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  • 2801.
    Ziegert, Kristina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Rämgård, Margareta
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Mapping family and social space in caring: a metamethod study2008In: Parallel presentations: International Journal of Qualitative Studies on Health and Well-being, Taylor&Francis , 2008, p. 29-29Conference paper (Refereed)
    Abstract [en]

    Social relations are about how we treat each other. They imply explicit and tacit knowledge, rules of behaviour, and values inherent in specific social spaces. When a family is struck by a life-threatening illness, the individual’s ‘‘life space’’ tends to shrink. This impacts the mutual relationships in the family, as well as the situation in the home. Therefore, there are obvious dialectics between spatial and social dimensions, when close relatives are afflicted by serious illness. This paper explores how research on homecare involves space in analysing social issues.Meta-method analysis was chosen, in order to extend the review format and analyse meta-questions. Meta-synthesis in different research areas and fora involved the examina- tion of a set of qualitative studies. Material was collected using the Cinahl, PubMed and Academic Search data- bases. These were supplemented by the Social Science Index, Sociological Abstract and Science Direct, to explore if aspects of care and space are treated in social science. The sample consisted of 38 articles, displaying a wide variety of methods. Findings suggest that in the fields of caring and sociological research, spatial factors are only implicitly described, and the dynamics of the social and spatial dialectics in home caring relationships seem to be rare. The concept of space in caring is found in a few studies in human geography. The observed absence of a spatial perspective in caring is problematic, since it neglects the fact that relationship and caring are situated in context.

  • 2802.
    Ziegert, Kristina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Schjetlein, Anne-Marie
    Halmstad County Hospital, Halmstad, Sweden.
    Learning of simulated cardiac arrests in hospital environments to support performance of the multidisciplinary team2014Conference paper (Refereed)
    Abstract [en]

    Background: Survival after cardiac arrest in hospital environments has in various studies reported to be between 15-39%. In Swedish hospitals 30% of patients who suffer cardiac arrest survive to discharge. There are significant opportunities for improvement in cardiac arrests in hospitals, especially those on general wards. There are few studies of the multidisciplinary team performance regarding both technical and non-technical skills in simulated cardiac arrest on general wards.

    Summary of Work: The focus of this study was to observe the multidisciplinary team performance in simulated cardiac arrest on general wards to gain knowledge about existing methods and thus be able to identify areas for improvement. The study design was an exploratory observational study. There were 33 participants in a total of three wards. The simulated cardiac arrest was videotaped, and a patient simulator was used.

    Summary of Results: The results suggest that guidelines not always were adhered to cooperation. In the order for the guidelines to work in the multidisciplinary team, background knowledge is required. However, the team leader did not coordinated to the multidisciplinary team work, and did not use effective communication.

    Conclusions: Finally, the result suggested suboptimal performance regarding leadership and communication, which in turn affected resources and working environment. The opportunity with simulation is to train together in a situation without any risk for the patients.

    Take home Messages: Simulated cardiac arrests will give the opportunity to train the multidisciplinary team technical and non-technical skills.

     

  • 2803.
    Zingmark, Erika
    et al.
    Halmstad University, School of Health and Welfare.
    Wiklund, Ida
    Halmstad University, School of Health and Welfare.
    Förändrad kosthållning genom motiverande samtal: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Unhealthy eating habits are a major problem that causes most diseases in Sweden today. Diet has a major impact on becoming ill and good healthcare is of high importance for av healthier population. Within healthcare Motivational Interviewing is used as a method to increase motivation to make a change. Aim: To describe the patient's experience and change following a MI-based dietary counseling performed by the nurse. Method: General literature study with content analysis. Result: The literature study is based on nine scientific articles that resulted in three main categories with respective subcategories. The result showed that MI counseling can help people change their diet with the help of motivation and support from the nurse, but it also showed barriers to the implementation of a change in diet. The result also took on the physical and cognitive changes that occurred after the MI interview with the nurse. Conclusion: To make a change, motivation is required. Motivation can be positively or negatively affected by various aspects such as the caregiver's implementation of the conversation and the patients own will to change. The result indicated that the patient's change is affected by the quality of the motivational interview.

  • 2804.
    Zlocki, Jakob
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF).
    Johansson, Mattias
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF).
    Mindfulness och dess effekt på uppmärksamhets- och perceptionsförmåga bland tävlingsinriktade idrottsutövare: En experimentell pilotstudie.: 2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to examine the effect of one 45 minute mindfulness session on: (1) Sustained attention abilities, (2) executive attention abilities, and (3) perceptual abilities. An experimental study was carried out on athletes (n = 48) who all met the specific requirements for being able to participate in this study. The results showed no significant difference in all three variables between the experiment group and the control group. In conclusion, the results and implications are discussed in relation to previous research, supported by theoretical frames of references. 

  • 2805.
    Zvizdic, Jasmina
    et al.
    Halmstad University.
    Öresjö, Maria
    Halmstad University.
    Sjuksköterskors erfarenhet kring vårdandet av patienter med akut förvirring2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Acute confusion is a cognitive impairment that occurs suddenly. Affected patients are for example perceived as agitated, restless and apathetic. Patients describe the experience of acute confusion as an abstract reality, this complicates the care process. The aim of this study was to describe nurses’ experience in the care of acutely confused patients. The method was a literature study with a systematic approach where the data processing was inspired by qualitative content analysis. The literature study shows that nurses who meet acute confused patients in wards may experience a lack of time and increased stress. The patient with acute confusion also affects other health careers and patients, requiring more resources in terms of monitoring and nurses with the right skill sets. Nurses are more focused on preserving the safety of the acutely confused patients than the person behind the acute confusion. Nurses’ attitudes towards the acutely confused patients are based on gaining control of the patients through various strategies. Unawareness of acute confusion is displayed by nurses’ inconsistency of the use of evidence-based knowledge. Prioritizing work is necessary to make the work more effective, it also helps the nurse to be at hand for all patients, although, managing and using time more effectively falls at the expense of the acutely confused patients. Good communication and awareness of the ageism that occurs is of importance so that the patients’ experiences become optimal and for reduction of suffering when in or after an acute confusion state.

  • 2806.
    Åhlander, Sofia
    et al.
    Halmstad University, School of Health and Welfare.
    Westerberg, Johanna
    Halmstad University, School of Health and Welfare.
    Med andras ögon: Hur pedagogik gestaltar sig i omvårdnad2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Human beings who are in need of caring in nursing requires pedagogical learning in the form of support from the nurse facing the issues and challenges they are receiving. How pedagogical learning is designed in different care situations is not yet sufficiently scientifically explored, making it important to map the problem of the lack of pedagogical learning in nursing. The aim was to identify what pedagogical learning is in nursing. The method is a literature review of 8 scientific articles that formed the basis for the result. The results showed six different sub-themes; pedagogical flaws, pedagogical innovation, the nurse, the patient's life-world, pedagogical mutuality and pedagogical care and who formed the main theme "With the eyes of others”. Pedagogic is one of the most important key aspects in nursing in order to initiate a proper care to the patient. In order to integrate pedagogy as part of the care process, more training, knowledge and research in pedagogy is needed and learning how unique nursing situations for the unique patient should be applied.

  • 2807.
    Åhsberg, Lina
    et al.
    Halmstad University, School of Health and Welfare. 1993.
    Ejdersand, Elin
    Halmstad University, School of Health and Welfare.
    Bergqvist, Lisa
    Halmstad University, School of Health and Welfare.
    ''Det är inte en resursfråga, det är en prioriteringsfråga'': En kvalitativ studie om förvaltningschefers upplevelser av förutsättningar för att bedriva ett hälsofrämjande ledarskap2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det hälsofrämjande ledarskapet fokuserar på friskfaktorer genom att synliggöra och lyfta fram de styrkor som finns på arbetsplatsen. För att kunna skapa en hälsofrämjande arbetsplats behövs det kunskap om hälsofrämjande arbete hos ledarna, det behövs således förutsättningar för chefer att kunna bedriva ett hälsofrämjande ledarskap. Studiens syfte var att belysa hur förvaltningschefer i kommuner i Hallands län upplever förutsättningarna för att bedriva ett hälsofrämjande ledarskap. Den teoretiska referensramen utgår ifrån hälsopromotion med fokus på främjande, hälsofrämjande ledarskap och dess förutsättningar, krav-resursmodellen, kompetens och kompetensutveckling. Studien utgår ifrån ett hermeneutiskt synsätt där slutsatser dragits med induktiv ansats. Metoden i studien baserades på en kvalitativ ansats genom åtta semistrukturerade intervjuer. Studiens resultat har analyserats genom en konventionell innehållsanalys. Analysen resulterade i fyra kategorier: Arbetsform och förutsättningar för ett hälsofrämjande ledarskap som visade chefernas upplevelse av hälsofrämjande ledarskap. Goda möjligheter till stöd i det dagliga arbetet var såväl befintliga som önskvärda stödjande strukturer och resurser inom organisationen. Hanterbara arbetskrav i form av prioritering av resurser där cheferna förmedlade deras upplevda arbetskrav inom organisationen, vilka inte ansågs vara för höga. Vikten av att prioritera resurser och tid låg till grund för ett hälsofrämjande ledarskap. Slutligen var goda förutsättningar för kompetensutveckling och dagligt lärande vilket förekom på såväl individ som gruppnivå. Utifrån resultatet kan slutsatserna dras att cheferna upplevde att det fanns goda förutsättningar för att bedriva ett hälsofrämjande ledarskap i form av stöd, krav och resurser samt kompetensutveckling. Prioritering av resurserna låg till grund för chefernas förutsättningar för att bedriva ett hälsofrämjande ledarskap.

  • 2808.
    Åkerborg, Susanne
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Bousova, Lenka
    Halmstad University, School of Social and Health Sciences (HOS).
    Cronqvist, Linnea
    Halmstad University, School of Social and Health Sciences (HOS).
    Den skapande konstens betydelse vid psykisk ohälsa2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In today's information society with many impressions and activities people feel stressed. The mental illness is high and the Swedish health care system needs improvement for these patients. Art-making activities are still a relatively unknown area of nursing care. The purpose of this study was to illustrate how art-making activities can affect patients' mental illness and why art-making activities may be important in nursing care. The study was conducted as a literature review in which 15 scientific qualitative studies, quantitative studies and combined studies were included. Art-making can give patients a better mental health by expressing emotions such as fear, hope and strength. Art-making can relieve various symptoms such as pain, anxiety and loss of appetite. The personal development can be seen to increase by strengthening identity, meaningfulness and increased self-confidence. New coping strategies can be developed by focusing on art-making and increased well-being can be experienced as well as the long and short term. Art-making in the healthcare environment can result in an experience of a less clinical atmosphere and the social network is perceived to be strengthened by new relationships created in the context of art. Using art-making activities in nursing care can provide opportunities to relieve patients' traumatic experiences and feelings. An openness to new ideas, wider knowledge and use of evidence-based care can help nurses to promote patient health. More research in art-making linked to care is desirable, both nationally and internationally.

  • 2809.
    Åkerlund, Ejvor
    et al.
    Health Care Center, Varberg, Sweden.
    Odams, Eva
    Maternal Care Center, Varberg, Sweden.
    Larsson, Irene
    Health Care Center, Veddige, Sweden.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nipple necrosis after reduction mammaplasty: A case report1995In: International Journal of Rehabilitation and Health, ISSN 1068-9591, E-ISSN 1573-1537, Vol. 1, no 4, p. 285-289Article in journal (Refereed)
    Abstract [en]

    The aim of this case report was to describe a rare complication in the rehabilitative phase: nipple necrosis resulting from reduction mammaplasty. the patients in the two cases presented, having systemic disease, did not receive optimal treatment for the prevention of pyoderma gangraenosum; a plausible cause of the complication. Patients having systemic disease ought to undergo thorough examinations before submitting to any reduction mammaplasty. © 1995 Plenum Publishing Corporation.

  • 2810.
    Åkerström, Lisa
    Halmstad University, School of Health and Welfare.
    Trycksår hos barn på barnintensivvårdsavdelning: Sjuksköterskans förebyggande åtgärder2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Pressure ulcer is an injury caused by hospitalizations when sustained pressure over bony prominence or devices for a prolonged period of time pressure ulcer may appear. Critically ill infants and children admitted to the pediatric intensive care unit (PICU) are at risk of developing pressure ulcer. Patricia Benner’s nursing theory is used as theoretical guideline for this study. The aim of this study was to describe preventing measures against pressure ulcers performed by nurses for infants and children admitted at PICU.  A systematic literature review was conducted and three databases resulting in eleven articles. The result was presented in three categories: follow routines and guidelines, identify associated risk factors for pressure ulcer on patients in the PICU and also practical nursing and tools. The result of this study showed that pressure ulcer can be prevented with guidelines, education and tools. For some patients in the PICU pressure ulcer could not be prevented due to their clinical instability. Hospital staff and board should implement evidence basted pressure ulcer prevention measures. Further research concerning Swedish practice could be needed.  

  • 2811.
    Åkesson, Per
    Halmstad University, School of Social and Health Sciences (HOS).
    Att vara eller inte vara fysiskt aktiv bland medelålders män: En litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Iakttagelser har dock visat en minskad grad av fysisk aktivitet hos befolkningen. Könsskillnader har visats vara en faktor, män och kvinnor har ibland olika motivationskällor till fysisk aktivitet. Syfte : Syftet med den här studien var att beskriva vad som motiverar medelålders män till fysisk aktivitet. Metod : Genom att ha en litteraturstudie som metod var målet att få en fördjupning av det nuvarande kunskapsområdet som berör syftet. Studien har inkluderat 15 stycken artiklar från databaserna: Cinahl, Pubmed, Sciverse och Academic search elite. Artiklarna lästes och genomgick en temaanalys. Resultat : Resultatet delades in i fem teman. Socioekonomi och psykosociala faktorer menar att socioekonomisk tillhörighet och till exempel socialt stöd är betydande faktorer. Närmiljön och dess tillgångar är styrande med tillgängliga parker, cykelbanor etcetera som visats stimulera mäns motionsvanor. Förhållandet till det manliga idealet menar bland annat att det finns förutfattade meningar om hur män ska bete sig och hur detta påverkar deras motivation till fysisk aktivitet. Möjligheter till fysisk aktivitet på arbetet och fritiden visade att ett tungt jobb minskar chansen till motion på fritiden. Vardagsmotion eller bekvämlighet är till stor del styrande av ekonomiska resurser samt om utvecklade cykel och promenadvägar som finns tillgängligt. Implikation: För att främja fysisk aktivitet hos medelålders män bör både yttre och inre faktorer tillgodoses. Mer företag bör överväga att införa hälsovård. Kanske viktigast att ge arbetare i låga socioekonomiska grupper exempelvis förmånliga priser på gymkort. Det rekommenderas upprätthållande av platser såsom cykelbanor och motionsspår, där fysisk aktivitet kan utövas. Åtgärder som riktar sig till att stärka mäns självförtroende och andra inre egenskaper som är viktiga för att främja motivation till fysisk aktivitet hos medelålders män.

  • 2812.
    Ålenius, Piamari
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Schagerlöv, Caroline
    Halmstad University, School of Social and Health Sciences (HOS).
    Det är det lilla som gör det stora: -hälsofrämjande åtgärder vid hypertoni2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Hypertension is common in today's society and is therefore considered to have become a national disease. An estimated 1.8 million of Sweden's adult population have hypertension. Hypertension accounts for about 13 percent of the total mortality in the world, and is seen as a risk factor for numerous cardiovascular diseases. Today there are international guidelines for the treatment of hypertension in, England and USA. However, there are no specific Swedish guidelines for treatment of hypertension. The purpose of this study was to elucidate how health interventions can influence blood pressure in people with hypertension. The results of this literature study are based on a review of 16 scientific articles which was based on literature review and order problem. The health-promoting interventions that can affect blood pressure in people with hypertension are highlighted in the results. Such interventions are weight loss, physical activity, diet, alcohol, smoking, stress and support. The effect of health promotion interventions has shown that lowering blood pressure can occur if lifestyle changes are implemented and carried out. A braking in the development of hypertension can lead to health-economic benefits to the community. National guidelines and care programs for the treatment of hypertension should be developed to a braking of hypertension to happen.

  • 2813.
    Årestedt, K.
    et al.
    Linnéuniversitetet, Sweden.
    Ågren, S. A. Susanna
    Linköping University, Dept Med & Hlth Sci, Linköping, Sweden .
    Flemme, Inger
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Moser, D. M. Bedbra
    Univ Kentucky, Coll Nursing, Lexington, KY 40506, USA.
    Strömberg, A. S. Anna
    Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden .
    Psychometric properties of the Swedish version of the Control Attitudes Scale (CAS) for patients with cardiac disease and their partners2010In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 31, no Supplement 1, p. 230-230Article in journal (Other academic)
  • 2814.
    Årneby, Henrik
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS).
    The acute effect of a foam rolling and a dynamic stretch warm-up routine on jumping performance2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Self-myofascial release is widely used by athletes but the scientific evidence of its supposedly positive effects is limited. This study was conducted to investigate the effects of foam rolling as a warm-up routine in comparison with a dynamic stretching routine and how it may affect the jumping performance among subjects familiar with weight training. Aim: The aim of this study was to investigate the acute effect of foam rolling vs. a standardized dynamic stretch warm-up routine on jumping performance. Method: Twelve subjects, mean (SD) age 25.1 (± 3.0) years, participated in a randomized, controlled, crossover study. All subjects completed a standardized foam rolling (FR) and a dynamic stretch (DS) warm-up routine on separate days of testing. Squat jump (SJ), counter movement jump (CMJ) and loaded counter movement jump (L-CMJ) all performed bilaterally and unilaterally were conducted to investigate the acute effect of the two warm-up routines. A dependent T-test was used to investigate differences between the warm-up routines. Results: A statistical significant difference in favor of the DS was found for SJ performed bilaterally among males (p = 0.009). The mean (SD) jumping height for SJ FR was 35.6 (± 4.7) cm and for SJ DS 37.9 (± 5.2) cm. The male group also improved more in L-CMJ performed on the right leg with an external load of 54kg after DS compared to FR. No other statistical significant differences were found between the two interventions. A near statistical significant difference was found for SJ performed bilaterally for the total sample (p = 0.057) also in favor of the DS. The mean (SD) jumping height for SJ FR was 29.3 (± 8.7) cm and for SJ DS 30.5 (± 9.9) cm. Conclusion: Findings from this study supports a dynamic stretch warm-up routine prior to performing high intensity bilateral plyometrics instead of a foam rolling warm-up routine. However the data was inconsistent and more research with larger sample sizes is needed to further investigate the possible effects of foam rolling as a warm-up routine on jumping performance performed both bilaterally and unilaterally.

  • 2815.
    Åsa, Augustsson
    Halmstad University, School of Social and Health Sciences (HOS).
    Kära Dagbok...: Dagbokens betydelse för patienten2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vid sjuksköterskans omvårdnadsarbete ska fokus ligga i den enskilda patientens behov och önskningar och omvårdnaden skall vara individanpassad. Patienten skall vara delaktig och uppleva trygghet och respekt. Vid god omvårdnad måste sjuksköterskan utgå från den unika patientens behov, erfarenheter och upplevelser varpå kunskap om personen i fråga krävs. Dagboksanteckningar kan identifiera tillstånd och känslor hos patienten, vilket kan fångas upp av sjuksköterskan som i sin tur får ökad förståelse för den individuella patientens behov. Syftet med studien var att beskriva dagbokens betydelse ur patientens perspektiv. En litteraturstudie där resultatet baserades på tolv artiklar genomfördes. Resultatet belyser att dagböcker som företeelse kan identifiera känslor och tillstånd hos patienterna vilket kan hjälpa sjuksköterskan till ökad förståelse för den individuella patientens behov. Dagböckerna ökade patienternas medvetenhet om sin sjukdom eller tillstånd, vilket ledde till bättre följsamhet vid egenvård, symtomlindring och ökad delaktighet i vården. Detta kan ses som ett verktyg utifrån vilket sjuksköterskan planerar olika omvårdnadsåtgärder vilket bör uppmärksammas och utvecklas i omvårdnadsutbildningar. Dagbokens användningsområde bör expanderas och kommande forskning bör genomföras i syfte att utveckla dagbokens betydelse som ett effektivt omvårdnadsverktyg i dagliga rutiner.

  • 2816.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Uppsala, Sweden.
    Demmelmaier, Ingrid
    Uppsala University, Uppsala, Sweden.
    Emilson, Christina
    Uppsala University, Uppsala, Sweden.
    Pettersson, Susanne
    Uppsala University, Uppsala, Sweden.
    Bergman, Stefan
    Spenshult Centre for Rheumatic Disease, Oskarström, Sweden.
    Step-Up: An Innovative Stepped-Care Protocol for Tailored Behavioral Medicine Treatment in the Management of Musculoskeletal Pain in Primary Care2013In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, no Suppl. 3, p. A120-A120Article in journal (Refereed)
    Abstract [en]

    Background: Multimodal rehabilitation and tailored behavioral medicine treatments should be provided to patients suffering from persistent and activity limiting pain according to current state-of-science. There is also evidence that a minimal intervention including 'stay-active advice' can produce effects comparable to effects of comprehensive treatment packages. Nevertheless, there is a gap of knowledge regarding which individuals who benefit the most from which modalities of pain treatment, at what time point, and with the highest cost-effectiveness. Accordingly, we have set up an innovative stepped-care protocol for the management of musculoskeletal pain in primary care, which is evaluated in a randomized controlled trial.

    Objectives: The aim is to compare effects and cost-effectiveness of a stepped care model including advice and tailored behavioral medicine pain treatment (experimental condition) with a stepped care model including advice and physical exercises (comparison condition) for patients with low back and neck pain and/or widespread pain including fibromyalgia in primary care. A further aim is to characterize patients who benefit/do not benefit from the respective steps i.e. treatments varying in dose and content.

    Methods: A stratified randomized stepped care design is applied. Stratification is based on primary care center and psychological risk profile. A consecutive selection is performed at primary care centers in southern, central and northern Sweden. After having received a minimal intervention (step 1) comprising 'stay-active advice', participants scoring high on the Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) according to preset criteria are randomly allocated to an eight-week treatment in step 2. The experimental condition includes supervised physical exercises integrated with either (a) graded activity, or (b) hierarchical graded exposure depending on psychological risk profile. The comparison condition includes supervised physical exercises irrespective of risk profile. Primary outcome is pain-related disability complemented with a comprehensive set of secondary outcomes adhering to the IMMPACT recommendations.

    Results: The stepped-care design will be presented including illustrations of conclusions possible to draw with this kind of innovative design.

    Conclusions: There is a call for stepped-care interventions within pain intervention research, particularly in the primary care setting. However, published studies are still lacking. This study will contribute to an important progression of behavioral medicine pain treatments by the way treatments are tailored in accordance with psychological risk profile. This will be discussed to stimulate research activities and collaboration within this area of research and clinical implementation.

  • 2817.
    Ödegård, Synnöve
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hallberg, Lillemor
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perceived potential risk factors in child care2004In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 18, no 1, p. 38-52Article in journal (Refereed)
    Abstract [en]

    This study is based on semi-structured interviews focusing on staff members’ opinions about potential risk factors that could threaten patient safety. The aim was to acquire more in-depth knowledge about the causes of patient injuries. The study, which was conducted at a children's hospital, has a qualitative approach that is influenced by the critical incident technique. A total of 28 persons were interviewed. Analysis of the data resulted in five qualitatively differentiated categories of potential risk factors: a large influx of patients, a lack of professional experience, a lack of inter-professional communication and cooperation, and deficiencies related to work hours and to the physical environment. The results reflect a complex picture where the risks, as described by the informants, can either alone or in concert directly or indirectly affect the individual in the practice of his or her profession or contribute to a mistake.

  • 2818.
    Öijervall, Jörgen
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjuksköterskors erfarenheter av verksamma faktorer i processorienterad omvårdnadshandledning i grupp, ett år efter avslutad sjuksköterskeutbildning: Nurses' experiences of the active factors in process-oriented clinical group supervision, one year after degree2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Processorienterad omvårdnadshandledning i grupp är ett stöd för studenter att utveckla sin förmåga att hantera komplexa vårdsituationer. Reflektionen har en central roll samt handledarens förhållningsätt. Den omvårdnadsteoretiska förankringen beskrivs som betydelsefull, men det finns beskrivningar att alla handledare inte använder omvårdnad som teoretisk grund. Studiens syfte var att beskriva sjuksköterskors erfarenheter av verksamma faktorer i processorienterad omvårdnadshandledning i grupp, ett år efter avslutad sjuksköterskeutbildning. Analysen har gjort med hjälp av kvalitativ innehållsanalys utifrån intervjuer med 18 sjuksköterskor presenteras i fyra kategorier: Handledarens karaktär, Handledningssessionens struktur, Pedagogiska metoder och Reflekterande kommunikation. Resultatet visar att handledarens personliga egenskaper har stor betydelse likaså vikten av att ha ett uppmuntrande förhållningssätt gentemot deltagarna. handledarens engagemang för att skapa trygghet, detta kan medföra att hanledaren kan bli en god rollmodell. En annan viktig faktor är att handledningssessionerna har en tydlig struktur, detta visar sig betydelsefullt för att skapa trygghet och att bibehålla fokus på problemställningarna. Resultatet beskriver olika pedagogiska strategier, såsom rollspel och att använda gruppen för att stödja lärprocesser.  Ytterligare en viktig faktor är att handledningen utgår från ett omvårdnadsteoretiskt perspektiv, då detta fungerar som en kompass i omvårdnadshandledningen. Vikten av ett omvårdnadsteoretiskt perspektiv beskrivs mer implicit i resultatet. Däremot beskrivs vikten av reflekterad kommunikation mer tydligt i materialet.  Reflekterad kommunikation bidrar till studenternas fördjupade kunskaper kring omvårdnadens praktiska genomförande. Ytterligare forskning bör fokuseras på hur det omvårdnadsteoretiska perspektivet kan belysas som en verksam faktor i omvårdnadshandledning

  • 2819.
    Öijervall, Jörgen
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Främjande faktorer för professionell utveckling i processorienterad omvårdnadshandledning i grupp: Sjuksköterskors erfarenheter ett år efter avslutad sjuksköterskeutbildning2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 1, p. 9-13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe nurses' experiences of factors enhancing professional development trough process-oriented group super- vision, one year after completed nursing education. The objective of process-oriented group supervision in nursing care is to support students’ development of their ability to manage complex care situations. The attitude of the supervisor and the students’ willingness to reflect on them- selves have been described as playing key roles in process-oriented group supervision during nursing education. The link to nursing science has also been described as significant by several researchers, but some supervisors are not using nursing science as a foundation in group supervision for nurses. The analysis was completed using a qualitative content analysis method based on interviews with 18 nurses resulting in the general theme “Process oriented pedagogy” which is presented in three categories: Supervisor’s character, Pedagogical strategy and Reflective communication. The findings suggest that the supervisor's personal qualities in combination with an inspiring structure are impor- tant to promote the participants’ reflective communication during the group supervision sessions. Reflective communication supports the students’ development towards a deeper professional knowledge. Further research should focus on the use of nursing science as a foundation in clinical process-oriented group supervision.

  • 2820.
    Öijervall, Jörgen
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Promoting factors for professional development in process oriented group supervision. Nurses experiences one year after completed nursing degree2013In: Breaking Barriers 2013, 2013, p. 43-44Conference paper (Refereed)
    Abstract [en]

    The aim of this study was to describe nurses' experiences of factors enhancing professional development trough process-oriented group supervision, one year after completed nursing education. The objective of process-oriented group supervision in nursing care is to support students’ development of their ability to manage complex care situations. The attitude of the supervisor and the students’willingness to reflect on themselves have been described as playing key roles in process-oriented group supervision during nursing education. The link to nursing science has also been described as significant by several researchers, but some supervisors are not using nursing science as a foundation in group supervision for nurses. The analysis was completed using a qualitative content analysis method based on interviews with 18 nurses resulting in the general theme “Process oriented pedagogy” which is presented in three categories: Supervisor’s character, Pedagogical strategy and Reflective communication. The findings suggest that the supervisor's personal qualities in combination with an inspiring structure are important to promote the participants’ reflective ommunication during the group supervision sessions. Reflective communication supports the students’ development towards a deeper professional knowledge. Further research should focus on the use of nursing science as a foundation in clinical process-oriented group supervision.

  • 2821.
    Önnerfält, Jenny
    et al.
    Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden & Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Paediatrics, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    Erlandsson, Lena-Karin
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Orban, Kristina
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Broberg Olsson, Malin
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Thorngren-Jerneck, Kristina
    Department of Paediatrics, Clinical Sciences, Lund University, Lund, Sweden & Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    A family-based intervention targeting parents of preschool children with overweight and obesity: Conceptual framework and study design of LOOPS- Lund Overweight and Obesity Preschool Study2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, no 1, article id 879Article in journal (Refereed)
    Abstract [en]

    Background: As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score.

    Methods/Design: The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress.

    Discussion: The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity.

    Trial registration: ClinicalTrials.gov NCT00916318

    © 2012 Önnerfält et al.; licensee BioMed Central Ltd.

  • 2822.
    Östberg, Anna-Lena
    et al.
    Karlstad University, Karlstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Gullberg, Bo
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Råstam, Lennart
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Lindblad, Ulf
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Tooth loss and obesity in a defined Swedish population2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 4, p. 427-433Article in journal (Refereed)
    Abstract [en]

    Aims: To explore the association between tooth loss and obesity in an adult Swedish population, and to investigate the influence of socioeconomy, life-style, and co-morbidity.

    Methods: A cross-sectional population health survey conducted in 2001-2005 in 2816 randomly selected Swedish men and women (age: 30-74 years; participation rate 76%). Main measures were; tooth loss: < 20 remaining teeth (self-reported), general obesity: BMI[≥]30 kg m-2, abdominal obesity: waist circumference > 88 in women and > 102 cm in men. Adjustments were made for socioeconomy, life-style, and co-morbidity.

    Results: 420 individuals (21.2%) had < 20 remaining teeth: 30-59 years 6.0%, 60-74 years 53.5%. Mean BMI was similar in men and women (26.9 kg m-2), however, both general and abdominal obesity was still more frequent among women (both p < 0.001). There was a significant interaction between age and tooth loss in the association with both general (p = 0.004) and abdominal obesity (p < 0.011) in men. In participants below 60 years of age, the association between tooth loss and general obesity (OR 2.17 [95% CI 1.51 - 3.12]) and abdominal obesity (2.23 [1.58 - 3.15]), respectively, was statistically significant independent of age and gender, and remained so also when accounting for differences in socioeconomy, life-style, and co-morbidity. There was no similar association in those 60 years or older. The findings in men and women were robust and concordant.

    Conclusions: Common mechanisms for oral health and obesity should be explored more also including longitudinal designs. The findings are important for targeting comprehensive interventions against obesity and tooth loss, especially among younger adults.

  • 2823.
    Österlind, Jane
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden & Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
    Hansebo, Görel
    Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
    Andersson, Janicke
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Ternestedt, Britt-Marie
    Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
    Hellström, Ingrid
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    A discourse of silence: professional carers reasoning about death and dying in nursing homes2011In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 31, no 4, p. 529-544Article in journal (Refereed)
    Abstract [en]

    Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucault's discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics: (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly person's death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.

  • 2824.
    Ørstavik, Kristin
    et al.
    Faculty of Medicine, University of Oslo.
    Namer, Barbara
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Schmidt, Roland
    Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Schmelz, Martin
    Department of Anesthesiology Mannheim, University Heidelberg, Mannheim, Germany,.
    Hilliges, Marita
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS).
    Weidner, Christian
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Carr, Richard W.
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Handwerker, Hermann
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Jørum, Ellen
    Laboratory of Clinical Neurophysiology, Department of Neurology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
    Torebjörk, H. Erik
    Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Abnormal Function of C-Fibers in Patients with Diabetic Neuropathy2006In: Journal of Neuroscience, ISSN 0270-6474, E-ISSN 1529-2401, Vol. 26, no 44, p. 11287-11294Article in journal (Refereed)
    Abstract [en]

    The mechanisms underlying the development of painful and nonpainful neuropathy associated with diabetes mellitus are unclear. We have obtained microneurographic recordings from unmyelinated fibers in eight patients with diabetes mellitus, five with painful neuropathy, and three with neuropathy without pain. All eight patients had large-fiber neuropathy, and seven patients had pathological thermal thresholds in their feet, indicating the involvement of small-caliber nerve fibers. A total of 163 C-fibers were recorded at knee level from the common peroneal nerve in the patients (36–67 years old), and these were compared with 77 C-fibers from healthy controls (41–64 years old). The ratio of mechano-responsive to mechano-insensitive nociceptors was ~2:1 in the healthy controls, whereas in the patients, it was 1:2. In patients, a fairly large percentage of characterized fibers (12.5% in nonpainful and 18.9% in painful neuropathy) resembled mechano-responsive nociceptors that had lost their mechanical and heat responsiveness. Such fibers were rarely encountered in age-matched controls (3.2%). Afferent fibers with spontaneous activity or mechanical sensitization were found in both patient groups. We conclude that small-fiber neuropathy in diabetes affects receptive properties of nociceptors that leads to an impairment of mechano-responsive nociceptors. Copyright © 2006 Society for Neuroscience

  • 2825.
    Ørstavik, Kristin
    et al.
    Department of Neurology, Rikshospitalet University Hospital, Oslo, Norway.
    Weidner, Christian
    Department of Physiology, University of Erlangen/Nürnberg, Erlangen, Germany; Universitat Erlangen/Nurnberg, Inst. Physiol./Exp. Pathophysiol., Erlangen, Germany.
    Schmidt, Roland
    Dept. of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Schmelz, Martin
    Department of Physiology, University of Erlangen/Nürnberg, Erlangen, Germany.
    Hilliges, Marita
    Department of Basic Oral Sciences, Karolinska Institute, Huddinge, Sweden.
    Jørum, Ellen
    Department of Neurology, Rikshospitalet University Hospital, Oslo, Norway.
    Handwerker, Herman
    Department of Physiology, University of Erlangen/Nürnberg, Erlangen, Germany.
    Torebjörk, Erik
    Dept. of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Pathological C-fibres in patients with a chronic painful condition2003In: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 126, no 3, p. 567-578Article in journal (Refereed)
    Abstract [en]

    Little is known about the contribution of C-afferent fibres to chronic painful conditions in humans. We sought to investigate the role of C-fibres in the pathophysiology of pain and hyperalgesia in erythromelalgia as a model disease for chronic pain. Erythromelalgia is a condition characterized by painful, red and hot extremities, and patients often report tenderness on walking. We made microneurographic recordings from single C-fibres in cutaneous fascicles of the peroneal nerve in patients suffering from this disease. All patients had had a pain attack recently and psychophysical signs of allodynia and punctate hyperalgesia were found. We obtained recordings from a total of 103 C-fibres and found significantly lower conduction velocities and increased activity-dependent slowing of the conduction velocity of afferent C-fibres in the patients compared with healthy controls. Furthermore, several units with biophysical properties of mechano-insensitive fibres were pathological, being spontaneously active or sensitized to mechanical stimuli. Since these fibres also mediate the axon reflex flare, their hyperexcitability might account not only for ongoing pain and tenderness but also for redness and warming in this pain syndrome. The changes in conductive properties found in the C-fibres of these patients could be the first signs of a small-fibre neuropathy. This is the first systematic study of single C-fibres in patients and it shows an active contribution of mechano-insensitive fibres to chronic pain.

  • 2826.
    Überbacher, Ewa
    Halmstad University, School of Social and Health Sciences (HOS).
    VÄGAR TILL REFLEKTION: Avdelningschefers uppfattningar inom somatisk omvårdnad2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Continuous feedback through reflection can be used as a tool by the department head for leading the development, learning and innovation in nursing work. The aim of the study was to describe the department heads´perceptions of reflection in nursing care by a phenomenographical approach. The analysis of 15 interviews resulted in five description categories of reflection. Knowledge integral reflection captures students´training that can be used in nursing work. Processing creates a continuous thought process in nursing work. Reflection development was reinforced among employees when talking to each orther. Managerial reflection was described as a separate forum in the process manager role. Patient-oriented reflection highlighted the patient´s participation. The conclusion was that department heads used reflection on different levels and in different contexts. Reflection proved important in nursing care. Study findings may help to increase knowledge in order to develop leadership whick leads to beter quality of care and patient safety. Continued research should focus on intervention studies with an emphasis on reflection.

  • 2827.
    Berglund, Maria (Editor)
    Växjö universitet, Växjö, Sverige.
    Johansson Sundler, Annelie (Editor)
    Växjö universitet, Växjö, Sverige.
    Roxberg, Åsa (Editor)
    Växjö universitet, Växjö, Sverige.
    Vårdvetenskapliga vägskäl2008Report (Other academic)
    Abstract [en]

    Denna vårdvetenskapliga jubileumsskrift tar läsaren med på en resa genom den utveckling som skett av ämnet vid forskarutbildning i vårdvetenskap vid Växjö universitet. Många bäckar små… ett talesätt som kan illustrera det gemensamma arbete och den samlade kunskap som ligger bakom denna skrift. I skriften får vi stifta bekantskap med vårdvetenskapen i varierande kontexter alltifrån rättpsykiatri till akut- och hemsjukvård. Sammanställningen av den vårdvetenskapliga forskning som under denna femårsperiod har gjorts på IVOSA visar att vårdvetenskapen är en autonom vetenskap med en tydlig substans eller kärna. I kärnan finns patienten, och ämnet tar sin utgångspunkt i människors existens. Med fokus på människan som är i behov av vård framträder lidande, hälsa och välbefinnande som väsentliga begrepp. I bokens delar fördjupas och kontextualiseras vårdvetenskapen i skiftande vårdande liksom lärande miljöer. En vårdvetenskap med grund i ett patientperspektiv behövs såväl akademiskt som i vården för att anta både dagens och morgondagens utmaningar.

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