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  • 201.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Department of Nursing, Lund University, Lund, Sweden.
    Factors influencing nurse supervisor competence: a critical incident analysis study2005In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 13, no 3, p. 231-237Article in journal (Refereed)
    Abstract [en]

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

  • 202.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Löfgren, H.
    Department of Educational and Psychological Research, School of Education, Malmö University, Malmö, Sweden .
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychiatric nurses' conceptions of how a group supervision programme in nursing care influences their professional competence: a 4-year follow-up study2001In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 9, no 3, p. 161-171Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

    © 2001 Blackwell Science Ltd.

  • 203.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Löfgren, H.
    Department of Educational and Psychological Research, School of Education, Malmö University, Malmö, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Psychiatric nurses' conceptions of how group supervision in nursing care influences their professional competence2000In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 8, no 3, p. 175-185Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 204.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Petersson, Ann
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Nilsson, Inger
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Andersson, Britt I.
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Petersson, Ingemar F.
    Department of Research and Development, Spenshult Hospital, Halmstad, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    A nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis: A qualitative study2006In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 8, no 3, p. 133-139Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe a nurse-led rheumatology clinic’s impact on empowering patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic, inflammatory disease that attacks many joints, causing considerable functional restrictions for patients. Consequently, these patients are dependent on a wide variety of health-care services. A descriptive, qualitative design inspired by phenomenography was chosen. The conceptions were collected through interviews with 16 strategically selected patients with RA. Three descriptive categories comprising eight conceptions emerged: teaching (gaining insight and receiving information), regular review (receiving security, realizing regularity, and achieving accessibility), and attention (getting a holistic assessment, receiving coordinated care, and getting sufficient time). A nurse-led rheumatology clinic can be a source for empowering patients with RA to adopt new stances to alternative actions and achieve a higher level of faith in their own abilities.

  • 205.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, IngelaHögskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Psykiatrisk omvårdnad: att stödja hälsofrämjande processer2006Collection (editor) (Other (popular science, discussion, etc.))
    Abstract [sv]

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

    (Beskrivning från förlaget)

  • 206.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    The Sahlgrenska Academy at Göteborg University, Department of Primary Health Care, Göteborg, Sweden.
    Fridlund, Bengt
    The Sahlgrenska Academy at Göteborg University, Department of Primary Health Care, Göteborg, Sweden.
    The development of a questionnaire for evaluating process-oriented group supervision during nursing education2008In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 8, no 2, p. 88-93Article in journal (Refereed)
    Abstract [en]

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

  • 207.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Science, Göteborg, Sweden.
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Sweden.
    Svensson, Marie-Louise
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    The Sahlgrenska Academy at Göteborg University, Department of Primary Health Care, Göteborg, Sweden.
    Effects of process-oriented group supervision as reported by nursing students: a pilot study2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 1, p. 26-29Article in journal (Refereed)
    Abstract [en]

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

  • 208.
    Arvidsson, Barbro
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Skärsäter, Ingela
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Science, Göteborg, Sweden.
    Öijervall, Jörgen
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Process-oriented group supervision implemented during nursing education: nurses’ conceptions 1 year after their nursing degree2008In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 16, no 7, p. 868-875Article in journal (Refereed)
    Abstract [en]

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

  • 209.
    Arvidsson, Ellinor
    et al.
    Halmstad University, School of Health and Welfare.
    Karisaar, Alicia
    Halmstad University, School of Health and Welfare.
    Sjuksköterskors attityder gentemot patienter med alkoholberoendeproblematik: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In Sweden alcohol is consumed by people of all ages and by different social economic groups. Around 320 000 individuals in the Swedish society suffers from an alcoholrelated problem. Alcohol is considered as a legal substance and it is most common that nurses' at some point in their career will meet a patient who suffers from a    alcohol-related disease. The aim of this study was to investigate nurses' attitudes towards patients with alcohol-related problems. The study was conducted as a literature study. The result of the study is based on eight articles which was analyzed and processed. From this process three different categories emerged and founded the result: Nurses' attitudes: negative, neutral and positive, Nurses' attitudes regarding the right to receive care towards patients with alcohol-related problems and How education can affect nurses' attitudes towards patients with alcohol-related problems There was existing negative, neutral and positive attitudes among the nurses'. The nurses' experiences was the main consideration that contributed to the attitudes. Regardless the attitude, the nurses' opinions were that patients with alcohol-related problems had the right to demand care and to be treated. To achieve more positive attitudes among the nurses', they need more education about the subject alcoholrelated problems.

  • 210.
    Arvidsson, Jenny
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Theodorsson, Linda
    Halmstad University, School of Social and Health Sciences (HOS).
    Den fysiska aktivitetens betydelse för depression2011Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Depression is a disease where scientists are not in agreement on its origin. Research indicates that depression will be the second most common disease in the world year 2020. Physical activity is important for the public health and benefits the individuals both physically and psychologically. The purpose of this literature study was to illustrate the relation between depression and physical activity. The result is based on 14 articles which relate to the purpose. The result showed that persons who are physically active have less risk of suffering from psychological difficulties such as depression. There is also a connection between how much physical activity that is carried out and the degree of depression. The nurse's role is important to prevent and relieve depression. In consultation with the patient, physical activity can be suggested as a complement to medical treatment. It can be enough with a couple of walks per week to prevent beginning of depression as well as ease symptoms for those who already suffer from depression. If more people exercised on a regular basis the frequency of depression would most likely be reduced. Further research in this area should be carried out as well as the implementation of knowledge that already exists. It is important that the beneficial effects, which physical activity has on depression, reach all relevant persons within health and medical care industries and that it is implemented. In conjunction with additional research this can lead to physical activities being partial replacement to medical treatment.

  • 211. Arvidsson, Julia
    Difference in Jump Height and Jump Length in Youth Soccer Players Selected or Not Selected for the National Team2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: With the aim of professional status and sporting success, selection processes and talent identification in youth players are common in football clubs and national teams. Football requiring different types of abilities, standing out in certain abilities can be important in the selection process for national teams. Physical abilities including maximal power can differ between players in the same age group due to growth and maturation and might therefore be important factors in the selection process. Previous studies have mentioned maximal power as one of many performance indicators for football performance. However, few studies have investigated its importance regarding youth players selected or not selected for the national team. Aim: The study was designed to measure and compare jump height and jump length in three different jump tests between youth soccer players selected or not selected for the national team. Methods: Twenty-two (n=22) players, eleven national players and eleven non-national players performed three different jump tests. The players were 17±2 years old from the club Halmstads BK, Halmstad. The study was an observational crosssectional study that was designed to measure and compare jump height and jump length in three different jump tests between youth soccer players selected or not selected for the national team. The jump tests that were used in the present study was Countermovement Jump (CMJ), Abalakov Jump (AJ) and Standing Long Jump (SLJ). Mean scores for the tests in both groups were analyzed and compared and the criterion level for significance was set to p ≤ 0.05. Results: The results showed a significant difference between the groups regarding jump height in CMJ (p=0.013) and in AJ (p=0.010). No significant difference was found regarding jump length in SLJ (p=0.084). Conclusion: The findings of this study showed a significant difference in Countermovement Jump (CMJ) and Abalakov Jump (AJ) between national players (NP) and non-national players (NNP). The study found no significant difference between the groups in Standing Long Jump (SLJ). The results indicate the use of maximal power as a performance indicator and part of the selection of players to national teams. Anthropometric data (age, weight and height) was similar between the groups, therefore, other maturation and growth factors together with biological age are aspects that might have influenced the results. Future studies are suggested to investigate maturation status and its importance for maximal power in national players and non-national players. 

  • 212.
    Arvidsson, Susann
    Högskolan i Jönköping, Jönköping, Sverige.
    Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a desciptive and interventional study2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The overall aim of this thesis with a salutogenic approach was to describe health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, and to evaluate the effects of an intervention study with a self-care promoting PBL-program for people with rheumatic diseases having chronic musculoskeletal pain, sleep disturbances and/or fatigue.

    Methods: This thesis is comprised of four samples: a randomly selected sample from a Swedish general population (study I) and three different samples containing people with rheumatic diseases registered at a hospital for rheumatic diseases in the southwest of Sweden (studies II, III and IV). Study I had a longitudinal cohort design with an eight-year follow-up in a general population. There were 1109 participants without chronic pain and 700 participants with chronic musculoskeletal pain. Study II had a longitudinal cohort design with participants with rheumatic diseases (n=185) 12 months after rehabilitation at a hospital for rheumatic diseases. Study III had a descriptive qualitative design with a phenomenological approach based on a reflective life-world perspective. Twelve participants were interviewed about their experiences about health-promoting self-care. Study IV had a randomised controlled design with post-test six months after the one-year self-care promoting problem-based learning (PBL) program for people with rheumatic diseases. The participants were randomly assigned to the experimental group, 54 participants, or to the control group, 148 participants. Data in studies I, II and IV were analysed with statistics. In study III a Husserlian phenomenological approach based on a reflective life-world perspective was used in the data collection and analysis.

    Results: Study I: Although participants without chronic musculoskeletal pain reported better health-related quality of life (HRQL) than participants with chronic musculoskeletal pain, similar health factors were found to promote a better HRQL in the eight-year follow-up. The most important factors were feeling rested after sleep and having good sleep structure. Study II: The most important factors promoting better outcome in HRQL 12 months after rehabilitation in participants with rheumatic diseases were having a strong sense of coherence (SOC), feeling rested after sleep, having work capacity, and having good sleep structure. Study III: The meaning of health-promoting self-care as experienced by people with rheumatic diseases was that self-care takes place against a background of continual hope and belief to be able to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three interrelated constituents elucidated the experiences: dialogue, power struggle and choice. Study IV: At the six month follow-up the participants in the experimental group had stronger empowerment after participation in the self-care promoting PBL-program compared with the control group which only got standard care for people with rheumatic diseases. There were no differences in HRQL, self-care ability, SOC, pain, quality of sleep or fatigue between the experimental group and the control group. The participants in the experimental group also stated that they had implemented lifestyle changes which they had not done without the PBL-program.

    Conclusion: The results of this thesis provide a valuable and useful insight in health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, but also in that people with rheumatic diseases have benefit from taking part in patient education with a self-care promoting PBL-program. These results contribute to evidence supporting the introduction of a more salutogenic approach in rheumatology care and research.

  • 213.
    Arvidsson, Susann
    et al.
    Department of Research and Development, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Bergman, Stefan
    Department of Research and Development, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Chronic musculoskeletal pain and sleep disturbances as predictors for lower vitality measured by the short form 36 (SF-36) - A eight-year follow up study2006In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 65, no Suppl. 2, p. 656-656Article in journal (Other academic)
    Abstract [en]

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

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

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

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

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

  • 214.
    Arvidsson, Susann
    et al.
    FoU Centrum, Spenshult, Halmstad, Sverige & Hälsohögskolan, Jönköping, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Hälsohögskolan, Jönköping, Sverige.
    Bergman, Stefan
    FoU Centrum, Spenshult, Halmstad, Sverige.
    Factors promoting health-related quality of life in patients with rheumatic diseases 12 months after rehabilitation2010In: Svenska Läkaresällskapets Riksstämma 2010: Program: Reumatologi, 2010, p. 3-3Conference paper (Refereed)
    Abstract [en]

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

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

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

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

  • 215.
    Arvidsson, Susann
    et al.
    Research and Development Centre Spenshult, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Research and Development Centre Spenshult, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Factors promoting health-related quality of life in people with rheumatic diseases: a 12 month longitudinal study2011In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 12, article id 102Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 216.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Feeling rested predicts good health in subjects with and without chronic musculoskeletal pain2008In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 67, no Suppl. II, p. 552-552Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 217.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Feeling rested predicts good health in subjects with and without chronic musculoskeletal pain2008Conference paper (Refereed)
  • 218.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Faculty of Nursing Science, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain2008In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 6, article id 98Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 219.
    Arvidsson, Susann
    et al.
    Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Experiences of health-promoting self-care in people living with rheumatic diseases2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 6, p. 1264-1272Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 220.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    People with Rheumatic Diseases Experiences of Health-Promoting Self-Care2010In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 69, no Suppl. 3, p. 743-743Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

    Disclosure of Interest: None declared

  • 221.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult hospital for rheumatic diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    People with Rheumatic Diseases Experiences of Health-Promoting Self-Care2010In: QMSH 10: 6th Nordic Interdisciplinary Conference on Qualitative Methods in the Service of Health: May 2-4, 2010 • Uppsala, Sweden: Program and Abstracts, Uppsala: Uppsala universitet, 2010, p. 67-67Conference paper (Refereed)
  • 222.
    Arvidsson, Susann
    et al.
    FoU Centrum, Spenshult, Halmstad, Sverige & Hälsohögskolan, Jönköping, Sverige.
    Bergman, Stefan
    FoU Centrum, Spenshult, Halmstad, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Gjøvik, Norge.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Bengtsson-Tops, Anita
    School of Health Sciences & Social Work, Växjö University, Växjö, Sweden.
    Upplevelse av hälsobefrämjande egenvård vid reumatisk sjukdom2009Conference paper (Refereed)
    Abstract [en]

    Bakgrund

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

    Metod

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

    Resultat

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

    Sammanfattning

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

  • 223.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Tingström, Pia
    The Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, p. 1500-1514Article in journal (Refereed)
    Abstract [en]

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

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

    Design: Randomized controlled trial.

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

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

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

  • 224.
    Arvidsson, Susann
    et al.
    FoU Centrum, Spenshult, Halmstad, Sverige & Hälsohögskolan, Jönköping, Sverige.
    Bergman, Stefan
    FoU Centrum, Spenshult, Halmstad, Sverige.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Gjøvik University College, Gjøvik, Norge.
    Fridlund, Bengt
    Hälsohögskolan, Jönköping, Sverige.
    Tingström, Pia
    Linköpings universitet, Linköping, Sverige.
    Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-232010In: Svenska Läkaresällskapets Riksstämma 2010: Program: Reumatologi, 2010, p. 3-3Conference paper (Refereed)
    Abstract [en]

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

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

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

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

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

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

  • 225.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Tingström, Pia
    Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-232012In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, no 2, p. 101-109Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 226.
    Arvidsson, Susann
    et al.
    Rheumatology, Spenshult Hospital, Oskarström, Sweden.
    Bergman, Stefan
    Rheumatology, Spenshult Hospital, Oskarström, Sweden.
    Petersson, Ingemar
    Rheumatology, Spenshult Hospital, Oskarström, Sweden.
    In Patient Team Care Improved Health-Related Quality of Life for Patients with Rheumatic Diseases over Three and Six Months2006In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 65, no Suppl. 2, p. 274-275Article in journal (Refereed)
    Abstract [en]

    Background: For measuring outcomes in team care, different aspects in the ICF (International Classification of Functioning) are relevant. Health-related quality of life as measured by SF-36 includes aspects of body function as well as activity and participation. HADS (Hospital Anxiety and Depression Scale) reflects more personal factors. Individuals with rheumatic diseases experience lower degree of health-related quality of life, compared with the general population.

    Objectives: To examine health-related quality of life as well as anxiety and depression in patients with rheumatic diseases directly after and three and six months after a period of three weeks in patient team based multiprofessional rehabilitation at a unit specialised for patients with different rheumatic diseases.

    Method: Quasi-experimental design with pre- and post-test in consecutive adult patients (Rheumatoid arthritis n=23, Spondylarthritides n=14, Osteoarthritis n=6, Other inflammatory rheumatic diseases n=10), one week before(n=55), one week after(n=53), three (n=40) and six months (n=36) after a period of three weeks of in patient team based multiprofessional care at a unit for rheumatic diseases. The instruments used for outcome measurements were the Short Form 36 Health questionnaire (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Statistical analysis was done with the SPSS package 13.0. Differences between groups were evaluated with Wilcoxon signed rank test.

    Results: The patients reported worse outcome on the eight health scales in SF-36, at baseline and one week, three and six months after the rehabilitation, when comparing with the norm for the Swedish population. The mean values for SF-36 improved in all eight subscales one week after the rehabilitation period and six of the health scales obtained statistically significant improvement (p<0.05). Three and six months later there was still a statistically (p<0.05 for 3/8 subscales; Role Physical (RP), Vitality(VT) and Mental Health(MH)) and/or clinically significant (5/8 subscales; Physical function(PF), Bodily Pain(BP), General Health(GH), Social Fundtioning(SF) and Role Emotional(RE)) improvement as compared to the levels before the rehabilitation period. The levels for anxiety and depression as measured by HADS improved significantly (p<0.05) one week after the rehabilitation period as compared to baseline. Three and six months after the rehabilitation period, the levels were the same as at baseline.

    Conclusion: Earlier studies and this study have shown that people with rheumatic diseases experience reduced health-related quality of life and increased anxiety and depression. The result from this study showed that after a period of three weeks in patient team based multiprofessional rehabilitation, the experience of health-related quality of life was improved also after three and six months whereas the improvement in anxiety and depression returned to baseline after three and six months. Thus, improvements in health-related quality of life seem to reflect other aspects of the disease consquences than anxiety and depression.

  • 227.
    Arvidsson, Susann
    et al.
    R&D-center, Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Bergman, Stefan
    R&D-center, Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Petersson, Ingemar F.
    R&D-center, Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    In-patient team care improved health-related quality of life for patients with rheumatic diseases over three and six months2006Conference paper (Refereed)
  • 228.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Gilljam, Britt-Mari
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Region Halland, Halmstad, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Ruland, Cornelia Maria
    The Centre for Shared Decision Making and Collaborative Care Research (CSDM), Oslo University Hospital, Oslo, Norway & University of Oslo, Oslo, Norway.
    Nordby-Bøe, Trude
    The Centre for Shared Decision Making and Collaborative Care Research (CSDM), Oslo University Hospital, Oslo, Norway.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Redesign and Validation of Sisom, an Interactive Assessment and Communication Tool for Children With Cancer2016In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 4, no 2, article id e76Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Children with cancer undergo intensive and long treatment periods that expose them and their families to a number of difficult physical, mental, and social challenges. Empowering children by actively involving them in their care can help them to cope with these challenges. It can, however, be difficult for children to be involved and talk about their illness experiences in a "traditional" conversation with health care professionals, especially for younger children. Sisom (Norwegian acronym "Si det som det er" or "Tell it how it is") is an interactive computer-based assessment and communication tool to give children (aged 6-12 years) with cancer a "voice" in their care. Because of technological advances and widespread use of mobile devices Sisom had to be redesigned to better meet the needs of children of today.

    OBJECTIVE: To redesign Sisom for use on mobile devices and to validate and adapt it for use in a Swedish population of children with cancer.

    METHODS: A user-experience design was used. Content adaptation included forward-backward translation by Swedish and Norwegian translators. Healthy children (n=5), children with experiences of cancer treatment (n=5) and their parents (n=5), and pediatric nurses (n=2) were then involved in culturally adapting Sisom to the Swedish context. The iterative low- and high-fidelity evaluation was supported by a think aloud method, semistructured interviews, and drawings to capture children's views of Sisom. The redesign and evaluation continued until no further changes or improvements were identified by the participants or the researchers.

    RESULTS: Children, parents, and pediatric nurses offered many suggestions for improvements to the original version in terms of content, aesthetics, and usability of Sisom. The most significant change that emerged through user input was a modification that entailed not using problem-focused statements in the assessment items. The parents and pediatric nurses considered the revised assessment items to be general and less diagnosis specific. The evaluation of aesthetics resulted in brighter colors and more positive and exciting details in the animations. The evaluation of usability included improvements of the verbal instructions on how to navigate in Sisom 2, and also that the answers to assessmentitems in Sisom 2 should be saved to provide the children with the option to pause and to continue answering the remaining assessment items at a later stage.

    CONCLUSIONS: Overall, this paper describes the process of using user-experience design with children in order to redesign and validate an interactive assessment and communication tool and how the outcomes of this process resulted in a new version, Sisom 2. All participants confirmed the usability and qualities of using the final version. Future research should be directed toward the implementation of Sisom 2 in clinical practice and to evaluate outcomes from individual and organizational levels.

  • 229.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nylander, Maria
    Spenshult Research and Development Centre, Halmstad, Sweden & Swedish Rheumatism Association, Stockholm, Sweden.
    Bergman, Stefan
    Spenshult Research and Development Centre, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Callers´perceptions of their contact with a rheumatology telephone helpline2019In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 17, no 1, p. 105-112Article in journal (Refereed)
    Abstract [en]

    Background: Telephone helplines are useful for improving patients' access to healthcare services and reducing the need for frequent face‐to‐face contact with healthcare professionals. Little is known about how people who phone a helpline perceive the encounter.

    Objectives: The aims of the present study were to describe the variation in how callers perceive their encounter with a rheumatology telephone helpline.

    Methods: The  study  had  a  descriptive,  qualitative  design  and  used  a phenomenographic approach, comprising 27 semi‐structured telephone interviews with callers to Rheuma Direct, a rheumatology telephone helpline with specially trained nurses. The callers comprised 22 women and five men, aged 22–89 years (mean 54 years).

    Results: The callers phoned Rheuma Direct when they had problems obtaining answers to questions on the internet or from healthcare professionals. Three descriptive categories emerged: constructive dialogue, specialized competence and applicability. The callers perceived that it was a constructive dialogue when they were able to discuss their concerns with someone, received emotional support, felt reassured and were satisfied with the information provided. They perceived specialized competence when the nurses were experienced and skilful, the advice provided complemented previously received information and when they had more knowledge after the call. The callers perceived that Rheuma Direct had applicability because it was easy to access and they could make different choices before, during and after the telephone call. 

    Conclusions: Callers to a rheumatology telephone helpline perceived it as a valuable complement to other sources of information, and felt that it could provide them with the tools to manage their disease better, as well as future contacts with healthcare professionals. © 2018 The Authors Musculoskeletal Care published by John Wiley & Sons Ltd.

  • 230.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Spenshult Research and Development Centre, Halmstad, Sweden.
    Nylander, Maria
    Spenshult Research and Development Centre, Halmstad, Sweden.
    Bergman, Stefan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Spenshult Research and Development Centre, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    People's perceptions of their phone call with rheuma directly, a rheumatic diseases helpline2017In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, no Suppl. 2, p. 1544-1545, article id AB1238-HPRArticle in journal (Refereed)
    Abstract [en]

    Background Information on rheumatic diseases is often complex to understand or scary, and additional support is often necessary. Rheuma Directly (RD) is a helpline with specially trained nurses on rheumatic diseases, funded by the Swedish Rheumatism Association and Spenshult Research and Development Centre. Little is known of how people calling a helpline perceive the contact.

    Objectives To describe the variation in how people perceive the contact with the helpline RD.

    Methods The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 27 semi-structured telephone interviews. The informants were 22 female and 5 men, and their ages ranged from 22 to 89 years (mean 54 years).

    Results The informants called RD when they had problems getting answers to their questions through the Internet or from healthcare professionals. Three different description categories emerged: Specific competence, Constructive dialogue, and Applicability. The informants' perceived Specific competence when the nurses were knowledgeable, the call was complementary to previously received information and when the informants had greater knowledge after the contact with RD. They perceived that it was a Constructive dialogue when they got someone to discuss with, a “sounding board”, and perceived emotional support, felt reassured and were satisfied with the answer. The informants perceived Applicability because RD was available and they could make different choices according to their own desire; before (how and when they would contact RD), during (what to tell and what question they would ask) and after (how and what they would do after the contact with RD).

    Conclusions People calling RD perceived that the telephone call with the nurses meant meeting specific competence, gaining constructive dialogue and that the helpline was applicable. This knowledge ad to a fuller understanding of factors that from a caller's perspective, are important when calling a helpline with specially trained nurses on rheumatic diseases. © 2017, Published by the BMJ Publishing Group Limited.

  • 231.
    Ashfaq, Awais
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Predicting clinical outcomes via machine learning on electronic health records2019Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The rising complexity in healthcare, exacerbated by an ageing population, results in ineffective decision-making leading to detrimental effects on care quality and escalates care costs. Consequently, there is a need for smart decision support systems that can empower clinician's to make better informed care decisions. Decisions, which are not only based on general clinical knowledge and personal experience, but also rest on personalised and precise insights about future patient outcomes. A promising approach is to leverage the ongoing digitization of healthcare that generates unprecedented amounts of clinical data stored in Electronic Health Records (EHRs) and couple it with modern Machine Learning (ML) toolset for clinical decision support, and simultaneously, expand the evidence base of medicine. As promising as it sounds, assimilating complete clinical data that provides a rich perspective of the patient's health state comes with a multitude of data-science challenges that impede efficient learning of ML models. This thesis primarily focuses on learning comprehensive patient representations from EHRs. The key challenges of heterogeneity and temporality in EHR data are addressed using human-derived features appended to contextual embeddings of clinical concepts and Long-Short-Term-Memory networks, respectively. The developed models are empirically evaluated in the context of predicting adverse clinical outcomes such as mortality or hospital readmissions. We also present evidence that, surprisingly, different ML models primarily designed for non-EHR analysis (like language processing and time-series prediction) can be combined and adapted into a single framework to efficiently represent EHR data and predict patient outcomes.

  • 232.
    Ashfaq, Awais
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Lönn, Stefan
    Research and Development, Region Halland, Sweden.
    Nilsson, Håkan
    Economic Department, Region Halland, Sweden.
    Eriksson, Jonny
    Halland Hospital, Region Halland, Sweden.
    Kwatra, Japneet
    Brigham and Women’s Hospital, US.
    Yasin, Zayed
    Brigham and Women’s Hospital, US.
    Slutzman, Jonathan
    Massachusetts General Hospital, US.
    Wallenfeldt, Thomas
    CGI Group Inc. Consultants to Government and Industries, Sweden.
    Obermeyer, Ziad
    School of Public Health, University of California at Berkeley, US.
    Anderson, Philip
    Department of Emergency Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, US..
    Lingman, Markus
    Halland Hospital, Region Halland, Sweden.
    Data Profile: Regional Healthcare Information Platform in Halland, Sweden2019In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685Article in journal (Refereed)
    Abstract [en]

    Accurate and comprehensive healthcare data coupled with modern analytical tools can play a vital role in enabling care providers to make better-informed decisions, leading to effective and cost-efficient care delivery. This paper describes a novel strategic healthcare analysis and research platform that encapsulates 360-degree pseudo-anonymized data covering clinical, operational capacity and financial data on over 500,000 patients treated since 2009 across all care delivery units in the county of Halland, Sweden. The over-arching goal is to develop a comprehensive healthcare data infrastructure that captures complete care processes at individual, organizational and population levels. These longitudinal linked healthcare data are a valuable tool for research in a broad range of areas including health economy and process development using real world evidence.

    Key messages

    Structured and standardized variables have been linked from different regional healthcare sources into a research information platform including all healthcare visits in the county of Halland in Sweden, from 2009 to date.

    Since 2015, the regional information platform integrates a cost component to each healthcare visit: thus being able to quantify patient level value, safety and cost efficiency across the continuum of care.

  • 233.
    Ashfaq, Awais
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research. Halland Hospital, Region Halland, Sweden.
    Pinheiro Sant'Anna, Anita
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Lingman, Markus
    Halland Hospital, Region Halland, Sweden & Institute of Medicine, Dept. of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nowaczyk, Sławomir
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Readmission prediction using deep learning on electronic health records2019In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 97, article id 103256Article in journal (Refereed)
    Abstract [en]

    Unscheduled 30-day readmissions are a hallmark of Congestive Heart Failure (CHF) patients that pose significant health risks and escalate care cost. In order to reduce readmissions and curb the cost of care, it is important to initiate targeted intervention programs for patients at risk of readmission. This requires identifying high-risk patients at the time of discharge from hospital. Here, using real data from over 7,500 CHF patients hospitalized between 2012 and 2016 in Sweden, we built and tested a deep learning framework to predict 30-day unscheduled readmission. We present a cost-sensitive formulation of Long Short-Term Memory (LSTM) neural network using expert features and contextual embedding of clinical concepts. This study targets key elements of an Electronic Health Record (EHR) driven prediction model in a single framework: using both expert and machine derived features, incorporating sequential patterns and addressing the class imbalance problem. We show that the model with all key elements achieves a higher discrimination ability (AUC 0.77) compared to the rest. Additionally, we present a simple financial analysis to estimate annual savings if targeted interventions are offered to high risk patients. © 2019 The Authors

  • 234.
    Ask, AnnaLisa
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Grimberg, Carolina
    Halmstad University, School of Social and Health Sciences (HOS).
    Att stödja de som stödjer: Närståendes behov av stöd för en förbättrad interaktion med person med psykossjukdom2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Personer med psykossjukdom får idag omfattande stöd av sina närstående. Den stödjande rollen kan innebära en hög belastning och börda för närstående. Interaktionen med en person med psykossjukdom kan försvåras av en rad olika faktorer och har visats betydelsefull för sjukdomsprognosen. I sjuksköterskans arbete ingår att ge stöd och vägledning till närstående. Syftet med föreliggande litteraturstudie var att beskriva närståendes behov av stöd som kan förbättra interaktionen med person med psykossjukdom. I resultatet framkommer att närstående behöver stöd i att acceptera och förstå, både personen med psykossjukdom och sin stödjande roll. Vidare behöver närstående stöd i att bära bördan samt stöd i kommunikation och problemlösning för att exempelvis bättre kunna hantera situationer och skapa en bättre interaktion. Den kliniska verksamheten bör satsa på interventioner som förbättrar interaktionen och kan utformas som bland annat utbildning. Sjuksköterskor bör därför få fortlöpande utbildning i pedagogik. Fortsatt forskning bör fokusera mer specifikt på interaktionen mellan närstående och person med psykossjukdom och studera ett mer omfattande urval av närstående till person med psykossjukdom.

  • 235.
    Ask, Stephanie
    et al.
    Halmstad University, School of Health and Welfare.
    Edberg, Josefin
    Halmstad University, School of Health and Welfare.
    När sjuksköterskan bär samvetet på sina axlar: En litteraturstudie om samvetsstress2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In the nurse's work, care is given to patients where emotional strain become visible to the nurse. When the demands become larger than the nurse can manage while he or she is susceptible to other people's feelings, stress of conscience occurs. The aim of the study was to explore stress of conscience in the nurse. The method in this study was a general literature study that included 12 result articles. The result resulted in three themes: contributing factors, health effects and preventive factors. The result demonstrated that an insufficient working environment and bad conscience are factors that generate stress of conscience and that nurses have different tendency to be affected by stress of conscience, depending on their background and their experiences. Stress of conscience can be prevented by getting support from home, support from the organization and from colleagues, but also through the opportunity of reflection. The nurse which are affected by stress of conscience will have consequences that affect his/her private life which eventually can lead to burnout. Present research on stress of conscience is insufficient. Increased knowledge and additional research on the subject is required to lessen this relatively unexplored health problem.

  • 236.
    Askenvind, Malin
    et al.
    Halmstad University, School of Health and Welfare.
    Petersson, Charlotte
    Halmstad University, School of Health and Welfare.
    Fysisk aktivitet i omvårdnad för patienter med depression2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Depression is a psychiatric condition that increases all over the world. Depression can be diagnosed as mild, moderate and severe. Physical activity (pa) is a movement that concerns the skeletal muscles. Previous research shows that the daily recommendation for pa in depression should last at least 30 minutes. Lately it has been shown both international and national that pa is far more noted in the steps of treatment of depression. Aim: The purpose of the study was to describe physical activity in nursing in depression. Method: Systematic searches were made in databases for nursing research and resulted in 11 scientific articles analyzed by inspiration from content analysis. Results: The analysis of the 11 results articles identified three main themes: Prerequisites for physical activity, Effects of physical activity, Experience of physical activity. It was found in 10 of the 11 results articles that physical activity had a positive effect on depression. Support from another was an important part in the process for the patients with depression. Conclusion: The study's conclusion shows that stronger knowledge support is needed through research on pa in depression. Knowledge support can promote more evidence in the nursing process and thus reduce patient suffering in depression. 

  • 237.
    Asker-Arnason, Lena
    et al.
    Section of Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences, Lund University.
    Wengelin, Åsa
    Centre for Languages and Literature, Department of Linguistics, Lund University.
    Sahlén, Birgitta
    Section of Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences, Lund University.
    Process and product in writing: A methodological contribution to the assessment of written narratives in 8-12 year old Swedish children using ScriptLog2008In: Logopedics Phoniatrics Vocology, ISSN 1401-5439, Vol. 33, no 3, p. 143-152Article in journal (Refereed)
    Abstract [en]

    Twenty-seven children, with typical language development (TLD), 8-10 years old and 10-12 years old, were assessed with keystroke-logging in order to investigate their narrative writing. Measures of the writing process and the written product were used. One purpose was to explore how children produce written narratives in on-line production, and to relate the writing process to the written product. The results showed that those children who produced the final text faster, also wrote stories that comprised of more words. In the group of older children, children with better narrative ability used less pause time than those with worse ability, and the girls were faster writers than the boys. We believe that keystroke-logging gives valuable information for the assessment of young children's writing and that it is a potentially valid assessment tool for children from about 10 years of age.

  • 238.
    Asker-Árnason, Lena
    et al.
    Lund University.
    Ibertsson, Tina
    Lund University.
    Wass, Malin
    Linköping University.
    Wengelin, Åsa
    Lund University.
    Sahlén, Birgitta
    Lund University.
    Picture-elicited written narratives, process and product, in 18 children with cochlear implants2010In: Communication Disorders Quarterly, ISSN 1525-7401, E-ISSN 1538-4837, Vol. 31, no 4, p. 195-212Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to explore the narrative writing of 18 children, ages 11 to 19, with severe and profound hearing impairment who had cochlear implants (CI), compared with the performance of hearing children. Nine of the 18 children had prelingual deafness and 9 children had postlingual deafness. The hearing impairment was progressive in 11 children. The participants thus formed a heterogeneous group, which was split in two ways: according to age at testing and age at implantation. The narratives were collected by means of keystroke logging. The difference between the children with CI and the hearing children was most prominent for two measures: the percentage of pause time (in the group of children older than 13 years) and lexical density. Furthermore, the children implanted after 5 years of age performed more like the hearing children. This group consisted of children with postlingual deafness and also of children who were deafened progressively. Our interpretation is that these children benefited from the early linguistic input. Taking the whole group of participants into consideration, the results reflect linguistic and cognitive processing limitations in complex linguistic tasks like narration for the children with CI in comparison with their hearing peers.

  • 239.
    Aspe Carlsson, Madelene
    Halmstad University, School of Health and Welfare.
    Comparison of cortisol concentrations between three different conditions during the recovery from physical activity amongst the elderly: a randomised controlled cross-over study2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background

    It is estimated that around the year 2050 people over 60 years will double, and it is essential to investigate how to promote healthier lifestyles for the elderly. Exposure to the natural environment and green exercise have demonstrated health benefits, such as positive association on the perceived general health, well-being and decreased cortisol concentrations. Theories have suggested that nature is beneficial to recover in after stressors due to the characteristics of nature. Some characteristics of nature provided with added relaxations such as lush plants or open spaces and could increase the recovery. Today, people still react to stressors and stimulate the body's stress systems the same way they did during the stone age, and therefore, when people recover in nature, hormones decrease and the ability to recover increases. Therefore, the overall aim of the study was to investigate potential cortisol concentrations in three different conditions (indoor, outdoor and simulated outdoor) after a stress response from physical activity to identify health-promoting behaviours and health factors.

    Method

    The study was part of the HERO project, and the method was based on a randomised controlled cross-over design. The participants were recruited from local gyms using a purposive selection, and 48 elderly (male n = 21; women n = 27), between 66 to 80 years old participated. All participants performed three separate modified Astrand submaximal tests with 120 minutes of recovery after physical activity in three different environments (indoor, outdoor and simulated outdoor) in a randomised order. The biomarker cortisol was collected with blood samples during each test and analysed at baseline, immediately after the finished test, 60 minutes and 120 minutes after recovery. Bayesian repeated measures analysis of variance (R-ANOVA) were used as a statistical test in the analysis and were performed in JASP. The result was further interpreted by applying Ulrich’s theory of nature’s restorative effect and a health promotion perspective.

    Result

    All participants completed all experimental tests in each condition. The result supported the alternative hypothesis in outdoor exposure (BF10 = 7.257), indicating a decrease in cortisol concentrations over time, at baseline and after 120 minutes of recovery (BF10 = 3.363), and immediately after finished test and after 120 minutes of recovery (BF10 = 2.699). There were no statistically differences over time in cortisol levels in indoor (BF10 = 0.452) or simulated outdoor (BF10 = 0.150). Between indoor, outdoor and simulated outdoor, no differences in cortisol levels at baseline (BF10 = 0.279), T1 (BF10 = 0.189), T2 (BF10 = 0.097) or T3 (BF10 = 0.198) were found.

    Conclusion

    The finding in the present study supports the hypothesis that outdoor exposure appears to decrease cortisol concentrations over time and provide with additional positive health effects, which could not be observed in an indoor or simulated outdoor environment. Therefore, the outdoors is suggested to be a favourable environment for the elderly to perform and recover after a stress response from physical activity. The result can partially be explained by Ulrich’s theory which states nature as a favourable environment to recover in. How society and other areas such as healthcare and city planning could use the outdoor environment to promote physical activity in the elderly, and for the long term, improve public health, is essential to discuss further.

  • 240.
    Aspeflo, Karina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Vendelstrand, Hanna
    Halmstad University, School of Social and Health Sciences (HOS).
    Lär mig det jag vill, på mitt sätt: Patientundervisning utifrån informationsbehovet hos patienter med cancer2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Patients often experience that the information they are given is wrong. Wrong in the consideration of too little, to much, none at all, given at the wrong time, too complicated or in a difficult technical language that they do not understand. The purpose of this study was to illuminate what information needs patients with cancer may have. The study was based on 20 scientific articles and shows that most patients with cancer want to have all available information regarding both diagnosis and treatment including the available choices. However, there are some who only want limited information; therefore it is important to evaluate each patient's information needs. Well-informed patients experience less anxiety and distress and get a sense of control over their complex situation. It is therefore important for the nurse to have knowledge of the need for information and the important factors that can alter and satisfy the needs of patients. By providing patient education more space in the education of nurses, and make nurses more aware of new research, the patients' situation can in the future be further improved.

  • 241.
    Asplid, Matilda
    et al.
    Halmstad University, School of Health and Welfare.
    Becerra Ponce, Gabriela
    Halmstad University, School of Health and Welfare.
    Becerra Ponce, Paula
    Halmstad University, School of Health and Welfare.
    Att leva med en smittsam blodsjukdom2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Human immunodeficiency virus (HIV), hepatitis b and c are contagious blood diseases that exists worldwide. These three diseases are considered to be generally dangerous and as a notifiable disease. Living with a contagious blood disease can be stressful to patients both physically and mentally. The purpose of this literature study was to describe patients' experience of living with contagious blood diseases. The study is a general literature study, where qualitative research was used to produce the result. The result consists of three themes and seven different subthemes. That resulted in the creation of three themes: fear, the feeling of being unseen and the feeling of being seen. Living with a contagious blood disease can be stressful to a patient. There is a great fear for the consequence of the disease. Getting social support from relatives and their social environment has a major impact on the patient's life. The lack of social support can make the patient avoid social contact. Patients’ take alternative means such as alcohol, drugs and the patient can develop depression. As a formal caregiver it is important to see the person behind the infection, as the patient experience the meeting with formal caregivers as negative. The formal caregivers are afraid of the disease and to be infected. The patient feels judged and chooses to avoid treatment.

  • 242.
    Assarsson, Cecilia
    et al.
    Halmstad University.
    Sjöqvist, Amanda
    Halmstad University.
    Föräldrars påverkan på barns matvanor och fysiska aktivitet: En litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Övervikt och fetma är ett av de största folkhälsoproblemen i världen. I Sverige är vart femte barn i yngre skolåldern överviktig och fem procent utav dem är feta. Det är därför viktigt att veta hur stor påverkan föräldrar har på barns matvanor och fysisk aktivitet.

    Syfte: Syftet med litteraturstudien var att beskriva hur föräldrar påverkar barns matvanor och fysiska aktivitet.

    Metod: En systematisk litteraturstudie har gjorts med hjälp av databaserna PubMed och CINAHL. De inkluderade artiklarna (n=22) har analyserats och kvalitetsgranskats för att få fram ett så relevant resultat som möjligt. Dataanalys gjordes på artiklarna och dem var publicerade mellan 2009-2014.

    Resultat: Resultatet är redovisat i fyra temaområden om hur föräldrar påverkar sina barn och de områdena är föräldrars livsstil, föräldrars kunskap, föräldrars stöd och föräldrars regler och kontroll i hemmiljön. Dessa teman påverkar genom olika faktorer så som socioekonomi och utbildning, samt hemmiljön som påverkar både matvanor och den fysiska aktiviteten. Föräldrars kontroll och uppfostringsstil har en påverkan på matvanor medan stöd är det som har effekt på den fysiska aktiviteten.

    Implikation: Föräldrar behöver kunskap och medvetenhet om barnfetman och det kan uppnås med hjälp av ett högre socialt stöd. Det sociala stödet kan ges från skolan eller interventioner som involverar både föräldrar och barn.

  • 243.
    Astell, Mimi
    et al.
    Halmstad University, School of Health and Welfare.
    Truedsson, Henrik
    Halmstad University, School of Health and Welfare.
    Individers upplevelser av att leva med urostomi: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    An individual that undergoes urostomy surgery is put under a lot of stress, since the individual loses control of a basic need. Both pre- and postoperative care is crucial in order for the individuals to prepare for their new life situation after the surgery. It is important that nurses possess knowledge of care of urostomy in order to be able to teach good self-care. This can lower the risk of complications and it gives the “individual” the opportunity to rediscover independence. Purpose: The aim of the literature study was to highlight the experience of individuals living with urostomy. Method: The study was done in the form of a general literature study were scientific articles were systematically reviewed. Result: The result is based on six scientific articles that resulted in three categories: The importance of the support, The effect on self-image and changed life situation. The individuals experienced that support from both family and friends as well as from healthcare personnel was of importance. The urostomy had an effect on body-image both physically and mentally. It was difficult to choose clothing since the urostomy was in the way. A change in self-esteem was also affected by the body-image and it was mentally stressful to look at yourself in the mirror. The fear of leakage restricted the life of many and obstructed individuals from performing every day activities. Because of the urostomy both the social and sex life was affected.

  • 244.
    Atteia, A.
    et al.
    Depto. de Genética Molecular, Inst. de Fisiología Celular, Univ. Nacl. Auton. de Mex., Mexico.
    van Lis, R.
    Depto. de Genética Molecular, Inst. de Fisiología Celular, Univ. Nacl. Auton. de Mex., Mexico.
    Wetterskog, Daniel
    Department of Plant Physiology, Göteborg University, Göteborg, Sweden.
    Gutiérrez-Cirlos, E.-B.
    Department of Biochemistry, Dartmouth Medical School, Hanover, United States.
    Ongay-Larios, L.
    Unidad de Biología Molecular, Inst. de Fisiología Celular, Univ. Nacl. Auton. de Mex., Mexico.
    Franzén, Lars-Gunnar
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Plant Cell Biology: Energy transduction in plant cells.
    González-Halphen, D.
    Depto. de Genética Molecular, Inst. de Fisiología Celular, Univ. Nacl. Auton. de Mex., Mexico.
    Structure, organization and expression of the genes encoding mitochondrial cytochrome c1 and the Rieske iron-sulfur protein in Chlamydomonas reinhardtii2003In: Molecular Genetics and Genomics, ISSN 1617-4615, E-ISSN 1617-4623, Vol. 268, no 5, p. 637-644Article in journal (Refereed)
    Abstract [en]

    The sequence and organization of the Chlamydomonas reinhardtii genes encoding cytochrome c 1 ( Cyc1) and the Rieske-type iron-sulfur protein ( Isp), two key nucleus-encoded subunits of the mitochondrial cytochrome bc 1 complex, are presented. Southern hybridization analysis indicates that both Cyc1 and Isp are present as single-copy genes in C. reinhardtii. The Cyc1 gene spans 6404 bp and contains six introns, ranging from 178 to 1134 bp in size. The Isp gene spans 1238 bp and contains four smaller introns, ranging in length from 83 to 167 bp. In both genes, the intron/exon junctions follow the GT/AG rule. Internal conserved sequences were identified in only some of the introns in the Cyc1 gene. The levels of expression of Isp and Cyc1 genes are comparable in wild-type C. reinhardtii cells and in a mutant strain carrying a deletion in the mitochondrial gene for cytochrome b (dum-1). Nevertheless, no accumulation of the nucleus-encoded cytochrome c 1 or of core proteins I and II was observed in the membranes of the respiratory mutant. These data show that, in the green alga C. reinhardtii, the subunits of the cytochrome bc1 complex fail to assemble properly in the absence of cytochrome b.

  • 245.
    Attema, Joanne L.
    et al.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Pronk, Cornelis J. H.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Norddahl, Gudmundur L.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Nygren, Jens Martin
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Bryder, David
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Hematopoietic stem cell ageing is uncoupled from p16 INK4A-mediated senescence2009In: Oncogene, ISSN 0950-9232, E-ISSN 1476-5594, Vol. 28, no 22, p. 2238-2243Article in journal (Refereed)
    Abstract [en]

    Somatic stem cells are ultimately responsible for mediating appropriate organ homeostasis and have therefore been proposed to represent a cellular origin of the ageing process-a state often characterized by inappropriate homeostasis. Specifically, it has been suggested that ageing stem cells might succumb to replicative senescence by a mechanism involving the cyclin-dependent kinase inhibitor p16(INK4A). Here, we tested multiple functional and molecular parameters indicative of p16(INK4A) activity in primary aged murine hematopoietic stem cells (HSCs). We found no evidence that replicative senescence accompanies stem cell ageing in vivo, and in line with p16(INK4A) being a critical determinant of such processes, most aged HSCs (>99%) failed to express p16(INK4A) at the mRNA level. Moreover, whereas loss of epigenetically guided repression of the INK4A/ARF locus accompanied replicative senescent murine embryonic fibroblasts, such repression was maintained in aged stem cells. Taken together, these studies indicate that increased senescence as mediated by the p16(INK4A) tumor suppressor has only a minor function as an intrinsic regulator of steady-state HSC ageing in vivo.

  • 246.
    Augustsson, Emelie
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjösten, Josefin
    Halmstad University, School of Social and Health Sciences (HOS).
    Att vara patient efter ett suicidförsök2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Suicid har länge varit den främsta dödsorsaken bland unga människor.Det är en stor uppgift för sjukvården att bemöta patienterna på ett respektfullt sätt med en öppenhet och acceptans. Att ge en personcentrerad vård kräver ett holistiskt synsätt, vilket kan vara en utmaning och bygger på god kommunikation. Det finns endast ett fåtal studier genomförda om patienters upplevelser av att bli vårdade på sjukhus. Det gör att behovet av fler studier kring ämnet bör genomföras. Syftet var att belysa patienters upplevelser av omvårdnad på sjukhus efter suicidförsök.Studien var en litteraturstudie där resultatet baserades på 11 vetenskapliga artiklar som granskades och bearbetades. Resultatet visade att de suicidala patienterna var känsliga för attityder och i behov av att vistas i en miljö där de kände sig trygga. De nämnde även vikten av att få prata med någon för att känna sig betydelsefull och bli tagen på allvar. Det framkom att patienterna tyckte att sjuksköterskan var i behov av att förbättra kompetensen kring kommunikation med patienter med psykiska problem.Patienternas upplevelser av omvårdnad på sjukhus efter suicidförsök är fortfarande otillräckligt utforskad och mer forskning och kunskap behövs.

  • 247.
    Axelsson, Liza
    et al.
    Halmstad University, School of Health and Welfare.
    Söderblom, Sara
    Halmstad University, School of Health and Welfare.
    Upplevelsen av att leva med schizofreni2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Schizophrenia is a mental illness where the person’s experience of the disease is an important basis for nursing care. To improve the care, more knowledge is required about the experience of living with schizophrenia. The aim of the study was to describe the experience of living with the mental illness schizophrenia. The study was conducted as a literature study. The literature search was done systematically, resulting in 14 scientific articles that shaped the outcome of the study. A content analysis was conducted, which resulted in three categories: alienation, losses and valuable life. The results showed that people with schizophrenia feel loneliness and alienation. The disease also contributed to huge losses of life. Despite setbacks several factors that could lead to a meaningful life was revealed. To create good caring, people with schizophrenia felt that health professionals need to show respect, listen and give space. Increased knowledge about the disease is recommended to reduce the stigma of schizophrenia. Further research on how health professionals should behave against people with schizophrenia is requested.

  • 248.
    Axelsson, Mikael
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Bång, Patrik
    Halmstad University, School of Social and Health Sciences (HOS).
    Thorell, Snezana
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjuksköterskans upplevelse av arbetet med suicidala patienter inom psykiatrisk heldygnsvård.2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Approximately 800 000 people around the world, are calculated to commit suicide in 2014. In most cases, the underlying explanation is psychiatric disorders. Depression and substance-use are the most common causes of suicide-attempts or completed suicide, and in many cases the suicidal patient has been in contact with psychiatric services short before the suicide-attempt. Dealing with suicidal patients in daily work demands specialized knowledge in psychiatric care, and also good knowledge concerning prevention-work in inpatient wards. The purpose of this study was to explore the nurses’ experiences in prevention-work concerning suicidal patients in inpatient wards. The study was a qualitative interview-study with a phenomenological approach. Results show that it is often hard to decide what causes suicide, but that being confronted with suicidal patients creates concerns about one’s own competence, about what the nurse might have missed and what could have been done in a better way. It is of importance to ventilate and process the experience of a suicide attempt or completed suicide, to maintain a correct approach and view of one’s own work as a nurse.

  • 249.
    Axelsson, Pia
    et al.
    Halmstad University, School of Health and Welfare.
    Rajkovic, Charlott
    Halmstad University, School of Health and Welfare.
    Peer learning under specialistsjuksköterskeutbildningen inom intensivvård: - ett handledarperspektiv2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Peer learning is a precepting method that clarifies the link between theoretical knowledge and practical skills, and at the same time enables more students to be offered placement for clinical education. Therefore, it would be of interest to explore if the precepting strategy can be appropriate in the postgraduate nursing education in critical care. The purpose of the study was to explore peer learning as a precepting method in the postgraduate nursing education in critical care in preceptors’ point of view. The study was conducted by a focus group interview with a descriptive design with an inductive approach and data was analysed with manifest content analysis. The study revealed six categories and four subcategories. The interaction between the students was considered to develop the ability of communication and cooperation. The students could build on their former knowledge, considered as equals, and went from an inhibitive role as students. The patient and the relatives were not perceived to resent the student reasoning, they rather expressed they learned from it. The unique way to preserve students' knowledge and skills led to an early development of their already existing knowledge. The early training in communication and cooperation can be considered beneficial because deficiencies in these areas generate the most common incidents in healthcare today. The conclusion is that peer learning can be applied as a precepting method in the postgraduate nursing education in critical care. Further research of peer learning in postgraduate nursing educations is needed and also how the patient and family members experience the students' reasoning, are of great interest.

  • 250.
    Axelsson, Åsa
    Halmstad University, School of Social and Health Sciences (HOS).
    Bystander cardiopulmonary resuscitation: would they do it again?2001In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 16, no 1, p. 15-20Article in journal (Refereed)
    Abstract [en]

    During the last three decades, community education programs have been initiated with the purpose of teaching community citizens cardiopulmonary resuscitation (CPR). Millions of people have learned the technique. However, the frequency of bystander initiated CPR prior to emergency medicine service (EMS) arrival is still very low. This can lead one to ask if CPR training is optimal. Perhaps motivational aspects and psychological inhibitors to starting CPR should be included in CPR training. So far, CPR training has been skills oriented and has assumed that a bystander competent in CPR will intervene when required. However, this does not seem to be the case, as there are indications in recent research, for example, that the will to help and the courage to intervene are also needed. Bystanders who intervene in a cardiac arrest event improve the victim's chance of survival. However, there is little knowledge regarding the rescuers' reactions concerning their performance and whether they will overcome the trauma of the event and be prepared to do it again.

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