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  • 51.
    hildingh, cathrine
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of nursing, Lund University, Lund, Sweden.
    A 3-year follow-up of participation in the Heart & Lung School after a cardiac event2004Konferensbidrag (Refereegranskat)
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  • 52.
    hildingh, cathrine
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Medicine and Care, Faculty of Health Science, Linköping University, Linköping, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Medicine and Care, Faculty of Health Science, Linköping University, Linköping, Sweden.
    Peer support groups after a cardiac event, a 12-month follow-up2002Konferensbidrag (Refereegranskat)
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  • 53.
    Hildingh, Cathrine
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Social network and experiences of social support among women 12 months after their first myocardial infarction1997Ingår i: International Journal of Rehabilitation and Health, ISSN 1068-9591, E-ISSN 1573-1537, Vol. 3, nr 2, s. 131-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Few studies exist concerning the situation of women after a myocardial infarction (MI). The aim of this longitudinal study was to map out women’s social network and social support 12 months after a first MI. A sample of 200 consecutively chosen female patients below 70 years of age (ranges 35-70 years) answered a similar questionnaire on different occasions: before hospital discharge and at 3 and 12 months after the MI event. We analyzed the data with descriptive and inferential statistics. The results showed that 90% of the women had network members available who provided them with support. The strongest bonds existed between patient and close relatives, such as children, parents, or siblings, and then with spouse and intimate friends, in that order. The bonds between patients and health care professionals were not strong at the time of the MI, but subjects reported a significant increase (p < .0007) during the following 12 months. The need for material support was highest directly after the MI and for informational support 3 months later, and after 12 months the need for belonging dominated. More than half of the women had participated in secondary prevention programs. Further research is necessary to be able to understand enabling and limiting aspects of social support in connection with recovery from MI. © 1997 Springer Nature Switzerland AG. Part of Springer Nature.

  • 54.
    Hildingh, Cathrine
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Baigi, Amir
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Sense of coherence and experiences of social support and mastery in the early discharge period after an acute cardiac event2008Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, nr 10, s. 1303-1311Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: The aim of this study was to examine sense of coherence and experiences of change in social support and mastery from a short-term perspective in patients who had been admitted to hospital with a suspected myocardial infarction.

    Background: The early discharge period after an acute cardiac event can be a stressful and vulnerable time when psychosocial resources are of the utmost importance. A positive outcome in an encounter with a stressor is thought to be linked to a strong sense of coherence, social support and mastery.

    Design: A multi-centre survey was conducted in three hospitals in southern Sweden.

    Methods: The sample was 300, 241 of whom completed the questionnaires; while in hospital and two weeks postdischarge.

    Results: In the early discharge period a low sense of coherence was found in over 60% of the sample. There was an association between social support and mastery and between sense of coherence and mastery. Differences in social support ratings, with lower ratings two weeks postdischarge, were found among women and persons over 65 years of age.

    Conclusions: This study adds knowledge about experiences in the early discharge period. Changes in ratings of social support but not in ratings of mastery were found between baseline and two weeks postdischarge.

    Relevance to clinical practice: Healthcare professionals need to be sensitive to patients’ sense of coherence, mastery and need for social support during the early discharge period. They can help patients to identify adequate support strategies and prevent future potential complications. However, to routinely assess sense of coherence, social support and mastery, there is a need for a simple and useful instrument in clinical practice.

  • 55.
    Hildingh, Cathrine
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Lidell, Evy
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Access to the world after myocardial infarction: experiences of the recovery process2006Ingår i: Rehabilitation Nursing, ISSN 0278-4807, Vol. 31, nr 2, s. 63-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Myocardial infarction (MI) is a traumatic health event and at the same time a transition of vital importance in human life. The purpose of this study was to elucidate recovery patterns after myocardial infarction with regard to the content of patients' experiences. The study used a descriptive design and a qualitative method. Interviews with 16 men and women were performed, and data were subjected to a thematic content analysis. The recovery process had a pattern of ability, restraints, and reorientation. Through self-help and help from others, the mutual sharing of burdens, and clarifying restraints to recovery, the recovery process progressed toward reorientation. New values and motivation for change, as well as a new balance within the self and relationships were found. The MI had been integrated into life and, through the recovery process, patients' attitudes were better focused, leading to an enhanced quality of life.

  • 56.
    Hildingh, Cathrine
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Lidell, Evy
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Women's experiences of recovery after myocardial infarction: a meta-synthesis2007Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 36, nr 6, s. 410-417Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Women report lower well-being, compared with men, during recovery after myocardial infarction (MI). To support women in their recovery it is important to understand their experiences from their own perspective. However, a single study using a qualitative method does not have the potential to contribute to evidence-based nursing practice, and it is therefore important to synthesize findings from several qualitative studies. Objectives: The aim of this study was to perform a meta-synthesis of findings of women's experiences of recovery after MI. Methods: A meta-synthesis with seven qualitative studies, including a total of 70 women, was performed. Results: Recovery was characterized by subordination and superordination. The women strived to preserve their self, and at the same time they were strongly oriented toward other people. Four concepts emerged: protecting, adjusting, downgrading, and succumbing. Conclusion: Women oscillate between subordination and superordination. Protecting the matriarchy and being a victim of the patriarchy shed light on this ambivalence in the same way as adjusting to the situation and succumbing to the disease do.

  • 57.
    Isaksson, R.
    et al.
    Cent Hosp, Halmstad, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Paulsson, Gun
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Nederfors, T.
    Cent Hosp, Halmstad, Sweden.
    Evaluation of an oral health programme for nursing personnel in special housing facilities for the elderly. Part II: Clinical aspects.2000Ingår i: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 79, nr 5, s. 1291-1291Artikel i tidskrift (Övrigt vetenskapligt)
  • 58.
    Isaksson, Rita
    et al.
    Oral Health Centre, Central Hospital, Halmstad, Sweden.
    Paulsson, Gun
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Oral Public Health, Malmö University, Malmö, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Nederfors, Tommy
    Högskolan i Halmstad, Akademin för hälsa och välfärd. Oral Health Centre, Central Hospital, Halmstad, Sweden.
    Evaluation of an oral health education program for nursing personnel in special housing facilities for the elderly. Part II: Clinical aspects2000Ingår i: Special Care in Dentistry: managing special patients, settings, and situations, ISSN 0275-1879, E-ISSN 1754-4505, Vol. 20, nr 3, s. 109-113Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel’s knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3-4 months after nursing personnel had attended an oral health education program. Following the Intervention, a statistically significant improvement was recorded for changes In oral mucosal color, a modified plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents.

  • 59.
    Jacobsson, Anna
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Pihl, Emma
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Mårtensson, Jan
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Emotions, the meaning of food and heart failure: a grounded theory study2004Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 46, nr 5, s. 514-522Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Many patients with heart failure have generalized wasting, referred to as cardiac cachexia. This leads to skeletal muscle wasting, impaired mobility, reduced functional capacity and poor prognosis. Patients with heart failure have symptoms that can affect their food intake, for example breathing difficulties, fatigue, nausea, loss of appetite, early feeling of fullness and ascites. These dietary problems and patients' nutritional status, can be significantly improved by means of simple nursing interventions.

    Aim:

    This paper reports a grounded theory study which developed a theoretical model of experiences of food and food intake among patients with heart failure.

    Methods:

    A descriptive and exploratory design, with a grounded theory analysis, was used. Data were collected in 2002 through interviews with 11 patients with heart failure. Findings. Two core categories emerged: emotions and the meaning of food. Psychosocial meaning could be associated with positive feelings of well-being, or negative feelings of sorrow. Physiological meaning could be associated with positive feelings of comfort or negative feelings of burden. Patients' experiences of food and eating changed during the development of the disease. Feelings of fatigue and lack of appetite gave rise to a feeling of deprivation because of missing both eating and the related social environment. This could lead to a loss of personal identity.

    Discussion:

    Although the findings of a qualitative study cannot be generalized, they raise important clinical nursing issues. With increasingly shorter hospital stays, these problems will need to be addressed by community healthcare staff and family carers. Therefore, all healthcare professionals need knowledge about heart disease and information techniques if they are to be able to give appropriate care to this group.

    Conclusion:

    Ignorance about food and eating can easily lead to malnourishment, with an increased risk of the patients falling into a vicious circle. Implications of the study for health care practice and research are identified.

  • 60.
    Jacobsson, Anna
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Pihl-Lindgren, Emma
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Malnutrition in patients suffering from chronic heart failure; the nurse's care2001Ingår i: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 3, nr 4, s. 449-456Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic heart failure is associated with a bad prognosis with considerably shortened survival and repeated hospitalisations. Patients suffering from heart failure also have symptoms that can affect their food intake, for example, tiredness when strained, breathing difficulties and gastrointestinal symptoms like nausea, loss of appetite and ascites. Pharmacological therapy can lead to a loss of appetite, which will make the intake of food inadequate to fill the required energy and nutritional needs. The nurse's interest in and knowledge of diet issues can improve these patients' nutritional status, The aim of this literature review was to describe the nurse's interventions regarding malnutrition in patients suffering from chronic heart failure. The literature search gave 13 articles, which were analysed, and sentences whose content was related to the aim were identified. Three areas of content appeared; drug treatment and consequences, gastrointestinal effects, and information and education. The results show that the nutritional status of these patients can be significantly improved by means of simple nursing interventions. Future research should focus on controlled experimental studies to evaluate differences in body weight, body mass index and quality of life between patients suffering from chronic heart failure, who are taking part in a fully enriched nutrition intervention, and patients suffering from chronic heart failure, who are eating their normal diet.

  • 61.
    Johansson, Elsie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Roxberg, Åsa
    Växjö University, Växjö, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Växjö University, Växjö, Sweden.
    Nurse’s consolation: A grounded theory study2008Ingår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, nr 2, s. 19-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’ professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.

  • 62.
    Johansson, Elsie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Roxberg, Åsa
    School of Health Sciences and Social Work, Växjö University.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Nurses' consolation: a grounded theory study2008Ingår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, nr 2, s. 19-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.

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  • 63.
    Johansson, Ingrid
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Coping strategies of relatives when an adult next-of-kin is recovering at home following critical illness2004Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 20, nr 5, s. 281-291Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The trend within the Swedish healthcare system is to reduce the duration of hospital care. This means that a patient who is discharged to their home after critical illness is highly likely to be functionally impaired, and therefore, requires care-giving assistance from a family member. The aim of this study was to generate a theoretical model with regard to relatives’ coping when faced with the situation of having an adult next-of-kin recovering at home after critical illness. The design incorporated grounded theory methodology. Four coping strategies exhibiting different characteristics were identified: volunteering, accepting, modulating and sacrificing. Factors determining the choice of coping strategy were the physical and psychological status of the relative, previous experience of ICU-care and the psychological status of the patient. The theoretical model described in this article can contribute to expanding healthcare professionals’ understanding of the coping strategies of relatives during recovery, but also provide inspiration for social action to be taken.

  • 64.
    Johansson, Ingrid
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Hildingh, Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Wenneberg, Stig
    Department of Health Sciences, Örebro University, Örebro, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ahlström, Gerd
    Department of Health Sciences, Örebro University, Örebro, Sweden.
    Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis2006Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, nr 5, s. 463-471Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area.

    Background: When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery.

    Method: Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home.

    Findings: The theoretical model was developed in 2004–2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated.

    Conclusion: This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used.

  • 65.
    Johansson, Peter
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Oleni, Magnus
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Nurses' assessments and patients' perceptions: development of the night nursing care instrument (NNCI), measuring nursing care at night2005Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, nr 5, s. 569-578Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Nursing care provided at night has a different purpose and objective to that provided during the day. A review of the literature does not reveal any scientifically tested research instruments for evaluating and comparing the nurse's assessment of nursing care with the patient's perception at night.

    Aims and objectives:

    The aim of this study was to develop and test an instrument for evaluating nursing care and to compare nurses' assessments with patients' perceptions of nursing care provided at night.

    Design:

    The study was carried out in two phases; the first had an explorative design and the second an evaluative and comparative design. The Night Nursing Care Instrument (NNCI) included two questionnaires; one for nurses and one for patients. These questionnaires were developed from a nursing framework and covered the following three areas:,nursing interventions', 'medical interventions' and 'evaluation'.

    Methods:

    Nurses (n = 40) on night duty on a medical ward at a central hospital in southern Sweden were consecutively selected, to participate in the study. The patients (n = 80) were selected by means of convenience sampling. In order to achieve construct validity, factor analysis of each individual area was carried out. Reliability in terms of internal consistency was tested by Cronbach's alpha.

    Results:

    The overall NNCI had acceptable reliability and validity. There was no statistically significant difference between nurses' assessments and patients' perceptions in any of the three areas of 'nursing interventions', 'medical interventions' or 'evaluation'. The patients rated night nursing care as satisfactory for the majority of the items. Relevance to clinical practice: These findings demonstrate that it is possible to create a short instrument with acceptable reliability and validity, which is easy to use in clinical practice. The results also show that night nurses need to improve their ability to assess patients' needs during the night to increase the quality of night nursing care.

  • 66.
    Jormfeldt, Henrika
    et al.
    Department of Health Sciences, Lund University, Lund.
    Svedberg, Petra
    Department of Health Sciences, Lund University, Lund.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Perceptions of the concept of health among nurses working in mental health services: a phenomenographic study2007Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 16, nr 1, s. 50-56Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A new understanding of the concept of health is needed to meet the goal of mental health nursing, which besides reducing disease is to strengthen the patient's health. The aim of the present study was to describe perceptions of the concept of health among nurses working in mental health services. Twelve Swedish nurses working in mental health services were interviewed and data were analysed with a phenomenographic approach. The nurses expressed 10 perceptions, which constituted three description categories: autonomy, process, and participation. The result showed that health was more than absence of disease. Simultaneously, perceptions were expressed indicating that health was viewed as absence of disease, which implies that the concept is not sufficiently defined. The result emphasizes the need to clarify the concept of health if it is to be used as a goal in mental health nursing and to integrate a clarified definition of health at all hierarchical levels in mental health care services.

  • 67.
    Koinberg, Inga Lill
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Holmberg, Lars H.
    Department of Surgical Sciences, Division of Surgery, Uppsala University, Uppsala, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Breast cancer patients' satisfaction with a spontaneous system of check-up visits to a specialist nurse2002Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, nr 3, s. 209-215Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe breast cancer patients' satisfaction with a spontaneous system of check-up visits to a specialist nurse. Background: There is little evidence that routine follow-up visits after breast cancer surgery influence survival or patient satisfaction. Consequently, there is a need to evaluate alternative follow-up programmes. Sample: A strategic sample of 19 breast cancer patients, who were not involved in a routine follow-up system but who had the possibility of contacting a specialist nurse when necessary, were interviewed. Method: A qualitative descriptive design inspired by the method of phenomenographic analysis was used. Findings: Five description categories and 606 statements showing similarities and differences in conceptions were obtained. The patients satisfaction with the knowledgeable and professional skills of the nurses was high. Confirmation and trust were important and necessary in order for the women with breast cancer to feel secure. Patients had a need for information and self-care education. Accessibility and early assessment by professional personnel or an oncology nurse were essential in a system without routine follow-ups. Discussion: This study identifies key issues in a specialist nurse-led check-up system. The findings can be used for developing an education programme for women who have undergone breast cancer surgery. Additionally, the findings emphasize the need to introduce more flexible solutions to the follow-up programmes, one alternative being specialist nurse-led check-ups.

  • 68.
    Koinberg, Inga-Lill
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Surgery, Varberg Hospital, Varberg, Sweden & Division of Nursing, Department of Medicine and Care, Linköping University, Linköping, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Nursing, Lund University, Lund, Sweden.
    Engholm, G.-B
    Department of Oncology, Örebro, University Hospital, Örebro, Sweden.
    Holmberg, L.
    Division of Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Nurse-led follow-up on demand or by a physician after breast cancer surgery: A randomised study2004Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 8, nr 2, s. 109-117Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The value of routine follow-up with frequent visits to a breast cancer specialist - both in terms of detection of recurrence and patient satisfaction - has been questioned. The aim of this study was to compare nurse-ted follow-up on demand versus physician follow-up after breast cancer treatment with regards to patients’ well-being, satisfaction, access to medical care and medical safety. Two hundred and sixty-four consecutively selected women with newly diagnosed breast cancer, classified as UICC stage I or stage II, were randomised to follow-up at two hospitals in Sweden, either by routine medical follow-up, the physician group (PG, n = 131), or on demand by a specialist nurse, the nurse group (NG, n = 133). Measures were done at baseline and twice a year over a period of 5 years by means of a questionnaire containing the Hospital Anxiety and Depression Scale (HAD), and the Satisfaction and Accessibility (SaaC) scale. Number of contacts with the health care services, number of diagnostic procedures, and time to recurrence or death were monitored. The ratings of HAD and SaaC did not show any statistically significant differences between the groups. The levels of anxiety and depression were generally low and levels of patient satisfaction high. There were no differences between the groups concerning time to recurrence or death. This study indicates that women with breast cancer in stages I to II can be followed up by a specialist nurse with high patient satisfaction and good medical safety. © 2004 Published by Elsevier Ltd.

  • 69.
    Koinberg, Inga-Lill
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Langius-Eklöf, Ann
    Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Holmberg, Lars
    Department of Surgical Sciences, Division of Surgery, Uppsala University, Uppsala, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    The usefulness of a multidisciplinary educational programme after breast cancer surgery: A prospective and comparative study2006Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 10, nr 4, s. 273-282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to compare and evaluate a multidisciplinary educational programme with traditional follow-up visits to a physician after breast cancer surgery in terms of well-being, aspects of self-care and coping ability 1 year after diagnosis. A reduction in the intensity of follow-up after breast cancer surgery is recommended. New follow-up models are being debated and could be of interest. The study design was non-randomised and comparative. Ninety-six consecutively selected women with newly diagnosed breast cancer, classified as stage I or stage II, participated in either a multidisciplinary educational programme (n = 50), or traditional follow-up by a physician (n = 46). Three questionnaires were used: Functional Assessment of Cancer Therapy-General (FACT-G), a study specific questionnaire regarding self-care aspects (SCA) and Sense of Coherence (SOC). With the exception of physical well-being at baseline there was no significant difference between the groups. The women in the multidisciplinary educational programme increased their physical and functional well-being (P < 0.01). The women in traditional follow-up by a physician increased their functional well-being while social/family well-being (P < 0.01) decreased over time. There was a statistically significant difference in SOC (P < 0.001) in the traditional follow-up by a physician between baseline (mean = 74.4, SD = 12.4) and the 1-year follow up (mean = 67.7, SD = 11.4). Thus, women in the traditional follow-up by a physician scored lower in the area of SOC 1 year after diagnosis. A multidisciplinary educational programme may be an alternative to traditional follow-up by a physician after breast cancer surgery, but more research is needed about the financial benefits and effectiveness of such a programme. (c) 2006 Elsevier Ltd. All rights reserved.

  • 70.
    Kristofferzon, Marja-Leena
    et al.
    Department of Caring Science and Sociology, University of Gävle.
    Johansson, Ingela
    Department of Medical and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Brännström, Margareta
    Department of Nursing, Umeå University, Umeå, Sweden.
    Arenhall, Eva
    Department of Cardiology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Baigi, Amir
    General Practice and Public Health, Halland County Council, Falkenberg, Sweden.
    Brunt, David
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Fridlund, Bengt
    Shool of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Nilsson, Ulrica
    Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Persson, Sylvi
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Rask, Mikael
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Wieslander, Inger
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Lund University Hospital and Lund University, Lund, Sweden.
    Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: a pilot study2010Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, nr 3, s. 168-174Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required.

    AIMS: The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.

    METHODS: A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.

    RESULTS: Two separate factor analyses each revealed a two-factor structure on both occasions: "Sexual appetite" and "Sexual expectations" with gender-neutral questions and "Sexual sensitiveness" and "Sexual ability" with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test-retest values for all but one question exceeded 0.70.

    CONCLUSIONS: The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.

  • 71.
    Kristén, Lars
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Idrott, hälsa och fysisk aktivitet.
    Patriksson, Göran
    Göteborgs Universitet: Idrottshögskolan: Institutionen för pedagogik och didaktik.
    Fridlund, Bengt
    Linnéuniversitetet: Institutionen för vårdvetenskap och socialt arbete.
    Benefits of sport activities for disabled children and youth. / Die Bedeutung des Sports fuer behinderte Kinder und Jugendliche2003Ingår i: Towards a society for all through adapted physical activity: Proceedings. Kongressbericht Wien 3-7 juli 2001 / [ed] Maria Dinold ... et.al., Wien: Institut für Sportwissenschaft , 2003, s. 394-398Konferensbidrag (Refereegranskat)
    Abstract [en]

    Describes a phenomenography-based study that attempted to show how children and adolescents with disabilities felt about the consequences of taking part in sports activities. Provides information about the sports program involved, informants, interviews, and results.

  • 72.
    Kristén, Lars
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Luleå, University of Technology, Luleå, Sweden.
    Patriksson, Göran
    Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Conceptions of Children and Adolescents with Physical Disabilities about Their Participation in a Sports Programme2002Ingår i: European Physical Education Review, ISSN 1356-336X, E-ISSN 1741-2749, Vol. 8, nr 2, s. 139-156Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sport and leisure can be of significant importance for the well-being and social support of children and adolescents with physical disabilities. However, it has been established that organized sport sometimes has a social construction, in that those without disabilities are favoured at the expense of others. The aim of this study was, therefore, to describe conceptions of children and adolescents with physical disabilities about their participation in a sports programme. Using questions based on a holistic view of the human being, 20 children and adolescents were interviewed. The method of analysis used was inspired by phenomenography. Six categories emerged: Getting new friends, learning, strengthening one’s physique, becoming someone, experiencing nature and having a good time. The findings show the great diversity of sports participation. Further, the conceptions mirror the difficulty of dividing people into groups and of delimiting important areas. The findings highlight the importance of programmes where actors from different sections of society cooperate. Even if the findings cannot be generalized, they nevertheless demonstrate that physical activity involves many positive factors both at the individual and at the society level. © 2002, North West Counties Physical Education Association and SAGE Publications. All rights reserved.

  • 73.
    Kristén, Lars
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Luleå University of Technology, Luleå, Sweden.
    Patriksson, Göran
    Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities2003Ingår i: European Physical Education Review, ISSN 1356-336X, E-ISSN 1741-2749, Vol. 9, nr 1, s. 23-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Parents of children and adolescents with physical disabilities have an important role in strengthening and supporting their children in everyday life. Children and adolescents with physical disabilities do not ordinarily have natural access to club activities, nor do they receive the same support for physical activities as their peers without disabilities. The aim of this Swedish study was to describe parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities. The data were collected from 20 parents of children and adolescents with disabilities in the 9-15 year age group through interviews based on a holistic view. The method of analysis used was inspired by phenomenography. Three descriptive categories emerged: achieving good health, being part of a social group and learning a sporting activity. The findings show that the parents regarded sport as a form of health education and as a means for their children to achieve increased participation in society. The findings also show that the learning process was important for empowering the children to influence their life situation.

  • 74.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bergman, Stefan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande och livsstilsförändrande arbete.
    Fridlund, Bengt
    Hälsohögskolan Jönköping.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Patients’ experiences of nurse-led follow-up in biological therapy – a qualitative study2011Ingår i: / [ed] The European Leage Against Rheumatism, London: BMJ , 2011, s. 755-755Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Pain, stiffness and functional restrictions of the joints are the main problems for patients with inflammatory rheumatic diseases. When conventional drugs fail to delay the development of the disease the patients may require biological therapy. These patients usually have rheumatologist follow-up twice a year. Nurse-led clinics have been proposed for patients treated with biological therapy that are in low disease activity or remission (Disease Activity Score, DAS <3.2). In an ongoing study at a Swedish rheumatology clinic every other rheumatologist follow-up has been replaced by a rheumatology nurse-led follow-up. At the nurse-led follow-up the patients' disease activity is assessed by examining tender or swollen joints and laboratory tests.Objectives: The purpose of this study was to describe patients' experiences of nurse-led follow-up in biological therapy.Methods: The study had a descriptive design with a qualitative content analysis approach. In qualitative content analysis the interpretations vary in depth and level of abstraction: the manifest content describes the visible, what the text says and creating categories, the latent content involves an interpretation of the underlying meaning of the text, what the text talks about and creating a theme. Seventeen interviews were conducted based on a strategic sampling in order to achieve variation in experiences of nurse-led follow-up in terms of sex, age, civil status, education, duration of disease and therapy and ways of administration.Results: The content analysis of the interviews resulted in the theme "The rheumatology nurse promotes patients with added value" which was based on four categories: familiarity, security, availability and participatory: Familiarity meant that it was easier to ask the rheumatology nurse about disease, treatment and how to live with a chronic disease than the rheumatologist. Patients experienced security in the rheumatology nurse's knowledge and skill. Availability meant that it was easy to contact the rheumatology nurse who spent time to patients' needs. Patients experienced being participatory in their biological therapy and in the rheumatology nurse's examination of the disease activity.Conclusions: The rheumatology nurse follow-up resulted in that patients experienced familiarity, security, availability and being participatory in their biological therapy. The rheumatology nurse promoted patients from another perspective, than the rheumatologist, in the rheumatology care. By replacing every other rheumatologist follow-up with a rheumatology nurse-led follow-up for patients with biological therapy, who are in low disease activity or remission, the rheumatology care will be more complete. A rheumatology nurse and a rheumatologist have different perspectives and complement each other. When patients are given the opportunity to meet both professions regularly they are able to receive optimal rheumatology care.

    Disclosure of Interest: None Declared

    Citation: Ann Rheum Dis 2011;70(Suppl3):755

  • 75.
    Larsson, Ingrid
    et al.
    School of Health Sciences, Jönköping University.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Patients' independence of a nurse for the administration of subcutaneous anti-TNF therapy: a phenomenographic study2010Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, nr 2, s. 5146-1-5146-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffness and functional restrictions. When conventional drugs fail to delay the development of the rheumatic disease, the patient may require biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It is therefore important that the patient perspective focuses on the life-changing situation caused by the administration of regular subcutaneous injections. The aim of this study was to describe variations in how patients with rheumatic diseases experience their independence of a nurse for administration of subcutaneous anti-TNF therapy. The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Four ways of understanding the patients' experience of their subcutaneous anti-TNF therapy and independence of a nurse emerged: the struggling patient; the learning patient; the participating patient; the independent patient. Achieving independence of a nurse for subcutaneous anti-TNF injections can be understood by the patients in different ways. In their strive for independence, patients progress by learning about and participating in drug treatment, after which they experience that the injections make them independent.

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  • 76.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bergman, Stefan
    Spenshult, Oskarström, Sweden.
    Biological therapy could be monitored by a rheumatology nurse-led clinic without any differences in outcome – a randomised controlled study2012Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Patients with rheumatic diseases treated with biological therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients who are in low disease activity or remission.

    Objectives: To compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients treated with biological therapy with low disease activity or in remission.

    Methods: In a prospective controlled study 107 patients were randomised into two groups with six months follow up to a rheumatology nurse (intervention group; n=53) or to a rheumatologist (control group; n=54). Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. In the nurse-led rheumatology clinic the patients´ disease activity was assessed by examination of tender or swollen joints and laboratory tests. The rheumatology nurse also had a dialogue concerning the patient’s needs with regard to drug therapy, smoking habits and psychosocial aspects. After 12 months 97 patients completed the study. Main outcome was disease activity measured by DAS28.

    Results: Patients had mean age of 55.4 years and disease duration of 16.7 years. DAS28 was 2.1. At inclusion there were no significant differences in DAS28 between the groups. There were no differences (p=0.67) in change of DAS28 between the intervention group (0.14) or control group (0.20) from inclusion to 12 months.

    Conclusions: In patients with low disease activity biological therapy could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.

  • 77.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Hälsohögskolan Jönköping, Jönköping, Sverige.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bergman, Stefan
    Spenshult, Oskarström, Sverige.
    Sjuksköterskemottagning för patienter med en reumatisk sjukdom behandlade med biologiska läkemedel – ett randomiserat, kontrollerat försök jämförande sjuksköterskemottagning med läkarmottagning2012Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Bakgrund Målet med behandling av reumatiska sjukdomar är att ta kontroll över ledsmärta och svullnad, reducera ledskador samt förebygga funktionsnedsättningar. För patienter med otillräcklig respons på traditionella läkemedel har forskningen inom reumatologin varit av stor betydelse och medfört utveckling av biologiska läkemedel. Behandling med biologiska läkemedel för patienter med reumatisk sjukdom följs vanligtvis upp av en reumatolog. För patienter som är lågaktiva i sin sjukdom eller i remission har uppföljning via en sjuksköterskemottagning föreslagits. Syfte var att jämföra sjuksköterskemottagning med läkarmottagning avseende behandlingsresultat för patienter behandlade med biologiska läkemedel med låg eller ingen sjukdomsaktivitet.

    Metod Ett randomiserat kontrollerat öppet försök med 12 månaders uppföljning genomfördes mellan oktober 2009 och augusti 2011. Avsikten var att ersätta ett av de två årliga läkarbesöken med ett sjuksköterskebesök. En sjuksköterskemottagning utformades utifrån en personcentrerad vård med patientens behov i fokus. Inklussionskriterier var patienter med en reumatisk sjukdom behandlade med biologiskt läkemedel och en sjukdomsaktivitet, Disease Active Score 28 (DAS28) ≤3.2. Av 107 patienter randomiserades 53 patienter till uppföljning av sjuksköterska och 54 patienter till uppföljning av läkare. Hypotesen var att behandlingsresultatet på en sjuksköterskemottagning inte skulle vara sämre än på en läkarmottagning vid 12 månaders uppföljning. Huvudutfallsmått var DAS28.

    Resultat Efter 12 månader hade 47 patienter i sjuksköterskegruppen och 50 patienter i läkargruppen fullföljt studien. Patienterna hade en medelålder på 55.4 år, sjukdomsduration på 16.7 år och DAS28 var 2.1. Det fanns ingen statistiskt signifikant skillnad mellan grupperna. Efter 12 månader var det inte någon statistisk signifikant skillnad (p=0.66) i förändring av DAS28 mellan sjuksköterskegruppen (0.14) eller läkargruppen (0.20). I utfallsmåtten sänka, svullna och ömma leder, global hälsa och smärta (VAS) eller Health Assessment Questionnaire (HAQ) var det inte heller någon statistisk signifikant skillnad i förändring efter 12 månader mellan grupperna. Båda grupperna var lika nöjda med vården och säkra på att få hjälp från reumatologmottagningen vid problem med lederna.

    Sammanfattning Patienter med en stabil reumatisk sjukdom behandlade med biologiskt läkemedel kan följas upp vid en sjuksköterskemottagning utan någon skillnad i behandlingsresultat med avseende på DAS28.

  • 78.
    Larsson, Ingrid
    et al.
    Jönköping University, Jönköping, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bergman, Stefan
    Spenshult Hospital, R&D Center, Spenshult Hospital, Oskarström, Sweden.
    Treatment Outcomes From a Nurse-Led Rheumatology Clinic in Monitoring of anti-TNF Therapy – a Randomised Controlled Trial2012Ingår i: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, nr 10, s. S667-S667, artikel-id 1559Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients with chronic inflammatory arthritis (CIA) treated with anti-TNF therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients with low disease activity or in remission. The purpose of this trial was to compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients undergoing anti-TNF therapy with low disease activity or in remission.

    Methods: A randomized controlled trial (RCT) with a 12-month follow-up was conducted with 107 patients randomised into two groups with a 6-month follow up to a nurse-led rheumatology clinic based on a person-centred care (intervention group; n=53) or to a rheumatologist-led clinic (control group; n=54). The intention of the interventional trial was to replace one of the two annual rheumatologist monitoring visits by a nurse-led rheumatology monitoring visit for patients undergoing anti-TNF therapy. Inclusion criteria were patients undergoing anti-TNF therapy and Disease Activity Score 28 (DAS28) ≤3.2. The hypothesis was that the outcomes from nurse-led clinic will not be inferior to those obtained by rheumatologist-led clinic at 12-month follow-up. Primary outcome was disease activity measured by DAS28.

    Results: After 12 months 47 patients in the intervention group and 50 patients in the control group completed the trial and there were no differences (p=0.66) in mean change of DAS28 between the intervention or control group. There were no differences (p>0.05) in mean change in Visual Analogue Scales (VAS) for pain, Health Assessment Questionnaire (HAQ), satisfaction or security with the rheumatology care  between the two groups, see table.

    Conclusion: In monitoring of anti-TNF therapy treatment outcomes for patients at a nurse-led rheumatology clinic are not inferior to those obtained by rheumatologist-led clinic at 12-month follow-up. The follow-up care of anti-TNF therapy may advantageously be performed by a nurse-led clinic based on a person-centred care. The results from this trial demonstrated that patients with CIA undergoing anti-TNF therapy, with low disease activity or in remission, could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.

  • 79.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Teleman, Annika
    R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Bergman, Stefan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. R&D Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad.
    Biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic2014Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, Suppl. 3, s. 139-140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients with chronic inflammatory arthritis (CIA) treated with biological therapy are usually monitored by rheumatologists. Research shows that a nurse-led rheumatology clinic is safe and effective in monitoring biological therapy (1) and contributed added value in patients within rheumatology care, because the encounter with the nurse led to a sense of security, familiarity and participation (2).

    Objectives: To compare the cost of monitoring biological therapy in a nurse-led rheumatology clinic with those of a rheumatologist-led clinic in patients with low disease activity or in remission.

    Methods: Cost comparison was based on data from a 12 month randomised controlled trial (1). A total of 107 patients were randomly assigned to either a rheumatologist-led clinic or to a nurse-led rheumatology clinic. The purpose of the intervention was to replace one of two annual monitoring visits at the rheumatologist-led clinic (control group; n=54) by a visit to a nurse-led rheumatology clinic (intervention group; n=53), based on person-centred care. Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. All outpatient visits, team rehabilitation and all the telephone advice at the Rheumatology Clinic were registered for the patients who participated in the trial. Main outcome measures were direct costs related to rheumatology care during the 12 month follow-up period.

    Results: After 12 months 97 patients completed the study. At the inclusion the patients had mean age of 55.4 years, disease duration of 16.7 years, and DAS28 was 2.1, with no significant differences between the two groups. There was no mean difference in changes in clinical outcome between the two groups (DAS28 -0.06; p=0.66). The total annual cost of team rehabilitation in rheumatology care, per patient monitored by the nurse-led rheumatology clinic was €580 compared with €1278 for monitoring by a rheumatologist-led clinic, translating in a €698 (55%) lower annual cost. The annual cost of just the outpatient rheumatology care provided by rheumatologist and rheumatology nurse, per patient was €457 for monitoring by the nurse-led rheumatology clinic compared with €598 for monitoring by a rheumatologist-led clinic, translating in a €141 (24%) lower annual cost.

    Conclusions: Patients with stable CIA undergoing biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic compared to a rheumatologist-led clinic, with no difference in clinical outcome as measured by DAS28.

    References

    1. Larsson et al. (2014). Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs, 70(1): 164-175.
    2. Larsson et al. (2012). Patients’ experiences of a nurse-led rheumatology clinic in Sweden – a qualitative study in patients undergoing biological therapy. Nurs Health Sci, 14(4): 501-507.
  • 80.
    Larsson, Ingrid
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Spenshult Research and Development Centre, Halmstad, Sweden.
    Fridlund, Bengt
    School of Health and Welfare, Jönköping University, Jönköping, Sweden .
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Teleman, Annika
    Capio Movement Hospital, Halmstad, Sweden.
    Svedberg, Petra
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Bergman, Stefan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Spenshult Research and Development Centre, Halmstad, Sweden & University of Gothenburg, Gothenburg, Sweden.
    A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial2015Ingår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 16, artikel-id 354Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Recommendations for rheumatology nursing management of chronic inflammatory arthritis (CIA) from European League Against Rheumatism (EULAR) states that nurses should take part in the monitoring patients’ disease and therapy in order to achieve cost savings. The aim of the study was to compare the costs of rheumatology care between a nurse-led rheumatology clinic (NLC), based on person-centred care (PCC), versus a rheumatologist-led clinic (RLC), in monitoring of patients with CIA undergoing biological therapy.

    Methods: Patients with CIA undergoing biological therapy (n = 107) and a Disease Activity Score of 28 ≤ 3.2 were randomised to follow-up by either NLC or RLC. All patients met the rheumatologist at inclusion and after 12 months. In the intervention one of two annual monitoring visits in an RLC was replaced by a visit to an NLC. The primary outcome was total annual cost of rheumatology care.

    Results: A total of 97 patients completed the RCT at the 12 month follow-up. Replacing one of the two annual rheumatologist monitoring visits by a nurse-led monitoring visit, resulted in no additional contacts to the rheumatology clinic, but rather a decrease in the use of resources and a reduction of costs. The total annual rheumatology care costs including fixed monitoring, variable monitoring, rehabilitation, specialist consultations, radiography, and pharmacological therapy, generated €14107.7 per patient in the NLC compared with €16274.9 in the RCL (p = 0.004), giving a €2167.2 (13 %) lower annual cost for the NLC.

    Conclusions: Patients with CIA and low disease activity or in remission undergoing biological therapy can be monitored with a reduced resource use and at a lower annual cost by an NLC, based on PCC with no difference in clinical outcomes. This could free resources for more intensive monitoring of patients early in the disease or patients with high disease activity.

    Trial registration: The trial is registered as a clinical trial at the ClinicalTrials.gov (NCT01071447). Registration date: October 8, 2009.

    © 2015 Larsson et al.

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  • 81.
    Lidell, Evy
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Axelsson, Åsa
    Institutionen för vårdvetenskap och hälsa, Göteborgs Universitet.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Jönköping.
    Mårtensson, Jan
    School of Health Sciences, Jönköping University, Jönköping.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    A masters programme in cardiovascular nursing: a two-year-follow-up2009Ingår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 29, nr 2, s. 48-49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate professional development and promotion as well as whether the new competence was requested after completion of a one-year master programme (MP) in Cardiovascular (CV) nursing. In Sweden the first one-year MP within the CV area took place between 2003 and 2005 at Halmstad University with a follow-up in 2007. The sample consisted of seventeen former students who had completed the MP. A questionnaire was developed comprising twenty items grouped into three main sections. Most of the nurses stated that their knowledge was requested and that they had developed their professional attitude, skills and knowledge. Seven of the nurses had a new position and five of them had advanced in terms of leadership. In three cases, the master exam was critical for the employers’ decision. Six of the nurses who had a new post had obtained an increase in salary. In conclusion, the MP led to increased competence as well as improved career prospects. Information about the MP should be available at clinics, and collaboration between clinical practice and education is necessary in order to ensure relevant use of master educated nurses’ competence.

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  • 82.
    Lidell, Evy
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Long-term effects of a comprehensive rehabilitation programme after myocardial infarction1996Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 10, nr 2, s. 67-74Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to determine the long-term effects on myocardial infarction (MI) patients of a six-month comprehensive rehabilitation programme (CRP) conducted by an interdisciplinary team regarding cardiac events, physical and psychological conditions, life habits, and cardiac health knowledge. The results of a multivariate analysis carried out five years after the MI showed that cardiac events and psychological condition were not significantly influenced by the CRP. However, it was found that the physical condition of the patients benefited from the CRP; self-reported physical fitness (p < 0.002) and physical exercise test (p < 0.007). CRP participation was linked to significant modifications of life habits (diet change; p < 0.04, sexual activity; p < 0.000). The cardiac health knowledge was significantly improved by participation in the CRP (basic cardiac knowledge; p < 0.005; knowledge about misconceptions; p < 0.04). In conclusion, CRPs have had positive long-term effects on physical condition, life habits and cardiac health knowledge. No such effects, however, were found regarding either cardiac events or psychological condition.

  • 83.
    Lidell, Evy
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Göteborg University, Gothenburg, Sweden & Kuopio University, Kuopio, Finland.
    Segesten, Kerstin
    Göteborg University, Gothenburg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Göteborg University, Gothenburg, Sweden & Kuopio University, Kuopio, Finland.
    A myocardial infarction patient’s current anxiety: Assessed with a phenomenological method1997Ingår i: International Journal of Rehabilitation and Health, ISSN 1068-9591, E-ISSN 1573-1537, Vol. 3, nr 3, s. 205-218Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to illustrate how a patient with a myocardial infarction history may experience current anxiety. We conducted the assessment using a phenomenological method. The participant was a 62-year old man, chronically ill due to two myocardial infarctions and heart failure. Five categories emerged from the data: distress, worthlessness, insecurity, indifference, and lack of strength, illustrating feelings embedded in the current anxiety. These feelings relate to past and present experiences as well as to an insecure future. The findings are not generalizable in a statistical manner, but they are an illustration of the importance of identifying a cardiac patient’s current anxiety from a holistic perspective, in order to understand what is occurring emotionally and to understand the need for emotional support. Qualities in the caring relationship may create possibilities for this patient to receive and perceive emotional support. © 2019 Springer Nature Switzerland AG. Part of Springer Nature.

  • 84.
    Lilja, Ylva
    et al.
    Deptartment of Health Sciences, Kristianstad University, Ängelholm Hospital, Ängelholm, Sweden.
    Rydén, Stefan
    Deptartment of Surgery, Ängelholm Hospital, Ängelholm, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Effects of extended preoperative information on perioperative stress: an anaesthetic nurse intervention for patients with breast cancer and total hip replacement1998Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 14, nr 6, s. 276-282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An anaesthetic nurse intervention was performed in order to evaluate the effects of extended preoperative information, given by anaesthetic nurses, on perioperative stress in patients operated on for breast cancer or total hip replacement (THR). Forty-six consecutive patients scheduled for surgery for breast cancer, and 55 for THR, were randomized into two groups which were given different modes of preoperative information. Patients in the control group were informed about pre-and postoperative routines by a ward nurse. Patients in the intervention group were given extended formalized information by an anaesthetic nurse. Wilcoxon rank sum test was used to show relations between variables. There were no significant differences between the intervention group and control group for patients with breast cancer or for patients with THR. Breast cancer patients in the intervention group were significantly more anxious than THR patients in the intervention group (P<0.01). Breast cancer patients in the intervention group showed the highest anxiety scores on the Hospital Anxiety and Depression Scale (HADS) scale on the day of surgery. This information may reflect an increased level of anxiety due to the extended information given preoperatively. The information may thus have had a negative effect on breast cancer patients, resulting in an increased state of anxiety. The result indicates a need for individualized modes of information to provide a proper balance between enough and too much information. © 1998 Harcourt Brace & Co. Ltd.

  • 85.
    Lindgren, Eva-Carin
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Influencing Exercise Adherence in Physically Non-active Young Women: Suggestion for a Model1999Ingår i: Women in Sport & Physical Activity Journal, ISSN 1063-6161, E-ISSN 1938-1581, Vol. 8, nr 2, s. 17-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to develop a theoretical understanding of what could influence exercise adherence in physically non-active young women. Interviews with twelve physically non-active young women werw strategically selected and analyzed by grounded theory. The results were that several factors could influence exercise adherence in physically non-active young women, and that these factors can be regarded as a number of interrelated dimensions. The influence was coming either from the exercise or from the environment connected to the exercise. The participants wanted to feel enjoyment and to learn something during the exercise (recreation/learning influence). They also wanted to feel belongingness during the exercise (social influence). An influence that promotes health or builds skills (investment influence) could be a trigger to start exercising among the participants, but not to maintain exercise adherence. Influence coming from the environment (enabling influence) was both important and stimulating for physically non-active young women in establishing regular exercise. It is important to present the model developed in this study to communities, sport federations and other authorities working with health promotion activities so that they can explore innovative ways to promote exercise adherence among physically non-active young women. Good examples could be to offer non-cometitive sports as well as to develop well-designed exercise programs for physically non-active young women.

  • 86.
    Lindgren, Eva-Carin
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Motives for participation in sport and exercise among young women2000Ingår i: Sport Psychology Conference in the New Millennium -A dynamic research-practice perspective, proceedings / [ed] Björn A. Carlsson, Urban Johnson, Fredrik Wetterstrand, Halmstad: Centre for Sport Science [Centrum för idrottsvetenskap] , 2000, s. 254-258Konferensbidrag (Refereegranskat)
  • 87.
    Lindgren, Eva-Carin
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Patriksson, Göran
    University of Gothenburg, Gothenburg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Empowering young female athletes through a self-strengthening programme: A qualitative analysis2002Ingår i: European Physical Education Review, ISSN 1356-336X, E-ISSN 1741-2749, Vol. 8, nr 3, s. 230-248Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe how young female athletes perceived the influences of a self-strengthening programme. The self-strengthening programme for young female athletes was run by the Swedish Sport Confederation. The programme was designed to empower young female athletes. The study methodology was based on a phenomenographic approach and entailed interviews with a strategically selected group of 14 participants in the programme. The informants were between 13 and 20 years of age and came from individual and team sports. The findings show that perceived influences of the programme were: a feeling of self-confidence; a feeling of being seen and confirmed; awareness of women’s issues; a feeling of belongingness; and an improvement in coaching skills. The self-strengthening programme empowered young female athletes due to increased self-efficacy and an increased awareness of women’s issues.

  • 88.
    Lindgren, Eva-Carin
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Tebelius, Ulla
    Högskolan i Halmstad, Akademin för lärande, humaniora och samhälle, Centrum för samhällsanalys (CESAM).
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    The impact of sport on young women’s attitude to physical activity in adult life2000Ingår i: Women in Sport & Physical Activity Journal, ISSN 1063-6161, E-ISSN 1938-1581, Vol. 9, nr 1, s. 65-86Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sport participation or regular physical activity is often seen as a factor, which leads to better health and well being. Sport also has a social function, as most of the activities are performed together with other people. However, while club sports in Sweden have a stimulating effect on young men, there is a risk that they do not provide enough scope for young women. In particular, early specialization and a high level of seriousness do not suit all young sportswomen. The purpose of this study was to develop a theoretical understanding of the ways in which sport has influenced young women’s lifestyles in terms of their attitudes to physical activity in adult life. The data were collected using strategic interviews and analyzed using the grounded theory method. Based upon the results, young women’s physically active lifestyles varied depending on how they valued their sport in combination with how they handled their sport. Sport was regarded as having a positive effect on health and well-being. This led to the young women studied intending to pursue a physically active lifestyle also in adult life. They enjoyed participating in sport, but not particularly sport with a high level of seriousness or a high level of vigor, which is what characterizes most club sports today.

  • 89.
    Lundén, Karin
    et al.
    Gothenburg University, Sweden.
    Baigi, Amir
    Dept. of Primary Health Care, Gothenburg University, Sweden.
    Lidell, Evy
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Hildingh, Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Fridlund, Bengt
    School of Health Sciences and Social Work, Växjö University, Sweden.
    Coronary care unit nurses' outlook on death - their own thoughts as well as those of their patients: a pilot study2007Ingår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 27, nr 3, s. 9-12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    No studies have examined the  level of preparedness of CCU  nurses to deal with cardiac patients’  death issues. Accordingly,  the aim of this pilot study was to  explore and describe CCU nurses’  outlook on their own as well  as their patients’ thoughts about  death. A pilot study was conducted  in 2005 at a University Hospital  in southern Sweden. The 63  (93%) nurses answered a newly  established 18-item questionnaire  regarding their own and their  patients’ thoughts about death.  Descriptive statistics revealed  that 90% of nurses believed that  patients often thought about  death. Regarding their outlook on  death issues, 41% were aware of  their personal standpoint, 63%  were clear about their plan of  action, 34% showed openness  towards their patients and 26%  expressed educational adequacy.  These low figures pertaining to  both personal and professional  awareness indicate a lack of  knowledge and competence. Clinical  implications are the provision  of various forums at CCUs  on this subject and the creation of  awareness at all levels of nursing  education. Research implications  are to further develop the instrument  and implement an intervention  at the CCU of how to care  for dying cardiac patients in a  professional manner.

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  • 90.
    Marklund, Berit
    et al.
    Research and Development Unit, Primary Health Care Halland, Falkenberg, Sweden & Research and Development Unit, Lövgärdet Primary Health Care, Göteborg, Sweden & Department of Primary Health Care, Göteborg University, Göteborg, Sweden & Research and Development Unit, Primary Health Care Halland, Falkenberg, Sweden.
    Månsson, Jörgen
    Research and Development Unit, Primary Health Care Halland, Falkenberg, Sweden & Research and Development Unit, Lövgärdet Primary Health Care, Göteborg, Sweden & Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Anderberg, Carl-Peter
    Research and Development Unit, Lövgärdet Primary Health Care, Göteborg, Sweden.
    Hagberg, Kerstin
    Research and Development Unit, Lövgärdet Primary Health Care, Göteborg, Sweden.
    Lyder, Inger
    Research and Development Unit, Lövgärdet Primary Health Care, Göteborg, Sweden.
    Bengtsson, Calle
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Effects on Sickness Pattern of Early Mini-rehabilitation Groups Among Patients with Musculoskeletal Problems in Primary Healthcare1999Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 6, nr 2, s. 90-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    People with musculoskeletal problems are repetitive users of the occupational and primary healthcare services; it seems that traditional medical treatment and physiotherapy are of little help. The aim of this study was to evaluate the effects on the sickness pattern among patients with musculoskeletal problems after an early rehabilitation programme and 3 months later based on interdisciplinary efforts in primary healthcare. The intervention was implemented in one of two primary healthcare areas during a 10-month period involving an intervention group (n=138) and a control group (n=75). Descriptive and analytical statistics were used. The result reflected a significantly shorter average sick period in the intervention group (63.8 days) than in the control group (92.8 days). The study indicates that such a model of early rehabilitation based on interdisciplinary efforts has the potential to provide significant socioeconomic benefits. © 1999 Scandinavian University Press.

  • 91.
    Marklund, Bertil
    et al.
    Primary Health Care Research and Development Unit, County Council Mailand, Falkenberg, Sweden.
    Almroth, Birgitta
    Primary Health Care Research and Development Unit, County Council Mailand, Falkenberg, Sweden.
    Schaffrath, Ann Marie
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Gunnarsson, Birgitta
    Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Höijer, Barbro
    Atomen Pharmacy, Göteborg, Sweden.
    Fridlund, Bengt
    Primary Health Care Research and Development Unit, County Council Mailand, Falkenberg, Sweden.
    Promoting medical self-care: evaluation of a family intervention implemented in the primary health care by pharmacies1999Ingår i: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 16, nr 5, s. 522-527Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Medical self-care is the range of behaviours undertaken by people to promote or restore health when dealing with a medical problem.

    Objectives: The aim of the study was to evaluate medical self-care effects of a family intervention implemented in primary health care by pharmacies, in terms of non-professional and professional involvement.

    Methods: The intervention was implemented in one of two primary health care areas during a 4-month period and involved consecutive families acting as an intervention (IG, n = 94) or a control (CG, n = 93) group. Eight telephone interviews were conducted with each family. The families were asked about complaints of illness, how long they prevailed and how they were treated.

    Results: The results showed (P < 0.05–0.0001) that the IG had more medical problems (931 versus 621) compared with the CG, were less hospitalized (4 versus 10), stayed at home more to take care of sick children (84 versus 40), read more medical brochures (121 versus 31), tried more non-medical treatments (228 versus 116), and had fewer visits to the department of paediatrics but more visits to primary health care (69 and 98 versus 90 and 68).

    Conclusions: Due to the non-randomization procedure, some caution with regard to generalization of the results must be taken, but they are in concordance with established knowledge of the usefulness of medical self-care. The results indicate that a brief intervention for families can change the use of health authorities. It therefore seems meaningful to implement the intervention in a more comprehensive way in the primary health care setting, while at the same time trying to implement it as a large-scale randomized experimental study, comprising aspects such as the individual's need for care, the use of the right organization level and the assessment of economic costs and savings.

  • 92.
    Marklund, Bertil
    et al.
    Primary Health Care Research and Development Unit, County Council Halland.
    Wallin, I.
    Medical Group Mölndals-Bro, Mölndal.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    A primary preventive coronary health survey among a finnish immigrant population in Sweden1999Ingår i: Coronary Health Care, ISSN 1362-3265, E-ISSN 1532-2025, Vol. 3, nr 1, s. 32-37Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Primary prevention strategies aimed at immigrants are insufficiently documented in primary health care services and, in Sweden, this is especially true regarding coronary health care with a gender perspective. The aim of this study was to examine the coronary health condition among a Finnish immigrant population in Sweden in terms of gender differences. Immigrated Finns (256 men and women aged 25-64) belonging to one primary health care centre were invited to participate in a coronary health survey. The instruments used, comprising a well-established self-rated questionnaire as well as tests forming a coronary heart disease (CHD) risk index, were analysed using descriptive and inferential statistics. The findings show that 23% were at high risk; more men than women (P<0.015). Men indicated more problems in food (e.g. fibre intake P<0.012) and drink (e.g. alcohol use P<0.000) habits while women indicated more psychosocial problems (e.g. psychosocial strain P<0.020). Furthermore, male and female Finnish immigrants are at least at an equal risk of CHD compared to their Swedish and Finnish counterparts, due to a high smoking rate (42% and 43%). Both genders show higher body mass index and waist-hip ratio figures compared to Swedish people on average. Establishing permanent connections with immigrant organizations and finding key persons anchored both among the immigrants and in the primary health care are important tasks in order to reach compliance in coronary health care. An important research implication would be to implement a primary prevention clinical trial based partly on the general findings of risk indicators and partly on gender differences among the risk indicators with regard to language obstacles.

  • 93.
    Morténius, Helena
    et al.
    FoUU Region Halland, Halmstad, Sweden & Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hildingh, Cathrine
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer. Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Fridlund, Bengt
    University of Gothenburg, Gothenburg, Sweden & School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Strategic Communication Intervention to Stimulate Interest in Research and Evidence-Based Practice: A 12-Year Follow-Up Study With Registered Nurses2016Ingår i: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 13, nr 1, s. 42-49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Bridging the research–practice gap is a challenge for health care. Fostering awareness of and interest in research and development (R & D) can serve as a platform to help nurses and others bridge this gap. Strategic communication is an interdisciplinary field that has been used to achieve long-term interest in adopting and applying R & D in primary care.

    Aim

    The aim of the study was to evaluate the impact of a strategic communication intervention on long-term interest in R & D among primary care staff members (PCSMs) in general and registered nurses (RNs) in particular.

    Methods

    This prospective intervention study included all members of the PCSMs, including RNs, in a Swedish primary care area. The interest of PCSMs in R & D was measured on two occasions, at 7 and 12 years, using both bivariate and multivariate tests.

    Results

    A total of 99.5% of RNs gained awareness of R & D after the first 7 years of intervention versus 95% of the remaining PCSMs (p = .004). A comparison of the two measurements ascertained stability and improvement of interest in R & D among RNs, compared with all other PCSMs (odds ratio 1.81; confidence interval 1.08–3.06). Moreover, the RNs who did become interested in R & D also demonstrated increased intention to adopt innovative thinking in their work over time (p = .005).

    Linking Evidence to Action

    RNs play an important role in reducing the gap between theory and practice. Strategic communication was a significant tool for inspiring interest in R & D. Application of this platform to generate interest in R & D is a unique intervention and should be recognized for future interventions in primary care. Positive attitudes toward R & D may reinforce the use of evidence-based practice in health care, thereby making a long-term contribution to the patient benefit. © 2015 The Authors

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  • 94.
    Månsson, J.
    et al.
    Research and Development Unit, Prim. Hlth. Care, Co. Cncl. H., Falkenberg, Sweden.
    Marklund, Bertil
    Prim. Hlth. Care R. and D. Unit, County Council Halland, Falkenberg, Sweden.
    Bengtsson, C.
    Department of Primary Health Care, Göteborg Univ., Vasa Hospital, Gothenburg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Evaluation of an educational programme for the early detection of cancer1999Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 37, nr 3, s. 231-242Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Avoiding patient's and doctor's delay is important for the detection of cancer. In order to study the possibilities for shortening the delay, without causing anxiety, an educational programme for early detection of cancer (EPEDC) was worked out, aimed to be evaluated at the community level. A community with 77 100 inhabitants, was informed about cancer symptoms in a letter. Participants who observed the cancer symptoms, described in the letter, were invited to visit the health centres, where they were interviewed and examined according to a specially designed schedule. Guidelines for taking care of these participants were also worked out. Fifteen previously unknown cancers were detected. By means of a telephone interview and a questionnaire the reactions to the EPEDC were studied. The results indicate that it is possible to inform and educate the population about cancer symptoms without causing anxiety on condition that there is an organisation which can be contacted without delay by subjects with potential cancer symptoms. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.

  • 95.
    Mårtensson, Irene E.
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Factors influencing the patient during weaning from mechanical ventilation: a national survey2002Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 18, nr 4, s. 219-29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Successful weaning depends on the application of skilled judgement and decision making to nursing and medical interventions. The intensive care nurse is in an unique position for adopting a holistic approach to weaning. Such an approach needs teamwork and consideration of all the factors that could influence the outcome of the weaning phase. The aim of this study was to conduct a survey, to establish the factors taken into consideration and documented during weaning at the intensive care units (ICUs) in Sweden. A questionnaire was developed and sent to all 92 ICUs. The results identified that nutrition, communication, analgesics and sedatives, psychological and metabolic factors, as well as weaning methods and measurable parameters were taken into consideration. Written instructions for weaning were used by only three ICUs and weaning protocols were not common. A holistic approach to the discontinuation of mechanical ventilation is a valuable means of improving the quality of care and merits further research.

  • 96.
    Mårtensson, J.
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Karlsson, J.E.
    Department of Cardiology, Ryhov County Hospital, Jönköping, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Female patients with congestive heart failure: how they conceive their life situation1998Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 28, nr 6, s. 1216-1224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Congestive heart failure (CHF) is a significant health problem for women, particularly elderly women. The risk factors for heart failure appear to be different in women than in men, with hypertension and diabetes playing a greater role in women and ischaemic heart disease a greater role in men. The aim of this study was to describe, from a nurse's perspective, how female patients with CHF conceive their life situation, interview questions were designed with a focus on five dimensions: biophysical, socio-cultural, emotional, intellectual and spiritual-existential. A qualitative method was used with a phenomenographic approach, as this approach examines aspects of the surroundings as they are conceived. Five categories emerged in the results: feeling content, feeling a sense of support, feeling a sense of limitation, feeling anxiety and feeling powerless. A sense of limitation regarding working capacity and being able to support those in their surroundings causes patients with CHF to experience anxiety due to feeling insecure about themselves and in relation to their surroundings. This may result in feelings of worthlessness in women with CHF, both concerning their own capacity and the fact that they feel they are a burden to those around them. Through nursing intervention, these patients can receive help to break this vicious circle of feeling limited and powerless. This can be done by encouraging them to verbalize their feelings and set realistic goals and expectations, and by increasing their knowledge and that of their families concerning CHF and its symptoms, with a focus on self-care and existing possibilities. These measures will make it easier for woman with CHF to maintain a hopeful perspective and a sense of control, competence, and self-esteem.

  • 97.
    Mårtensson, Jan
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Dracup, Kathleen
    School of Nursing, University of California, San Francisco.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Decisive situations influencing spouses' support of patients with heart failure: A critical incident technique analysis2001Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 30, nr 5, s. 341-350Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    The aim of this study was to describe decisive situations experienced by spouses of patients with heart failure that could potentially affect their ability to provide social support to the patient.

    METHODS:

    A qualitative descriptive design with a critical incident technique was used. Twenty-three informants, 15 women and 8 men, who were spouses of patients with severe heart failure were strategically chosen to ensure maximal variation in sociodemographic data and experiences as a spouse.

    RESULTS:

    Decisive situations influenced the experience of spouses of patients with heart failure in a manner that was either positive (involvement with others) or negative (feeling like an outsider). When spouses were given attention and treated like persons of value, they experienced involvement with others. In these cases, spouses had someone to turn to and were included in the physical care. In contrast, when spouses were kept at a distance by the patient, were socially isolated, and received insufficient support from children, friends, and health care professionals, they experienced feeling like an outsider.

    CONCLUSIONS:

    By identifying spouses' experiences, health care professionals can assess which kind of specific interventions should be used to improve the life situation of the patient with heart failure and his or her spouse.

  • 98.
    Mårtensson, Jan
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Strömberg, A.
    Department of Cardiology, Heart Centre, Linköping University Hospital Linköping, Sweden.
    Dahlström, U.
    Department of Cardiology, Heart Centre, Linköping University Hospital Linköping, Sweden.
    Karlsson, J. E.
    Department of Cardiology, County Hospital Ryhov Jönköping S-551 85, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Patients with heart failure in primary health care: effects of a nurse-led intervention on health-related quality of life and depression2005Ingår i: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 7, nr 3, s. 393-403Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim:

    To determine the effects of a nurse-led intervention designed to improve self-management of patients with heart failure in a primary health care setting regarding health-related quality of life and depression.

    Methods:

    Patients at eight primary health care centres were screened by the Diagnosis Related Groups registry for the diagnosis of heart failure and eligibility for a cluster randomised study. A total of 153 patients were included (n = 78 in the intervention group, 54% males, mean age 79 years, 59% in New York Heart Association class III-IV). The intervention involved patient and family education about heart failure and self-management and monthly telephone follow-up during 12 months by a primary health care nurse.

    Results:

    The effects of the nurse-led intervention were limited. Significant differences were found in the physical dimension measured by the SF-36 health survey, and in depression measured by the Zung Self-rating Depression Scale. In comparison within groups at the 3 and 12-month follow-up, the intervention group significantly maintained their health-related quality of life measured by the SF-36 health survey, and their experience of depression measured by the Zung Self-rating Depression Scale to a greater extent than in the control group, especially among women.

    Conclusion:

    A nurse-led intervention directed toward patients with heart failure in a primary health care setting resulted in limited effects between the groups, although the physical and mental status were retained during 12 months of follow-up to a greater extent than in the control group.

  • 99.
    Mårtensson, Lena I.
    et al.
    Veddige Health Care Centre, Veddige, Sweden.
    Pettersson, Lisbeth
    Varberg Health Care Centre, Varberg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Department of Primary Health Care, Göteborg University, Göteborg, Sweden.
    Patients with fibromyalgia and their conception of health after an intervention programme1995Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 2, nr 3-4, s. 113-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fibromyalgia is a well-known syndrome interpreted as general muscular pain in the whole body and as pressure soreness in the so-called tender points. The cause of the syndrome is not yet clear and it has therefore been difficult to find proper treatment. The aim of this study was to describe how patients with fibromyalgia conceived their health after having taken part in an intervention programme based on ego-strengthening psychotherapy and the salutogenetic model. The intervention was performed by an occupational therapist and a physiotherapist. In this study, 10 patients were interviewed and data were analysed by the phenomenographic method. Four different catagories of health conceptions became evident as a result of the intervention; receiving confirmation, creating distance to things, gaining insight, and gaining control. The results showed that the patients had increased their sense of meaningfulness, comprehensibility and manageability of the pain syndrome, which led to improved health. Due to the fact that this kind of intervention requires comparatively small resources in terms of staff and financial expenditure it is suitable in small clinics, e.g. health care centres. Further research should be aimed at finding out whether this intervention also suits patients with other diagnoses or whether treatment in larger groups might produce equally favourable results. © 1995 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

  • 100.
    Mårtensson, Lena
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd. Veddige Health Care Centre, Veddige, Sweden; Primary Health Care Research and Development Unit, County Council Halland, Falkenberg, Sweden; Vuxenpsykiatrisk Mottagning, Varberg, Sweden.
    Marklund, Bertil
    Halland County Council, Falkenberg, Sweden; University of Gothenburg, Gothenburg, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Akademin för hälsa och välfärd. University of Gothenburg, Gothenburg, Sweden.
    Evaluation of a biopsychosocial rehabilitation programme in primary healthcare for chronic pain patients1999Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 6, nr 4, s. 157-165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The responsibility of primary healthcare for treatment and rehabilitation of chronic pain patients has increased in the last decade. Experiences of multidisciplinary, behavioural treatments in pain clinics have demonstrated positive effects. The aim of the study was to evaluate a biopsychosocial rehabilitation programme in primary healthcare for chronic pain patients. The study included 70 chronic pain patients, who participated in an intervention based on ego-strengthening psychotherapy, led by an occupational therapist and a physiotherapist. The study was performed by Visual Analogue Scale (VAS) and a questionnaire as well as statistically analysed. The results showed increased general well-being (p < 0.01) and ability of pain management (p < 0.001) together with decreased level of perceived complaints (p < 0.001). The intervention was also associated with positive changes in personality, physical and cognitive factors. The results suggest that the biopsychosocial rehabilitation programme is useful in primary healthcare. Further studies should be carried out into the effects of such a rehabilitation programme in controlled randomized designs. © 1999 Scandinavian University Press.

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