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Nordgren, Lena, DocentORCID iD iconorcid.org/0000-0003-0667-7111
Publikasjoner (10 av 32) Visa alla publikasjoner
Kårefjärd, A. & Nordgren, L. (2019). Effects of dog-assisted intervention on quality of life in nursing home residents with dementia. Scandinavian Journal of Occupational Therapy, 26(6), 433-440
Åpne denne publikasjonen i ny fane eller vindu >>Effects of dog-assisted intervention on quality of life in nursing home residents with dementia
2019 (engelsk)Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, nr 6, s. 433-440Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: People with dementia often have a poor quality of life. Therefore, methods that can improve their life situation must be identified. One promising method is dog-assisted intervention.

AIM: This study aimed to investigate the effects of dog-assisted intervention on quality of life in nursing home residents with dementia.

MATERIALS AND METHODS: A one-group, pretest post-test study design was used. Quality of life was measured using the QUALID in 59 nursing home residents prior to and after a dog-assisted intervention. Non-parametric tests were used to analyze the data, and effect sizes were calculated.

RESULTS: The participants' total scores improved significantly between baseline and post-test 1 (p = < 0.001) and worsened significantly at post-test 2 (p = 0.025). The largest effect size was found for the item 'Verbalization suggests discomfort' (p = 0.001).

CONCLUSION: The results indicate that dog-assisted interventions can have positive effects on quality of life in nursing home residents with moderate to severe dementia.

SIGNIFICANCE: The results contribute to a growing knowledge base about non-pharmacological methods that can be used in dementia care. Occupational therapists should consider dog-assisted interventions when planning activities that can reduce the illness burden and improve the quality of life for people with dementia.

Emneord
Animal-assisted therapy, dementia, occupational therapy, quality of life
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-352956 (URN)10.1080/11038128.2018.1467486 (DOI)000466582700004 ()29693512 (PubMedID)
Forskningsfinansiär
The Dementia Association - The National Association for the Rights of the Demented
Tilgjengelig fra: 2018-06-08 Laget: 2018-06-08 Sist oppdatert: 2019-05-20bibliografisk kontrollert
Andersson, L. & Nordgren, L. (2019). Heart Failure Patients' Perceptions of Received and Wanted Information: A Cross-Sectional Study. Clinical Nursing Research, 28(3), 340-355
Åpne denne publikasjonen i ny fane eller vindu >>Heart Failure Patients' Perceptions of Received and Wanted Information: A Cross-Sectional Study
2019 (engelsk)Inngår i: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 28, nr 3, s. 340-355Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

This study aimed to investigate heart failure patients’ perceptions of received and wanted information and to identify differences regarding received and wanted information in relation to sociodemographic variables. A cross-sectional descriptive design was used. Patients with heart failure (n = 192) were recruited from six primary health care centers in Sweden. Data were collected by a postal questionnaire. A majority of the respondents had received information about the condition and the medication. Within primary health care, most respondents had been informed about medication. The respondents wanted more information about continued care and treatment, medication, and the condition. There were significant differences between sociodemographic groups concerning what information they wanted. Clinical nurses can support patients with heart failure by using evidence-based methods that strengthen the patients’ self-efficacy and by individualized information that increases patients’ knowledge and improves their self-care behaviors. Future studies are needed to identify informational needs of particular fragile groups of patients.

Emneord
cross-sectional, heart failure, information, primary health care, specialist heart failure care
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-356996 (URN)10.1177/1054773818787196 (DOI)000456682100006 ()29986617 (PubMedID)
Tilgjengelig fra: 2018-08-10 Laget: 2018-08-10 Sist oppdatert: 2019-03-13bibliografisk kontrollert
Johnsson, L. & Nordgren, L. (2019). How general practitioners decide on maxims of action in response to demands from conflicting sets of norms: a grounded theory study. BMC Medical Ethics, 20, Article ID 33.
Åpne denne publikasjonen i ny fane eller vindu >>How general practitioners decide on maxims of action in response to demands from conflicting sets of norms: a grounded theory study
2019 (engelsk)Inngår i: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 20, artikkel-id 33Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: The work of general practitioners (GPs) is infused by norms from several movements, of which evidence based medicine, patient-centredness, and virtue ethics are some of the most influential. Their precepts are not clearly reconcilable, and structural factors may limit their application. In this paper, we develop a conceptual framework that explains how GPs respond, across different fields of interaction in their daily work, to the pressure exerted by divergent norms.

Methods: Data was generated from unstructured interviews with and observations of sixteen Swedish GPs (who have by definition more than five years of experience after license to practice) and family medicine residents (with less than five years of experience) between 2015 and 2017. Straussian Grounded Theory was used for analysis.

Results: We found that GPs’ maxims of action can be characterised in terms of dichotomous responses to demands from four distinct sets of norms, or “voices”: the situation, the self, the system, and the profession. From the interactions between these voices emerge sixteen clusters of maxims of action. Based on the common features of the maxims in each cluster, we have developed a conceptual framework that appears to be rich enough to capture the meaning of the ethical decisions that GPs make in their daily work, yet has a high enough level of abstraction to be helpful when discussing the factors that influence those decisions.

Conclusions: Our four-dimensional model of GPs' responses to norms is a first step toward a middle-range theory of quality from GPs' perspective. It brings out the complexity of their practice, reveals tensions that easily remain invisible in more concrete accounts of their actions, and aids the transferability of substantive theories on GPs' ethical decision making. By explaining the nature of the ethical conflicts that they experience, we provide some clues as to why efforts to improve quality by imposing additional norms on GPs may meet with varying degrees of success.

Emneord
General practitioners, Grounded Theory, Quality of care, Professional ethics, Family medicine, Ethical decision making, Sweden
HSV kategori
Forskningsprogram
Bioetik
Identifikatorer
urn:nbn:se:uu:diva-380517 (URN)10.1186/s12910-019-0360-3 (DOI)000468055900003 ()31088448 (PubMedID)
Tilgjengelig fra: 2019-03-28 Laget: 2019-03-28 Sist oppdatert: 2019-06-19bibliografisk kontrollert
Nordgren, L. (2018). Can therapy dogs improve quality of life in people with dementia disease?. In: : . Paper presented at Nordic Conference in Nursing Research: Methods and Network for the future.13-15 juni 2018. Oslo, Norge..
Åpne denne publikasjonen i ny fane eller vindu >>Can therapy dogs improve quality of life in people with dementia disease?
2018 (engelsk)Konferansepaper, Oral presentation with published abstract (Annet vitenskapelig)
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-356997 (URN)
Konferanse
Nordic Conference in Nursing Research: Methods and Network for the future.13-15 juni 2018. Oslo, Norge.
Tilgjengelig fra: 2018-08-10 Laget: 2018-08-10 Sist oppdatert: 2019-01-03
Söderlund, A., Nordgren, L., Sterling, M. & Stålnacke, B.-M. (2018). Exploring patients’ experiences of the whiplash injury-recovery process: A meta-synthesis. Journal of Pain Research, 11, 1263-1271
Åpne denne publikasjonen i ny fane eller vindu >>Exploring patients’ experiences of the whiplash injury-recovery process: A meta-synthesis
2018 (engelsk)Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 11, s. 1263-1271Artikkel, forskningsoversikt (Fagfellevurdert) Published
Abstract [en]

Purpose: The aim of this study was to conduct a meta-synthesis to analyze qualitative research findings and thereby understand patients’ experiences of whiplash-associated disorders (WAD) and the injury-recovery process. Materials and methods: A qualitative meta-synthesis, which is an interpretive integration of existing qualitative findings, was performed. The databases PubMed, PsychINFO, Scopus, and Web of Science were searched. The Critical Assessment Skills Programme was used to assess the quality of the included studies. Results: Four studies were included. The synthesis resulted in several codes, 6 categories, and 3 themes (distancing from normalcy, self-efficacy in controlling the life situation after the injury, and readjustment and acceptance) that described the participants’ pain beliefs, their WAD-related life situation and their future expectations and acceptance. Changes in self-image were difficult to cope with and likely led to perceived stigmatization. Struggling with feelings of loss of control appeared to lead to low confidence and insecurity. Focusing on increasing knowledge and understanding the pain and its consequences were believed to lead to better strategies for handling the situation. Furthermore, recapturing life roles, including returning to work, was challenging, but an optimistic outlook reinforced symptom improvements and contributed to feelings of happiness. Conclusion: The results of the present study provide a comprehensive understanding of patients’ complex, multifaceted experiences of WAD, and the injury-recovery process. The findings can guide us in the development of new ways to evaluate and manage WAD. The results also indicate that a more patient-centered approach is needed to determine the depth and breadth of each patient’s problems.

HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-348698 (URN)10.2147/JPR.S158807 (DOI)000437149100001 ()29988716 (PubMedID)
Tilgjengelig fra: 2018-04-17 Laget: 2018-04-17 Sist oppdatert: 2018-11-23bibliografisk kontrollert
Nordgren, L. & Söderlund, A. (2018). Social support, self-rated health and low mood in people on sick leave due to heart failure: a cross-sectional study.. Scandinavian Journal of Public Health, 46(6), 606-612
Åpne denne publikasjonen i ny fane eller vindu >>Social support, self-rated health and low mood in people on sick leave due to heart failure: a cross-sectional study.
2018 (engelsk)Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 6, s. 606-612Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

AIMS: The aim of this study was to investigate social support in relation to self-rated health and the prevalence of low mood in people on sick leave due to heart failure.

METHODS: A cross-sectional design was used, and 590 individuals on sick leave due to heart failure in Sweden responded to the postal questionnaire. The questions therein concerned received and needed functional and structural support from managers, work colleagues, families and friends. Multivariate analyses were conducted.

RESULTS: The variables of income and needed support from family contributed significantly and negatively to self-rated health. Those who perceived that they needed more support from their manager reported experiencing low mood more frequently.

CONCLUSIONS: The results showed a negative relation between manager support and low mood. Thus, support from managers and perceptions of low mood during sick leave are negatively associated, however, we do not know anything about the causality of this association. The results also indicated that needed support from family was negatively associated with self-rated health. The results also highlighted a multidimensional frailty in people with heart failure that needs to be recognized in future research as well as in clinical practice.

Emneord
Cross-sectional, depression, heart failure, self-rated health, sick leave, social support
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-342490 (URN)10.1177/1403494817718070 (DOI)000441724500003 ()29160157 (PubMedID)
Forskningsfinansiär
Swedish Social Insurance Agency, 25728/2010
Tilgjengelig fra: 2018-02-21 Laget: 2018-02-21 Sist oppdatert: 2018-10-15bibliografisk kontrollert
Bjurling-Sjöberg, P., Wadensten, B., Pöder, U., Jansson, I. & Nordgren, L. (2018). Struggling for a feasible tool - the process of implementing a clinical pathway in intensive care: A grounded theory study. BMC Health Services Research, 18, Article ID 831.
Åpne denne publikasjonen i ny fane eller vindu >>Struggling for a feasible tool - the process of implementing a clinical pathway in intensive care: A grounded theory study
Vise andre…
2018 (engelsk)Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, artikkel-id 831Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Clinical pathways can enhance care quality, promote patient safety and optimize resource utilization. However, they are infrequently utilized in intensive care. This study aimed to explain the implementation process of a clinical pathway based on a bottom-up approach in an intensive care context.

Methods: The setting was an 11-bed general intensive care unit in Sweden. An action research project was conducted to implement a clinical pathway for patients on mechanical ventilation. The project was managed by a local interprofessional core group and was externally facilitated by two researchers. Grounded theory was used by the researchers to explain the implementation process. The sampling in the study was purposeful and theoretical and included registered nurses (n31), assistant nurses (n26), anesthesiologists (n11), a physiotherapist (n1), first- and second-line managers (n2), and health records from patients on mechanical ventilation (n136). Data were collected from 2011 to 2016 through questionnaires, repeated focus groups, individual interviews, logbooks/field notes and health records. Constant comparative analysis was conducted, including both qualitative data and descriptive statistics from the quantitative data.

Results: A conceptual model of the clinical pathway implementation process emerged, and a central phenomenon, which was conceptualized as 'Struggling for a feasible tool,' was the core category that linked all categories. The phenomenon evolved from the 'Triggers' ('Perceiving suboptimal practice' and 'Receiving external inspiration and support'), pervaded the 'Implementation process' ('Contextual circumstances,' 'Processual circumstances' and 'Negotiating to achieve progress'), and led to the process 'Output' ('Varying utilization' and 'Improvements in understanding and practice'). The categories included both facilitating and impeding factors that made the implementation process tentative and prolonged but also educational.

Conclusions: The findings provide a novel understanding of a bottom-up implementation of a clinical pathway in an intensive care context. Despite resonating well with existing implementation frameworks/theories, the conceptual model further illuminates the complex interaction between different circumstances and negotiations and how this interplay has consequences for the implementation process and output. The findings advocate a bottom-up approach but also emphasize the need for strategic priority, interprofessional participation, skilled facilitators and further collaboration.

HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-364675 (URN)10.1186/s12913-018-3629-1 (DOI)000449346000002 ()30400985 (PubMedID)
Tilgjengelig fra: 2018-10-31 Laget: 2018-10-31 Sist oppdatert: 2019-01-04bibliografisk kontrollert
Bjurling-Sjöberg, P., Wadensten, B., Pöder, U., Jansson, I. & Nordgren, L. (2017). Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice. Journal of Interprofessional Care, 31(2), 233-244
Åpne denne publikasjonen i ny fane eller vindu >>Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice
Vise andre…
2017 (engelsk)Inngår i: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 31, nr 2, s. 233-244Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was balancing intertwined responsibilities. In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon's contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.

Emneord
Grounded theory, intensive care unit, interprofessional care, interviews, practice, roles, teamwork
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-317286 (URN)10.1080/13561820.2016.1255184 (DOI)000395098400017 ()28140715 (PubMedID)
Tilgjengelig fra: 2017-03-13 Laget: 2017-03-13 Sist oppdatert: 2018-01-29bibliografisk kontrollert
Catharina, F., Lindbäck, C., Christina, T. & Nordgren, L. (2017). Healthcare professionals’ perceptions of their work with patients of working age with heart failure. Nordic journal of nursing research
Åpne denne publikasjonen i ny fane eller vindu >>Healthcare professionals’ perceptions of their work with patients of working age with heart failure
2017 (engelsk)Inngår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

There is a lack of knowledge about healthcare professionals’ perspectives on rehabilitation in relation to heart failure.Still, collaboration between different professionals can impact patients. The purpose of this study was to describe healthcareprofessionals’ perceptions of their work with patients of working age with heart failure. The sample population consisted of sixnurses, one physiotherapist and one cardiologist. One individual interview and two focus-group interviews were conducted.The interviews were analyzed using qualitative content analysis. Three descriptive categories were constructed: ‘the impact ofheart failure on patients’ life situations’, ‘heart failure service’, and ‘patients’ process of returning to work’. To support patients,healthcare professionals need to find ways to combine patients’ personal needs with protocol-driven care.

HSV kategori
Forskningsprogram
Vårdvetenskap
Identifikatorer
urn:nbn:se:uu:diva-342559 (URN)10.1177/2057158517744128 (DOI)
Tilgjengelig fra: 2018-02-22 Laget: 2018-02-22 Sist oppdatert: 2018-03-22bibliografisk kontrollert
Nordgren, L. & Söderlund, A. (2016). Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden: a cross-sectional study. Disability and Rehabilitation, 38(2), 168-173
Åpne denne publikasjonen i ny fane eller vindu >>Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden: a cross-sectional study
2016 (engelsk)Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 2, s. 168-173Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

PURPOSE: The aim of this study was to investigate associations between socio-demographic factors, experiences of positive/negative encounters with healthcare professionals, and the encounters' impact on the ability to return to work in a population of people on sick leave due to heart failure.

METHODS: This was a cross-sectional study. Data were collected from two official registries in Sweden and from a postal questionnaire. In all, 590 people with heart failure responded to the questionnaire. Associations between variables were calculated with bivariate correlation analyses and logistic regression analyses.

RESULTS: For people on sick leave due to heart failure, positive encounters with healthcare professionals are associated with being Swedish-born, female gender, and high income. People with high income are more likely to be supported back to work by positive encounters with healthcare professionals. To perceive that healthcare professionals believe in person's ability to return to work can be facilitating.

CONCLUSIONS: Women, people who are not foreign-born, and people with high income are more likely to perceive encounters with healthcare professionals as positive. Healthcare professionals who work with rehabilitation for people with heart failure need to be aware of social inequalities and that being on sick leave is a process of change. Implications for Rehabilitation A failing heart limits everyday life implying risk for long-term sick leave. Even though there are rehabilitation programs for people with heart failure, vocational rehabilitation is often over-looked. The knowledge about factors associated with sick leave due to heart failure is scarce. Experiences of positive encounters with healthcare professionals were associated with being Swedish-born, female gender, and high income. People with high income were more likely to be supported back to work by positive encounters with healthcare professionals. Healthcare professionals who work with rehabilitation for people with heart failure can support patients with heart failure by showing them confidence and trust. However, they need to be aware that sick leave implies a process of change.

Emneord
Adults; heart diseases; return to work; sick leave
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-262353 (URN)10.3109/09638288.2015.1031289 (DOI)000364971000005 ()25835330 (PubMedID)
Tilgjengelig fra: 2015-09-14 Laget: 2015-09-14 Sist oppdatert: 2017-12-04bibliografisk kontrollert
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0003-0667-7111