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  • 2801.
    Werkander Harstäde, Carina
    et al.
    Linnaeus University, Växjö, Sweden.
    Roxberg, Åsa
    Linnaeus University, Växjö, Sweden; Mälardalen University College, Västerås, Sweden & Haraldsplass University College, Bergen, Norway.
    The Room as Metaphor: Next-of-Kin’s Experiences in End-of-Life Care2015In: International Journal of Palliative Care, ISSN 2356-7074, Vol. 2015, p. 1-7, article id 357827Article in journal (Refereed)
    Abstract [en]

    The “room” in end-of-life is a phenomenon that needs deeper understanding as it is a dimension that shows how health and suffering are shaped. Research on the concept of room was chosen as theoretical foundation in this study in order to reach a profound understanding of the next-of-kin’s “room” in end-of-life care. Lassenius’s hermeneutic interpretation in metaphorical language was used as an deductive-inductive approach to the empirical data. The data material comprised 33 interviews with next-of-kin about their experiences of end-of-life care when being close to a relative dying from a cancer disease. The analysis of the data formed four cases: the Standby, the Asylum, the Wall, and the Place. These cases lend their voices to the experiences of the next-of-kin in the study. The findings of this study explain and may well assist nurses to understand the experiences of being next-of-kin in end-of-life care as forming a room of rest from the suffering, a room of controlling the suffering, a room of hiding from the suffering, and a room of belonging.

    © 2015 Carina Werkander Harstäde and Åsa Roxberg

  • 2802.
    Werkander Harstäde, Carina
    et al.
    Karolinska Institute, Stockholm, Sweden; Gotland University College, Visby, Sweden & Linnaeus University, Växjö, Sweden.
    Roxberg, Åsa
    Linnaeus University, Växjö, Sweden & Haraldsplass University College, Bergen, Norway.
    Andershed, Birgitta
    Gjøvik University College, Gjøvik, Norway & Ersta Sköndal University College, Stockholm, Sweden.
    Brunt, David
    Linnaeus University, Växjö, Sweden.
    Guilt and shame – a semantic concept analysis of two concepts related to palliative care2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, p. 787-795Article in journal (Refereed)
    Abstract [en]

    Background

    The theoretical viewpoint of the study was based on the fundamental motive in caring science; the suffering person and his/her health and life situation, which according to the philosophy of palliative care also includes the next-of-kin. The latter often wish to participate in the care of their loved ones and it is thus important for them to be able to make decisions that can generate a meaningful participation. Unfulfilled obligations or wrong decisions, concerning their dying relative, can result in experiences of guilt and shame in relation to the care of the loved one. A semantic concept analysis can provide a deeper understanding of these concepts and create a deeper insight into what the concepts mean for the individual.

    Aim

    The aim of the study was to elucidate the meaning of and the distinction between the concepts of guilt and shame.

    Methods

    Semantic concept analysis based on Koort and Eriksson.

    Findings

    The findings show that guilt and shame are two separate concepts. Guilt contains meaning dimensions of being the cause of and sin. Shame contains meaning dimensions of something that gives rise to shame and ability to experience shame. The synonyms for each concept do not overlap each other

    Conclusion

    The semantic analysis creates an understanding of the concepts ontologically and provides a basis for theoretical, contextual and clinical understanding and development. © 2012 Nordic College of Caring Science.

  • 2803.
    Werkander Harstäde, Carina
    et al.
    Linnaeus University, Växjö, Sweden.
    Roxberg, Åsa
    Linnaeus University, Växjö, Sweden.
    Brunt, David
    Linnaeus University, Växjö, Sweden.
    Andershed, Birgitta
    Gjøvik University College, Gjøvik, Norway & Ersta Sköndal University College, Stockholm, Sweden.
    Next of Kin's Experiences of Shame in End-of-Life Care2014In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 16, no 2, p. 86-92Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain a greater understanding of the experiences of shame of next of kin in end-of-life care. Seventeen next of kin who had lost a family member were interviewed. A method inspired by Gadamer's hermeneutic approach was used to interpret possible experiences of shame and to discuss these interpretations. The result showed that next of kin's experiences of shame are linked to their perception of the remaining time and are guided by views on morality and what is right and wrong. Shame can occur when the next of kin are involved and actually cause harm to the family member as well as in situations that are beyond their control. Shame can also involve actions that have nothing to do with what they have actually done but is instead a shame that is placed on them by others, for example, health professionals or relatives. Shame is interpreted as experiences of ignominy, humiliation, and disgrace. Second-order shame is also found. It is important that health professionals are aware of these experiences of unhealthy shame when they meet and support next of kin in end-of-life care. © 2014 by The Hospice and Palliative Nurses Association.

  • 2804.
    Wern, Maria
    Halmstad University, School of Health and Welfare.
    Omvårdnadsansvarig sjuksköterskas arbetsuppgifter och kompetens2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In Sweden 121 671 children were admitted to hospital care in 2014.  Each and every one of them needed a nurse responsible for their care, a primary nurse (PN). According to Swedish law, everyone has the right to a steady care taker if there is a need. The aim of this study was to describe what work assignments a PN within pediatric care has, and what competencies pediatric nurses consider important. Interviews with pediatric nurses were carried out to achieve this. The transcribed material has been worked at through a qualitative content analysis resulting in three categories that reflect a PN work assignments; Knowledge, Team work and Security. These three categories include work assignments such as: knowledge about the child, coordinate and planning, to be a patient confidant, and to educate. The results contribute to and elucidate a primary nurse’s work assignments and help spread knowledge about their role.

  • 2805.
    Westerberg, Martin
    Halmstad University, School of Business and Engineering (SET).
    MUSKULÄR STYRKA VID MULTIPLA REPETITIONER:: SKILLNADER VID STYRKETEST I BÄNKPRESS OCH LIGGANDE BÄNKRODD MED SKIVSTÄNGER AV OLIKA DIAMETEROMFÅNG2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: A complex interaction between muscles, tendons, bones, joints and nerves are required for optimal function of the human hand. It is known that an individual’s grip strength is vital for performance of physical demanding tasks such as strength training with free weights. Strength training including a thicker grip around the bar may enhance the strength of the grip in the athlete without other special routines for grip strength development. The purpose of this investigation was to examine the difference in performance in multiple repetitions in two strength training exercises using two different sizes on the bar, to look for correlations between grip strength of the subjects hand and the amount of repetitions executed with two different size of the bar and finally the correlation of hand size and the amount of repetitions executed with two different size of the bar.

    Method: 15 strength training men (23,9 ± 4,1 years), underwent measurements of hand size, maximum grip strength, 1 repetition maximum (1RM), a 80 % of 1RM weight strength test with two different  bar sizes.

    Results: The results from the present investigation indicates a 21,1 % reduction of 80 % of 1 RM weight performance in repetitions executed in the bench press with the thicker diameter of the bar and a 66,2 % reduction in repetitions executed with a 80 % of 1 RM weight in the lying bench row with the thicker diameter of the bar. The size of the hand or the maximum grip strength does not influences the performance in the 80 % of 1 RM strength test.

    Conclusion: With support of the results from this present investigation the size of the bar diameter significant influences the performance in maximum repetitions executed in a set in strength training with free weights, in a rowing exercise the repetitions executed reduced with 66,2 % and in the bench press the reduction of executed repetitions were 21,1 % with the thicker diameter of the bar. The size of the hand do not influences the performance of maximal executed repetitions with the thicker bar diameter. Maximal grip strength has no influence of the performance according to the findings of this investigation.

  • 2806.
    Westergren, Jessica
    et al.
    Halmstad University, School of Education, Humanities and Social Science.
    Levander, Thererse
    Halmstad University, School of Education, Humanities and Social Science.
    Stöd till anhörigvårdare vid vård i livets slut: En litteraturstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    To be a family caregiver at the end of life in homecare can be experienced as psychologically, emotionally and physicaly exhausting. It has also been found that the districtnurse finds it difficult to meet the needs of support that the family caregivers are in need of. The proportion of patients who choose to end their life at home through palliative homecare increases. A litterature study was conducted with the purpose of examining the perceived needs of family caregivers when they cared for a close one in the end of life at home. The family caregivers experience of support was considered subjective, but the literaturestudy showed there were common denominators of support such as; instrumental support, emotional support and informative support. There is a need for continued research on palliative home care as more people choose to end their lives at home and the proportion of family caregivers´are increasing. It is therefore important that the districtnurse is properly equipped to meet the needs of support that caregiver´s inquire for.

  • 2807.
    Westergården, Malin
    Halmstad University, School of Health and Welfare.
    Upplevelser av det dagliga livet bland kvinnor med långvarig utbredd smärta: En kvalitativ studie2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Långvarig smärta beskrivs idag som ett folkhälsoproblem, där cirka 10 % av befolkningen har långvarig utbredd smärta (Chronic Widespread Pain- CWP). Tillståndet är vanligare hos kvinnor än hos män och medför stora kostnader för samhället, däribland hälso- och sjukvården men ger framförallt konsekvenser för personen som drabbats och dess anhöriga. Trots att CWP är vanligare hos kvinnor än män så finns en brist på studier som fokuserar på enbart kvinnor med CWP och få studier har beskrivit hur kvinnor med CWP upplever detta fenomen ur ett vardagsperspektiv. En ökad kunskap om kvinnors upplevelser i det dagliga livet i förhållande till CWP kan därmed ge förbättrad förståelse hur det är att leva med CWP och bidra till arbetet med att förbättra hälsan hos kvinnor med CWP. Syftet med studien var därför att utforska olika upplevelser av hur det dagliga livet påverkas av CWP bland kvinnor. I studien deltog totalt 19 kvinnor i åldern 45- 67 år, som i en tidigare undersökning år 1995 inte rapporterade CWP men som år 2016 rapporterat CWP. Ett ändamålsenligt urval tillämpades med syftet att erhålla en variation hos deltagarna, vilket innefattade ålder, smärtpunkter, utbildningsnivå, civilstatus och sysselsättning. Datainsamlingen genomfördes utifrån individuella intervjuer med öppna frågor. Materialet spelades in och transkriberades ordagrant. Därefter genomfördes en kvalitativ innehållsanalys med fokus på latent innehåll som resulterade i ett övergripande tema, tre teman och åtta subteman. Det övergripande temat, förflyttningen mellan smärtan i skuggan av livet och leva livet i skuggan av smärtan framkom utifrån temana, leva med osynliga utmaningar, kämpa med begränsningar och möta det dagliga livet med plasticitet. Att leva med osynliga utmaningar relaterades till att känna sig försummad, vilket innebar känslor av att vara misstrodd och att upplevas som utåt sett frisk till följd av att smärta är en subjektiv upplevelse. Känna ensamhet bland andra människor innefattade en känsla av att inte vara en del av en social kontext och även i en social kontext, ändå känna sig ensam. Att kämpa med begränsningar relaterades till rörelsen mellan förmåga och oförmåga och innebar en osäkerheten att kunna delta i vardagliga aktiviteter till följd av smärtan. Kämpa med stress och oro inbegrep smärtans påverkan på hela kroppen och vara beroende av andra innefattade behovet av andras stöd för att utföra aktiviteter. Att möta det dagliga livet med plasticitet relaterades till att stå stilla och resignera, vilket inbegrep att avstå från aktiviteter som kunde generera mer smärta. Gå fram och tillbaka genom anpassning innebar att hitta nya sätt och göra det bästa av situationen. Att sträva framåt med motstånd och kämpaglöd innefattade att vägra låta smärtan ställa villkoren och att strida mot smärtan. Kvinnor med CWP upplever det dagliga livet olika och bör således ses som en heterogen grupp. Det fanns en variation i hur kvinnor med CWP upplevde osynliga utmaningar och hur de kämpade med begränsningar i det dagliga livet. Sättet i hur de valde att svara an på begränsningar eller osynliga utmaningar skiljde sig åt mellan kvinnorna, där deras plasticitet hade en påverkan hur de hanterade CWP. Detta belyste komplexiteten i hur kvinnor med CWP hanterade inställningen de hade mot smärtan. Inställningen varierade mellan att tillåta smärtan överskugga det dagliga livet, anpassa sitt liv efter smärtan eller vägra att smärtan bestämde villkoren, dvs. förflyttningen mellan smärtan i skuggan av livet och leva livet i skuggan av smärtan. Mer kvalitativ forskning gällande kvinnor med långvarig utbredd smärta behövs för att stödja kvinnor med CWP att hitta sin egen motvikt för att hantera det dagliga livet och samtidigt ge kvinnorna en möjlighet att berätta sin historia.

  • 2808.
    Westergården, Malin
    et al.
    Halmstad University.
    Aili, Katarina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – a constant balancing2019In: Annals of the Rheumatic Diseases, 2019, article id A1063Conference paper (Refereed)
  • 2809.
    Westergården, Malin
    et al.
    Halmstad University, School of Health and Welfare.
    Aili, Katarina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). RandD Spenshult, Halmstad, Sweden & Karolinska Institutet, Unit of occupational medicine, Institute of Environmental Medicine, Stockholm, Sweden.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). RandD Spenshult, Halmstad, Sweden.
    Living every-day life in the shadow of pain or live every-day life with the pain in the shadow – A constant balancing2019In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 1063-1064Article in journal (Refereed)
    Abstract [en]

    Background: Approximately 10% of the population report chronic widespread pain (CWP), the condition is more common in women than in men. Long-term pain is a public health problem. For most women, the pain interferes with many aspects of every-day life and implies large consequences. Thus, knowledge about how to facilitate life for these women is important.

    Objectives: To explore women’s experiences of how CWP influence their daily life

    Methods: The study has a latent qualitative content analysis design 1 . Individual interviews were conducted in 19 women 45-67 of age, who had reported CWP in a survey 2016. CWP was defined according to the 1990 ACR criteria for fibromyalgia. Pain that had lasted for more than three months, during the last 12 months, was considered chronic. A latent qualitative content analysis was used to analyze the main questions “Can you describe your experiences of living with CWP?” and “How do the CWP influence your life today?” The interviews were recorded, transcribed verbatim and coded into eight subcategories and three categories; represent the manifest content, and a latent theme exploring the interpreted content of women’s experiences of how CWP influence their every-day life.

    Results: The interviewed women expressed a life with CWP as “Living every-day life in the shadow of pain or live every-day life with the pain in the shadow” including three categories; the experience of alienation, limitations and plasticity. 1) The experiences of alienation appeared in the subcategories; suspicion and loneliness. Suspicion meant a feeling of not be taken seriously by healthcare and authorities and loneliness meant not being able to participate in social contexts. 2) The experiences of limitations in daily life includes the subcategories; barriers, stress, and dependence of other people. Barriers meant that fatigue limits the activities in every-day life, stress that constitutes limitations in life and dependence on other people’ support. 3) The experiences of plasticity referred to the subcategories resignation, adjustment and resistance. Resignation meant refraining from activities that could affect the pain, such as gardening, walking and dancing. Adjustment were manifested by making the best of the situation, and resistance meant to resist letting the pain set the terms, to give the pain a fight.

    Conclusion: Women with CWP have to deal with their physical, mental, social and spiritual environment in every-day life. They express a constant balancing in their life between mastering the pain in order to continue living as normal, and allowing the pain to set the terms, i.e. living every-day life in the shadow of pain or live every-day life with the pain in the shadow. Healthcare professionals may consider supporting the patients in finding their individual counterweight to manage life in order to reach better treatment outcome. © Westergården, Aili & Larsson 2019. No commercial re-use. See rights and permissions. Published by BMJ.

  • 2810.
    Westerlund, Anna
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Bellocco, Rino
    Karolinska Institutet, Stockholm, Sweden.
    Svensson, Madeleine
    Karolinska Institutet, Stockholm, Sweden.
    Sundström, Johan
    Uppsala University, Uppsala, Sweden.
    Åkerstedt, Torbjörn
    Stockholm University, Stockholm, Sweden.
    Lagerros, Ylva Trolle
    Karolinska Institutet, Stockholm, Sweden.
    Sleep duration does not predict major adverse cardiac events in the Swedish National March cohort study2011In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 12, no Supplement 1, p. S22-S22Article in journal (Refereed)
    Abstract [en]

    Introduction and Objectives: Experimental research suggests that sleep deprivation may alter physiological factors associated with an increased risk for cardiovascular diseases (CVDs). Prior observational studies examining the effects of sleep duration have focused on narrowly defined CVD outcomes, such as myocardial infarction or stroke only. A more comprehensive measure of CVDs is lacking. Therefore, we examined the relationship between sleep duration and Major Adverse Cardiac Events (MACE).

    Materials and Methods: In 1997, 39,047 Swedish residents (women: 64%, age: 18-94 years) were enrolled in the National March cohort study and asked to self-report their habitual sleep duration in a questionnaire. They were followed-up over approximately 7 years to study incidents of MACE. Events were defined as death from all CVDs, nonfatal myocardial infarction, stroke, or heart failure. The relationship between sleep duration and MACE was analyzed using Cox proportional hazards models.

    Results: A total of 1,730 events were observed during a median follow-up period of 7.25 years. We found 665 nonfatal myocardial infarctions, 641 nonfatal strokes, 212 nonfatal heart failures, and 198 deaths from all CVDs. Age- and sex-adjusted hazard ratios (95% confidence intervals) of MACE (with 7 hours of sleep/day as the reference group) for individuals reporting ≤5, 6, and ≥ 8 hours of sleep were 1.24 (1.05-1.47), 1.03 (0.91-1.16), and 1.09 (0.97-1.23), respectively. Adjusting for BMI and physical activity did not change the hazard ratios. When adjusting for additional confounders, e.g., depressive symptoms, sleep apnea, and smoking, the association between ≤5h of sleep and MACE was attenuated (HR: 1.22, 95% CI: 0.98-1.52).

    Conclusion: Sleep duration was not associated with the risk of Major Adverse Cardiac Events. Sleep duration, however, may not in itself explain the effects of inadequate sleep on cardiovascular diseases. Yet, it may serve as an essential component in the understanding of cardiovascular diseases. Copyright © 2011 Elsevier B.V. All rights reserved.

  • 2811. Westlund, Linett
    et al.
    Zakrisson, Clara
    Ett närmast omöjligt arbete: Sjuksköterskans upplevelse av ohälsa relaterat till stress på arbetsplatsen2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Stress är ett begrepp som har ökat i användning den senaste tiden och är en allvarlig psykisk och fysisk åkomma där sjuksköterskor är den yrkesgrupp som drabbas mest av ohälsa på arbetsplatsen. Arbetsrelaterad stress hos sjuksköterskan uppkommer av höga krav i kombination med bristande känsla av kontroll vilket kan orsaka en psykisk ohälsa som kan resultera i ångest och depression. Det påverkar sjuksköterskans prestationsförmåga som drabbar organisationen negativt då vårdskador och dödligheten hos patienter ökar. Syftet med litteraturstudien var att beskriva sjuksköterskans upplevelse av stress på arbetsplatsen relaterat till ohälsa. Studien baserades på 13 vetenskapliga artiklar som svarade mot syftet. Resultatet innefattade tre huvudkategorier; upplevelser av mänskliga faktorer, upplevelser av organisatoriska faktorer och upplevelsen av den egna ohälsan, samt nio underkategorier. Sjuksköterskans upplevelse av stress skapades av bristande kunskap, hög arbetsbelastning, kollegiala konflikter, oregelbundna arbetstider och emotionell utmattning. Den höga arbetsbelastningen inkluderade stor patientvolym, korta vårdtider och den administrativa delen som tog mycket av den patientcentrerade tiden. Arbetstiderna ansågs vara ett stressmoment då övertid som orsakande brist på återhämtning var vanligt förekommande. För att stressen ska kunna reduceras är det av vikt att uppmärksamma mer personalresurser, mindre patientgrupper, längre upplärningstid för de nyutbildade och mer ledarskapsutbildningar till handledare. Forskningen som finns tillgänglig måste nå fram till organisationen för att åtgärder ska sättas in så att sjuksköterskorna vill stanna kvar inom professionen.

  • 2812.
    Wetterholtz, Ingrid
    et al.
    Halmstad University, School of Health and Welfare.
    Nordblom, Ylva
    Halmstad University, School of Health and Welfare.
    Det glömda samtalet: En litteraturstudie om sjuksköterskans samtal kring sexuell hälsa.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sexuell hälsa är ett område inom omvårdnad som kan vara utmanande och kan ställa

    krav på att bemötandet bör ske utifrån patientens förutsättningar. Välbefinnande och

    sexuell hälsa ingår som komponenter i holistisk omvårdnad men det är endast hälften

    av sjuksköterskorna som känner sig trygga att ta upp ämnet. Syftet med

    litteraturstudien var att beskriva hindrande och främjande faktorer som kan påverka

    huruvida sjuksköterskan samtalar om sexuell hälsa med patienten. Vetenskapliga

    artiklar samlades in genom strukturerade sökningar i databaser utifrån studiens syfte

    och resulterade i tio artiklar som bearbetades. Resultatet beskrivs i tre olika teman,

    kunskap, attityder och arbetsmiljö. Resultatet visar att sjuksköterskor uppger att de

    har kunskap om hur olika sjukdomar eller behandlingar kan påverka sexuell hälsa

    men över häften av sjuksköterskorna gav ingen information eller rådgivning i ämnet.

    Hindrande faktorer som framkom, var brist på kunskap om hur ämnet skall tas upp,

    samt attityder, rutiner, tidsbrist och brist på avskilt utrymme. Främjande faktorer var

    utbildning, erfarenhet, rutiner, möjligheten till kontinuitet mellan sjuksköterskan och

    patienten samt att patienten för ämnet på tal. Litteraturstudiens resultat tyder på att

    fortsatt omvårdnadsforskning behövs om hur patienten upplever problem med sexuell

    hälsa, till följd av sjukdom och behandling, samt om omhändertagandet i vården.

  • 2813.
    Wiberg, Alexandra
    Halmstad University, School of Health and Welfare.
    Football Fitness as an activity for healthpromotion among women: A mixed methodstudy2019Independent thesis Advanced level (degree of Master (One Year))Student thesis
    Abstract [sv]

    Bakgrund: Tidigare forskning visade attd 23 % vuxna och 81% av tonåringar över hela världen inte uppfyllede rekommendationerna för fysisk aktivitet 2010. Fysisk inaktivitet är relaterat till ökad risk för sämre hälsa och att drabbas av livsstilssjukdomar. Fotboll Fitness är ett relativt nytt koncept av organiserad fysisk aktivitet med måttlig och hög intensitet. Träningsformen kombinerar styrka och kondition som passar alla åldrar och könstillhörighet oavsett tidigare fotbollserfarenheter eller fysisk förmåga. Att vara en del av en grupp och etablera sociala relationer har visats vara relaterat till förbättrat välbefinnande samt var en av huvudfaktorerna till deltagande. Syftet med studien var därför att undersöka om deltagande i Fotboll Fitness var relaterat till positiva förändringar av psykisk hälsa och välbefinnande samt att sträva efter att utforska och skap en förståelse för kvinnors erfarenheter av deltagandet.

     Metod: Kvinnorna (N=18) i åldern 15 till 54 år medverkade i en 6 veckors intervention, 2 träningspass i veckan, á 90 minuter. Följande inklusionskriterier användes för att genomföra urvalet: (1) bör var mindre fysisk aktiva än 150 minuter i veckan, (2) hade inte spelat organiserad fotboll under de 10 senaste åren och (3) var inte kliniskt diagnostiserade med psykisk ohälsa. Studien genomfördes med en mixad metod genom en experimentell design som involverade tre tidpunkter för att mäta kvinnors upplevda välbefinnande, aktuella fysiska funktioner, socialt kapital och om deltagande i Fotboll Fitness upplevdes som meningsfullt. Vidare genomfördes fokusgruppsintervjuer efter avslutad intervention. Kvantitativ data analyserades genom Bayesian repeated measures analysis of variance (R-ANOVA) och ett one pair sample t-test användes som statistiska tester i analysen och utfördes i JASP. Kvalitativ data analyserades genom en kvalitativ innehållsanalys med en induktiv ansats.

    Resultat: Resultatet av den kvantitativa analysen visade att Fotboll Fitness hade en positiv inverkan på kvinnors välbefinnande (BF10=3659.057), och sociala kapital (BF10=831.785) över tid. Vidare visade resultatet att kvinnor som deltog upplevde att det var meningsfullt att delta i Fotboll Fitness (BF10=2.570e+6). Analysen visade stöd för nollhypotesen gällande att Fotboll Fitness ska ge effekt på kvinnors nuvarande upplevda vardagsfunktioner (BF10=.0576). Det kvalitativa resultatet visade att kvinnor upplevde trygghet, gemenskap, tillfredsställelse och glädje under deltagandet vilket skapade ett mervärde för kvinnor utan tidigare erfarenheter av fotboll.

    Slutsats: Resultatet från föreliggande studie stödjer hypotesen om att Fotboll Fitness bidrar till positiva förändringar av psykisk hälsa och välbefinnande. Kvinnorna som deltog i studien upplevde trygghet, gemenskap, tillfredsställelse och glädje i deltagandet vilket är faktorer som bidrar till en ökad hälsa och ett ökat välbefinnande. Resultatet från studien visade att kvinnorna värdesatte gruppträning där de fick möjlighet att skapa sociala relationer i samband med träningen och att det var positivt med en inkluderande tränare och grupp som skapade en trygg miljö. Dessa faktorer bidrog till att kvinnor som deltog upplevde att deltagandet i Fotboll Fitness tillförde ett mervärde vilket indikerar att ytterligare studier bör undersöka sambandet mellan Fotboll Fitness och livstilsprediktorer .

  • 2814.
    Wiberg, Alexandra
    et al.
    Halmstad University, School of Health and Welfare.
    Bergman, Daniel
    Halmstad University, School of Health and Welfare.
    RELATIONEN MELLAN AUTONOMISTÖD OCH FYSISK AKTIVITET: En kvantitativ studie baserad på elever i årskurs 92015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to examine, in a population of ninth grade high-school students,whether autonomy support from parents and the fulfilment of basic psychological needspredicted participation in physical activity both in leisure time and in PE classes. Based onprevious research we hypothesised that autonomy support would have an indirect effect onparticipation in physical activity in leisure time and school sports through the psychologicalbasic needs.The study involved 193 students from ninth grade in the Swedish school system.Mediation analyses were performed to investigate the stated hypotheses. The results showedthat a positive indirect effect from autonomy support on participation in physical activity inleisure time through psychological basic needs. Further there was no statistically significantcorrelation between autonomy support, basic needs and participation in PE classes.Based on this study we concluded that autonomy supports as well as the psychologicalbasic needs are two important factors to focus on to get high-school students to be physicallyactive.

  • 2815.
    Wiberg, Anna
    Halmstad University, School of Social and Health Sciences (HOS).
    Stressrelaterad ohälsa hos föräldralösabarn och ungdomar i länder utanför Europa2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: There are 143 million orphans and adolescentsaround the world today. They have lost an important protection in their lives. The protection a genetic parent is expected to provide is the best for the child or adolescent to survive.Purpose:The purpose of this study was to illuminate factors thattrigger stress-related illness among orphans in countries outside Europe.Method:This paper is performed as a literature study and it isbased upon 12 scientific articles.Results:A total of three themes are presented which were; Care,witnessed violence and the feeling of powerlessness. Common to the three themes is that they showed how the situation and health is of orphaned children and adolescents. Stress occurred for example at times when they had witnessed a serious incident which changed their life situation.They experienced negative attitudes from society which made it difficult for the orphaned children and adolescents to have a normal life.Implication:This knowledge can be used to create a supportiveenvironment for the children and adolescents. More information to guardians and concerned organizations about health promotion is also an appropriate measure. 

  • 2816.
    Wickholm, Maritha
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Women's health after a first myocardial infarction: a comprehensive perspective on recovery over a 4-year period2003In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 2, no 1, p. 19-25Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Little attention has so far been focused on follow ups of women's long-term recovery after a myocardial infarction (MI), especially from a comprehensive perspective.

    AIM:

    The aim of this study was to prospectively determine women's self-rated health after a first MI from a comprehensive perspective on recovery over a 4-year period.

    METHODS:

    Consecutively chosen women (n=240) who had suffered a first MI were asked to complete a self-rated questionnaire regarding health (including not only biophysical, but also behavioral, emotional, social and working conditions) before being discharged from hospital as well as 1 and 4 years later. The results were analyzed by descriptive and inferential statistics.

    RESULTS:

    Health improvements, especially during the first year, could be observed in the women's behavioral condition regarding their attitude to diet consciousness, exercise, simultaneous capability and smoking behavior as well as in the emotional condition regarding their stressful life events, depressed mood and loss of control. In the social condition, the women considered that the healthcare professionals had improved their support over time as well as treating the women's complaints more seriously. Regarding the working condition, the women felt that they were being controlled at work, especially during the first year after the MI.

    CONCLUSIONS:

    Based on a comprehensive perspective on women's recovery after a first MI, a favorable development of the women's health was observed in the behavioral and emotional conditions while deterioration in the social and working conditions was observed over time. Thus, further efforts are needed in the two latter conditions by means of further studies in combination with greater support from healthcare professionals.

  • 2817.
    Widäng, Ingrid
    et al.
    Jönköping University.
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Self-respect, dignity and confidence: conceptions of integrity among male patients2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 42, no 1, p. 47-56Article in journal (Refereed)
    Abstract [en]

    Background.

    Integrity is a complex and important concept in ethical reasoning and in nursing care. Integrity is part of being a human being, a wholeness, and in this sense it also refers to health. Preserving patients' integrity is an important aspect of nursing care, as a number of situations arise in which they can feel threatened or violated. Integrity can also refer to acting according to general ethical principles and rules, i.e. moral integrity.

    Aim.

    The aim of this Swedish study was to describe how male patients conceive integrity.

    Methods.

    Seventeen male patients were strategically selected for interviews, which were analysed by a phenomenographical approach.

    Findings.

    The patients expressed 12 different conceptions of integrity that were summarized into three description categories: self-respect, dignity and confidence. This means that patients give themselves integrity when they believe in themselves, have the courage to set boundaries, have control over themselves and their situation, and have the possibility of being alone. Caregivers can preserve a patient's integrity by seeing him as trustworthy and as a whole person, and by showing respect. Confidence in a caring situation is characterized by trust in professionals, a balance between patients' and the caregivers' wishes, patient participation, the possibility of being free and confidentiality of information.

    Discussion.

    Integrity could be described as what something 'is' and as a 'relationship' with oneself and others. It is imperative that caregivers are aware of patients' conceptions of integrity in order to identify and preserve their integrity and also so that they treat them in accordance with moral integrity. The findings are limited to male patients, and questions about female patients' conceptions are raised.

  • 2818.
    Widén, Louise
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Andersson, Emma
    Halmstad University, School of Social and Health Sciences (HOS).
    Den som inget frågar, får inget veta: Sjuksköterskors professionella möte med våldsutsatta kvinnor2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Våld mot kvinnor är ett stort problem i dagens samhälle. Våldet har stora effekter på kvinnors hälsa och sjukvården har ett optimalt läge i att upptäcka och hjälpa kvinnorna ur våldssituationen. Sjuksköterskan är ofta den första inom vården som möter kvinnorna. Möten med våldsutsatta kvinnor omges av utmaningar för sjuksköterskan både på ett professionellt och personligt plan. Syftet med studien var att belysa bemötande och omhändertagande av våldsutsatta kvinnor ur ett sjuksköterskeperspektiv. Utifrån analys av 12 vetenskapliga artiklar framkom fyra faktorer som arbetets resultat bygger på. För att sjuksköterskor skall vårda våldsutsatta kvinnor på ett optimalt vis behövs kunskap om våld, ett bra förhållningssätt gentemot patienten, god hantering av egna känslor samt förståelse av miljöns betydelse. Samtliga faktorer har ett stort samband med varandra och är grundläggande för sjuksköterskor i mötet med våldsutsatta kvinnor. Pågående forskning inriktas på att fördjupa kunskap och insatsmetoder för organisationer och myndigheter i bekämpandet av våld. Grundutbildningen för sjuksköterskor borde inkludera undervisning om våld i närarelation och förbereda sjuksköterskor för att kunna hantera den emotionella press som kan uppstå i mötet med våldsdrabbade kvinnor. 

  • 2819.
    Wieslander, Inger
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Cardiac rehabilitation in hospital and at home: a long-term study from the perspective of women who have suffered their first myocardial infarction2004Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim of this licentiate thesis was to describe and compare, from a longitudinal perspective, the extent of cardiac rehabilitation efforts as well as changes in social support and social network in women who have suffered their first myocardial infarction (MI). The studies had a descriptive, comparative and longitudinal design. Data were collected from healthcare professionals at 18 acute hospitals, who on two occasions answered a questionnaire dealing with cardiac rehabilitation efforts. From these 18 hospitals, 240 women who had suffered a first MI were consecutively chosen to answer a questionnaire on three occasions on the subject of social support and social network. Descriptive and inferential statistics were used to analyse data over time. The result showed that patients with different ischaemic heart disease diagnoses and their next-of-kin were offered different cardiac rehabilitation programmes (CRPs). None of the hospitals offered a CRP that was specifically designed for women. The women experienced that the extent of general support, support from relatives, and professional support changed positively over time. The women who participated in a CRP reported less need for professional support over time compared to non participants. This licentiate thesis provides knowledge about social support and social network that can be used to develop CROPs based on the special needs of women with MI and their relatives.

  • 2820.
    Wieslander, Inger
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Baigi, Amir
    Göteborg University.
    Turesson, Christina
    Central Hospital Halmstad.
    Fridlund, Bengt
    Växjö University.
    Women's social support and social network after their first myocardial infarction: a 4-year follow-up with focus on cardiac rehabilitation2005In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, no 4, p. 278-285Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge about women's recovery following a myocardial infarction (MI) with focus on how their social support and network change over time as a result of participation in a cardiac rehabilitation programme (CRP) is not well established. Aim: The aim of this study was to describe and compare social support and network changes over a 4-year period in women with a first MI, based on socio-demographic and situational data. Method: A longitudinal, comparative study with a non-randomised design including pre- and post-tests (1 and 4 years after MI) was carried out in 18 hospitals in Sweden. Consecutively chosen women (N = 240) answered a questionnaire on the subject of social support and network. Results: The women who participated in a CRP were mainly dependent upon professional support during the first year after MI (p < 0.0001), while those who declined to participate in a CRP needed professional support throughout the whole 4-year period (p = 0.001). Participation in CRP was dependent on the women's age, those under 60 years (p = 0.050). Conclusion: There is a need to develop CRPs that are specifically designed for women based ontheir age and family relationships. Nurses' training programmes should place greater emphasis on cardiac rehabilitation from the perspective of women with focus on professional support. © 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  • 2821.
    Wieslander, Inger
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cardiac rehabilitation efforts for patients with ischaemic heart disease - a 5-year comparative review in five counties in western Sweden2001In: Coronary Health Care, ISSN 1362-3265, E-ISSN 1532-2025, Vol. 5, no 1, p. 16-24Article in journal (Refereed)
    Abstract [en]

    Today’s cardiac rehabilitation programmes are multiphase and interdisciplinary. The aim of the study was to compare different cardiac rehabilitation approaches available to patients with ischaemic heart disease and their next-of-kin during a 5-year period in five counties in Western Sweden. Questionnaires were answered on two occasions, in 1993 and 1998, dealing with the cardiac rehabilitation organization, the target groups invited, rehabilitation efforts, and the health-care professionals involved in the cardiac rehabilitation. The results show that patients with myocardial infarction and their next-of-kin were offered a well-functioning cardiac rehabilitation, both in 1993 and in 1998, at the university, county and district county hospitals. For patients who had undergone bypass surgery and their next-of-kin, cardiac rehabilitation was only available to a lesser extent. Patients with angina pectoris and their next-of-kin had the least possibility of receiving cardiac rehabilitation during the 5-year period. No cardiac rehabilitation programmes were specially designed for women, and an age limit existed in some cases. The most developed cardiac rehabilitation effort was the stress management education. The health-care professionals most frequently included in the cardiac rehabilitation teams at the university and district hospitals were dieticians, cardiologists, physiotherapists and nurses, both in 1993 and in 1998. The corresponding health-care professionals at the county hospitals were cardiologists, social workers, clergymen, physiotherapists and nurses. A research implication can be to identify who the next-of-kin are, what their experiences are of participating in a cardiac rehabilitation programme and how important they are to these patients.

  • 2822.
    Wieslander, Inger
    et al.
    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.
    Mårtensson, Jan
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Cardiac Rehabilitation Nurses’ Experiences of Factors Influencing Female Patients’ Recovery After Their First Myocardial Infarction2013In: European Journal of Cardiovascular Nursing, London: Sage Publications, 2013, Vol. 12, p. S77-S78Conference paper (Refereed)
    Abstract [en]

    Introduction

    Secondary prevention care after a Myocardial Infarction (MI) has not improved during the last 15 years at the same rate as acute MI care. One reason could be that research and health care focus more on treatment, symptoms and risk factors and not on the individuals’ perceptions of the recovery process after an MI. Most previous research focuses on recovery from the women’s and their partners’ point of view. Since cardiac rehabilitation nurses meet many women after MI, their experiences of the women’s recovery process may be an important complement perspective.

    Purpose

    The aim was to explore cardiac rehabilitation nurses’ experiences of factors influencing female patients’ recovery after their first MI.

    Method

    The study was conducted using qualitative content analysis. Twenty cardiac rehabilitation nurses were interviewed and the study was carried out at 10 hospitals in Sweden.

    Conclusions

    Cardiac rehabilitation nurses experienced that women’s recovery after an MI was influenced by factors that were both related to their own individual as well as by their surroundings factors. The underlying meaning of women´s recovery is characterized as the transition process to the recovery to health.

  • 2823.
    Wieslander, Inger
    et al.
    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 Jönköping.
    Mårtensson, Jan
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Female patients' recovery after their first myocardial infarction2013Conference paper (Refereed)
    Abstract [en]

    Introduction

    Secondary prevention care after a Myocardial Infarction (MI) has not improved during the last 15 years at the same rate as acute MI care. One reason could be that research and health care focus more on treatment, symptoms and risk factors and not on the individuals’ perceptions of the recovery process after an MI. Most previous research focuses on recovery from the women’s and their partners’ point of view. Since cardiac rehabilitation nurses meet many women after MI, their experiences of the women’s recovery process may be an important complement perspective.

    Purpose

    The aim was to explore cardiac rehabilitation nurses’ experiences of factors influencing female patients’ recovery after their first MI.

    Method

    The study was conducted using qualitative content analysis. Twenty cardiac rehabilitation nurses were interviewed and the study was carried out at 10 hospitals in Sweden.

    Conclusions

    Cardiac rehabilitation nurses experienced that women’s recovery after an MI was influenced by factors that were both related to their own individual as well as by their surroundings factors. The underlying meaning of women´s recovery is characterized as the transition process to the recovery to health.

  • 2824.
    Wieslander, Inger
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Mårtensson, Jan
    Högskolan Jönköping, Jönköping, Sverige.
    Fridlund, Bengt
    Högskolan Jönköping, Jönköping, Sverige.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Factors influencing female patients’ recovery after their first myocardial infarction as experienced by cardiac rehabilitation nurses2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, p. 230-240Article in journal (Refereed)
    Abstract [en]

    Background: In the developed part of the world, coro- nary heart disease is the major cause of death and is one of the leading causes of disease burden. In Swe- den, more than 30,000 people per year are affected by myocardial infarction and out of these approximately 40% are women. Nearly 70% of the women survive and after a myocardial infarction a recovery process follows. Today’s health care focuses more on treat- ment, symptoms and risk factors than on the indi- viduals’ perceptions of the recovery process. Aim: To explore cardiac rehabilitation nurses’ experiences of factors influencing female patients’ recovery after their first myocardial infarction. Methods: Twenty cardiac rehabilitation nurses were interviewed. The study was conducted using qualitative content analy- sis. Results: The cardiac rehabilitation nurses experi- enced that women’s recovery after a first myocardial infarction was influenced whether they had a suppor- tive context, their ability to cope with the stresses of life, if they wanted to be involved in their own per- sonal care and how they related to themselves. Con- clusions: Women’s recovery after a myocardial in- farction was influenced by factors related to sur- roundings as well as own individual factors. The un- derlying meaning of women’s recovery can be de- scribed as the transition process of a recovery to health. Our findings suggest that a focus on person- centered nursing would be beneficial in order to promote the every woman’s personal and unique re- covery after a myocardial infarction. Finally, the car- diac rehabilitation nurses’ experiences of factors influencing male patients’ recovery after their first myo- cardial infarction should be important to investigate. 

  • 2825.
    Wieslander, Inger
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Jönköping University, Jönköping, Sweden.
    Mårtensson, Jan
    Jönköping University, Jönköping, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Women’s experiences of how their recovery process is promoted after a first myocardial infarction: Implications for cardiac rehabilitation care2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30633Article in journal (Refereed)
    Abstract [en]

    Background: A rapid improvement in the care of myocardial infarction (MI) in the emergency services has been witnessed in recent years. There is, however, a lack of understanding of the factors involved in a successful recovery process, after the initial stages of emergency care among patients, and in particular those who are women. Both preventive and promotive perspectives should be taken into consideration for facilitating the recovery process of women after a MI.

    Aim: To explore how women’s recovery processes are promoted after a first MI.

    Methods: A qualitative content analysis was used.

    Findings: The women’s recovery process is a multidirectional process with a desire to develop and approach a new perspective on life. The women’s possibility to approach new perspectives on life incorporates how they handle the three dimensions: behaviour, that is, women’s acting and engaging in various activities; social, that is, how women receive and give support in their social environment; and psychological, that is, their way of thinking, reflecting, and appreciating life.

    Conclusions: The personal recovery of women is a multidirectional process with a desire to develop and approach a new perspective on life. It is important for cardiac rehabilitation nurses to not only focus on lifestyle changes and social support but also on working actively with the women’s inner strength in order to promote the recovery of the women.

  • 2826.
    Wikander, Robert
    et al.
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
    Augustsson, Johan
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
    Kan ett nyutvecklat handledsstöd förbättra möjligheterna för funktionell träning av övre extremiteten för reumatiker?: En SEMG-studie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In a general rehabilitation phase weight training is an important part because of muscle weakness may contribute lower functional ability and could lead to decreasing movement patterns. Limited range of motion (ROM) in the upper extremity is a contributing factor to individuals unable to perform everyday activities. Several studies have documented that patients with rheumatoid arthritis (RA) have impaired hand function due to reduced grip strength and limitations in ROM. Functional training is designed to strengthen the weak muscles that cause imbalance or pain while your body becomes more mobile. Using everyday movements and implement them with training will make the training more functional. The purpose of this study was to develop and evaluate a new wrist support that increases the possibilities to functional training of upper extremities for rheumatoid arthritis patients.

    The study involved 27 women, 8 were diagnosed with RA and 19 healthy subjects. The average age was 38 year (20-73year). Muscle activity in m. trapezius and m. rhomboideus was measured using surface electromyography (sEMG) in three exercises to compare the differences between both RA and healthy, and with and without a developed product.

    The results showed that it was possible to perform functional training of upper extremities without using the hand grip strength. There were no significant differences in muscle activity in m. trapezius and m. rhomboideii with or without the product. The results also showed that rheumatic muscles are not different from healthy muscles. The participants' subjective opinions were very positive there 24 of 27 participants found it easier to carry out the exercise

    with the product and 9 of 27 felt it was easier to focus on exercise.

    The study resulted in a new wrist support that allows functional training of m.trapezius and m.rhomboideus for patients with rheumatoid arthritis.

  • 2827.
    Wikström, I.
    et al.
    Malmö University Hospital, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nilsson, K.
    Malmö University Hospital, Sweden.
    Roos, E.
    Lund University, Sweden.
    Jacobsson, L. T. H.
    Lund University, Sweden.
    Validity and reliability of anew leisure index - The PSLS2007In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 66, no Suppl. 2, p. 661-661Article in journal (Other academic)
  • 2828.
    Wikström, Ingegerd
    et al.
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nilsson, Käth
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Roos, Ewa
    Department of Orthopaedics, Clinical Sciences, Lund University, Sweden.
    Jacobsson, Lennart
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Reliability, validity and responsiveness of a new leisure index: The Patient-Specific Leisure Scale (PSLS)2009In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 7, no 3, p. 178-193Article in journal (Refereed)
    Abstract [en]

    Objectives:

    To investigate the reliability, validity and responsiveness of a new Patient-Specific Leisure Scale (PSLS), constructed to identify goals and outcomes for individual patients with rheumatoid arthritis (RA).

    Methods:

    Forty-nine patients with RA were used to evaluate test-retest reliability, and 100 consecutive RA patients were used for construct validity. Twenty-five RA patients, commencing with treatment on tumour necrosis factor (TNF) inhibitors, were evaluated before the start and after three months of therapy, to test responsiveness. The most important leisure activity (as judged by the patients) was used when evaluating reliability and validity. The perceived difficulty with each activity was scored from 0 to 10 (0 = able to perform activity without difficulty, 10 = unable to perform activity).

    Results:

    Test-retest reliability indicated a good agreement (0.62-0.87) using weighted kappa. Construct validity was demonstrated by modest positive correlation between leisure activity and Health Assessment Questionnaire (HAQ) (rs = 0.27, p = 0.005) visual analogue scale (VAS) pain (rs = 0.28, p = 0.004) VAS global (rs = 0.22, p = 0.027), VAS fatigue (rs = 0.24, p = 0.013), joint index of 28 swollen joints (rs = 0.22, p = 0.027) and negative correlations with short-form-36 (SF-36) physical functioning (rs = -0.18, p = 0.008), bodily pain (rs = -0.31, p < 0.001), general health (rs = -0.23, p = 0.019), vitality (rs = -0.31, p < 0.001), social function (rs = -0.24, p = 0.016) and role-emotional (rs = -0.28, p = 0.005). Mean improvement for the most important leisure activity was 1.36, (p = 0.036, 95% confidence interval 0.10-2.62). Standardized response mean and effect size for the most important activity in PSLS was 1.05 and 0.72, respectively, and for HAQ 0.34 and 0.28, respectively.

    Conclusions:

    PSLS appears to be feasible, reliable, valid and responsive for measuring leisure activities in RA. It provides both an individual result which is useful in clinical work, and results at a group level.

  • 2829.
    Wikström, Ingegerd
    et al.
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Jacobsson, Lennart
    Department of Rheumatology, Malmö University Hospital, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    How people with rheumatoid arthritis perceive leisure activities: A qualitative study2005In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 3, no 2, p. 74-84Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore how people with rheumatoid arthritis (RA) perceive leisure activities. METHOD: A phenomenographic approach using semi-structured interviews to explore the impact of RA on leisure pursuits was used. RESULTS: Three descriptive categories containing 11 conceptions emerged: (1) Experiencing constraints included four conceptions: seeing limitations, needing time, finding balance, being dependent. (2) Experiencing coherence included four conceptions: accepting feelings participating in a social context, being active, having insight. (3) Finding solutions included three conceptions: choosing, planning, and adapting. CONCLUSIONS: This study emphasizes the limited choices and problems people with RA had participating in leisure activities, as well as its impact on self-esteem.

  • 2830.
    Wilhsson, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ungdomars strävan mot att lyckas och nå framgång i livet – skolan som hälsofrämjande arena2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The overall aim of the dissertation was to gain greater knowledge about perspectives on adolescent´s health as a basis for developing actions to promote health in schools.

    Methods: Study I had a quantitative, descriptive cross-sectional design, in which the data was collected from 948 adolescent (11-15 years old) and analyzed with multivariate logistic regression. Study II had a qualitative, investigative design, in which the data was collected from 117 adolescent (14-17 years old) and analyzed with Grounded Theory methodology. Study III had a qualitative, descriptive design, in which the data was collected from 42 adolescent (14-16 years old) and analyzed with qualitative content analysis. Study IV had a qualitative, descriptive design, in which the data was collected from 27 stakeholders and analyzed with qualitative content analysis.

    Results: The adolescent aspire to make out and be successful both in the present and the future. This aspiration is experienced by the adolescent as a struggle about time, a struggle that they cope with by using various strategies to balance schoolwork and leisure. The girls’ aspiration is to achieve success in school in order to be independent in the future. Success, for the boys, entails being successful in one of their leisure activities such as sport, which demonstrates their physical strength. Success is of importance for the boys in the present, while on the other hand the girls view their success in a longer time perspective. The focus in health promotion should be aimed at supporting the adolescent´s sense of coherence, at strengthening their optimism early in their teenage years as well as making more visible the organizational and contextual structures and norms that affect the health and lifestyles of girls and boys.

    Conclusions: In summary, the dissertation shows that perspectives on adolescent’s health should be understood at different levels in society and include a gender perspective. Furthermore, factors that are important for adolescent’s lifestyle should be discussed from a salutogenic perspective and the health promotion performed in schools should develop actions that have contextual and gender-specific points of departure in order to enhance the health and lifestyles of girls and boys.

  • 2831.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Högdin, Sara
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Handling Demands of Success Among Girls and Boys in Primarly School: A Conceptual Model2017In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 33, no 4, p. 316-325Article in journal (Refereed)
    Abstract [en]

    Stress among adolescents in Western societies is becoming an issue of increasing concern, and the global trend of adolescents’ health shows a gradual deterioration that is independent of national differences and increases with age. The aim of this study was to explore the main concern of adolescents and about how they cope with demands in everyday life. Participants were 14–16 years old, and data were collected from three sources. A constructivist grounded theory was used as a method for generating a model of the adolescents’ description of how they cope with demands in their everyday lives. The main concern described by participants in this study was to strive to be successful and to succeed in the present and throughout their lives. We conclude that differences between girls and boys, in terms of coping with demands in their everyday lives, are important to consider in the development of health promotion initiatives targeted at adolescents. © The Author(s) 2016

  • 2832.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Högdin, Sara
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Halmstad project – a participatory intervention to promote children's mental health2013In: 21st International Conference on Health Promoting Hospitals and Health Services: Abstract book, Copenhagen: WHO-CC , 2013, p. 123-123Conference paper (Other academic)
  • 2833.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Högdin, Sara
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Halmstadprojektet – en deltagarstyrd intervention för att främja barns psykiska hälsa2013Conference paper (Other academic)
  • 2834.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Högdin, Sara
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Handling demands on success among girls and boys in primarly school – a conceptual model2016Conference paper (Other academic)
    Abstract [en]

    Background: Stress among adolescents in Western societies is becoming an issue of increasing concern and the global trend of adolescents’ health shows a gradual deterioration that is independent of national differences and increases with age. Research shows that many adolescents report high levels of stress, associated with a change in expectations about performance and an increased focus on school results.

    Purpose/methods: The aim of this study was to explore the main concern of adolescents to get a deeper knowledge on how they cope with demands in everyday life. Grounded theory was used as a method to generate a model.

    Results: The core category “striving to be successful and to succeed” explains participants’ main concern in their everyday lives as a continuous process aiming for success in the present and to succeed throughout their lives. The category is what the participants describe as a race against time and can be divided into the two conceptual categories “struggling with time” and “separating life into different worlds”, pronouncing how they struggle and cope with their main concern in order to obtain wellbeing. Our results show a difference between how girls and boys cope with their demands.

    Conclusions: We show that girls and boys used different strategies to cope with stress in their everyday life. The results are based on adolescent’s experiences and are therefore an important contribution for initiating interventions aimed at promoting adolescents mental health from a gender perspective.

  • 2835.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Högdin, Sara
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Girls and boys strategies to handle and cope with school-related stress2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no Suppl. 1, p. 221-221Article in journal (Refereed)
    Abstract [en]

    Background

    A trend of increased stress and deteriorating mental health of adolescents is a global challenge (Currier et al, 2012). Research shows that many adolescents report high levels of stress associated with an increased focus on school performance (Moknes et al, 2014). These demands generally have a stronger impact on girl’s health (Låftman & Modig, 2013) due to context and social construction of norms, values and beliefs about femininity and masculinity (Connell, 2002; Butler, 1999). The aim was to get a deeper understanding of girls and boys perceptions of how they handle demands and school-related stress.

    Methods

    This study has an explorative design and was analyzed by qualitative content analysis described by Graneheim and Lundman (2004). The participants were 42 adolescents 15 years old, interviewed in five focus groups, dived by gender from five randomly selected schools. Two additional gender mixed focus groups with 14 adolescents 15 years old, were recruited from two of the randomly selected schools.

    Results

    The results show that girls and boys handle school-related stress by using similar strategies, but in different ways. Girls express that they have to prioritize to deselect activities they use to do to handle demands from school, and boys prioritize their own activities to obtain strength to cope with demands. Girls often think about their future while boys more often live in present time, and don’t worry so much about the future. Girls receive social support and recovery from friends and family, while boys do various activities with their friends and family to get energy.

    Conclusions

    This study shows that girls and boys used different strategies to handle demand and school-related stress. The results are based on adolescent’s experiences and could therefore be an important foundation for interventions that promote adolescents capabilities to cope with increasing demands and to handle school-related stress.

    Key messages:

    • This study shows that girls and boys perceived and used different strategies to handle demand and school-related stress

    • The result is an important foundation for interventions that promote adolescents capabilities to cope with increasing demands and to handle school-related stress

    © The Author 2016.

  • 2836.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Högdin, Sara
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Strategies of Adolescent Girls and Boys for Coping With School-Related Stress2017In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 33, no 5, p. 374-382Article in journal (Refereed)
    Abstract [en]

    Stress among adolescents in Western societies is becoming an issue of increasing concern of adolescent’s health. The aim of this study was to gain greater knowledge about how girls and boys perceive and cope with school-related stress. Participants were 14- to 15-year-old adolescents from a medium-sized municipality in southern Sweden. The data were collected from focus group interviews. The data were subjected to qualitative content analysis. The findings show that adolescents ‘‘prioritizing the future or the present by making choices, finding their own private sphere to relax, and recovering with family and friends.’’ There were gender differences in how these strategies were used. The findings could be used for initiating and planning health promotion interventions in school with focus on supporting girls’ and boys’ equal terms to cope with school-related stress in present and for the future and to give equal condition for future studies and opportunities in life. © The Author(s) 2016

  • 2837.
    Wilhsson, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    A stakeholder perspective on adolescents' needs for support to cope with school-related stressManuscript (preprint) (Other academic)
    Abstract [en]

    Background; Adolescents’ experiences of stress have increased in recent decades and is associated with an increase of psychosomatic symptoms and poorer academic achievement. Identification of ways to support adolescents’ handling of school related stress is a major challenge to promote their health and academic achievement. The purpose of this study was to describe the stakeholder’s perspectives on services that are needed for supporting adolescents in secondary school when coping with school-related stress.

    Methods; Representatives from the school health service and school management organization (n=23) from five secondary schools and parents (n=4) were recruited by snowball sampling. Interviews were analyzed by qualitative content analysis with an inductive approach.  

    Results; The study highlight different aspects of stakeholders’ perceptions of what is needed to support adolescents who experience school-related stress. Described are actions such as highlighting and changing organizational and contextual structures and developing the dialogue between the school and the home. Other described actions are to support adolescents’ abilities to plan and visualizing how time is used and to strengthen their adolescents’ belief in their own abilities.

    Conclusions; Our findings could be used in schools for developing interventions from a salutogenic approach to promote adolescents’ health in the present and for the future.

  • 2838.
    Wiman, Virginia
    Halmstad University, School of Social and Health Sciences (HOS).
    Småföretagares upplevelser av företaget som en hälsofrämjande arena2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Workplace health promotion leads to better health, increased staff morale, higher productivity and reduced absenteeism. The leader­ship is very important for the health of the employees and the small business has the biggest need for health promotion because they have less access to occupational health service and often lack of knowledge and resources to manage health and safety problems. A qualitative approach was used and 10 managers in small business were interviewed to describe how managers in small business perceive the company as a health promotion arena for the employees. The informants were selected through a strategic selection and maximal variation was pursued. Collected data were analyzed using content analysis. The result is described in the main categories: sees the workplace as an arena, sees the opportunity to promote employees health and sees a need for external support. The overall theme of the result was; Health promotion leadership in order to perceive the company as a health promotion arena. The conclusions were that managers play a key role in workplace health promotion and that there is a need for external support for the managers. For development of healthy organiza­tions it is necessary with a comprehensive strategy in which employers, employees and society is pursuing the same goal.

  • 2839.
    Wiman, Virginia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Views of the workplace as a health promotion arena among managers of small companies2016In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 75, no 8, p. 950-960Article in journal (Refereed)
    Abstract [en]

    Introduction: Several studies have shown that workplace health promotion leads to better health, increased productivity, as well as reduced absenteeism and presenteeism among employees. The objective of this study was to describe how managers in small companies (10–19 employees) perceive their company as an arena for promoting employees’ health.

    Method: A sample of 10 managers (four women) was strategically selected. Semi-structured interviews were conducted with each person. Interviews were transcribed and analysed using qualitative content analysis. The analysis focused on both manifest and latent content.

    Results: Three main categories emerged from the analysis: the potential to promote employees’ health, responsibility as an employer and the need for external support. An arena for workplace health promotion is created when managers prioritise health at the workplace.

    Conclusion: Small companies often lack the knowledge and resources to manage health and safety problems and also have less access to occupational health services. This paper highlights the importance of the views of small company managers as resources for the development of health promotion. © 2016 by Health Education Journal

  • 2840.
    Wiman, Virginia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Region Halland, Halmstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Workplace health promotion; views from managers of small companies2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no Suppl. 2, p. 129-129Article in journal (Other academic)
    Abstract [en]

    Background: Workplace health promotion leads to better health, high morale, increased productivity and reduced absenteeism among employees. The role of leadership is vital when creating strategies for workplace health promotion. Small companies (less than 50 employees) have increased need for health promotion, as they often lack knowledge and resources to manage health and safety problems. Moreover, small companies have less access to occupational health service. The aim of this study was to describe how managers at small companies perceive their company as an arena for health promotion. 

    Methods: A sample of ten managers (four females) was strategically selected using maximal variation in terms of branch of industry. Semi-structured interviews were conducted. The interviews were transcribed and analyzed using qualitative content analysis. The analysis comprised of both manifest and latent content and triangulation between the authors was used. 

    Results: Three main categories emerged from the analysis; sees the workplace as a possible arena, sees the opportunity to promote employees health and sees a need for external support. More in-depth analysis resulted in six subcategories. The latent content of these categories is described by the theme; Health promotion leadership in order to perceive the company as a health promotion arena. A key factor for workplace health promotion was the manager´s view of health promotion as a beneficial factor for the company. Furthermore, the managers expressed that they could promote employees´ health by organizing health promotion activities and promote a positive psychosocial work environment. The findings showed a need for easily accessible external support to assist managers in their work with health promotion. It is essential that the external support contributes with inspiration and knowledge of health promotion activities, for example by highlighting good practice from other small companies. 

    Conclusions: Using the manager´s view about the workplace as an arena for promoting health can be a step towards strategies for implementing workplace health promotion. However, for the development of healthy organizations it is necessary to have a comprehensive strategy in which employers, employees and society is pursuing the same goal.

  • 2841.
    Winberg, Birgitta
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Self-reported behavioural and medical changes in women after their first myocardial infarction: a 4-year comparison between participation and non-participation in a cardiac rehabilitation programme2002In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 1, no 2, p. 101-107Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Women's recovery following a myocardial infarction (MI) has not yet been studied in a thorough manner.

    AIM: Therefore, the aim of this study was to compare women's self-reported behavioural and medical changes, both in those women who voluntarily participated and those women who did not participate in a cardiac rehabilitation programme (CRP).

    METHODS: A non-randomised comparative study design, including pre- (baseline) and post-tests (1 and 4 years after), was implemented in 18 hospitals in Sweden. Consecutively chosen women suffering their first MI (N=240) completed a questionnaire regarding behavioural and medical factors.

    RESULTS: At baseline, significant differences existed between the groups regarding time stress (increased in the CRP group) and hypertension (increased in the non-CRP group). The behavioural factors improved, irrespective of CRP participation or not, with the exception of time stress, which was consistently high in the CRP group both 1- and 4-years after the MI. Regarding the medical factors, the significant difference in hypertension disappeared after 1 year. Four years after the MI, the CRP group reported significantly less rehospitalisation and more interventive cardiology compared to the non-CRP group.

    CONCLUSION: The women benefited from CRP participation in relation to medical factors, but not at all in relation to behavioural factors. Accordingly, randomised clinical trials are necessary to perform in order to determine the effects of a long-term individual-based supportive CRP, performed by well-educated healthcare professionals.

  • 2842.
    Wingerstad, Stina
    et al.
    Halmstad University, School of Health and Welfare.
    Westerberg, Marie
    Halmstad University, School of Health and Welfare.
    Motiverande samtal i omvårdnaden av personer med ätstörningar: En bro till den terapeutiska alliansen2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Eating disorders are characterised as a sustaining disorder of eating and mainly affects young women. Previous research has found that lack of motivation and ambivalence complicates the recovery. From a caring perspective, motivation to change is important for recovery. The aim of the literature review was to illustrate motivational interviewing in the care of people with eating disorders. The study was performed as a literature review through structured searching with critical review of previous research. The literature review found associations between motivational interviewing and improved motivation in people with eating disorders. Motivational interviewing resulted in increased readiness for change and increased commitment in treatment. Motivational interviewing made it possible with openness, honesty and understanding between the nurse and the person with eating disorders; a therapeutic alliance was established. The study found that the therapeutic alliance entailed a mutual cooperation, in which the person found support to develop own resources for recovery. Research on motivational interviewing in the care of people with eating disorders is limited which leads to gaps in knowledge and indicates that further research is motivated. The study indicates that nurses need depth knowledge about eating disorders and motivational interviewing. 

  • 2843.
    Winlöf, Linnea
    et al.
    Halmstad University, School of Health and Welfare.
    Cardmarker, Lovisa
    Halmstad University, School of Health and Welfare.
    Sjuksköterskans roll vid fysisk aktivitet på recept: En allmän litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Nurses has a significant role in health promotion efforts that can reduce public health problems, such as inactivity with a purpose to improve public health. Physical activity on prescription's a method of reducing inactivity and promoting physical activity, which is based on a patient-centered view, where communication and knowledge about motivation and behavioral change are important components. The aim of this literature study was to investigate the nurses' role in the physical activity of prescription. The result's based on 11 scientific articles, five qualitative and six quantitative, which featured in one main theme; Nurses role and barriers that exist. The subthemes that emerged were; Motivation, Participation, Time, Knowledge and Routines and also External Factors. The nurses' role is to regularly motivate physical activity and to involve patients, and also to protect and promote the health of all people. Lack of time, ignorance and lack of routines indicate great barriers to why nurses doesn't prescribe physical activity on prescription. Furthermore, the patients economy, accessibility, and societies resources for physical activity are highlighted. Nurses' motivational role and the application of physical activity on prescriptions, is something that should be highlighted and clarified in undergraduate nursing education. In addition, healthcare professionals should continue to point out that physical activity can be a complement to medicine.

  • 2844.
    Winterling, Jeanette
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden & Center of Haematology, Karolinska University Hospital, Stockholm, Sweden.
    Wiklander, Maria
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Micaux Obol, Claire
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden & Stress Rehabilitation Research, Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Lampic, Claudia
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Eriksson, Lars E
    Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden & Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden & School of Health Sciences, City University London, London, United Kingdom.
    Pelters, Britta
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Wettergren, Lena
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Development of a Self-Help Web-Based Intervention Targeting Young Cancer Patients With Sexual Problems and Fertility Distress in Collaboration With Patient Research Partners2016In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 5, no 2, p. e60-, article id e60Article in journal (Refereed)
    Abstract [en]

    Background: The Internet should be suitable for delivery of interventions targeting young cancer patients. Young people are familiar with the technologies, and this patient group is small and geographically dispersed. Still, only few psycho-educational Web-based interventions are designed for this group. Young cancer patients consider reproductive health, including sexuality, an area of great importance and approximately 50% report sexual problems and fertility-related concerns following cancer treatment. Therefore, we set out to develop a self-help Web-based intervention, Fex-Can, to alleviate such problems. To improve its quality, we decided to involve patients and significant others as research partners. The first 18 months of our collaboration are described in this paper. The intervention will subsequently be tested in a feasibility study followed by a randomized controlled trial.

    Objective: The study aims to describe the development of a Web-based intervention in long-term collaboration with patient research partners (PRPs).

    Methods: Ten former cancer patients and two significant others participated in building the Web-based intervention, using a participatory design. The development process is described according to the design step in the holistic framework presented by van Gemert-Pijnen et al and evaluates the PRPs’ impact on the content, system, and service quality of the planned intervention.

    Results: The collaboration between the research group and the PRPs mainly took place in the form of 1-day meetings to develop the key components of the intervention: educational and behavior change content, multimedia (pictures, video vignettes, and audios), interactive online activities (eg, self-monitoring), and partial feedback support (discussion forum, tailored feedback from experts). The PRPs influenced the intervention’s content quality in several ways. By repeated feedback on prototypes, the information became more comprehensive, relevant, and understandable. The PRPs gave suggestions concerning the number of exercises and pointed out texts and pictures needing revision (eg, experienced as normative or stereotypical) to increase the persuasiveness of the program. The system quality was improved by PRPs’ feedback on design, technical malfunctions, and navigation on the website. Based on feedback about availability of professional support (technical problems and program content), the organization for support was clarified, which increased service quality. The PRPs also influenced the research project on an overall level by suggesting modifications of inclusion criteria for the RCT and by questioning the implementation plan.

    Conclusions: With suggestions and continuous feedback from PRPs, it was possible to develop a Web-based intervention with persuasive design, believed to be relevant and attractive for young persons with cancer who have sexual problems or fertility distress. In the next step, the intervention will be tested in a feasibility study, followed by an RCT to test the intervention’s effectiveness in reducing sexual problems and fertility distress.

  • 2845.
    Wubker, Ansgar
    et al.
    University of Witten/Herdecke, Essen, Germany & Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Health Devision, Essen, Germany.
    Zwakhalen, Sandra
    Maastricht University, Maastricht, Netherlands.
    Challis, David
    The University of Manchester, Manchester, United Kingdom.
    Suhonen, Riita
    University of Turku, Department of Nursing Science, Turku, Finland.
    Karlsson, Staffan
    Lund University, The Swedish Institute of Health Sciences, Lund, Sweden.
    Zabalegui, Adelaida
    School of Health Sciences, Hospital Clínic de Barcelona, Mataró (Barcelona), Spain.
    Soto, Maria
    Gérontopôle de Toulouse, Department of Geriatric Medicine, University Hospital de Toulouse, Toulouse, France.
    Saks, Kai
    University of Tartu, Department of Internal Medicine, Tartu, Estonia.
    Sauerland, Dirk
    University of Witten/Herdecke, Department of Institutional Economics and Health Systems Management, Witten, Germany.
    Costs of care for people with dementia just before and after nursing home placement: primary data from eight European countries2015In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 16, no 7, p. 689-707Article in journal (Refereed)
    Abstract [en]

    Background: Dementia is the most common cause of functional decline among elderly people and is associated with high costs of national healthcare in European countries. With increasing functional and cognitive decline, it is likely that many people suffering from dementia will receive institutional care in their lifetime. To delay entry to institutional care, many European countries invest in home and community based care services.

    Objectives: This study aimed to compare costs for people with dementia (PwD) at risk for institutionalization receiving professional home care (HC) with cost for PwD recently admitted to institutional long-term nursing care (ILTC) in eight European countries. Special emphasis was placed on differences in cost patterns across settings and countries, on the main predictors of costs and on a comprehensive assessment of costs from a societal perspective.

    Methods: Interviews using structured questionnaires were conducted with 2,014 people with dementia and their primary informal caregivers living at home or in an ILTC facility. Costs of care were assessed with the resource utilization in dementia instrument. Dementia severity was measured with the standardized mini mental state examination. ADL dependence was assessed using the Katz index, neuropsychiatric symptoms using the neuropsychiatric inventory (NPI) and comorbidities using the Charlson. Descriptive analysis and multivariate regression models were used to estimate mean costs in both settings. A log link generalized linear model assuming gamma distributed costs was applied to identify the most important cost drivers of dementia care.

    Results: In all countries costs for PwD in the HC setting were significantly lower in comparison to ILTC costs. On average ILTC costs amounted to 4,491 Euro per month and were 1.8 fold higher than HC costs (2,491 Euro). The relation of costs between settings ranged from 2.4 (Sweden) to 1.4 (UK). Costs in the ILTC setting were dominated by nursing home costs (on average 94 %). In the HC setting, informal care giving was the most important cost contributor (on average 52 %). In all countries costs in the HC setting increased strongly with disease severity. The most important predictor of cost was ADL independence in all countries, except Spain and France where NPI severity was the most important cost driver. A standard deviation increase in ADL independence translated on average into a cost decrease of about 22 %.

    Conclusion: Transition into ILTC seems to increase total costs of dementia care from a societal perspective. The prevention of long-term care placement might be cost reducing for European health systems. However, this conclusion depends on the country, on the valuation method for informal caregiving and on the degree of impairment.

  • 2846.
    Wärnestål, Pontus
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lindberg, Susanne
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Effects of Using Child Personas in the Development of a Digital Peer Support Service for Childhood Cancer Survivors2017In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 19, no 5, article id e161Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Peer support services have the potential to support children who survive cancer by handling the physical, mental, and social challenges associated with survival and return to everyday life. Involving the children themselves in the design process allows for adapting services to authentic user behaviors and goals. As there are several challenges that put critical requirements on a user-centered design process, we developed a design method based on personas adapted to the particular needs of children that promotes health and handles a sensitive design context.

    OBJECTIVE: The purpose of this study was to evaluate the effects of using child personas in the development of a digital peer support service for childhood cancer survivors.

    METHODS: The user group's needs and behaviors were characterized based on cohort data and literature, focus group interviews with childhood cancer survivors (n=15, 8-12 years), stakeholder interviews with health care professionals and parents (n=13), user interviews, and observations. Data were interpreted and explained together with childhood cancer survivors (n=5) in three explorative design workshops and a validation workshop with children (n=7).

    RESULTS: We present findings and insights on how to codesign child personas in the context of developing digital peer support services with childhood cancer survivors. The work resulted in three primary personas that model the behaviors, attitudes, and goals of three user archetypes tailored for developing health-promoting services in this particular use context. Additionally, we also report on the effects of using these personas in the design of a digital peer support service called Give Me a Break.

    CONCLUSIONS: By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that were successfully used to design and develop health-promoting services for children in vulnerable life stages. The child-personas serve as effective collaboration and communication aids for both internal and external purposes.

  • 2847.
    Wärnström, Mathias
    Halmstad University, School of Business, Engineering and Science.
    The effects of Foam Rolling and Static Stretching on bilateral forward jumping ability and flexibility of the hamstrings musculature2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Foam rolling (FR) is a promising new trend in the world of resistance training, sports and  athletics. It is often used as a warm up activity as a substitute or addition to  stretching modalities such as static stretching (SS). The proposed benefits behind FR is that it can lead to  both acute and chronic increases in performance and flexibility. Aim: The aim of this study was to investigate the effects of two different warm­up intervention protocols  of the hamstrings musculature on: 1) Performance in the bilateral standing long jump 2) Flexibility in a  supine active­knee­extension test. Method: The study consisted of sixteen male participants who were all healthy adult recreational athletes.  The two different interventions were, a) Static Stretching protocol (SS) and b) a Foam Rolling protocol  (FR). These were compared to a baseline warm up (BLWU). The SS consisted of 1 x 30 seconds of active  SS using the lying supine active­knee­extension position after a short warm­up. The FR consisted of 1  bout of 30 seconds of FR of the hamstrings musculature of each leg after a short warm­up. BLWU  consisted of a short warm­up (5 submaximal bilateral standing long jumps). Performance was measured  using a bilateral standing long jump test. Flexibility was measured with a goniometer using a lying supine active ­knee­ extension test. The student’s t­test was used to study differences between and within groups (BLWU, SS, FR). Results: No differences between BLWU and Post­SS (p=0.89) as well as BLWU compared to Post­FR (p=0.86) was detected for performance. However, an increase in flexibility was shown favoring Post­SS over BLWU (p=0.021) as well as Post­FR over BLWU (p=0.045). No significant difference was seen  between changes in the Post­SS and Post­FR groups in either performance or flexibility (p=0.887 and  p=0.944 respectively). Conclusion: It seems that both SS and FR are similarly viable and effective methods for acute increases  in flexibility in the active­knee­extension test without subsequent decreases in performance of the bilateral standing long jump.  

  • 2848.
    Wästberg, Birgitta
    et al.
    Department of Health Sciences, Division of Occupational Therapy and Gerontology, Lund University, Lund, Sweden.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Division of Occupational Therapy and Gerontology, Lund University, Lund, Sweden.
    Eklund, Mona
    Department of Health Sciences, Division of Occupational Therapy and Gerontology, Lund University, Lund, Sweden.
    Client perceptions of a work rehabilitation programme for women: The Redesigning Daily Occupations (ReDO) project2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 2, p. 118-126Article in journal (Refereed)
    Abstract [en]

    Aim: The Redesigning Daily Occupations programme (ReDO) is a Swedish work rehabilitation programme for women on sick leave due to stress-related disorders. The aim of the study was to investigate the participants' perceptions of taking part in the work rehabilitation programme. Methods: Seven of the 38 women who completed ReDO were interviewed during and after the programme. The interviews were analysed by manifest and latent content analysis. Results: The informants were satisfied with the content of the programme and the support they received in the programme and when returning to work. The women thought they had become more aware of what they did during a day and how they performed their daily activities, which helped them to change their ways of performing them. The result highlighted different parts of their rehabilitation process which constituted four sub-themes: "Perceptions of the ReDO", "The intrinsic process", "Person-related changes", and "Perceptions of returning to work", and formed the core theme "Critical parts of the rehabilitation process". Conclusions: The findings may not be generalized to other settings and future research should further investigate work rehabilitation for the target group. © 2013 Informa Healthcare.

  • 2849.
    Wästberg, Birgitta
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden & Skåne University Hospital, Malmö-Lund, Lund, Sweden.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University, Lund, Sweden.
    Eklund, Mona
    Department of Health Sciences, Lund University, Lund, Sweden.
    Women's perceived work environment after stress-related rehabilitation: Experiences from the ReDO project2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 6, p. 528-534Article in journal (Refereed)
    Abstract [en]

    Purpose: The study aimed to investigate (a) if womens perceptions of their work environment changed during a 16-week rehabilitation period and at a 12-month follow-up; (b) whether such changes were related to outcomes in terms of return to work, well-being and valued occupations. Methods: Eighty-four gainfully employed women on sick-leave due to stress-related disorders responded to instruments assessing perceptions of the work environment, well-being (self-esteem, self-mastery, quality of life, perceived stress, self-rated health) and perceived occupational value. Data about return to work were collected from registers. Non-parametric statistics were used. Results: The increase in the womens ratings of their work environmentwas non-significant between baseline and completed rehabilitation but was statistically significant between baseline and the 12-month follow-up. No relationships were found between changes in perceptions of the work environment and outcomes after the rehabilitation. At the follow-up, however, there were associations between perceived work environment changes in a positive direction and return to work; improved self-esteem, self-mastery, quality of life, perceived occupational value and self-rated health; and reduced stress. Conclusion: It seems important to consider the work environment in rehabilitation for stress-related problems, and a follow-up appears warranted to detect changes and associations not visible immediately after rehabilitation.Implications for RehabilitationWork environmentPerceptions of the work environment seem important for return to work, although other factors are likely to contribute as well.Perceptions of the work environment are associated with several aspects of well-being.When developing rehabilitation interventions a focus on the clients' perceptions of their work environment seems vital. © 2015 Informa UK Ltd.

  • 2850.
    Wårdh, Inger
    et al.
    Dept of Gerodontology, Karolinska Institutet, Huddinge, Sweden.
    Paulsson, Gun
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Department of Health Sciences and Statistical, School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Nursing staff's understanding of oral health care for patients with cancer diagnoses: an intervention study2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 6, p. 799-806Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. The aim of this study was to evaluate long-lasting changes in the nursing staff's understanding of oral health care for cancer patients after an oral health care intervention. The study also assessed whether there were changes between registered nurses and auxiliary nurses. Background. The maintenance of good oral health care in cancer patients is essential for nutrition, recovery and wellbeing and requires the involvement of nursing staff. However, several studies reveal that the need to prioritize oral health care has not been made sufficiently clear. Methods. The nursing staff (registered nurses, n = 133 and auxiliary nurses, n = 109) on five wards at different hospitals providing cancer care took part in a four-hour oral healthcare training session, including the use of an oral assessment guide and answered a questionnaire initially and after this intervention. The data were statistically analyzed. Results. Several aspects of implementation opportunities improved, but they did not include attitudes to oral health care. Knowledge of oral diseases decreased, more for auxiliary nurses than for registered nurses. Conclusions. A four-hour oral health training session and subsequent activities improve the nursing staff's understanding of oral health care for patients with cancer diagnoses in some respects but not in terms of attitudes to oral health care or specific oral knowledge. Relevance to clinical practice. Oral healthcare education and training activities for nursing staff can produce some improvements in the understanding of oral health care for cancer patients but not in attitudes and specific oral knowledge. These areas must be covered during the basic education period or/and by a routine oral healthcare programme for nursing staff, probably including an oral healthcare standard.

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