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  • 351.
    Bökberg, Christina
    et al.
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Hallberg, Ingalill R
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Janlöv, Ann-Christin
    School of Health and Society, Kristianstad University, Sweden.
    Professional care providers and stakeholders’ views of best practice in the care for persons with dementia in Sweden2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Suppl. 1, p. S369-S370Article in journal (Refereed)
    Abstract [en]

    Introduction: Dementia implies progressive loss of mental and physical functions during the trajectory of the disease (Porter & Kaplan, 2012). Persons with dementia need involvement of various and several care providers throughout the stages of dementia, and more knowledge is needed about best practice strategies in this complexity of care (Gurner, 2001). The aim of the study was to explore professional care providers and stakeholders’ views of best practice in concepts of information, collaboration and communication in the care for persons with dementia in Sweden.

    Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.

    Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.

    Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.

    On the behalf of RightTimePlaceCare consortium. http://www.righttimeplacecare.eu.

  • 352.
    Bökberg, Christina
    et al.
    Lund University, Lund, Sweden.
    Ahlström, Gerd
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Lund University, Lund, Sweden.
    Significance of quality of care for quality of life in persons with dementia at risk of nursing home admission: a cross-sectional study2017In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, no 1, article id 39Article in journal (Refereed)
    Abstract [en]

    Background

    Quality of life in persons with dementia is, in large part, dependent on the quality of care they receive. Investigating both subjective and objective aspects of quality of care may reveal areas for improvement regarding their care, which information may ultimately enable persons with dementia to remain living in their own homes while maintaining quality of life. The aim of this study was to 1) describe self-reported quality of life in persons with dementia at risk of nursing home admission. 2) describe subjective and objective aspects of quality of care, 3) investigate the significance of quality of care for quality of life.

    Methods

    A cross-sectional interview study design was used, based on questionnaires about quality of life (QoL-AD) and different aspects of quality of care (CLINT and quality indicators). The sample consisted of 177 persons with dementia living in urban and rural areas in Skåne County, Sweden. Descriptive and comparative statistics (Mann-Whitney U-test) were used to analyse the data.

    Results

    Based upon Lawton’s conceptual framework for QoL in older people, persons with pain showed significantly lower quality of life in the dimensions behavioural competence (p = 0.026) and psychological wellbeing (p = 0.006) compared with those without pain. Satisfaction with care seemed to have a positive effect on quality of life. The overall quality of life was perceived high even though one-third of the persons with dementia had daily pain and had had a weight loss of ≥4% during the preceding year. Furthermore, 23% of the persons with dementia had fallen during the last month and 40% of them had sustained an injury when falling.

    Conclusion

    This study indicates need for improvements in home care and services for persons with dementia at risk for nursing home admission. Registered nurses are responsible for nursing interventions related to pain, patient safety, skin care, prevention of accidents, and malnutrition. Therefore, it is of great importance for nurses to have knowledge about areas that can be improved to be able to tailor interventions and thereby improve quality of care outcomes such as quality of life in persons with dementia living at home. © 2017 The Author(s).

  • 353.
    Bökberg, Christina
    et al.
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Hallberg, Ingalill R.
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Janlöv, Ann-Christin
    School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Professional care providers and stakeholders’ views of best practice in the chain of care for persons with dementia in Sweden2013In: Nordic Advances in Health Care Sciences Research: Abstract Book, 2013, p. 98-98Conference paper (Refereed)
    Abstract [en]

    Background: To meet the increasing needs for persons with dementia and their relatives a well-functioning health care system in which resources are used optimally is needed. For this to be achieved requires strategy and planning of synergies between the different cares providers. This study will explore professional caregivers’ and stakeholders’ views of best practice in terms of information, collaboration and communication in dementia care.

    Aim: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice in concepts of information, collaboration and communication throughout the trajectory of care from diagnosis to end of life care for persons with dementia in Sweden.

    Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.

    Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.

    Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.

  • 354.
    Bökberg, Christina
    et al.
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Ahlström, Gerd
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Karlsson, Staffan
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Hallberg, Ingalill Rahm
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Janlöv, Ann-Christin
    School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Best practice and needs for improvement in the chain of care for persons with dementia in Sweden: a qualitative study based on focus group interviews2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, no 1, article id 596Article in journal (Refereed)
    Abstract [en]

    Background: Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers' views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden.

    Methods: The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life).

    Results: The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in the chain of care, Competent staff a prerequisite for high-quality care, Day care facilitates transition in the chain of care and Next-of-kin participation is a prerequisite for continuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care.

    Conclusions: The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages. ©  Bökberg et al.; licensee BioMed Central Ltd. 2014

  • 355.
    Bökberg, Christina
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Ahlström, Gerd
    Older People's Health and Person-centred Care & Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH), Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    University of Turku, Finland & Turku University Hospital, Finland.
    Soto-Martin, Maria
    Gerontopôle Alzheimer´s Disease Research and Clinical Center, Toulouse University Hospital, France.
    Cabrera, Esther
    School of Health Sciences, TecnoCampus, University Pompeu Fabra, Mataró (Barcelona), Spain.
    Verbeek, Hilde
    Department of Health Services Research, Maastricht University, The Netherlands.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Stephan, Astrid
    School of Nursing Science, Witten/Herdecke University, Germany.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, School of Nursing, Midwifery, and Social Work, University of Manchester, England.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Care and Service at Home for Persons With Dementia in Europe2015In: Journal of Nursing Scholarship, ISSN 1527-6546, E-ISSN 1547-5069, Vol. 47, no 5, p. 407-416Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe available and utilized formal care and service at home for persons with dementia, from diagnosis to end-of-life stage, in eight European countries.

    Design: A descriptive cross-country design concerning eight European countries as a part of the European research project RightTimePlaceCare.

    Methods: The research team in each country used a mapping system to collect country-specific information concerning dementia care and service system. The mapping system consists of 50 types of care and service activities. Sixteen of the 50 predefined activities concerning care and service at home were selected for this study and subdivided into three categories, following the stages of dementia.

    Findings: Availability was reported to be higher than utilization, and the findings indicated more similarities than differences among the eight countries involved. Even though there were several available activities of "basic care and services" and "healthcare interventions," they were utilized by few in most countries. Furthermore, "specialized dementia care and services" were sparsely available and even more sparsely utilized in the participating countries.

    Conclusions: The findings indicated that persons with dementia in Europe received formal care and service on a general, basic level but seldom adjusted to their specific needs.

    Clinical Relevance: This study describes the gap between service provision and utilization enabling nurses to develop individually adjusted care plans for persons with dementia during the progress of the disease. The findings do not include matters of quality of care or how to best organize effective care and services. However, the activities of care and services presented here should shed light on what room there is for improvement when it comes to enabling persons with dementia to go on living at home. © 2015 Sigma Theta Tau International.

  • 356.
    Bökberg, Christina
    et al.
    Lund University, Lund, Sweden.
    Ahlström, Gerd
    Leino-Kilpi, Helena
    Soto-Martin, Maria E.
    Cabrera, Esther
    Verbeek, Hilde
    Saks, Kai
    Stephan, Astrid
    Sutcliffe, Caroline
    Karlsson, Staffan
    Care and Service at Home for People With Dementia in Europe2015In: Abstractbook Nordic Conference on Advances in Health Care Sciences Research, 2015, p. 22-22Conference paper (Refereed)
    Abstract [en]

    Purpose: To describe available and utilized professional care and service at home for people with dementia, from diagnosis to end-of-life stage, in eight European countries. Design: A descriptive cross-country design concerning eight European countries as a part of the European research project, RightTimePlaceCare (RTPC).

    Methods: The research team in each country used a mapping system to collect countryspecific information on a general level concerning dementia care and service system. The mapping system consisted of fifty types of care and service activities. Sixteen of the fifty predefined activities concerning professional care and service at home were selected for this study and subdivided into three categories, following the stages of dementia.

    Results: Availability was reported to be higher than utilization and the results indicated more similarities than differences among the eight countries involved. Even though there were several available activities of Basic care and services and Health care interventions they were utilized by few in most countries. Furthermore, Specialized care and services for people with dementia were sparsely available and even more sparsely utilized in the participating countries.

    Conclusions: The results indicated that people with dementia in Europe received professional care and service on a general, basic level but seldom received care and service adjusted to their specific needs.

    Clinical Relevance: This study highlights available and utilized types of care and service activities enabling nurses to develop individually adjusted care plans for people with dementia during the progress of the disease. Knowledge of care and services in other countries provides nurses with an important tool for the improvement of dementia care. However assessing the quality of care requires an indication of informal care provision in different countries.

  • 357.
    Börjesson, Åsa
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Göransson, Emelie
    Halmstad University, School of Social and Health Sciences (HOS).
    Vestberg, Natalie
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjuksköterskans hälsofrämjande arbete inom slutenvård: Faktorer som påverkar2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Ett hälsofrämjande perspektiv ska genomsyra hela hälso- och sjukvården där sjuksköterskan uppmanas att främja patienters hälsa. Trots detta visar studier att arbetssättet inom slutenvården gör det svårt försjuksköterskan att ägna tid åt hälsofrämjande insatser. Syftet med studien var att klargöra sjuksköterskans hälsofrämjande arbete inom slutenvården samt vilka faktorer som påverkar arbetet. En litteraturöversikt gjordes där 12 vetenskapliga artiklar bidrog till ett resultat. I resultatet framkom att majoriteten sjuksköterskor såg hälsofrämjande som en del i deras profession men det framkom även att tvetydighet råder om begreppets innebörd. Stor arbetsbörda och tidsbrist inom slutenvården utgjorde de största hindren för sjuksköterskans hälsofrämjande arbete. För att sjuksköterskan inom slutenvård ska arbeta med hälsofrämjande insatser krävs mer tid, stöttning från ledning och kollegor, vidareutbildning inom området samt tydligare riktlinjer om olika praktiska strategier.

  • 358.
    Börnhorst, Claudia
    et al.
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Siani, Alfonso
    Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Russo, Paola
    Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Kourides, Yannis
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Sion, Isabelle
    Department of Public Health, Ghent University, Ghent, Belgium.
    Molnár, Denés
    Department of Pediatrics, University of Pécs, Pécs, Hungary.
    Moreno, Luis A.
    Rodríguez, Gerardo
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Ben-Shlomo, Yoav
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Howe, Laura
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom, MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Mehlig, Kirsten
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Regber, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Bammann, Karin
    Institute for Public Health and Nursing Research (IPP), Faculty for Human and Health Sciences, University Bremen, Bremen, Germany.
    Foraita, Ronja
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
    Tilling, Kate
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Early Life Factors and Inter-Country Heterogeneity in BMI Growth Trajectories of European Children: The IDEFICS Study2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 2, article id e0149268Article in journal (Refereed)
    Abstract [en]

    Background

    Starting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences.

    Methods

    The sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences.

    Results

    Large between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages ≥ 3 years compared to the other countries. For instance, at age 11 years mean BMI values in Italian boys and girls were 22.3 [21.9;22.8; 99% confidence interval] and 22.0 [21.5;22.4], respectively, compared to a range of 18.4 [18.1;18.8] to 20.3 [19.8;20.7] in boys and 18.2 [17.8;18.6] to 20.3 [19.8;20.7] in girls in the other countries. After adjustment for early life factors, differences between country-specific BMI curves became smaller. Maternal BMI was the factor being most strongly associated with BMI growth (p<0.01 in all countries) with associations increasing during childhood. Gestational weight gain (GWG) was weakly associated with BMI at birth in all countries. In some countries, positive associations between BMI growth and children not being breastfed, mothers’ smoking during pregnancy and low educational level of parents were found.

    Conclusion

    Early life factors seem to explain only some of the inter-country variation in growth. Maternal BMI showed the strongest association with children’s BMI growth.

  • 359.
    Böröy, Jan
    Halmstad University, School of Health and Welfare.
    Dispositionell mindfulness, emotionsreglering och idrottspsykologiska färdigheter2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med den befintliga studien var att genom en pathanalys pröva delar av Birrer et al.´s (2012) föreslagna modell, detta genom att vid tre mättillfällen undersöka samband mellan dispositionell mindfulness, emotionsreglering och idrottspsykologiska färdigheter (motivation, coping).

    Resultat: Den befintliga studiens modell visade longitudinella predicerande samband mellan dispositionell mindfulness för emotionsreglering, samt emotionsreglering för coping och motivation (Inre motivation, amotivation).

    Design: Longitudinell korrelationsstudie med tre mätningar. Metod: 65 deltagare varav 33 kvinnor och 32 män fyllde i enkäten (se bilaga 1). Modellen baserades på de 47 deltagare som fyllt i enkäten vid samtliga tre tillfällen. Slutsats: Den befintliga studiens modell stämmer, vilket innebär att mindfulnessträning med högre grad av dispositionell mindfulness som följd även ger främjande effekter för flertalet processer. Vidare konstateras att emotionsreglering är en central del i påverkansprocessen av mindfulness för att nå de idrottspsykologiska färdigheterna. Dessutom kan både coping och motivation slås fast att ingå i en modell likt den som presenteras av Birrer et al. (2012) och att varje steg i modellen är viktigt. Slutligen kan det konstateras i den befintliga studiens modell att dispositionell mindfulness är predicerande för emotionsreglering som i sin tur är predicerande för coping och motivation.

  • 360.
    Böröy, Jan
    et al.
    Halmstad University, School of Health and Welfare.
    Mattsson, Emil
    Halmstad University, School of Health and Welfare.
    Samband mellan dispositionell mindfulness, påverkansmekanismer, psykologiska färdigheter och prestation2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to examine mindfulness and it´s connection with performance in sports. By examining the correlations between dispositional mindfulness, three mechanisms of action (Clarity, rumination and negative emotion regulation), four psychological skills (Motivation, coping, emotion control skills and motor control skills) and performance  according to Birrer, Morgan and Röthlin´s (2012) model. As a foundation for the study a survey was used which were answered by 242 athletes, average age was 18,42 years (SD=0,26) it was 69 women and 172 men. Correlation analysis and regression analysis were done and showed what correlations and predications that were given in the study. This study  didn´t find any direct correlations between dispositional mindfulness and performance. On the other hand correlations were found between dispositional mindfulness and rumination, rumination and coping and coping and performance. The psychological skills that had significant correlations with all of the mechanisms of action were coping and emotional control. From the main results can the conclusion be made that the psychological skills coping and emotional control are essential in the model from Birrer et al (2012). The hypothesis of this study, that Birrer et al.´s (2012) model is accurate, could after completion of the study be in many ways confirmed. This motivates further studies on this model.

  • 361.
    Cabrera, Esther
    et al.
    School of Health Sciences TecnoCampus, University Pompeu Fabra, Barcelona, Spain.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Verbeek, Hilde
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Soto-Martin, Maria
    Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France.
    Meyer, Gabriele
    Medical Faculty, Institute for Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Germany.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland/Turku University Hospital, Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Zabalegui, Adelaida
    Nursing Hospital Clinic of Barcelona, Spain.
    Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes: A systematic review2015In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, no 2, p. 134-150Article in journal (Refereed)
    Abstract [en]

    Background: Two-thirds of nursing home residents suffer from dementia and there is a need for effective and efficient interventions with meaningful outcomes for these individuals. This study aims to identify current best practices in non-pharmacological interventions in nursing homes.

    Methods: A systematic literature review was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration guideline. Studies and Randomized Controlled Trials (RCT) evaluating non-pharmacological interventions focused on improving the Quality of Care (QoC) and/or Quality of Life (QoL) of people with dementia (PwD) living in nursing homes were included. For individual study evaluation, the Cochrane Collaboration risk of bias assessment tool was used.

    Results: A total of 31 articles were included and five main categories emerged: psychosocial and educational, physical activity, sensorial therapies, staff-focused interventions and complex interventions. Psychosocial interventions were the most exhaustively studied and evaluated interventions. Few studies related to physical therapy were identified and they did not provide enough evidence of their effectiveness. Therapeutic touch was revealed to have positive effects on residents with dementia.

    Conclusion: Psychosocial interventions have been shown to have the potential to improve the QoL and QoC of people with dementia in nursing homes. Before implementation of the intervention, it is recommended that activities are adjusted according to residents' characteristics and external factors controlled to achieve effectiveness and to structure a well-designed intervention. However, there is not enough evidence to support the effectiveness of non-pharmacological interventions in general. Further well-designed research is needed on non-pharmacological interventions in nursing facilities. (C) 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.

  • 362.
    Calais, Ann-Sofi
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Holm, Karin
    Halmstad University, School of Social and Health Sciences (HOS).
    Att leva med åldersrelaterad makuladegeneration: En systematisk litteraturstudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Åldersrelaterad makuladegeneration är den vanligaste orsaken till uttalad synnedsättning hos äldre i västvärlden. Denna studie genomfördes som en litteraturstudie med syfte att beskriva upplevelsen av att leva med synnedsättning hos personer med AMD.

    Sju kategorier trädde fram: Behov av stöd och information, Förlust av självständighet, Utmaningar i vardagen, Anpassadestrategier, Påverkan på sociala livet, Rädsla och osäkerhet och Acceptans och hopp. Det visade sig att de upplevde en osäkerhet i förhållandet med hälso- och sjukvården då de kände att de inte fick tillräcklig information för att klara av sin situation. Minskad självständighet relaterat till ett ökat hjälpbehov var vanligt och att förlora möjligheten att köra bil var en viktig faktor i förlusten avsjälvständighet. AMD begränsade individens vardag på många nivåer och därmed även deras sociala aktiviteter och möjligheten att ta hand om sig själva och andra. Flera skapade olika strategier för att klara av vardagssysslor. Utmaningarna för dessa patienter ledde till en mångfald av emotionella reaktioner, många accepterade sin situation men levde ändå med en alltid närvarande rädsla för ytterligare försämring av synen. En tredjedel visade på depressiva symptom. Hälso- och sjukvården bör identifiera individers förmåga att kunna delta i aktiviteter som de tycker om, med hjälp av den informationen kan hälso- och sjukvården få ett hjälpmedel till att finna personer med risk för depression. Det är av vikt att hälso- och sjukvården fångar upp dessa individer för att kunna erbjuda dem hjälpmedel och stöd för att klara sin vardag.

  • 363.
    Calebrant, Honey
    Halmstad University, School of Social and Health Sciences (HOS).
    Anestesisjuksköterskans bedömning av patientens intraoperativa vätskebehov samt efterföljande åtgärder2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vätskebehandling är en kontroversiell fråga inom den perioperativa vården. Studier visar olika metoder för behandling, bland andra restriktiv och liberal vätskebehandling dock menar vissa att ingen metod är rätt utan behandlingen måste vara individ anpassad. Sexton anestesisjuksköterskor intervjuades med ett syfte att undersöka anestesisjuksköterskans bedömning av patientens intraoperativa vätskebehov samt efterföljande åtgärder. Tre kategorier uppstod genom innehållsanalys: Självständigt beslutsfattande, Stöd i beslutsfattande och Osäkerhet i beslutsfattande. Den första kategorin innefattade subkategorierna Preoperativt beslutsfattande och Kontinuerligt beslutsfattande. I kategorin Stöd i beslutsfattande ingick subkategorierna Stöd av anestesiolog samt Stöd av andra i teamet. I kategorin Osäkerhet i beslutsfattande framkom subkategorierna Saknar riktlinjer, Saknar utvärdering/respons samt Svårbedömd patient. Det finns motstridiga åsikter angående tillvägagångssätt för bedömning av patientens vätskebehov samt om det ska användas riktlinjer för vätskebehandling. Riktlinjer på arbetsplatsen skulle kunna förenkla anestesisjuksköterskans vätskebehandling samt tydliggöra detta ansvarsområde. Betydelsen av denna studie kan vara att anestesisjuksköterskans tillvägagångssätt för att bedöma patientens intraoperativa vätskebehov uppmärksammas i klinisk verksamhet samt att riktlinjer utformas som stöd för anestesisjuksköterskans bedömning och val av åtgärder.

  • 364.
    Calebrant, Honey
    et al.
    Halmstad University, School of Health and Welfare.
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jansson, Inger
    Institutet för hälsa och vårdvetenskap, Sahlgrenska Akademi, Göteborg, Sweden.
    How the Nurse Anesthetist Decides to Manage Perioperative Fluid Status2016In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 5, p. 406-414Article in journal (Refereed)
    Abstract [en]

    Purpose

    To determine the factors that affect how nurse anesthetists in a county in Sweden decide how to manage perioperative fluid status.

    Design

    A cross-sectional qualitative study was conducted at two surgical wards in a county hospital.

    Methods

    Sixteen nurse anesthetists were interviewed to explore how nurse anesthetists assess patients' intraoperative fluid requirements and the subsequent measures adopted.

    Finding

    Three categories emerged through content analysis: clinical criteria and the thought process that drives decision making, interdependence in decision making, and uncertainty in decision making.

    Conclusions

    This study revealed differences with regard to fluid management among nurse anesthetists in a county in Sweden. For the assessments and subsequent measures that are carried out to ensure optimal fluid therapy, more research is needed to provide evidence, and evidence-based guidelines need to be developed in Sweden. © 2016 American Society of PeriAnesthesia Nurses.

  • 365.
    Camilla, Bomgren
    et al.
    Halmstad University.
    Emma, Karlson
    Halmstad University.
    Sjuksköterskors hantering av yrkesrelaterad stress2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Many registered nurses are exposed to stress because of the works high job demands. Stress in healthcare can lead to negative consequences when it comes to registered nurses health. The negative consequences affects the nurse output of work which entails a less good quality in caring for the patients. This problem entails a lack of security for the patients and the nurse. A long lasting stress increases the risk of burnout which leads to major costs for the society. Purpose: The purpose was to illustrate how the registered nurses cope with occupational stress. Method: A literature study was conducted with three qualitative and nine quantitative articles. The articles were reviewed and the results were coded in four categories, who answered to the study’s purpose. Result: The study resulted in four categories which were by optimism, self control, relaxation and support. Conclusion: The result showed that the registered nurses have different strategies to cope with occupational stress. The study highlights the importance of handling with occupational stress to avoid the negative consequences of stress. More research with focus on how to minimize and cope with stress is in need to make a better work environment for nurses.

  • 366.
    Canivet, Catarina
    et al.
    Division of Social Medicine and Global Health, Department of Clinical Sciences Malmö, Malmö University Hospital, Lund University, Malmö, Sweden.
    Choi, BongKyoo
    Center for Occupational and Environment Health, University of California, Irvine, USA.
    Karasek, Robert
    Department of Work Environment, University of Massachusetts, Lowell, USA.
    Moghaddassi, Mahnaz
    Division of Social Medicine and Global Health, Department of Clinical Sciences Malmö, Malmö University Hospital, Lund University, Malmö, Sweden.
    Staland Nyman, Carin
    Unit of Social Medicine, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Östergren, Per-Olof
    Division of Social Medicine and Global Health, Department of Clinical Sciences Malmö, Malmö University Hospital, Lund University, Malmö, Sweden.
    Can high psychological job demands, low decision latitude, and high job strain predict disability pensions?: A 12-year follow-up of middle-aged Swedish workers2012In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 3, p. 307-319Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period. Methods: We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register. Results: Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04-2.0) and 1.7 in women (95 % CI, 1.3-2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women. Conclusions: High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile. © 2012 Springer-Verlag.

  • 367.
    Cardell, Amanda
    et al.
    Halmstad University, School of Health and Welfare.
    Mattsson, Jennie
    Halmstad University, School of Health and Welfare.
    Sjuksköterskors erfarenheter av avledning i samband med venpunktion på barn: - En intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Smärta i samband med venpunktion är en vanlig smärtsam procedur som barn utsätts för inom sjukvården. Avledning handlar om att rikta barnets uppmärksamhet från proceduren och på så sätt minska smärtupplevelsen.

    Syfte: Syftet var att belysa sjuksköterskors erfarenheter av avledning i samband med venpunktion på barn i åldrarna 2-5 år.

    Metod: Utifrån en kvalitativ design genomfördes en intervjustudie. Datainsamlingen utgick från semistrukturerade intervjuer med 13 sjuksköterskor inom barn- och ungdomssjukvården. Dataanalysen genomfördes via en kvalitativ innehållsanalys.

    Resultat: Resultatet presenteras utifrån tre kategorier: Positiva erfarenheter av avledning. Förutsättningar för en effektiv avledning och Metoder för avledning vid venpunktion. Sjuksköterskorna arbetade för att avledningen skulle anpassas efter barnet och därmed bidra till positiva erfarenheter av sjukvården.

    Slutsats: Det framkom att sjuksköterskorna hade positiva erfarenheter av avledning i samband med venpunktion på barn. Erfarenheten var att det bidrog till en lugn och trygg situation för såväl barnet, föräldrar, närstående som sjuksköterskan. Vidare forskning hade kunnat öka kunskapen om avledning och därmed skapa en bättre sjukvård för barn och ungdomar.

  • 368.
    Carlson, Susanne
    Halmstad University, School of Health and Welfare.
    Distriktssköterskans hälsofrämjande och förebyggande arbete med nyanlända flyktingar: En intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

      

    Multicultural health and medical care has increased in Sweden during the last few years due to war in Syria and unrest in other countries among others in the Middle East and in Afghanistan. This has led to human tragedies and big streams of refugees. Sweden has received a large number of these refugees. This poses new demands on district nurses who at an early stage meet the refugees. The purpose of the study was to describe district nurses experience of health promoting and preventive care of newly arrived refugees from a perspective of the care centre. Method: A qualitative interview study with seven district nurses from different care centres within a region in West Sweden. The material was analysed with a qualitative analysis of content. Result: The analysis resulted in eight subthemes and four themes. Main themes were: The importance of self-care in order to promote health, Preventive work from a perspective of the care centre, To communicate through a third party and Co-ordination between parties. Conclusion: District nurses health promoting and preventive care was important for newly arrived refugees as the district nurse was one of the professionals they met at an early stage. Advice on self-care characterized the health promoting work with newly arrived refugees but could be difficult, as many refugees were used always to meet a doctor in their home countries. Characteristic for the preventive work was above all the follow-up of vaccinations, which required big and demanding efforts for district nurses.

     

  • 369.
    Carlson, Susanne
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Cejku, Egzona
    Halmstad University, School of Social and Health Sciences (HOS).
    Omvårdnad vid missfall: En utmaning för sjuksköterskor2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Statistics indicate that at least 21 % of all women in Sweden who give birth to a child also have experienced a miscarriage. A miscarriage evokes many different emotions for affected couples such as loss, grief, guilt, anxiety and existential reflections. Miscarriage can be a traumatic experience for all parties involved and the role of nurses in supporting these needs is pivotal in ensuring a physical and psychological recovery. Nurses are required to identify the needs of individuals and apply the appropriate nursing intervention to support families during this time. The purpose of the literature review was to illustrate the nursing interventions provided by nurses when women suffering of miscarriages. This literature review on 13 scientific articles illustrated the following concepts used in the VIPS-model to source appropriate information, referrals or assistance: information/education, support, care, pain/sensory impression, observation/supervision, medical management, psychosocial and coordination. Another useful tool for nurses is Swanson’s theory of caring which offers insight on optimal nursing practices during the event of a miscarriage which may be integrated in the VIPS-model. The nurses need to gain increased knowledge of miscarriage to be able to take a holistic approach to the care required to ensure recovery both physically and psychologically. Therefore more research is needed to develop nursing care when women suffering of miscarriage.

  • 370.
    Carlsson, Björn A.
    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).
    Johnson, UrbanHalmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF).Josefsson, KarinHalmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF).Stambulova, NataliaHalmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Center for Sport and Health Science (CIHF).
    Proceedings of the Nordic Conference 2008: Health, Participation and Effects of Sport and Exercise2008Conference proceedings (editor) (Other (popular science, discussion, etc.))
  • 371.
    Carlsson, Bo
    et al.
    Department of Sport Science, Linnaeus University, Växjö, Sweden.
    Jonasson, Kalle
    Halmstad University, School of Education, Humanities and Social Science, Centrum för lärande, kultur och samhälle (CLKS).
    Jönsson, Kutte
    Department of Sport Sciences, Malmö University, Malmö, Sweden.
    Introduction: the blend of science and sport2019In: Sport in Society: Cultures, Media, Politics, Commerce, ISSN 1743-0437, E-ISSN 1743-0445, Vol. 22, no 9, p. 1497-1500Article in journal (Other academic)
  • 372.
    Carlsson, Caroline
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Tellberg, Christel
    Halmstad University, School of Social and Health Sciences (HOS).
    Distrikssköterskans preventiva åtgärder - att förebygga fotsår hos patienter med diabetes - en observationsstudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 373.
    Carlsson, Frida
    et al.
    Halmstad University, School of Health and Welfare.
    Larsson, Caroline
    Halmstad University, School of Health and Welfare.
    Nguyen, Linda
    Halmstad University, School of Health and Welfare.
    Effekterna av akupunktur, kognitivbeteendeterapi och ljusterapi hos vuxna med insomni2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Humans spend a third of life sleeping. The nightly sleep is vital for the development of energy and recovery. Insomnia is associated with reduced quality of life and is ranked as one of the most common reasons that adults seek contact with a physician. Many adults are prescribed hypnotics associated with hospitalization and then renew prescriptions, without the need for follow-up. Drug sensitivity increases with age, and therefore a non-pharmacological treatment should be a priority. The purpose of this study is to elucidate the effect of acupuncture, cognitive behavioral therapy and light therapy as a treatment for adults with insomnia. When categorizing the results four themes appear: time in bed, sleep quality and sleep efficiency, nighttime awakenings, total sleep time and sleep latency. The result shows that acupuncture and cognitive behavioral therapy proved to be effective in insomnia. Light therapy showed improvement in the subjective data but not on objective data. Further research is required to raise awareness among nurses in healthcare. Therefore, it is important to highlight the effects of non-pharmacological measures and how they can be applied in healthcare.

  • 374.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Att söka förlossningsvård i tidigt förlossningsskede2008In: Forskningskonferens: Konferens med fokus på forskning inom omvårdnad/vård, folkhälsovetenskap, handikapp, socialt arbete och idrottspsykologi, 2008, p. 16-16Conference paper (Other academic)
  • 375.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Att träda in i förlossningen: kvinnors tillit till sin egen förmåga att hantera förlossningen och deras upplevelse av det tidiga förlossningsarbetet2015Conference paper (Other academic)
  • 376.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Dagen då allt rasade samman: att bli anmäld som vårdpersonal2011Conference paper (Other (popular science, discussion, etc.))
  • 377.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Delaktighet för barn och unga i hälso- och sjukvård: En realitet eller ett omöjligt uppdrag2016Conference paper (Other academic)
  • 378.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Födandets rum: förlossningsrummet2010Conference paper (Refereed)
    Abstract [en]

    Background: In Sweden, pregnant women are encouraged to remain at home until the active phase of labour. This recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications, than women who remain at home until the active phase of labour. The objective of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to delivery ward.

    Method: In-depth interviews were conducted with nineteen women after they had given birth to their first child.

    A constructivist grounded theory method was used.

    Findings:Maintaining power” was identified as the core category, explaining the women’s experience of having enough power to deal with the situation, when labour started. Four related categories; “to share the experience with another”, “to listen to the rhythm of the body”, “to distract oneself” and” to be encased in a glass vessel”, explained how the women coped and thereby maintained power.

    Conclusions: The women in this study had a sense of power that was expressed as a driving

    force towards the birth, a bodily and mental strength linked to the conviction that they had the right to decide over their own bodies. This implies that women have the ability to make choices during the birth process that enable them to maintain their power.  The professionals need to be sensitive, supportive and respectful of women’s own preferences in the health care encounter, to promote the existing power throughout the birthing process.

  • 379.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Förlossningens latensfas2011Conference paper (Other academic)
  • 380.
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Maintaining power; an asset during early labour process2010Conference paper (Refereed)
  • 381.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Berg, Marie
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Sahlgrenska University Hospital, Gothenburg, Sweden.
    Adolfsson, Annsofie
    Örebro University, Örebro, Sweden.
    Sparud-Lundin, Carina
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Reprioritizing life: A conceptual model of how women with type 1 diabetes deal with main concerns in early motherhood2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1394147Article in journal (Refereed)
    Abstract [en]

    Purpose: Becoming a mother is related to increased demands for women with type 1 diabetes mellitus, and more research is needed to identify their needs for support in everyday living. Thus, the aim of this study was to explore the main concerns in daily life in early motherhood for women with type 1 diabetes and how they deal with these concerns. Method: A grounded theory study was conducted in which 14 women with type 1 diabetes were interviewed individually 7 to 17 months after childbirth. Results: A conceptual model was identified with the core category “reprioritizing life”, and three related categories: adjusting to motherhood, taking command of the diabetes, and seeking like-minded women. Becoming a mother was a turning point towards a greater awareness and acceptance of prioritizing diabetes management and health, and thus, life. There was a gap in provision of diabetes care after birth and during the time of early motherhood compared with during pregnancy. Conclusions: Healthcare contacts already planned before delivery can promote person-centred care during the whole period from pregnancy to motherhood. Moreover, providing alternative sources for health information and peer support could improve the life situation during early motherhood. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

  • 382.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Blomqvist, Marjut
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ethical and methodological issues in qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions: a critical review2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no Sup. 2, article id 1368323Article in journal (Refereed)
    Abstract [en]

    Undertaking research studies in the field of mental health is essential in mental health nursing. Qualitative research methodologies enable human experiences to become visible and recognize the importance of lived experiences. This paper argues that involving people with schizophrenia in research is critical to promote their health and well-being. The quality of qualitative research needs scrutinizing according to methodological issues such as trustworthiness and ethical standards that are a fundamental part of qualitative research and nursing curricula. The aim of this study was to critically review recent qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions, regarding descriptions of ethical and methodological issues in data collection and analysis. A search for relevant papers was conducted in three electronic databases, in December 2016. Fifteen qualitative interview studies were included and reviewed regarding methodological issues related to ethics, and data collection and analysis. The results revealed insufficient descriptions of methodology regarding ethical considerations and issues related to recruitment and sampling in qualitative interview studies with individuals with severe mental illness, putting trustworthiness at risk despite detailed descriptions of data analysis. Knowledge from the perspective of individuals with their own experience of mental illness is essential. Issues regarding sampling and trustworthiness in qualitative studies involving people with severe mental illness are vital to counteract the stigmatization of mental illness.

  • 383.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hallberg, Lillemor
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Odberg Pettersson, Karen
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Vad gör vi med latensfasen?2008Conference paper (Refereed)
  • 384.
    Carlsson, Ing-Marie
    et al.
    Länssjukhuset i Halmstad, Halmstad, Sverige.
    Hallberg, Lillemor
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Odberg-Pettersson, Karen
    Lunds universitet, Lund, Sverige.
    Kvinnor som söker vård i tidigt förlossningsskede och deras upplevelse av latensfasen2007In: Reproduktiv Hälsa, Stockholm: Svenska Barnmorskeförbundet , 2007, p. 21-21Conference paper (Refereed)
  • 385.
    Carlsson, Ing-Marie
    et al.
    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).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patient participation, a prequisite for care: A grounded theory study of healthcare professionals’ perceptions of what participation means in a paediatric care context2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 1, p. 45-52Article in journal (Refereed)
    Abstract [en]

    Aims

    To explore healthcare professionals’ perceptions of what patient participation means in a paediatric care context.

    Design

    A qualitative explorative design with grounded theory.

    Methods

    Fifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open-ended questions in a survey, during December 2015–May 2016. Grounded theory was used as a method.

    Results

    The study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category “participation a prerequisite for care” emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals’ different strategies used to enhance patient participation; “meeting each child where the child is,” “building a relationship with the child,” “showing respect for each individual child” and “making the most of the moment.” © 2017 The Authors. Nursing Open published by John Wiley & Sons Ltd

  • 386.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Sahlberg-Blom, Eva
    Hälsoakademin, Örebro University, Örebro, Sweden.
    Nissen, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Maintaining power: Women's experiences from labour onset before admittance to maternity ward2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 1, p. 86-92Article in journal (Refereed)
    Abstract [en]

    Background: in Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward. Method: interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used. Findings: 'Maintaining power' was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: to share the experience with another', to listen to the rhythm of the body', to distract oneself and to be encased in a glass vessel', explained how the women coped and thereby maintained power. Conclusions: the first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process. © 2010 Elsevier Ltd.

  • 387.
    Carlsson, Jessica
    Halmstad University, School of Health and Welfare.
    Livslidande hos kvinnor med endometrios2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Endometriosis is a chronic disease that affects 10-15 percent of all women of childbearing potential. The most common symptoms are pelvic pain, menstrual pain, intercourse pain, heavy bleeding, infertility, constipation, and diarrhea. Where symptoms are often diffuse and the knowledge of endometriosis in health care is poor, it takes between 8-11 years from the woman sought treatment for their pain at diagnosis is confirmed. The aim of the study was to describe life-suffering in women with endometriosis. The study was conducted as an integrative literature review, which provides a deeper understanding and a more complete picture of a phenomenon. The women described their life-suffering by it´s lack of understanding and knowledge about the disease. They experienced it particularly from the health care, family, friends, colleagues, and partners. Women's lives and physical functions were limited because of the disease, which affected the daily life. Many women experienced exclusion, having a social life was difficult which lead to a life-suffering.

    To live with uncertainty and anxiety about the future was also life-suffering, where the main concern was about the difficulties in becoming pregnant and to keep the baby. One conclusion was that district nurses should be better able to pay attention to women with endometriosis and belief in their illness experiences. More research is needed to elucidate the life-suffering of women with endometriosis and thereby improve knowledge about how district nurses best can meet these women.

  • 388.
    Carlsson, Sofie
    et al.
    Halmstad University, School of Health and Welfare.
    Johansson, Josefine
    Halmstad University, School of Health and Welfare.
    Evers Persson, Sara
    Halmstad University, School of Health and Welfare.
    Anestesisjuksköterskans uppfattning av att kunna arbeta evidensbaserat vid ett traumalarm: En intervjustudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Trauma är den vanligaste dödsorsaken under livets första fyra årtionden och kan orsaka stort lidande för den enskilda individen samt höga samhällskostnader. I Sverige saknas nationella och regionala riktlinjer för traumaomhändertagande, men ett flertal projekt pågår för att uppnå en säkrare traumavård. På grund av det låga antalet traumalarm av större dignitet får anestesisjuksköterskan, som ingår i det multiprofessionella traumateamet, efter genomgången Trauma Nursing Core Course (TNCC) -utbildning ringa praktisk övning vilket kan medföra en svårighet i att upprätthålla förvärvad kunskap. Syftet med studien var att beskriva anestesisjuksköterskans uppfattning av att kunna arbeta evidensbaserat vid omhändertagandet av en patient på akutmottagningen i samband med ett traumalarm. Semistrukturerade intervjuer genomfördes med sex verksamma anestesisjuksköterskor och analyserades med kvalitativ innehållsanalys. Efter bearbetning av data framträdde tre kategorier: krav på kunskap, krav på arbetssätt i akutrummet och möjlighet till utveckling. En rad specifika förutsättningar krävs för att anestesisjuksköterskan ska kunna arbeta evidensbaserat i samband med ett traumalarm. Det krävs att anestesisjuksköterskan har erhållit kunskap genom förvärvad erfarenhet i sina vardagliga anestesiologiska arbetsuppgifter, ett giltigt TNCC certifikat, delaktighet vid traumaövningar, debriefing efter traumalarm samt ges möjlighet till utveckling. Resultatet kan bidra till ökad medvetenhet hos anestesisjuksköterskor som medverkar i traumaomhändertagande att arbeta evidensbaserat, vilket i sin tur kan bidra till en ökad patientsäkerhet med förhoppningsvis minskat lidande för den enskilda patienten samt i förlängningen minskade kostnader för samhället.

  • 389.
    Carlstrand, Johanna
    et al.
    Halmstad University, School of Health and Welfare.
    Thorén, Annika
    Halmstad University, School of Health and Welfare.
    Alzheimers sjukdom: Att vara anhörig2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Alzheimer´s disease is growing steadily and is expected to have risen to the double by 2050. When a loved one is affected by Alzheimer´s disease it also changes the lives of the relative. As a nurse, it is very important to be aware of this to be able to give the relative information and the necessary support in the best way. Involving the relative in the care of the loved one´s health is very important to get as optimal care possible. The aim was to highlight the relative`s experience of living with a person with Alzheimers´s disease. The study was conducted as a literature review of ten scientific articles, the articles were reviewed, analyzed and coded. The coding resulted i six different categories. The results show that the relative´s life is turned up side down when a loved one is suffering from Alzheimer´s disease. The need of information about Alzheimer´s diease and support of various health care initiatives throughout the disease process is big. The nurse calls for more tools and more knowledge about Alzheimer´s disease in order to provide optimal care. This was strengthened when the relatives felt ill-prepared to provide care because the lack of knowledge.

  • 390.
    Carlström, Michelle
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Christensson, Hanna
    Halmstad University, School of Social and Health Sciences (HOS).
    Johansson, Åsa
    Halmstad University, School of Social and Health Sciences (HOS).
    "Jag kan inte sova!": -miljöfaktorer som kan påverka patienters sömn på sjukhus2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The sleep at the hospital is an important factor for the patient in order to recover. There is a lack of attention from health care professionals about sleeping problems that exist in the hospital. There are environmental factors that affect patients sleep negatively in the hospital. These factors can be improved if the problem identifies and care measures are taken. The aim of the study was to illuminate the environmental factors that may affect the patient's sleep in the hospital. The study was operating as a literature study where 21 scientific articles were collected and examined. The result of the study showed that the main environmental factors that interfered patients sleep was sound, light and temperature. Half of all the noise at the hospital was caused by nurses. The light was often very strong in the hospital, during the night the light was still strong to promote sleep. The temperature within the sleeping area was individual and is partly reflecting what patients are used to from home. By gaining knowledge about environmental factors that can interrupt the patient during sleep in the hospital, interventions can be taken to shorten the length of the stay and the patient can recover faster.

  • 391.
    Carlström, Michelle
    et al.
    Halmstad University, School of Health and Welfare.
    Wahlgren, Rebecka
    Halmstad University, School of Health and Welfare.
    Självskattad upplevelse av hälsa hos patienter på en psykiatrisk öppenvårdsmottagning2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Health development in Sweden is advancing, but the self-rated health is low. Self-assessment is a measure based on the individual's own perception of their health. Health is a subjective estimate where each individual has his views on the experience of health. Autonomy, social community and understandability are different dimensions of the concept of health based on the patients' experience of health. Many measuring devices in healthcare today intends to measure  health by the absence of symptoms. The purpose of this study was to ask how patients in a general psychiatric outpatient clinic self-rate their health on the basis of the dimensions of autonomy, social community and comprehensibility. The method used was a cross-sectional study with quantitative approach. A survey was conducted over three weeks. The result is based on 49 questionnaires. The result shows that the autonomy dimension were estimated lowest average and that the participants estimated highest average on the claim "can care about others." The conclusion of this study is that one reason to low value in the dimension autonomy may depend on the nurses' working environment and medical approaches. Implications of care is that the findings may lead to an increased awareness of self-rated health among both patients and nurses.

  • 392.
    Carnebratt, Jakob
    et al.
    Halmstad University, School of Health and Welfare.
    Sevholt, Simon
    Halmstad University, School of Health and Welfare.
    Mindfulness korrelationer med påverkansmekanismer, idrottspsykologiska färdigheter och prestation hos idrottare2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of present study was to empirically examine a theoretical model for correlations between dispositional mindfulness, impact mechanisms and sport psychological skills (Birrer, Röthlin & Morgan, 2012). The model is tested by (1) to examine the correlations between dispositional mindfulness and impact mechanisms (Self-regulation, Clarity and Rumination). (2) To examine correlations between impact mechanisms and sport psychological skills (Motor Control Skills, Arousal Regulation Skill, Motivation and Coping Skills). (3) In addition was also correlations between skills and self-rated sport performance (competitive and training performance) examined. The study involved 242 competitive athletes from sports clubs in southwestern Sweden. The current study supports Birrer with colleagues' (2012) model when the results (1) showed significant correlations between dispositional mindfulness and all three impact mechanisms. (2) Furthermore, the results showed that Self-Regulation is related to better Coping Skills, Intrinsic Motivation and Arousal Regulation Skill. The results showed that better Clarity about its inner emotional life is related to better Coping Skills, Intrinsic Motivation and Arousal Regulation Skill. The results also showed that less Rumination is related to better Coping Skills and Arousal Regulation Skill. (3) Better Coping Skills and higher levels of External Motivation appeared to be related to higher self-rated competitive performance. Finally, the results showed that better Coping Skills and higher levels of Intrinsic Motivation are related to higher self-rated exercise performance. The results were discussed in relation to research and theoretical frameworks.

  • 393.
    Carvell, Victoria
    et al.
    Halmstad University, School of Health and Welfare.
    Johansson, Caroline
    Halmstad University, School of Health and Welfare.
    Hälso- och sjukvårdens bemötande av patienter med självskadebeteende ur ett patientperspektiv.: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The health professionals’ attitude reflects in the meeting with patients with self-injury disorder and is crucial for the patients’ treatment. Therefore, it is important to highlight the patients’ experience of the meeting, which is the purpose of this literature study. The study is a systematic literature study with searches performed in three databases, Cinahl, PubMed and PsycINFO. The results were ten qualitative original articles, which have been reviewed, analysed and summed up. In the result three categories emerged: to be seen, environment and care contact, which showed that positive perceptions about health care was the feeling of being taken seriously, the promotion of integrity and that the health care professionals listened. Negative results that emerged was when patients felt pre-judged and also when they felt that the caregivers didn’t really care, which led to further guilt and shame. Previous negative experiences lead to patients feeling reluctant of seeking help. The literature overview shows that more research from a patient's perspective is needed to reach an evidence based and improved way of care giving for health professionals that meet and treat patients with self-injury behaviour.

  • 394.
    Castenbladh Rafors, Jennifer
    et al.
    Halmstad University, School of Health and Welfare.
    Ivarsson, Madelene
    Halmstad University, School of Health and Welfare.
    Synen på livet med ett öga: En enkätstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    At the moment there is little research about the outcome of people who have had an eye surgically removed. This may result in an ophthalmic nurse giving insufficient information to patients and relatives. Therefore, it would be interesting to investigate the vision related quality of life in relation to the eyesight of persons who have undergone an eye amputation. The purpose was to illustrate the vision related quality of life of people who have been subject to an eye amputation and have an eye prothesis. The study is a cross-sectional study with a descriptive design. The data collection was conducted using the questionnaire NEI-VFQ-25 together with supplementary questions which was sent to adults who have undergone an eye amputation in the last five years. The results showed that eye amputees had lower vision-related quality of life than participants in a control group from the H70 study 2014/2015 with and without visual symptoms. The biggest inconvenience for the participants was peripheral vision and both near activities and distance activities. The results of the study can provide the ophthalmic nurse with a deeper knowledge to be used working with personcentered care and provide thourough information to support persons how has went through an eye amputation to manage their new life situation. Further research on eye amputees vision-related quality of life nationally is needed because the result is based on a limited study group.

  • 395.
    Castro, Claudia
    et al.
    Halmstad University, School of Health and Welfare.
    Hasselquist, Molly
    Halmstad University, School of Health and Welfare.
    Ögonsjuksköterskans hälsofrämjande åtgärder vid åldersrelaterad makuladegeneration2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Age-related macular degeneration (AMD) is a chronic eye disease and is the most common cause of irreversible vision loss amongst elderly people within the industrial world. Underlying causes can be both genetical and environmental, prevention and treatment of AMD can increase quality of life and reduce visual impairment and all dysfunctionalities related to it. The aim of this study was to highlight ophthalmic nurses' health promoting work with patients with age-related macular degeneration. This integrative literature review showed that the level of awareness of AMD was low among both the general population and patients. Even patients with severe vision loss due to one or several eye diseases was unaware of their diagnosis. Patients with AMD felt that they were not given enough information about the disease, the risk factors, available health examinations and what possible treatments were available. To be affected with AMD entails a significant negative effect on patients quality of life. It was shown that there was a strong connection between vision loss and symptoms of depression. None of the studies were from Sweden or highlighted the Swedish conditions but highlights the importance of health promotion, awareness about chronic eye disease and its risk factors as very important. It would be of great interest to investigate the Swedish conditions for comparison. 

  • 396.
    Cato, Hampus
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
    Correlation Between 3000-meter Running Performance, Yo-Yo IR1 & Submaximal Treadmill Jogging Test2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Physiologic functional capacity through maximal oxygen uptake (V̇O2max) can be measured in many different ways depending on sport and qualities needed to be assessed.In handball a demanding 3000 meter (m) running test is used to evaluate V̇O2max. If this test is sport specific or if it could be replaced by a less strenuous test is unknown. Aim: The aim ofthis study was to compare performance on 3000-meter running with predicted V̇O2max from a submaximal treadmill jogging test (SMTJ) and performance of the Yo-Yo intermittentrecovery test 1 (IR1). Methods: Male handball players (n = 12) performed the 3000 m running test, the Submaximal Treadmill Jogging test and the Yo-Yo Intermittent Recovery test level 1. Measurements in seconds (s), ml ∙ kg-1 ∙ min-1 and meters where collected and correlated using Pearson r, interclass correlation. Results: A strong significant linear correlation (p < 0.01) was found between performance in 3000 m running (s) and Yo-Yo IR1 performance (m), r = - 0.724 (r2 = 0.524). A weak, not significant linear correlation (p > 0.05)was found between performance in 3000 m running (s) and predicted V̇O2max from submaximal treadmill test (ml ∙ kg-1 ∙ min-1), r = - 0.309 (r2 = 0.095). Conclusion: According to this study the 3000 m running test could be replaced by the Yo-Yo IR1 test or vice versa in adolescent male handball players. The submaximal treadmill test used in this study had several potential errors in estimating V̇O2max, this is probably the reason why only a weak correlation was found between the SMTJ and the 3000 m running test.

  • 397.
    Catrine, Aring
    Halmstad University, School of Health and Welfare.
    Bikini Fitness-atleters erfarenheter och upplevelser av kroppsuppfattning kopplat till sporten och tävling2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    A negative body image is more common among female athletes in leanness-sports compared to the general population (Goldfield, 2009; Kong & Harris, 2015). Body dissatisfaction can lead to unhealthy behaviors like excessive exercise, disordered eating or dieting to change the body and avoidance (Grogan, 2006).The aim of the current study was to examine Bikini Fitness athlete’s experience of body image associated with the sport and competition. Totally six female Bikini Fitness athletes of age 23-27 (M=25, SD=1,29) from southern Sweden participated in an individual interview of approximately 60 minutes. In the qualitative study, the data was analysed in a qualitative content analysis by guidelines of Lundman and Hällgren-Graneheim (2012). The result showed that the athletes experienced body dissatisfaction related to Bikini Fitness and reported experiences related to both a positive and a negative body image. Moreover, the result was in line with previous research that discovered body dissatisfaction among athletes in the physique sport(Chaba et al., 2018). The current study may contribute with meaningful knowledge regarding Bikini Fitness-athlete’s experiences of body image related to the sport and competition. Also, to create a deeper understanding of Bikini Fitness as a discipline and how the different elements and periods is experienced by the athletes in the sport and when they need extra social support.  

  • 398.
    Cecilia, Johansson
    et al.
    Halmstad University, School of Health and Welfare.
    Kocevic, Fahira
    Halmstad University, School of Health and Welfare.
    Vägen till ändrade levnadsvanor: -erfarenheter från personer med övervikt och fetma2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Some factors that contribute to overweight and obesity are lifestyle related and comprise a lack of physical activity and poor nutrition. Overweight and obese individuals may seek medical attention and acquire advice on how to lose their weight. The purpose of this study was to look into the experiences of the overweight and obese patients pertaining to lifestyle conversations with the district nurse. The study was conducted as an integrative literature overview, which enables a better understanding of a certain phenomenon within medical service. The results consist of sixteen scientific articles. The analysis reveals four categories: the significance of becoming motivated, the significance of one’s own attitude towards conversations about lifestyle, the significance of the district nurse’s communicative skills and the district nurse’s knowledge and competence. The communicative skills of the district nurse played a pivotal role in how the conversations about lifestyle were perceived by the patients. When the district nurse and the patient set individual goals together, the patient appeared more motivated to make a lifestyle change. On the other hand, the motivation of the patient decreased when the advice received was too generalized. Moreover, some patients believed that the district nurse was not adequately knowledgeable to deal with overweight and obesity. The categories correlate with Pender's health-promoting model as an explanation of patients' motivation in changing their lifestyles.

  • 399.
    Cederlöf, Åsa
    et al.
    Halmstad University, School of Health and Welfare.
    Ålenius, Piamari
    Halmstad University, School of Health and Welfare.
    Ambulanspersonalens upplevelse av regelbunden strukturerad fysisk aktivitet2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Ambulance personnel (specialist nurses and paramedics) are expected to self-manage the risk of both physical and mental strain while performing safe patient care. It is mainly physical strain that can lead to musculoskeletal disorders among ambulance personnel. These musculoskeletal disorders can result in work-related repetitive strain injuries in the neck, shoulders, lower back and knees. The aim of the study was to investigate how regular structured physical activity can positively impact ambulance personnel. The study was conducted with qualitative design and with an inductive approach where six male informants were interviewed. The conducted analysis process resulted in three distinct categories; self-perceived health benefits, safer caretaking and injury prevention. All respondents reported that they experienced improved stamina, sleep and faster recovery. Also, they experienced less musculoskeletal problems than prior to undertaking regular physical activity. Furthermore, the informants felt that regular physical activity as such, had an indirect influence on patient safety.

  • 400.
    Cejku, Egzona
    et al.
    Halmstad University, School of Health and Welfare.
    Boström, Lisa
    Halmstad University, School of Health and Welfare.
    Barnsjuksköterskans hälsofrämjande och förebyggande arbete mot övervikt och fetma hos barn inom barnhälsovården: En intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight and obesityin children is a global public health problem. The Child Health Care(CHC) havean important role in thepreventionof childhoodobesity and in the promotion ofchildren’s growth and development. The aimof this study was to illustrate thehealth promotion and preventativework of pediatricnurse’s against overweight and obesity in the CHC. Method: An interview study was conductedbased on a qualitative content analysis. The data collection was based on semi structured interviews with seven pediatric nursesworking at CHC:s.A qualitative content analysiswas used in the analysis process. Results: The result is dividedintofour categories based on the analysis: Assessment and follow-up of overweight and obesity, The good choices,Factors that concern the pediatric nurse’s work and The individual Child Care center.The pediatric nurse’shealth promotionand preventative work against overweight and obesity in children in the Child Health Care is based on promoting the good choices and creating a trustful relationship with the family. Conclusion: Hopefully thisstudy canhighlightthe pediatric nurse’shealth promotiveand preventative work against overweight and obesity in children.

567891011 351 - 400 of 1939
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