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  • 1.
    Andersson, Linda
    et al.
    Halmstad University, School of Health and Welfare.
    Svensson, Anna
    Halmstad University, School of Health and Welfare.
    Livet förändras: Upplevelsen av att leva med kronisk obstruktiv lungsjukdom2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Kronisk obstruktiv lungsjukdom är en progressiv sjukdom som kännetecknas av kronisk luftvägsobstruktion. Den främsta orsaken till sjukdomen är rökning. Andra orsaker till sjukdomen kan vara luftföroreningar samt ärftlighet. Tidigare forskning visar att kronisk sjukdom innebär begränsningar som ger upplevelsen av förlust, vilket ger upphov till lidande. KOL leder till andnöd vilket ger begränsningar i livet. Andning är förknippat med liv och vid andnöd kan livet upplevas hotat. Personer som drabbas blir beroende av att ha kontakt med hälso- och sjukvården och i de senare stadierna av sjukdomen är även behovet av omvårdnad stort.  Syftet med studien var att beskriva upplevelsen av att leva med KOL. Litteraturstudien baserades på 15 vetenskapliga artiklar. Resultatet innefattade fyra teman: att uppleva andnöd; att uppleva sociala och personliga förändringar; att hantera livet med KOL; att leva med en självförvållad sjukdom. Livet med KOL präglades av känslor så som oro, ångest, förlust, begränsningar, skam och skuld. Livet för personer med KOL kan upplevas lättare att hantera om en ny mening med livet hittas. Bemötandet från hälso- och sjukvården spelar in på hur personer med KOL upplever sin sjukdom och genom förståelse för hur personer med KOL upplever sjukdomen kan ett gott bemötande från sjuksköterskan samt personcentrerad omvårdnad ges. Mer forskning behövs så att sjuksköterskan får ökad förståelse för hur det är att leva med KOL och därigenom ge bästa möjliga omvårdnad.

  • 2.
    Andersson, Matilda
    Halmstad University, School of Business, Engineering and Science.
    Analysis of Changes in Running Technique Between a Shod and Barefoot Running Condition.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Lately, barefoot running has become popular and there is a debate on the pros and cons of barefoot running with regards to running injuries. Many factors are causing injuries and one of the factors discussed is the fact that we run in shoes. When we run in shoes the biomechanics of the running technique may and therefore be a possible cause to injury. Aim: The aim of the study was to assess how the foot strike pattern, angle of the knee and ankle joint at time of initial contact, as well as the step length changes between a shod and barefoot running condition in habitually shod runners when running in a pace equivalent to their running pace over ten kilometers. Method: Twenty-seven healthy runners (18 male, 9 female) were included in the study. The study took place at the fitness center of Halmstad University. Subjects ran on a treadmill, in an individual pace equivalent to their running pace over ten km, both in a shod and barefoot running condition. Two-dimensional analysis of the sagittal plane kinematics of the knee joint, ankle joint and foot position to horizontal, foot strike pattern and step length was done. Participants ran for ten minutes with shoes and for five minutes barefoot. Running technique was videotaped using an Iphone 6 camera and landmarks were marked with white tape to ease the analysis. Results: Changes in foot strike pattern was observed. When running barefoot 63% of the subjects adopted a non-heel strike pattern compared to 18.5% when shod (p=0.001). Knee flexion was increased at IC for the barefoot condition, with 164°±6 relative knee angle compared to 167°±6 when shod (p=0.001). Ankle angle at IC did not show a statistical significant difference between conditions (p=0.657). When barefoot the angle was 117°±8 compared to 115°±8 when shod. Foot angle to horizontal showed a flatter foot placement at IC with a less dorsiflexed foot for the barefoot condition (-4°±8) compared to shod (-12°±8), (p=0.001). Step length was decreased for the barefoot condition (0.82m ±0.15)   compared to shod (0.85m ±0.13), (p=0.008). Conclusion: Results are consistent with previous findings that barefoot running in some cases change the running technique with a flatter foot placement, an increased knee flexion at IC and a decreased step length. However, caution must be taken when habitually shod runners transition to barefoot running in regards to the biomechanical changes that may occur. To benefit from barefoot running a non-heel strike pattern is required. Further, the running technique may be the more important factor, regardless of wearing shoes or not.

  • 3.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer patients' experiences of care related to pain management before and after palliative care referral2004In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 13, no 3, p. 238-245Article in journal (Refereed)
    Abstract [en]

    Pain is the main problem for patients with cancer referred to palliative care (PC). Pain management in PC requires a multidimensional approach. A questionnaire was used to determine cancer patients' experiences of care related to pain management, before and after being referred to PC, and to also discover possible correlations between pain control and other aspects of care. Seventy-five consecutive patients from two PC teams were included in the study. The patients had experienced a statistically significant (P < 0.01) improvement in care after being referred to PC, despite the fact that pain control had not been optimized. Patients' description of 'pain control' after being referred to PC had a statistically significant correlation with their 'feeling of security' and 'continuity of care' throughout the same period. The conclusion is that care provided in PC is vital to successful pain management. Pain control depends not only on analgesics but also on many other aspects of care provided by the nurse. Continuity of care and the opportunity to talk increases the patients' feeling of security, which is also of utmost importance to successful pain management.

  • 4.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer-related pain in palliative care: patients' perceptions of pain management2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 45, no 4, p. 410-419Article in journal (Refereed)
    Abstract [en]

    Background: Pain is still a significant problem for many patients with cancer, despite numerous, clear and concise guidelines for the treatment of cancer-related pain. The impact of pain cognition on patients' experiences of cancer-related pain remains relatively unexplored. Aim: The aim of this study was to describe how patients with cancer-related pain in palliative care perceive the management of their pain. Method: Thirty patients were strategically selected for interviews with open-ended questions, designed to explore the pain and pain management related to their cancer. The interviews were analysed using a phenomenographic approach. Findings: Patients described 10 different perceptions of pain and pain management summarized in the three categories: communication, planning and trust. In terms of communication, patients expressed a need for an open and honest dialogue with health care professionals about all problems concerning pain. Patients expressed an urgent need for planning of their pain treatment including all caring activities around them. When they felt trust in the health care organization as a whole, and in nurses and physicians in particular, they described improved ability and willingness to participate in pain management. While the findings are limited to patients in palliative care, questions are raised about others with cancer-related pain without access to a palliative care team. Conclusion: The opportunity for patients to discuss pain and its treatment seems to have occurred late in the course of disease, mostly not until coming in contact with a palliative care team. They expressed a wish to be pain-free, or attain as much pain relief as possible, with as few side effects as possible.

  • 5.
    Ekström, Lina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Hansson, Frida
    Halmstad University, School of Social and Health Sciences (HOS).
    Beslut om övergången från kurativ till palliativ vård: Sjuksköterskors upplevelser och erfarenheter2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Nowadays, there are life-sustaining treatment that can prolong patients’ lives. This may make it difficult for medical personnel to set the limit for when the transition from curative to palliative care should be performed in institutional care. The purpose of the study was to describe the nurses’ experiences when a decision would be taken on when the patient went from curative to palliative care. In this study fifteen scientific articles were reviewed and analyzed. Four headlines emerged from the result: involvement, point in time, education/experience and feelings. One thing nurses had in common was that they thought that their opinion did not matter for the doctors about the transition from curative to palliative care, even though they spent more time with the patient and had a holistic point of view on the situation. The point in time was important in regards to when the decision was made and when the curative treatment was brought to an end. One difference between nurses was their experience and how secure they felt within their occupation. The nurses felt that it was difficult when there were not straight directives on how the treatment should be carried out. To be more secure in their jobs as nurses, there should be a higher level of education introduced throughout all of the health and medical care fields and there should be more research done about the patient’s experiences in their situation.

  • 6.
    Fluur, Christina
    et al.
    Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Strömberg, Anna
    Division of Nursing Sciences, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Thylen, Ingela
    Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
    Patients' experiences of the implantable cardioverter defibrillator (ICD); with a focus on battery replacement and end-of-life issues2013In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 42, no 3, p. 202-207Article in journal (Refereed)
    Abstract [en]

    Background: ICD deactivation at end-of-life is technically uncomplicated. However, it may present a psychological challenge to healthcare professionals, patients, and next-of-kin. Objective: This study explored patients' experiences of complex issues of battery replacement and deactivation of the ICD. Methods: Semistructured interviews were administered to 37 medically stable ICD-recipients. Results: The ICD-recipients lived with an uncertain illness trajectory, but the majority had not reflected on battery replacement or elective ICD deactivation. Healthcare professionals had rarely discussed these issues with patients. However, this was consistent with the ICD-recipients' wishes. Many patients had misconceptions about the lifesaving capacity of the ICD and the majority stated that they would not choose to deactivate the ICD, even if they knew they were terminally ill, and it meant they would receive multiple shocks. Conclusion: The ICD-recipients tended not to think about end-of-life issues, which imply that many patients reach the final stages of life unaware of the option of ICD deactivation. © 2013 Elsevier Inc.

  • 7.
    Fluur, Christina
    et al.
    Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Strömberg, Anna
    Division of Nursing Sciences, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Thylen, Ingela
    Division of Nursing Sciences, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Spouses’ reflections on Implantable Cardioverter Defibrillator treatment with focus on the future and the end-of-life: a qualitative content analysis2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 8, p. 1758-1769Article in journal (Refereed)
    Abstract [en]

    Aim. To explore future reflections of spouses living with an implantable cardioverter defibrillator recipient with focus on the end-of-life phase in an anticipated palliative phase.

    Background. A history of or risk for life-threatening arrhythmias may require an implantable cardioverter defibrillator. Despite the life-saving capacity of the device, eventually life will come to an end. As discussion about preferences of shock therapy at end-of-life phase seldom takes place in advance, the implantable cardioverter defibrillator recipients may face defibrillating shocks in the final weeks of their lives, adding to stress and anxiety in patients and their families.

    Design. Qualitative study with in-depth interviews analysed with a content analysis.

    Methods. Interviews were performed with 18 spouses of medically stable implantable cardioverter defibrillator recipients during 2011–2012.

    Results. The spouses described how they dealt with changes in life and an uncertain future following the implantable cardioverter defibrillator implantation. Six subcategories conceptualized the spouses' concerns: Aspiring for involvement; Managing an altered relationship; Being attentive to warning signs; Worries for deterioration in the partner's health; Waiting for the defibrillating shock; and Death is veiled in silence.

    Conclusion. Despite the partner's serious state of health; terminal illness or death and the role of the device was seldom discussed with healthcare professionals or the implantable cardioverter defibrillator recipient. Open and honest communication was requested as important to support coping with an unpredictable life situation and to reduce worries and uncertainty about the future and end-of-life. © 2013 John Wiley & Sons Ltd.

  • 8.
    Gagner, Sandra
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jägerstedt, Mika
    Halmstad University, School of Social and Health Sciences (HOS).
    Betydelsefull närhet och nödvändig distans: Sjuksköterskans professionella förhållningssätt inom palliativ vård2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Palliative care is an approach which has the main emphasis on the patient’s quality of life. It is characterized by a holistic view towards the patient’s physical, psychological, social and existential need. The nurse can work with palliative care in many different contexts, and to various degrees. Nonetheless, the nurse who conducts palliative care will always have a relation building function, and the relation between the nurse and the patient will have large impact of the patient’s perceived well-being. A nurse’s professional approach to palliative care is generally thought of as her taking on a compassionate role against her patients. The purpose of this paper was to describe the nurse’s experience of establishing and keeping a professional approach to her patients in palliative care. The study was conducted as a scientific literature review with a systematic gathering and scrutinizing of data. In total, eleven qualitative scientific articles were included in the review. Three main conclusions could be drawn. First, the nurses experienced that the relations within palliative care were characterized by closeness and emotional engagement. The close relationship between the nurse and her patients was regarded as being positive, although it constituted a risk of emotional overload. Second, it was found to be necessary for the nurse to maintain a professional distance to the patient to be able to separate work from private life. Third, many nurses identified a challenge of striking an appropriate balance between closeness and distance in order to be able to be personal without being private.

  • 9.
    Gustafsson, Sofia
    et al.
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
    Jeanette, Backholm
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
    PÅVERKAR ÅLDER, KÖN OCH TRÄNINGSMÄNGD FMS?: En tvärsnittsstudie mellan Functional movement screen samt sf-36v2 Health survey2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Regelbunden fysisk aktivitet motverkar en rad fysiska och mentala sjukdomar. Hälsovinster av fysisk aktivitet är bland annat en högre funktionell muskulär- och kardiovaskulär kapacitet samt en högre livskvalitet. Stillasittande och inaktivitet kan leda till övervikt, kardiovaskulära sjukdomar, cancer, psykosociala problem och metaboliska sjukdomar.

    Mellan män och kvinnor finns fysiologiska skillnader som visar sig i kroppsstorlek och muskelmassa. Detta ger generellt sett kvinnor mer flexibel fysik medan män är fysiskt starkare.

    WHOs rekommendationer om daglig fysisk aktivitet är 150 min/vecka av moderat aerobisk träning eller 75 min mer ansträngande aerobisk träning. Styrketräning som involverar större muskelgrupper rekommenderas i åldrarna 18-64.  

    Till hjälp att undersöka hypotesen har två oberoende test används. En skriftlig enkät, SF-36v2 Health Survey, samt ett fysiskt test, Functional Movement Screen.

    I denna studie undersöks huruvida det finns ett samband mellan en ökad träningsmängd och ett högre FMS-resultat samt om en högre ålder ger lägre FMS-resultat, oavsett kön. Vi tror oss även se ett samband mellan högre FMS-poäng och ett högre uppskattat mentalt och fysiskt mående.

    Testpersonerna (N:30) som deltog i studien var arbetande eller studerande män (N:15) och kvinnor (N:15) i åldrarna 20-65år.

    FMS-resultaten visade ingen signifikant skillnad mellan kön eller stigande ålder. Däremot ser vi signifikanta skillnader mellan könen vid specifika styrke- eller rörlighetstester i FMS. Kvinnorna visar tydligt via resultaten att de generellt har en mer flexibel fysik medan männen är starkare.

    Som slutsats av denna studie kan vi konstatera att FMS som testmetod är könsneutralt och kan användas på blandade populationer. Detta ger testmetoden en bred användbarhet på just en blandad population.

    Fler studier krävs för att få fram normerande poängsättning om FMS skall användas på medelmotionären. 

  • 10.
    Hagel, Sofia
    et al.
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Lindqvist, Elisabet
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Petersson, Ingemar F
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Meesters, Jorit J L
    Department of Rheumatology, Department of Physical Therapy, Leiden University Medical Center, Leiden, Netherlands & National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Klokkerud, Mari
    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Aanerud, Gerd J
    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Stovgaard, Inger H
    King Christian Xth Hospital for Rheumatic Diseases, University of Southern Denmark, Gråsten, Denmark.
    Hørslev-Petersen, Kim
    King Christian Xth Hospital for Rheumatic Diseases, University of Southern Denmark, Gråsten, Denmark.
    Strömbeck, Britta
    Department of Clinical Sciences in Lund, Orthopaedics, Lund University, Lund, Sweden.
    Vliet Vlieland, Thea P M
    Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands .
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS). Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Lund, Sweden & School of Business and Engineering, Department of Exercise Physiology, Biomechanics and Health, Spenshult, Halmstad, Sweden.
    Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflamatory arthritis in northern Europe, the STAR-ETIC collaboration2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 3, p. 250-257Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated.

    DESIGN: Multicentre prospective observational study in 4 European countries.

    METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed.

    RESULTS: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients.

    CONCLUSION: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation. © 2014 The Authors

  • 11.
    Holmqvist, Gärd
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Women's experiences of turning points and change through art therapy2015Conference paper (Other academic)
    Abstract [en]

    Women's experiences of turning points and change through art therapy 

    The aim of this study was to explore possible experiences of turning points and changes during individual art therapy. The question addressed was: how would you describe your experience of a turning point in the context of art therapy?

    Seventeen women who have attended art therapy were consecutively recruited from four different art therapists.  After group information the patients were asked to choose pictures they wanted to talk about during an individual interview. The images were photographed. Twelve woman described changes that can be viewed as a turning point and the other five described a more gradual unclear change.

  • 12.
    Holmqvist, Gärd
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundqvist Persson, Cristina
    Skaraborg Institute for Research and Development, Skövde, Sweden.
    Women’s experiences of change through art therapy2017In: Arts and Health, ISSN 1753-3015, E-ISSN 1753-3023, Vol. 9, no 3, p. 199-212Article in journal (Refereed)
    Abstract [en]

    Background: Art therapy is based on the conception that image making in a therapeutic context may facilitate processes of change.

    Methods: A semi-structured interview with focus on the image was conducted with 17 women in order to explore change, after which a qualitative content analysis was performed.

    Results: The women experienced internal change as a sudden, unexpected turning point or as a more gradual process, although some reported no internal change whatsoever. Five themes reflecting the women’s experiences of what was important for internal change emerged: Trust in the therapist, Belief in the method, Creative impulse, Meaning of the image and The art therapy process.

    Conclusions: Art therapy may contribute to change in the sense of moving from an inadequate to a healthier state. Even when art therapy does not lead to internal change it may be supportive and provide short-term help in everyday life.

    © 2016 Informa UK Limited, trading as Taylor & Francis Group

  • 13.
    Hubertsson, Jenny
    et al.
    Clinical Sciences Lund, Lund University, Lund, Sweden.
    Petersson, Ingmar
    Clinical Sciences Lund, Lund University, Lund, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Thorstensson, Carina
    Clinical Sciences Lund, Lund University, Lund, Sweden.
    Sickness absence in musculoskeletal disorders: patients' experiences of interactions with the Social Insurance Agency and health care. A qualitative study2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 107Article in journal (Refereed)
    Abstract [en]

    Background:

    Sickness absence has represented a growing public health problem in many Western countries over the last decade. In Sweden disorders of the musculoskeletal system cause approximately one third of all sick leave. The Social Insurance Agency (SIA) and the health care system are important actors in handling the sickness absence process. The objective was to study how patients with personal experience of sickness absence due to musculoskeletal disorders perceived their contact with these actors and what they considered as obstructing or facilitating factors for recovery and return to work in this situation.

    Methods:

    In-depth interviews using open-ended questions were conducted with fifteen informants (aged 33-63, 11 women), all with experience of sickness absence due to musculoskeletal disorders and purposefully recruited to represent various backgrounds as regards diagnosis, length of sick leave and return to work. The interviews were audio-recorded, transcribed verbatim and analysed using content analysis.

    Results:

    The informants' perceived the interaction with the SIA and health care as ranging from coherent to fragmented. Being on sick leave was described as going through a process of adjustment in both private and working life. This process of adjustment was interactive and included not only the possibilities to adjust work demands and living conditions but also personal and emotional adjustment. The informants' experiences of fragmented interaction reflected a sense that their entire situation was not being taken into account. Coherent interaction was described as facilitating recovery and return to work, while fragmented interaction was described as obstructing this. The complex division of responsibilities within the Swedish rehabilitation system may hamper sickness absentees' possibilities of taking responsibility for their own rehabilitation.

    Conclusions:

    This study shows that people on sick leave considered the interaction with the SIA and health care as an important part of the rehabilitation process. The contact with these actors was perceived as affecting recovery and return to work. Working for a more coherent process of rehabilitation and offering professional guidance to patients on sick leave might have an empowering effect.

  • 14.
    Ivarsson, Andreas
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Design Issues in Pre-injury Research – A Note on Prediction and Experimental Design2013In: Abstracts of the ISSP 13th World Congress of Sport Psychology: July 21-26, 2013, Beijing Sport University, Beijing, China, Beijing, 2013, p. 40-40Conference paper (Refereed)
    Abstract [en]

    During the last three decades, increased attention has been devoted towards psychological variables influencing injury risk (Hackfort & Kleinert, 2007). Of these prediction studies, a majority have used prospective designs with one single measurement point and continuous injury recording over a number of weeks. In order to grasp the changes in those variables, the use of repeated measure designs with multiple measurement points is warranted. Obtaining data from multiple points will enable use of advanced statistics, such as latent growth curve analysis. Unlike regular analyses (e.g., ANOVAs), growth curve analyses focus on within-person change and how within-person changes in state variables could affect injury risk. Based on findings from injury prediction research, investigators have targeted such variables (e.g., daily hassles, coping) in experimental studies aimed at preventing injuries. A meta-analysis, covering seven experimental studies, showed most studies to be effective in decreasing the number of injuries in the experimental groups (overall Hedges g Effect size = .81; Tranaeus, Ivarsson & Johnson, submitted). Even if the experimental studies have used true or quasi-experimental designs, several methodological issues can be addressed. First, in most of the studies a number of different mental skills are included in the intervention approach leading to difficulties in differentiating which specific mental skills may be responsible for producing reductions in injury. Second, since most of the experimental studies conducted used no-attentional control groups (i.e., the participants in these groups will not be given a placebo treatment), it is likely that large effects could be explained by the Hawthorn effect. Third, in most studies, researchers discuss the importance of their results based on suggested cut-off criteria for the p-values and/or effect sizes (ES). This procedure could be addressed as a limitation since p-values and/or effect sizes do not indicate anything about the results’ clinical significance (e.g., Ivarsson, Andersen, Johnson & Lindwall, 2013). Also, the fact that non-adjusted ES, which were reported in all studies providing ES, are positively biased due to sampling error (Synder & Lawson, 1993) might have led to overestimation of the intervention effects. This presentation will (a) highlight the designs of previous prediction studies while focusing on advantages of longitudinal repeated-measure designs (b) discuss different experimental designs that have been used in injury prevention research and, (c) suggest methodological and statistical considerations for future research on injury prevention.

  • 15.
    Jenelin, Anna-Karin
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Tongnuson, Malin
    Halmstad University, School of Social and Health Sciences (HOS).
    Uppfattningar om en god död i en palliativ kontext: - med fokus på en förbättrad omvårdnad2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The palliative care aims to achieve a good and peaceful death. A good death has proven to be an unique and varied experience why the patient should have an opportunity to comment on his impending death. Research has pointed out that there are different perceptions of what a good death means, from the patients’, relatives’ and nursing staff perspectives. The purpose of this study was therefore to elucidate knowledge about perceptions of a good death, in order to improve nursing care in a palliative context. This literature review is based on 15 scientific articles. The results showed that there are common perceptions of a good death, but also differences that are important from a nursing perspective. A good death can be summarized as symptom control, autonomy, social relationships, self image, synthesis and consent. Foremost it was conversation about the existential dimension, which was missing from the patients’ perspective. From the relatives’ perspective it was more desirable with information about the dying process in order to prepare for their relatives’ death. Palliative care philosophy aims to give the patients a holistic approach, where the promotion of quality of life is the focus, despite the fact that death is imminent. Holistic care was also the approach which emerged as the main idea of a good death from the nursing staff perspective. A good death in a palliative context is a research area that needs to be investigated further, especially concerning to the different views obtained about a good death from different perspectives.

  • 16.
    Kilic, Ö.
    et al.
    Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Kerkhoffs, G. M. M. J.
    Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
    Rosier, P.
    Royal Belgian Football Association, Brussels, Belgium.
    Gouttebarge, V.
    Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
    Exposure to physical and psychosocial stressors in relation to symptoms of common mental disorders among European professional football referees: A prospective cohort study2018In: BMJ Open Sport and Exercise Medicine, E-ISSN 2055-7647, Vol. 4, no 1, article id e000306Article in journal (Refereed)
    Abstract [en]

    Objectives The study aim was to explore the association of physical and psychosocial stressors (severe injuries, surgeries, recent life events, social support) with one-season onset of symptoms of common mental disorders (CMDs) among European professional football referees. Methods An observational prospective cohort study over a follow-up period of one season (2015-2016) was conducted among professional football referees from Belgium, Finland, France, Germany, Norway, Russia, Scotland and Sweden. Based on physical and psychosocial stressors as well as symptoms of CMD, an electronic questionnaire in English and French was set up and distributed by eight football federations involved. Results The prevalence of symptoms of CMD ranged from 5.9% for distress to 19.2% for eating disorders. A higher number of severe injuries and a lower degree of satisfaction about social support were significantly related to the occurrence of symptoms of CMD with an OR of 2.63 and an OR of 1.10, respectively. Conclusion A higher number of severe injuries and a lower degree on satisfaction about social support were found to be significantly associated with the onset of symptoms of CMD among European professional football referees. Referees suffering from severe injuries were nearly three times more likely to report symptoms of anxiety and depression. Referees who reported a low satisfaction of social support were significantly more likely to report symptoms of eating disorder. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.

  • 17.
    Landgren, Ellen
    Halmstad University, School of Health and Welfare.
    Patienters erfarenheter av hälsa vid tidig reumatoid artrit2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Living with rheumatoid arthritis (RA) can cause pain and disability. RA can result in sick leave and increased medical costs. There is a lack of studies on experience of health among pa-tients with early RA. Aim To describe the experience of health for patients with early RA. Method Individual interviews with 20 patients diagnosed with RA less than one year ago, were analyzed with qualitative content analysis with inductive approach. The analysis resulted in eight subcatego-ries and four categories. Results Patients with early RA describe health gives freedom through inde-pendence and painlessness, health brings joy in spite of disease, health provides safety by being able to work and being able to participate in family life and health gives physical and mental strength. Conclusion Patients experienced that they could be healthy although they had a chronic disease and hoped to resume their health and lifestyle as it was prior to their diagnosis. Health was related to feelings of freedom, joy of life, security and power, important factors for managing eve-ryday life when changes occurred due to a chronic illness. Knowledge of the patient group’s experi-ence of health enables more targeted, person-centered interventions, which can help patients achieve better health and lifestyle.

  • 18.
    Larsson, Jonas
    et al.
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Department of Medical Imaging and Physiology, Skåne University Hospital Department of Translational medicine, Lund University, Lund, Sweden.
    Engberg, Amanda
    Halmstad University, School of Business, Engineering and Science.
    Turnstedt, Max
    Halmstad University, School of Business, Engineering and Science.
    Dencker, Magnus
    Department of Medical Imaging and Physiology, Skåne University Hospital Department of Translational medicine, Lund University, Lund, Sweden.
    Bremander, Ann
    FoU Spenshult, Halmstad, Sweden.
    Olsson, M. Charlotte
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS).
    Cardiovascular Effects of Load Carriage in Soldiers; A Pilot Study2019In: Book of Abstracts of the 24th Annual Congress of the European College of Sport Science – 3rd - 6th July 2019, Prague – Czech Republic / [ed] Bunc, V. & Tsolakidis, E., European College of Sport Science , 2019, p. 422-423Conference paper (Refereed)
    Abstract [en]

    Introduction: Previous studies have shown that risk of physical fatigue increases if prolonged average work intensity exceeds 50% of oxygen uptake (VO2). In order to avoid persistent fatigue in a work setting, it is important to conduct suitable work capacity analyses. In physically demanding jobs where wearing protective gear and/or external load is mandatory, monitoring of cardiovascular demands through heart rate (HR) is one way to track the workers’ relative effort.  There are limited studies examining effects of load carrying on cardiovascular capacity where it appears that VO2peak differ when soldiers and firefighters are tested with work-related equipment/clothing compared to light clothing. The aim of this pilot study was to investigate effects of load (combat gear) on HR, VO2 and muscle oxygen saturation (SmO2) compared to no load in soldiers during a graded treadmill protocol.

    Methods: Eight volunteer army soldiers (1 woman, 7 men) performed a graded treadmill test until exhaustion. All soldiers performed the test twice, once with light clothes and no load (NL) and once with added load, their personal combat gear (CG), with at least 48 h between sessions. The treadmill protocol stages included supine and standing positions, followed by marching speeds of 5.4 km/h and 8 km/h at 0 incline (all 5 min) immediately followed by a set marching speed of 8 km/h with a starting incline of 2 % increasing the incline 2 % every third minute until voluntary exhaustion. Measurements of HR, VO2 and SmO2 were collected continuously and the last 30 s of each stage were averaged and used for statistical analyses (paired t-tests).

    Results: The mean added load for all soldiers with CG was 16.8 ± 1.1 kg. All soldiers completed at least 6 stages (range 6-11 stages) with both NL and CG, where time to exhaustion with NL was longer (19.1 ± 3.2 min) compared to CG (9.1 ± 2.9 min; p <0.01). Submaximal HR and VO2 were both significantly higher with CG compared to NL (at absolute intensities) at all marching speeds all soldiers completed (5.4 km/h 0 % grade - 8 km/h 4% grade; all p<0.05). For SmO2, marching with CG compared to NL resulted in increased muscle oxygen utilization, at submaximal stages 8 km/h 0% -4% grade (all p<0.05). For values at maximal effort the CG had a significantly lower VO2peak (3.7 ± 0.5 L/min) compared to NL (4.1 ± 0.6 L/min, p <0.01), whereas there was no difference in HRpeak or the lowest value of SmO2 between CG (193.1 ± 7.2 bpm; 42.4 ± 30.3%) and NL (195.4 ± 8.9 bpm; 47.0 ± 29.2%).

    Conclusions: This pilot study suggests that assessment of aerobic capacity in soldiers should be conducted with combat gear to help determine their actual work capacity during combat and other load carrying tasks. These results suggest that if soldiers’ work performance is determined without added load it overestimates their aerobic capacity (VO2peak) in tasks wearing combat gear, which might lead to added fatigability and deleterious effect on performance.

  • 19.
    Lilja, Josefine L.
    et al.
    Gothenburg Univ, Dept Psychol, S-40530 Gothenburg, Sweden..
    Lundh, Lars-Gunnar
    Lund Univ, Dept Psychol, Lund, Sweden..
    Josefsson, Torbjörn
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Falkenström, Fredrik
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Observing as an Essential Facet of Mindfulness: A Comparison of FFMQ Patterns in Meditating and Non-Meditating Individuals2013In: Mindfulness, ISSN 1868-8527, E-ISSN 1868-8535, Vol. 4, no 3, p. 203-212Article in journal (Refereed)
    Abstract [en]

    One of the most comprehensive measures of mindfulness is the Five Facet Mindfulness Questionnaire (FFMQ) with five factors-Observing, Describing, Acting with awareness, Non-judging, and Non-reactivity. Hierarchical confirmatory factor analyses, however, have suggested that only four of the FFMQ factors (i.e. all except Observing) were components of "an overall mindfulness construct"-which is puzzling because Observing represents a core aspect of all definitions of mindfulness. The purpose of the present study was to approach this problem by a person-oriented approach, focusing on patterns on the FFMQ scales, rather than linear associations between them. Data on the FFMQ were collected on 817 individuals. Cluster analysis according to the LICUR procedure was used to group these participants in 13 clusters, according to their profiles of scores on the five FFMQ scales. Of the participants, 325 were categorized as meditators and 317 as non-meditators. To test hypotheses about the relation between Observing and mindfulness (which we assumed should be higher among meditators), the meditators/non-meditators categorization was cross-tabulated with the FFMQ clusters. The results showed that all clusters in which meditators were over-represented had high scores on Observing, and all clusters in which meditators were under-represented had low scores on Observing-which supports the hypothesis that mindfulness is related to high levels of Observing. The relationship between Observing and Non-judging, however, was found to be more complex than expected. The results are discussed in terms of mindfulness seen as a multidimensional skill, which may develop differently in various subgroups of individuals.

  • 20.
    Lindberg, Susanne
    et al.
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Bergquist, Magnus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Unlocking design potential: Design with people diagnosed with schizophrenia2019In: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 44, no 1, p. 31-47Article in journal (Refereed)
    Abstract [en]

    With the expansion of e-health systems to more diverse and heterogeneous contexts and user groups, it is increasingly important to include users in design. Designers recognize the benefits of user participation, but including users with lowered cognitive and social abilities can be difficult. This paper intends to answer how these users can participate in the design of e-health systems. We conducted a case study with stakeholder interviews and design workshops with users diagnosed with schizophrenia to identify and overcome the challenges for participation. From the stakeholder interviews, we identified challenges relating to social interaction, technical experience, cognitive ability, and loss of individuality. We designed workshops that addressed these challenges and identify five strategies for unlocking the design potential of the participants: (1) work together with concrete materials and examples; (2) maintain a positive focus; (3) accept all ideas; (4) maintain and require realism; and (5) use previous interaction. We conclude that, when supported appropriately, it is possible to involve people diagnosed with schizophrenia. We also highlight the difficulty for someone not self-experienced to understand contexts as challenging and sensitive as this, and thus the value of user participation.

  • 21.
    Malmborg, Julia
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS), Biomechanics and Biomedicine.
    Orthorexic Eating Behavior in Relation to Health Status and Physical Activity: A Comparison Between Students in Two University Programs2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: It is discussed whether people within the area of health are more prone to developing ‘unhealthy’ behaviors regarding diet and physical activity. Orthorexia nervosa (ON) is a condition that describes an unhealthy obsession with healthy food. The research on ON is scarce and there are no studies assessing ON in relation to health status and physical activity.

    Aim: The aim of this study was to examine and compare orthorexic eating behavior in relation to health status and physical activity between students enrolled in the university programs of Biomedicine – Athletic Training (Biomedicine) and Construction and Real Estate Business (Business).

    Method: 129 subjects (32 men and 38 women from Biomedicine and 23 men and 36 women from Business) participated in this cross-sectional study. The subjects completed three questionnaires; The Short Form-36 Health Survey (SF-36), with eight different subscales, was used to assess mental and physical health status, the International Physical Activity Questionnaire (IPAQ) measured levels of physical activity and ORTO-15 examined eating behavior that indicated ON. T-tests and chi-square tests were used to analyze the data.

    Results: A total of 105 out of 128 subjects had a score indicating ON. Students from Biomedicine had a higher frequency of ON in comparison to Business (p < 0.000) and through the SF-36 subscale for bodily pain, Biomedicine reported a higher frequency of pain (p = 0.006). Results from measurements of physical activity did not differ significantly between Biomedicine and Business, but high-intensity physical activity seemed to occur more frequently in men than in women in total (p = 0.014).

    Conclusion: ON is a common condition in university students and even more frequent in students enrolled in a program directed towards health and nutrition. The high frequency of ON seen in Biomedicine could be a problem that needs to be addressed since the students, after graduation, are expected to coach other people to a healthy living. Further studies are needed to explore associations with ON to health and physical activity. There is also a need to develop valid and reliable instruments for assessing the condition.

  • 22.
    Sundell, Christoffer
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
    Samband mellan sprintförmåga och 1RM knäböj respektive vertikalhoppsförmåga hosjuniorfotbollsspelare2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: I en fotbollsmatch genomförs 150-250 högintensiva sprinter som varar i 2-4 sekunder. Sprinter kan vara en avgörande del i fotbollsmatcher vilket indikerar att det är viktigt för fotbollsspelare att utveckla sin sprintförmåga. Att träna upp sin maximala styrka har visat sig vara en viktig aspekt för att utveckla sprintförmåga på korta distanser eftersom kontaktiden med marken är längre vid start och accelerationsfasen. Även vertikal hoppförmåga har visat på samband med sprintförmåga. Det finns relativt få studier som har undersökt unilateral hoppförmåga och dess samband med sprintförmåga på viktiga distanser upp till 30 hos fotbollsspelare. Syfte: Syftet med studien var att undersöka om maximal styrka i nedre extremiteter har ett starkare samband med sprintförmåga upp till 30 m än vad unilateral hoppförmåga har Metod: Ett juniorfotbollslag inbjöds att medverka i studien. Maximal styrka i nedre extremiteter mättes med 1RM knäböjstest (kg) och den unilaterala hoppförmågan mättes med ett countermovement jump (UCMJ) (s) utfört på det dominanta benet. Sprintförmågan (s) mättes vid 5 m, 10 m, 15 m och 30 m. Spearman’s korrelationskoefficient (rs) användes för att studera sambandet mellan de olika testerna och ett rs >0,6 ansågs påvisa ett starkt samband. Resultat: Tretton fotbollsspelare deltog vid sprint-testet och vid test av 1RM i knäböj medan tio fotbollsspelare medverkade vid UCMJ. Samtliga fotbollsspelare var mellan 17-19 år gamla. Både 1RM i knäböj och UCMJ hade svaga samband med samtliga sprintdistanser. Korrelationerna mellan1RM i knäböj och sprintdistanser upp till 15 m (rs = -0,49, -0,58, -0,54, -0,21) var högre jämfört med korrelationerna mellan UCMJ och sprintdistanser upp till 15 m (rs = -0,37, -0,34, - 0,22, -0,32). Slutsats: Sambandet mellan sprintförmåga och maximal styrka respektive explosivitet i nedre extremiteter var svagt men något högre för 1RM i knäböj och sprintdistanser upp till 15 m än för UCMJ och samtliga sprintdistanser.

  • 23.
    Thylen, Ingela
    et al.
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Wenemark, Marika
    Division of Community Medicine, Linköping University, Linköping, Sweden.
    Fluur, Christina
    Department of Cardiology, County Council of Östergötland, Linköping, Sweden.
    Strömberg, Anna
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Årestedt, Kristofer
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Development and evaluation of the EOL-ICDQ as a measure of experiences, attitudes and knowledge in end-of-life in patients living with an implantable cardioverter defibrillator2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 2, p. 142-151Article in journal (Refereed)
    Abstract [en]

    Background: Due to extended indications and resynchronization therapy, many implantable cardioverter defibrillator (ICD) recipients will experience progressive co-morbid conditions and will be more likely to die of causes other than cardiac death. It is therefore important to elucidate the ICD patients' preferences when nearing end-of-life. Instead of avoiding the subject of end-of-life, a validated questionnaire may be helpful to explore patients' experiences and attitudes about end-of-life concerns and to assess knowledge of the function of the ICD in end-of-life. Validated instruments assessing patients' perspective concerning end-of-life issues are scarce.

    Aim: The purpose of this study was to develop and evaluate respondent satisfaction and measurement properties of the 'Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients' Questionnaire' (EOL-ICDQ).

    Methods: The instrument was tested for validity, respondent satisfaction, and for homogeneity and stability in the Swedish language. An English version of the EOL-ICDQ was validated, but has not yet been pilot tested.

    Results: The final instrument contained three domains, which were clustered into 39 items measuring: experiences (10 items), attitudes (18 items), and knowledge (11 items) of end-of-life concerns in ICD patients. In addition, the questionnaire also contained items on socio-demographic background (six items) and ICD-specific background (eight items). The validity and reliability properties were considered sufficient.

    Conclusions: The EOL-ICDQ has the potential to be used in clinical practice and future research. Further studies are needed using this instrument in an Anglo-Saxon context with a sample of English-speaking ICD recipients. © The European Society of Cardiology 2013.

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