the words troublesome or tiring when describing their affective pain. Sensory pain was described as prickling or sore by 15 patients. The patients perceived their pain as “aching all over” and expressed a wish for pain relief as well as a fear for increased pain. HRQOL especially physical functioning decreased for patients with average pain > 3. Being cared for by a nurseled or a physician-led palliative care team indicated no statistically significant differences for patients´ HRQOL or pain intensities. The patients had experienced a statistically significant better care after being referred to a palliative care team, despite that pain control had not been optimized. Patients expressed a need for communication, planning and trust in order to improve pain management. Continuity of care and the opportunity to talk increase the patients feeling of security, as well as improved their perceived pain control. Structured ongoing discussion concerning pain management from an early stage of the disease or already preoperatively can provide an important intervention to meet the results of this thesis. Pain assessment covering the multidimensionality of pain, and pain treatment plans including both pharmacological and non-pharmacological treatment are further important interventions.

  • 192.
    Boström, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Hinic, Hansi
    Halmstad University, School of Social and Health Sciences (HOS).
    Lundberg, Dag
    Dept. of Anaesthiol./Intensive Care, Lund University, Lund, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Pain and health-related quality of life among cancer patients in final stage of life: a comparison between two palliative care teams2003In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 11, no 3, p. 189-196Article in journal (Refereed)
    Abstract [en]

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

  • 193.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Lund University, University Hospital, Lund, Sweden.
    Fridlund, Bengt
    Lund University, University Hospital, Lund, Sweden; Department of Nursing, Lund University, Lund, Sweden.
    A comparison of pain and health-related quality of life between two groups of cancer patients with differing average levels of pain2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 5, p. 726-735Article in journal (Refereed)
    Abstract [en]

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

  • 194.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer patients' experiences of care related to pain management before and after palliative care referral2004In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 13, no 3, p. 238-245Article in journal (Refereed)
    Abstract [en]

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

  • 195.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer-related pain in palliative care: patients' perceptions of pain management2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 45, no 4, p. 410-419Article in journal (Refereed)
    Abstract [en]

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

  • 196.
    Bothmer, Margareta von
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Studenters hälsovanor – hur ser de ut? Är studenter motiverade att leva hälsosamt?2004In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 81, no 4, p. 319-333Article in journal (Refereed)
    Abstract [sv]

    Tvärsnittsstudie av studenters självskattade hälsa i relation till hälsovanor, motivation och personlighetsvariabler.

  • 197.
    Bramsved, Rebecka
    et al.
    Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Regber, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    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 status2016Conference paper (Refereed)
  • 198.
    Bramsved, Rebecka
    et al.
    Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Regber, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Novak, Daniel
    Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mehlig, Kirsten
    Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mårild, Staffan
    Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Effects of family disposable income on development of height and BMI from birth up to eight years of age2016In: European Obesity Summit (EOS) – Joint Congress of EASO and IFSO-EC: ABSTRACTS, Freiburg: S. Karger, 2016, Vol. 9, p. 44-44Conference paper (Refereed)
    Abstract [en]

    Introduction: Low socioeconomic position (SEP) is a known risk factor for development of obesity in childhood. e level of parental education is commonly used as proxy for SEP, but family disposable income is likely to also be of importance for SEP. e aim of this study was to determine the e ects of family disposable income on BMI and height trajectories from birth up to eight years of age, and the development of obesity at eight years of age.

    Methods: Growth data from birth to eight years age were collected for 3030 Swedish children. Register data on family disposable income was re- trieved from Statistics Sweden, and dichotomized for the analysis by the median value for the group. Register-derived information on parental ed- ucation and national background, maternal BMI, age and smoking status were considered as covariates in longitudinal mixed models and regres- sion analyses.

    Results: Mean birth weight was lower in families of lower income, 3.51 kg (SD 0.54) vs. 3.60 kg (SD 0.53) for children of higher-income parents, p < 0.0001. By age 5.5 years and 8 years, however, a reversed relation between groups was seen, where the children of lower income families showed signi cantly higher mean BMI. is di erence was no longer sig- ni cant when adjusting for covariates. Considering height, lower income was strongly related to lower height at 5.5 and 8 years, di erences were strengthened a er adjusting for confounders, -0.44 cm (95% CI -0.75,- 0.13) for age 5.5 years and -0.56 cm (95% CI -0.88, -0.23) at 8 years. e OR of obesity at 8 years age was 1.69 (95% CI 1.05–2.7) for the group of low income compared to the group of high income.

    Conclusions: Low family disposable income is related to increased risk of childhood obesity at 8 years of age. is could be attributed to a di erent growth pattern compared to children of high income. Our ndings that children of lower family income had lower mean birth weight and dis- played lower height later in childhood suggest that these children might have an unfavourable metabolic pro le and increased risk of developing the metabolic syndrome. © 2016 S. Karger GmbH, Freiburg 

  • 199.
    Bramsved, Rebecka
    et al.
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Regber, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Novak, Daniel
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mehlig, Kirsten
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Lissner, Lauren
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mårild, Staffan
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Parental education and family income affect birthweight, early longitudinal growth and body mass index development differently2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 11, p. 1946-1952Article in journal (Refereed)
    Abstract [en]

    AIM: This study investigated the effects of two parental socio-economic characteristics, education and income, on growth and risk of obesity in children from birth to 8 years of age.

    METHODS: Longitudinal growth data and national register-based information on socio-economic characteristics were available for 3,030 Swedish children. The development of body mass index (BMI) and height was compared in groups dichotomised by parental education and income.

    RESULTS: Low parental education was associated with a higher BMI from 4 years of age, independent of income, immigrant background, maternal BMI and smoking during pregnancy. Low family income was associated with a lower birthweight, but did not independently predict BMI development. At 8 years of age, children from less educated families had a three times higher risk of obesity, independent of parental income. Children whose parents had fewer years of education but high income had significantly higher height than all other children.

    CONCLUSION: Parental education protected against childhood obesity, even after adjusting for income and other important parental characteristics. Income-related differences in height, despite similar BMIs, raise questions about body composition and metabolic risk profiles. The dominant role of education underscores the value of health literacy initiatives for the parents of young children. ©2018 Foundation Acta Pædiatrica.

  • 200.
    Bremander, Ann
    et al.
    Spenshult Hosp Rheumat Dis, Ctr Res & Dev, S-31392 Oskarström, Sweden .
    Bergman, Stefan
    Spenshult Hosp Rheumat Dis, Ctr Res & Dev, Oskarström, Sweden .
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Perception of multimodal cognitive treatment for people with chronic widespread pain: changing one's life plan2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 24, p. 1996-2004Article in journal (Refereed)
    Abstract [en]

    Purpose.

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

    Methods.

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

    Results.

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

    Conclusion.

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

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