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  • 1. Arman, M.
    et al.
    Backman, M.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Hamrin, E.
    Women's Perceptions and Beliefs About the Genesis of Their Breast Cancer2006In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 29, no 2, p. 142-148Article in journal (Refereed)
    Abstract [en]

    A person's belief is seen as a set of assumptions, depending on perceptions, and formed with the influence of experiences and social culture. With the aim of understanding the beliefs about the genesis of their illness, 118 (59 + 59) women with different stages of breast cancer were interviewed. Half of the sample had chosen complementary care in an anthroposophical hospital, and the other half was a matched group. Qualitative content analysis was used. Three themes emerged: (1) belief in a link to life lived (71%), (2) heredity as the sole genesis (4%), and (3) rejection of the question (25%). Under beliefs in a link to life lived, external aspects to the patient's own life (eg, diet and lifestyle) were cited, as well as inner aspects such as psychosocial problems and stress. The findings show that women are well informed about medical facts, although their beliefs reveal a holistic approach. The women's beliefs, where inner psychosocial factors are uppermost, point to a reverse of the causal ranking of medical advisors. The difference between the groups was that the matching sample was more likely to reject the influence of possible causes from life lived. In a caring perspective, women's perceptions of the genesis of their illness are in some cases turned to creative health activities that may increase well-being.

  • 2.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Beskrivning av den svenska logopedkårens sammansättning samt av "afasilogopeders" arbetsmässiga förutsättningar - resultat från en enkätstudie2011In: Logopednytt, ISSN 1102-500X, no 2, p. 14-19Article in journal (Other (popular science, discussion, etc.))
  • 3.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Communication aid devices in Swedish aphasia rehabilitation: the experiences of speech-language pathologists2011In: 3rd Nordic Aphasia Conference, 2011, Helsinki, Finland: Aphasia rehabilitation today and in the future, Helsinki, Finland, 2011Conference paper (Refereed)
  • 4.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Communication difficulties and use of communication strategies: from the perspective of individuals with aphasia2012In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984, Vol. 47, no 2, p. 144-155Article in journal (Refereed)
    Abstract [en]

    Background:

    To enhance communicative ability and thereby the possibility of increased participation of persons with aphasia, the use of communication strategies has been proposed. However, little is known about how persons with aphasia experience having conversations and how they perceive their own and their conversation partner's use of communication strategies.

    Aims:

    To explore how people with aphasia experience having conversations, how they handle communication difficulties, and how they perceive their own and their communication partners’ use of communication strategies.

    Methods & Procedures:

    Semi-structured interviews were conducted with four women and seven men with chronic aphasia (n = 11). Interviews were video-recorded, transcribed verbatim and analysed by qualitative content analysis.

    Outcomes & Results:

    Informants appreciated having conversations despite the fact that they perceived their aphasia as a serious hindrance. Different factors related to the informants, the conversation partners, the conversation itself and the physical environment were perceived to impact on conversations. The importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies were acknowledged by the informants. The informants’ views on using communication aid devices or strategies varied considerably. Four themes that characterized the informants’ narratives were: loss and frustration, fear and uncertainty, shared responsibility based on knowledge, and longing for the past or moving forward.

    Conclusions & Implications:

    The informants longed to regain their former language ability and role as an active participant in society. To enhance participation of persons with aphasia, it is suggested that communication partner training should be an important and integral part of aphasia rehabilitation. Important elements of such training are reflecting on communication behaviours, training in real-life situations, and acknowledging each individual's special needs and preferences. To deal with the consequences of aphasia, counselling and psychological support may be needed.

  • 5.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    How do we work with persons with aphasia and their relatives?: Preliminary results from a survey of Swedish speech and language pathologists2009Conference paper (Other academic)
  • 6.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Svenska logopeders insatser till personer med afasi2011In: Logopednytt, ISSN 1102-500X, no 3, p. 18-23Article in journal (Refereed)
  • 7.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Working with families of persons with aphasia: a survey of Swedish speech and language pathologists2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 1, p. 51-62Article in journal (Refereed)
    Abstract [en]

    Purpose:The overall aim was to investigate how speech and language pathologists (SLPs), in Sweden are working with people with aphasia and their families and what their professional experiences are.

    Method:A cross-sectional study with a descriptive and comparative design. An 84-item study-specific questionnaire was sent to all Swedish SLPs, affiliated to SLOF (the Swedish professional association and trade union).

    Results:The response rate was 72.5% (n = 758). Thirty per cent worked with people with aphasia and typically met with their families. The participants considered the involvement of families as very important, especially concerning providing information of aphasia and training of communication strategies. However, involvement of families was limited due to a shortage of time, but also to perceived limited skill and knowledge.

    Conclusions:There was an evident discrepancy between what the participants claimed to be an important part of their work, and their actual practice. It is suggested that to facilitate family intervention, this should be explicitly expressed in both local and national guidelines. The content of the SLP education, and the need of further education and implementation of new knowledge into clinical practice also requires consideration.

  • 8.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia2013In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 27, no 2, p. 201-226Article in journal (Refereed)
    Abstract [en]

    Background:

    Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).

    Aims:

    To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.

    Methods & Procedures:

    An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.

    Outcomes & Results:

    The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.

    Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.

    Conclusions:

    The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.

  • 9.
    Blom Johansson, Monica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Östberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Sonnander, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Communication changes and SLP-services according to significant others of persons with aphasia2012In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 26, no 8, p. 1005-1028Article in journal (Refereed)
    Abstract [en]

    Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.

    Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others’ experiences of SLP services and their motivation to participate in these services. Finally, the significant others’ experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.

    Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.

    Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.

    Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.

  • 10.
    Borg, Tomas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Larsson, Sune
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Questionnaire to assess treatment outcomes of acetabular fractures2012In: Journal of Orthopaedic Surgery, ISSN 1022-5536, E-ISSN 2309-4990, Vol. 20, no 1, p. 55-60Article in journal (Refereed)
    Abstract [en]

    PURPOSE

    To construct a questionnaire to assess outcomes in patients who underwent internal fixation for acetabular fractures.

    METHODS

    27 female and 100 male consecutive patients (mean age, 50 years) who underwent internal fixation for acetabular fractures were included. Patients were asked to report their outcomes at months 6, 12, and 24 using a questionnaire. The initial questionnaire was constructed by an expert group. There were 11 closed questions, each came with 6 responses from ?no discomfort? to ?very severe discomfort?. Three open questions were added to cover topics that were not included. The content validity and relevance of the 11 closed questions was determined using factor analysis to determine the number of factors involved. Factorability of the correlation matrix was measured via the Bartlett test of sphericity and Kaiser-Meyer- Olkin (KMO) measure of sampling sufficiency. Factor loadings of <0.50 were considered acceptable for factor representation. Reliability in terms of internal consistency was expressed as Cronbach alpha coefficients. The responses to the 3 open questions were analysed and categorised by a single assessor.

    RESULTS

    120 (94%) of the patients completed at least one questionnaire, and 92 (72%) completed all 3 questionnaires during the follow-up period. Based on responses to the 6-month questionnaire, responses to the 11 closed questions were significantly intercorrelated (Spearman 0.17-0.80). After factor analysis and analysis of responses to open questions, the number of questions was reduced to 6 and included questions related to pain, walking, hip motion, leg numbness, sexual life, and operation scar. Reliability of the questionnaire was estimated to alpha=0.89. Criterion validity was adequate with a high correlation with the Short Form 36 (r=0.56-0.80).

    CONCLUSION

    Patients treated with acetabular fractures can be adequately assessed using the 6-item questionnaire and one global question concerning impact on activities of daily living.

  • 11.
    Borg, Tomas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Hernefalk, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Larsson, Sune
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Development of a pelvic discomfort index to evaluate outcome following fixation for pelvic ring injury2015In: Journal of Orthopaedic Surgery, ISSN 1022-5536, E-ISSN 2309-4990, Vol. 23, no 2, p. 146-149Article in journal (Refereed)
    Abstract [en]

    Purpose. To develop a pelvic discomfort index (PDI) to evaluate outcome following fixation for pelvic ring injury. Methods. 29 female and 44 male consecutive patients (mean age, 36 years) underwent internal fixation for pelvic ring injury of type B1 (n=10), B2 (n=22), B3 (n=15), C1 (n=18), C2 (n=5), and C3 (n=3), based on the AO/OTA classification. At postoperative 6, 12, and 24 months, patients were asked to assess their discomfort in the pelvis using a 14-item questionnaire. Three questions were open-ended, and responses were categorised by a single assessor. The remaining 11 questions were closed-ended and had 6 ordinal options from 'no discomfort' (score=0) to' extremely severe discomfort' (score=5). The content validity and relevance of the 11 closed-ended questions was determined. The 14-item questionnaire was compared with the 36-item Short Form Health Survey (SF-36). Results. Respectively at postoperative 6, 12, and 24 months, 78%, 71%, and 71% of the patients completed the 14-item questionnaire. Based on the factor analysis and responses to the open-ended questions, the number of items was reduced to 6 including pain, walking, mobility of the hips, loss of sensation in the legs, sexual life, and operation scar. Four factors could explain 96% of the total variance. The first factor involved the first 3 items (pain, walking, and hip motion) and addressed 'pelvis', whereas 3 factors involved the remaining items and each addressed peripheral neurology, sexual life, and operation scar. A PDI was developed using these 6 items. The PDI had high internal reliability (alpha=0.89), adequate content and criterion validity, and moderate correlation with the SF-36 total score or scores of physical function, bodily pain, and general health (r=0.50-0.77). Conclusion. The PDI provides valid, specific, and relevant information to assess

  • 12.
    Carlsson, Marianne
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Arman, Maria
    Backman, Marie
    Hamrin, Elisabeth
    Coping in women with breast cancer in complementary and conventional care over 5 years measured by the mental adjustment to cancer scale.2005In: J Altern Complement Med, ISSN 1075-5535, Vol. 11, no 3, p. 441-7Article in journal (Refereed)
  • 13.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindqvist, Ragny
    Ljunggren, Birgitta
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Relatives' opinions of IT support, perceptions of irritations and life satisfaction in dementia care2006In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 12, no 5, p. 246-250Article in journal (Refereed)
    Abstract [en]

    We studied relatives' opinions of IT support at a residential home for persons with dementia. We also investigated the relatives' perceptions of irritations and life satisfaction before and after increased IT support. This was accomplished using an experimental group (n = 14) and a control group (n = 8) of subjects in dementia care. The design was quasi-experimental with baseline assessments and three follow-ups. Data were collected using two questionnaires measuring opinions of the IT support: irritations in care (the Nursing Home Hassles Scale) and life satisfaction (the Life Satisfaction Questionnaire). Results showed that relatives' opinions of IT support were generally positive. In the experimental group, relatives' perceptions of practical/logistical irritations decreased between baseline and 12-month follow-up. In the control group, there was an increase in the total Nursing Home Hassles score between baseline and three-month follow-up. This difference did not persist at seven- and 12-month follow-ups. No significant differences were found for life satisfaction. We conclude that relatives had positive opinions of IT support, and their perceptions of practical/logistical irritations decreased after implementation of the IT support package.

  • 14.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ljunggren, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindqvist, Ragny
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care2005In: Journal of Telemedicine and Telecare, ISSN 1357-633X, Vol. 11, no 6, p. 304-309Article in journal (Refereed)
    Abstract [en]

    We measured staff members' satisfaction with their work before and after increased information technology (IT) support in dementia care. Comparisons were also performed of perceived life satisfaction and sense of coherence; Data were collected before, and 6 and 12 months after implementation of the first part of an IT support project. Instruments used were the Satisfaction with Work Questionnaires, the Life Satisfaction Questionnaire (LSQ) and the Sense of Coherence (SOC) scale. The study was performed in a residential home for persons with dementia. The participants were 33 staff members. The IT technology included general and individualized passage alarms, sensor-activated night-time illumination, fall detectors and Internet communication. Results showed that staff members' job satisfaction and perceived quality of care improved in comparison with the control group. Personal development, workload, expectations and demands, internal motivation and documentation, as well as the total scores for 'psychosocial aspects of job satisfaction' and 'quality of care aspects', increased in the experimental group. There were significant interaction effects for the factors family relation, close friend relation (LSQ), the total SOC scale and the meaningfulness subscale. The study showed that IT support in dementia care increased staff members' satisfaction with their work in several ways.

  • 15.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Ljunggren, Birgitta
    Lindqvist, Ragny
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Staff satisfaction with work, perceived quality of care and stress in elderly care: psychometric assessments and associations2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 4, p. 318-328Article in journal (Refereed)
    Abstract [en]

    Aims To evaluate validity and reliability of three questionnaires measuring 'work satisfaction', 'patient care' and 'staff health' for staff in elderly care and to study the relationship between staff members' satisfaction with work and perceived stress.

    Background Increased workload, difficulties in recruiting and retaining nurses are reported in elderly care. Valid and reliable instruments measuring staffs' perceptions of work are needed.

    Methods A convenience sample of 299 staff answered the questionnaires.

    Results Factor analysis of 'work satisfaction' gave eight factors, 'patient care' four factors and 'staff health' two factors, explaining 52.2%, 56.4% and 56.8% of the variance. Internal consistency was mostly satisfactory. Multiple regression analysis revealed a model that explained 41% of the variance in perceived stress symptoms.

    Conclusions There was support for the instruments' validity and reliability. Older age, higher scores/satisfaction with workload, cooperation, expectations and demands, personal development and lower scores on internal motivation contributed to less stress.

  • 16. Enskär, Karin
    et al.
    Hamrin, Elisabeth
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care.
    Swedish mothers and fathers of children with cancer: perceptions of well-being, social life, and quality care2011In: Journal of psychosocial oncology, ISSN 0734-7332, E-ISSN 1540-7586, Vol. 29, no 1, p. 51-66Article in journal (Refereed)
    Abstract [en]

    The overall aim was to describe and compare well-being, social life, and quality care among parents of children with cancer with respect to mothers versus fathers and whether the children were on versus. off treatment. The Life Situation Scale for Parents (LSS-P) was answered by 320 parents, comprising 85 mothers and 71 fathers of children on treatment, and 93 mothers and 71 fathers of children off treatment. The results show that the well-being of parents of children with cancer is affected by their child's situation, and that they experience such things as economic strain and a sense of being dependent on the care provided, especially during the child's treatment phase. Mothers whose children are receiving treatment see their life situation as less satisfying, and report being sadder and having lower self-esteem.

  • 17.
    Funkquist, Eva-Lotta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Carlsson, Marianne
    Department of Public Health and Caring Sciences.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
    Consulting on feeding and sleeping problems in child health care: what is at the bottom of advice to parents?2005In: Journal of Child Health Care, Vol. 9, no 2, p. 137-152Article in journal (Refereed)
  • 18.
    Gardulf, Ann
    et al.
    Karolinska Univ Hosp, Karolinska Inst, Dept Lab Med, Div Clin Immunol,Unit Clin Nursing Res & Clin Res, SE-14186 Stockholm, Sweden.;Japanese Red Cross Inst Humanitarian Studies, Tokyo, Japan..
    Nilsson, Jan
    Japanese Red Cross Inst Humanitarian Studies, Tokyo, Japan.;Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden..
    Florin, Jan
    Dalama Univ, Sch Educ Hlth & Social Studies, Falun, Sweden..
    Leksell, Janeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical diabetology and metabolism. Dalama Univ, Sch Educ Hlth & Social Studies, Falun, Sweden..
    Lepp, Margret
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden.;Ostfold Univ Coll, Holden, Norway..
    Lindholm, Christina
    Sophiahemmet Univ, Stockholm, Sweden..
    Nordström, Gun
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden.;Hedmark Univ Coll, Hedmark, Norway..
    Theander, Kersti
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden.;Cty Council Varmland, Primary Care Res Unit, Karlstad, Sweden..
    Wilde-Larsson, Bodil
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden.;Hedmark Univ Coll, Hedmark, Norway..
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Johansson, Eva
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Dept Nursing, Stockholm, Sweden..
    The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, p. 165-171Article in journal (Refereed)
    Abstract [en]

    Background: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. Objectives: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. Methods and participants; The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1[20-56] years, 87.3% women) from 11 universities/university colleges participated. Results: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27 years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (932% vs 875% of NSPGs). Summary and conclusion: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

  • 19.
    Hakimnia, Roya
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Höglund, Anna T
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Gävle University.
    Holmström, Inger K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Doing gender in the context of telenursing:: Analyses of authentic calls to a telenursing site in Sweden2015In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 3, no 2, p. 24-30Article in journal (Refereed)
    Abstract [en]

    Introduction: Aim: The aim of the present study was to analyze authentic health calls to a telenursing site in Sweden regardingreasons for calling and outcome of the calls with focus on a gender perspective. Background: Telephone advice nursing isan expanding service in many Western countries. In Sweden, all regions are now connected to a national telenursing service.Healthcare in Sweden is stipulated by law to be equitable. This includes the teleursing service, which is a new actor in Swedishhealthcare system, and which often is a citizen’s first contact with healthcare.Methods: The study had a descriptive and comparative design. 800 authentic calls to SHD were analysed regarding reasons forcalling, and outcome of the calls.Results: The results showed that men, and especially fathers, received more referrals to general practitioners than women. Themost common caller was a woman fluent in Swedish (64%), and the least likely caller was a man non-fluent in Swedish (3%).All in all, 70% of the callers were women. When the calls concerned children, 78% of the callers were female. In total, 9% ofthe calls were made by a man calling for another person. Callers were predominately young (mean age 29 years for women and33 for men).Conclusions: It is important that telenursing does not become a “feminine” activity, only suitable for young callers fluent inSwedish. Given the telenurses’ gatekeeping role, there is a risk that differences on this first level of health care can be reproducedthroughout the whole healthcare system. In striving for more equitable telenursing services, future research might investigate ifcampaigns encouraging men to call, and more frequent use of translators could enhance access to telenursing services.

  • 20.
    Hakimnia, Roya
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Holmström, Inger K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Höglund, Anna T
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Exploring the communication between telenurse and caller: A critical discourse analysis2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 24255Article in journal (Refereed)
    Abstract [en]

    Background

    Telenursing is an expanding service in most Western societies. Sweden is a front-line country, with all of its 21 counties connected to Swedish Healthcare Direct (SHD) 1177. The intention of the service is twofold: to make health care more efficient, while also making it more accessible and safe for patients. Previous research has shown, however, that the service is not used equitably. Gender, age, socio-economic, and ethnicity differences have been reported as determining factors for the use of the service and the advice given.

    Aim

    The aim of the study was to explore the communication between telenurses and callers in authentic calls to SHD 1177.

    Methodology

    A qualitative method, using critical discourse analysis (CDA), was chosen. The approach was deductive, that is, the analysis was made in view of a predetermined framework of theory. Twenty calls were strategically chosen and included in the study.

    Results

    The CDA resulted in five types of calls, namely a gatekeeping call, a gendered call, a call marked by impersonal traits, a call with voices of the life world, and finally a counter discourse call. The dominating patterns in the calls were of gatekeeping and biomedical character. Patterns of the societal gender order were found, in that representations of the reluctant male caller and the ideal female caller were identified, but also a call representing a counter discourse. The service seemed difficult to use for patients with low language proficiency.

    Conclusion

    Telenursing could potentially challenge inequalities in health care. However, the discourse of telenursing is dialectically related to neoliberal ideology and the ideology of medicine. It is also situated in a gendered context of ideal femininity and hegemonic masculinity. Through better awareness of gender biases and the callers’ different resources for making themselves heard, the communication between telenurse and caller might become more equal and thereby better suitable for all callers.

  • 21.
    Hedlund, Mathilde
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Ronne-Engström, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    From monitoring physiological functions to using psychological strategies: Nurses' view of caring for the aneurysmal subarachnoid haemorrhage patient2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 3, p. 403-411Article in journal (Refereed)
    Abstract [en]

    AIMS: The aims of this study were: (1) to describe nurses' views of the physical and supportive needs of patients who have suffered a subarachnoid haemorrhage (SAH), (2) to describe nurses' views of changes in social circumstances and (3) changes in the mental condition of patients after SAH. BACKGROUND: As patients with SAH are generally younger and predominantly female compared with other stroke groups they may have different needs of nursing support to facilitate adaptation. Caring for persons surviving stroke involves advanced nursing skills such as monitoring neurological functions in neurointensive care and providing physical care during rehabilitation. DESIGN: Explorative descriptive design. METHOD: Semi-structured interviews were performed with 18 nurses in neurointensive and rehabilitation care. A qualitative latent content analysis was conducted. RESULTS: Nurses viewed patients' need for support as a process ranging from highly advanced technological care to 'softer' more emotional care. However, shortages in the communication between neurointesive and rehabilitation nurses regarding this support were acknowledged. Changes in social circumstances and mental conditions were viewed both as obstacles and advantages regarding return to everyday life. Nurses also viewed that the characteristics of the group with SAH was not particularly different from the group with other types of stroke. CONCLUSIONS: Support to patients with SAH is viewed as a process carried out by nurses at neurointensive care units and rehabilitation units. Shortages in communication, regarding this support, were acknowledged. Obstacles and advantages with respect to returning to everyday life could apply to any stroke group, which could make it more difficult for nurses to detect the specific needs of patients with SAH. RELEVANCE TO CLINICAL PRACTICE: The communication between neurointensive nurses and rehabilitation nurses regarding support to patients with SAH is not satisfactory. Occasionally the specific needs of patients with SAH are not recognized.

  • 22.
    Hedlund, Mathilde
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Department of Neuroscience. Psykiatri.
    Stålenheim, Gunilla
    Department of Neuroscience. Psykiatri.
    Ekselius, Lisa
    Department of Neuroscience. Psykiatri.
    Carlsson, Marianne
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Diagnostic agreement between a doctor and a nurse for psychiatric disorders: A pilot study2005In: Nord J Psychiatry, Vol. 59, p. 339-342Article in journal (Refereed)
    Abstract [en]

    The aim with the present paper is to illustrate the use of multivariate strategies (i.e. integration of different multivariate methods) with five examples, four from the pharmaceutical industry and one from environmental research.

    In the first part, two examples wherein hierarchical models are applied to quality control (QC) and process control are discussed. In the second part a more complex problem and a strategy for material discovery/development are presented wherein a combination of multivariate calibration, multivariate analysis and multivariate design is needed. In the third part, a process analytical/optimization problem is illustrated with a two-step process, demanding that different multivariate tools are combined in a sequential way so that a useful model can be established and the process can be understood. In the final part the usefulness of principal component analysis followed by soft independent modelling of class analogy is illustrated with an example from environmental process monitoring. The five examples from quite different areas show that the chemometric tools are even more powerful if used integrated. However, different strategies and combinations of the tools have to be applied, depending on the problem and the aim.

  • 23.
    Hedlund, Mathilde
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Zetterling, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Ronne-Engström, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Depression and posttraumatic stress disorder after aneurysmal subarachnoid hemorrhage in relation to lifetime psychiatric morbidity2011In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 25, no 6, p. 693-700Article in journal (Refereed)
    Abstract [en]

    Introduction. Little is known about the roles that lifetime psychiatric disorders play in psychiatric and vocational outcomes of aneurysmal subarachnoid haemorrhage (SAH). Materials and methods. Eighty-three SAH patients without apparent cognitive dysfunction were assessed using the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I) after their SAH. Diagnoses were assessed for three time periods, 'lifetime before SAH', '12 months before SAH' and '7 months after SAH'. Results. Forty-five percentage of patients with SAH reported at least one lifetime psychiatric disorder. After SAH, symptoms of depression and/or post-traumatic stress disorder (PTSD) were seen in 41%, more often in those with a psychiatric history prior to SAH (p = 0.001). In logistic regressions, depression after SAH was associated with a lifetime history of major depression, or of anxiety or substance use disorder, as well as with lifetime psychiatric comorbidity. Subsyndromal or full PTSD was predicted by a lifetime history of major depression. After the SAH, 18 patients (22%) had received psychotropic medication and/or psychological treatment, 13 of whom had a disorder. Those with a lifetime history of major depression or treatment with antidepressants before SAH had lower return to work rates than others (p = 0.019 and p = 0.031, respectively). This was also true for those with symptoms of depression and/or PTSD, or with antidepressant treatment after SAH (p = 0.001 and p = 0.031, respectively). Conclusions. Depression and PTSD are present in a substantial proportion of patients 7 months after SAH. Those with a history of psychiatric morbidity, any time before the SAH, are more at risk and also constitute a risk group for difficulties in returning to work.

  • 24.
    Hedström, Mariann
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap..
    Ekman, Anna
    Uppsala Univ Hosp, Dept Medicat & Patient Safety, Uppsala, Sweden.
    Gillespie, Ulrika
    Department of medication and patient safety, Uppsala University Hospital, Uppsala.
    Mörk, Christina
    Uppsala Cty Council, Pharmaceut Comm, Uppsala.
    Åsberg, Kerstin Hulter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Development of the PHASE-Proxy scale for rating drug-related signs and symptoms in severe cognitive impairment2018In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, no 1, p. 53-60Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The need for assessment of possible drug-related signs and symptoms in older people with severe cognitive impairment has increased. In 2009, the PHASE-20 rating scale for identifying symptoms possibly related to medication was the first such scale to be found valid and reliable for use with elderly people. In this project, the aim was to develop and examine the psychometric properties and clinical utility of PHASE-Proxy, a similar scale for proxy use in assessing elderly people with cognitive impairment.

    METHODS: Three expert groups revised PHASE-20 into a preliminary proxy version, which was then tested for inter-rater reliability, internal consistency, and content validity. Its clinical usefulness was investigated by pharmacist-led medication reviews. Group interviews and a study-specific questionnaire with nursing home staff were used to investigate the feasibility of use.

    RESULTS: The PHASE-Proxy scale had satisfactory levels of inter-rater reliability (Spearman's rank correlation coefficient; rs = 0.8), and acceptable internal consistency (Cronbach's alpha coefficient; α = 0.73). The factor analysis resulted in a logical solution with seven factors, grouped into two dimensions: signs of emotional distress and signs of physical discomfort. The medication reviews, interviews, and questionnaires also found the proxy scale to be clinically useful, and feasible to use.

    CONCLUSION: The PHASE-Proxy scale appears to be a valid instrument that enables proxies to reliably assess nursing home residents who cannot participate in the assessment, to identify possible drug-related signs and symptoms. It also appears to be clinically useful and feasible for use in this population.

  • 25.
    Höglund, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Lännerström, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Kaminsky, Elenor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    From denial to awareness: a conceptual model for obtaining equity in healthcare2018In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, no 9Article in journal (Refereed)
  • 26.
    Höglund, Anna T.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Högskolan i Gävle.
    Holmström, Inger K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Mälardalens högskola.
    Kaminsky, Elenor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalens högskola.
    Impact of telephone nursing education program for equity in health2016In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, no 1, article id 152Article in journal (Refereed)
    Abstract [en]

    Background:The Swedish Healthcare Act prescribes that healthcare should be provided according to needs andwith respect for each person’s human dignity. The goal is equity in health for the whole population. In spite of this,studies have revealed that Swedish healthcare is not always provided equally. This has also been observed intelephone nursing.Therefore, the aim of the present study was to investigate if and how an educational intervention can improveawareness of equity in healthcare among telephone nurses.Methods:The study had a quasi-experimental design, with one intervention group and one control group. Abase-line measurement was performed before an educational intervention and a follow-up measurement wasmade afterwards in both groups, using a study specific questionnaire in which fictive persons of different age,gender and ethnicity were assessed concerning, e.g., power over one’s own life, quality of life and experience ofdiscrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, coveringaspects of inequality in healthcare related to gender, ageand ethnicity, and gender and intersectionality theoriesas explaining models for these conditions.Results:The results showed few significant differences before and after the intervention in the intervention group.Also in the control group few significant differences were found in the second measurement, although no interventionwas performed in that group. The reason might be that the instrument used was not sensitive enough to pick up anexpected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create asort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higherGood life-index than the fictive persons born outside Europe and of higher age in all assessments.Conclusion:The results are an imperative that equity in healthcare still needs to be educated and discussed indifferent healthcare settings. The intervention and questionnaire were designed to fit telephone nurses, but couldeasily be adjusted to suit other professional groups, who need to increase their awareness of equity in healthcare.

  • 27.
    Ivarsson, Ann-Britt
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sidenvall, Birgitta
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Performance of Occupations in Daily Life Among Individuals with Severe Mental Disorders2004In: Occupational Therapy in Mental Health, Vol. 20, no 2, p. 33-Article in journal (Refereed)
  • 28. Ivarsson, Ann-Britt
    et al.
    Sidenvall, Birgitta
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    The factor structure of the Burden Assessment Scale and the perceived burden of caregivers for individuals with severe mental disorders.2004In: Scand J Caring Sci, ISSN 0283-9318, Vol. 18, no 4, p. 396-401Article in journal (Refereed)
  • 29.
    Kaminsky, Elenor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. University of Gävle, Department of Health and Caring Sciences.
    Holmström Knutsson, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Mälardalens högskola, School of Health, Care and Social Welfare.
    Larsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Fredriksson, Mio
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Goals of telephone nursing work - the managers' perspectives: a qualitative study on Swedish healthcare direct2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, p. 188-Article in journal (Refereed)
    Abstract [en]

    Background

    Swedish Healthcare Direct (SHD) receives 6 million calls yearly and aims at increased public sense of security and healthcare efficiency. Little is known about what SHD managers perceive as the primary goals of telephone nursing (TN) work and how the organisation matches goals of health promotion and equitable healthcare, so important in Swedish healthcare legislation. The aim of the study was to explore and describe what the SHD managers perceive as the goals of TN work and how the managers view health promotion and implementation of equitable healthcare with gender as example at SHD.

    Methods

    The study was qualitative using an exploratory and descriptive design. All 23 managers employed at SHD were interviewed and data analysis used deductive directed content analysis.

    Results

    The findings reveal four themes describing the goals of TN work as recommended by the SHD managers. These are: ‘create feelings of trust’, ‘achieve patient safety’, ‘assess, refer and give advice’, and ‘teach the caller’. Most of the managers stated that health promotion should not be included in the goals, whereas equitable healthcare was viewed as an important issue. Varying suggestions for implementing equitable healthcare were given.

    Conclusions

    The interviewed managers mainly echoed the organisational goals of TN work. The managers’ expressed goal of teaching lacked the caller learning components highlighted by telenurses in previous research. The fact that health promotion was not seen as important indicates a need for SHD to clarify its goals as the organisation is part of the Swedish healthcare system, where health promotion should always permeate work. Time used for health promotion and dialogues in a gender equitable manner at SHD is well invested as it will save time elsewhere in the health care system, thereby facing one of the challenges of European health systems.

  • 30.
    Kaminsky, Elenor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Paediatric health calls to Swedish telenurses: a descriptive study of content and outcome2010In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 16, no 8, p. 454-457Article in journal (Refereed)
    Abstract [en]

    We collected data about telephone triage calls concerning children in Sweden. A sample of 110 paediatric calls were recorded. The transcribed data were analysed regarding word count, reasons for calling, results of calls, ages and gender of children, and gender of parents. The median call length was 4.4 min and the median child's age was 3.5 years. Mothers made 73% of calls, but mothers and fathers called to the same extent about daughters and sons, and regardless of age. The most common reasons for calls were ear problems, rash/wound or fever. In nearly half the calls, the telenurses provided self-care advice. Call length, word count or caller's part of word count did not differ according to gender of parents or children. However, mothers were more likely to receive self-care advice while fathers were more often referred to other health services by the telenurses. Telenurses might need to improve their gender competence, and more male telenurses in the service would potentially be beneficial to callers.

  • 31.
    Kaminsky, Elenor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Röing, Marta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    "If I didn't trust Swedish Healthcare Direct, I would never call" - views of making pediatric health calls2013In: Clinical Nursing Studies, ISSN 2324-7959, Vol. 1, no 3, p. 57-69Article in journal (Refereed)
    Abstract [en]

    The focus of the presented research is parents' expectations and experiences of calling Swedish Healthcare Direct (SHD)regarding pediatric health issues. Telenursing is a rapidly expanding service and SHD handles up to 2.4 million pediatrichealth calls yearly. Mothers make the majority of the calls and reportedly receive self-care advice more than fathers.Parents' views are important for the development and safe use of telenursing health services. The study is qualitative, withan exploratory and descriptive design. Twenty-one interviews with parents were analysed using content analysis.According to the interviewees, the decision to contact SHD or not is influenced by their degree of worry or trust in the service. Calls are carefully prepared, and who will call is often predetermined and affected by gender. Parents want to be given a chance to speak first in their communication with telenurses. They want to be listened to carefully and to be accorded respect, to have their needs fully explored and to have their concerns relieved. Most parents follow telenurses'recommendations, a few exclusively. Some primarily trust their own intuition. Learning is frequent, implying the publichealth potential of calls, not least for foreign-born callers. Exploring parents' expectations provides insight into parents'worries, potential to increase parents' learning and may develop their trust in telenurses' recommendations. Telenurses'awareness of gender impact can further develop the telenursing health service in providing safe care on equal terms for avulnerable patient group, children.

  • 32.
    Kristofferzon, Marja-Leena
    et al.
    Department of Caring Science and Sociology, University of Gavle,.
    Löfmark, Rurik
    Carlsson, Marianne
    Department of Caring Science and Sociology, University of Gavle.
    Coping, social support and quality of life over time after myocardial infarction2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 52, no 2, p. 113-124Article in journal (Refereed)
    Abstract [en]

    Aim

     This paper describes gender differences in perceived coping, social support and quality of life 1, 4 and 12 months after myocardial infarction.

    Background

     There is a shortage of studies with a longitudinal research design investigating coping, social support and quality of life in women and men after myocardial infarction.

    Methods

     A longitudinal, descriptive and comparative design was used for the study, which included 74 women and 97 men. At 12 months, 60 women and 88 men remained. Data were collected using the Jalowiec Coping Scale, a social support questionnaire, the SF-36 Health Survey (health-related quality of life) and the Quality of Life Index-Cardiac version (quality of life). The data were collected during the period 1999–2001.

    Results

     No statistically significant changes over time in coping assessments emerged in the study group, except for fatalistic coping, which diminished over time in men. Women used more evasive coping than men at 4 and 12 months. The perceived efficiency in coping with physical aspects of the heart disease increased. More women than men perceived available support from grandchildren and staff of the church. Health-related quality of life increased in women and men in physical functioning, role-physical, vitality, social functioning, and role-emotional scales. Moreover, an improvement in the mental health scale was evident in women and a reduction in pain in men. No statistically significant gender differences were found for quality of life at any point in time.

    Conclusions

     The findings can be used to inform caregivers that optimistic, self-reliant and confrontational coping were the most frequently used by both women and men over the first year after myocardial infarction, and that confrontational coping has been shown to have positive outcomes in the longer term. Nurses should tell women about the importance of seeking prompt treatment and discuss health problems with caregivers and significant others. Care planning should include family members and significant others so that they can support and encourage patients to cope with problems in daily life.

  • 33.
    Kristofferzon, Marja-Leena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Löfmark, Rurik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Managing consequences and finding hope: experiences of Swedish women and men 4-6 months after myocardial infarction2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 367-375Article in journal (Refereed)
    Abstract [en]

    Research has focused more on symptoms, risk factors and treatment, than on individuals' experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4-6 months after MI and their expectations for the future. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, 'Managing consequences of MI' and 'Finding a meaning in what had happened', were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients' needs of support both in a short- and long-term perspective.

  • 34.
    Kristofferzon, Marja-Leena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Löfmark, Rurik
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Perceived coping, social support, and quality of life 1 month after myocardial infarction: a comparison between Swedish women and men2005In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 34, no 1, p. 39-50Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The study objective was to compare coping, social support, and quality of life in Swedish women and men 1 month after myocardial infarction.

    DESIGN:

    The study design was cross-sectional and descriptive-comparative.

    SETTING:

    The study took place in 1 hospital service area in the middle of Sweden.

    SUBJECTS:

    The sample consisted of 74 women and 97 men.

    INSTRUMENTS:

    The Jalowiec Coping Scale, the Social Network and Social Support Questionnaire, the Short Form-36 Health Survey, and the Quality of Life Index-Cardiac Version were used.

    RESULTS:

    Compared with men, women used more evasive and supportive coping and rated psychologic aspects of the heart disease as more problematic to manage. More women perceived available support from friends and grandchildren, and more men perceived available support from their partner. Women rated lower levels in physical and psychologic dimensions of quality of life.

    CONCLUSION:

    The first month after myocardial infarction is a susceptible period especially for women. They used more evasive and supportive coping and experienced a lower quality of life compared with men.

  • 35.
    Kristofferzon, Marja-Leena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Löfmark, Rurik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Striving for balance in daily life: Experiences of Swedish women and men shortly after a myocardial infarction2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 2, p. 391-401Article in journal (Refereed)
    Abstract [en]

    The aim is to describe experiences of daily life of women and men during the first four to six months after a myocardial infarction. The focus is on problems, managing problems and support from their network. Background.  A cardiac event is traumatic and may influence well-being during a significant period of time. Few qualitative studies have investigated experiences of both women and men after a myocardial infarction and remarkably little research has been conducted on men's experiences. Design.  The study design was descriptive, retrospective and qualitative. Methods.  Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed using qualitative content analysis. Results.  Three themes were generated from the analysis: `Threatening ordinary life', `Struggling for control' and `The ambiguous network'. Physical symptoms and emotional distress were the most commonly described problems during the first months after a myocardial infarction. The informants manage the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviours and taking their own decisions and actions. The network was generally supportive but rather often the informants also experienced communication problems when they interacted with their network. Conclusions.  Women and men strive for balance between problems and resources in daily life after a myocardial infarction. How well they succeeded depends on how secure they feel how well they communicate their needs to their network and how sensitive their network is to their spoken and unspoken needs. Relevance to clinical practice.  The findings provide an insight into what kind of problems women and men may experience after myocardial infarction and how caregivers can aid them to increase security in their daily life. Some risk characteristics that may have increased their problems in daily life are suggested, for women and men respectively.

  • 36.
    Leppänen, Olli
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
    Rutanen, Juha
    Hiltunen, Mikko O
    Rissanen, Tuomas T
    Turunen, Mikko P
    Sjöblom, Tobias
    Brüggen, Josef
    Bäckström, Gudrun
    Carlsson, Marianne
    Buchdunger, Elisabeth
    Bergqvist, David
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
    Alitalo, Kari
    Heldin, Carl-Henrik
    Ostman, Arne
    Ylä-Herttuala, Seppo
    Oral imatinib mesylate (STI571/gleevec) improves the efficacy of local intravascular vascular endothelial growth factor-C gene transfer in reducing neointimal growth in hypercholesterolemic rabbits.2004In: Circulation, ISSN 1524-4539, Vol. 109, no 9, p. 1140-6Article in journal (Refereed)
  • 37.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Högman, Marieann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Suffering from meticillin-resistant Staphylococcus aureus: experiences and understandings of colonisation2009In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 73, no 3, p. 271-277Article in journal (Refereed)
    Abstract [en]

    The objective was to explore individuals' experiences and understandings of meticillin-resistant Staphylococcus aureus (MRSA) colonisation. Thirteen interviews were performed and processed using content analysis, resulting in the theme 'Invaded, insecure and alone'. The participants experienced fears and limitations in everyday life and expressed a need to protect others from contagion. Moreover, they experienced encounters with, and information from, healthcare workers differently: some were content, whereas others were discontent. The described fears, limitations and inadequate professional-patient relationship generated unacceptable distress for MRSA-colonised persons. Thus, the healthcare sector should assume responsibility for managing MRSA, and healthcare workers must improve their professionalism and information skills, so as to better meet MRSA-colonised persons' needs.

  • 38.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    MRSA-colonized persons' and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden2014In: Journal of infection and public health, ISSN 1876-035X, Vol. 7, no 5, p. 427-435Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Patient-professional interactions and adherence to infection control measures are central to the quality of care and patient safety in healthcare. Persons colonized with methicillin-resistant Staphylococcus aureus (MRSA) describe insufficient support and unprofessional behavior among healthcare personnel.

    METHODS:

    A descriptive qualitative study was conducted to investigate managers', physicians', registered nurses' and MRSA-colonized persons' experiences of patient-professional interactions in relation to and responsibilities for infection prevention in the care of colonized patients. Five persons with MRSA colonization and 20 healthcare personnel employed within infection, hematology, nephrology or primary healthcare settings participated. The data were collected using open-ended semi-structured individual interviews with the MRSA-colonized persons and semi-structured focus group interviews with the healthcare personnel.

    RESULTS:

    The participants perceived MRSA as an indefinable threat and described that the responsibility for infection prevention is important, but such adherence was a neglected and negotiable issue. The described actions that were acknowledged as unprofessional and inappropriate adherence to infection prevention resulted in stigmatized patients.

    CONCLUSION:

    Colonized persons' and healthcare personnel's understanding of MRSA determines whether the personnel's behavior is perceived as proper or improper. Individual responsibility for patient-professional interactions in relation to MRSA colonization and adherence to infection control measures should be more stringent.

  • 39.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Performance and acting in care relations: experiences of MRSA-colonized persons and healthcare personnel2012Article in journal (Other academic)
  • 40.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Högman, Marieann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    The Multidrug-Resistant Bacteria Attitude Questionnaire: validity and understanding of responsibility for infection control in Swedish registered district, haematology and infection nurses2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 3-4, p. 424-436Article in journal (Refereed)
    Abstract [en]

    Aim. To assess the discriminative and construct validity of the Multidrug-Resistant Bacteria Attitude Questionnaire and to study registered nurses knowledge of, behaviour toward and emotional responses to patients with multidrug-resistant bacteria in relation to how they understand their own, managers and politicians responsibility for adherence to preventive measures for infection control.

    Background. Multidrug-resistant organisms are a global problem and an essential topic in healthcare regarding patient safety improvement.

    Design. Descriptive and correlational cross-sectional survey.

    Method. Data were collected in a non-random sample consisting of 397 registered nurses; district, haematology or infection registered nurses. One-way analysis of variance and independent t-tests were used for comparisons and a principal component analysis was performed.

    Results. Discriminative and construct validity were supported, as the infection registered nurses generally had higher scores on knowledge, behaviour and emotional response, compared with district registered nurses and haematology registered nurses and the three-factor solution was confirmed. Registered nurses with higher scores on knowledge and emotional response attributed greater responsibility to themselves and to politicians. The Multidrug-Resistant Bacteria Attitude Questionnaire was translated using a forward-back translation process.

    Conclusion. The questionnaire has adequate psychometric properties. Insufficient knowledge of, behaviour toward and emotional response to patients with multidrug-resistant bacteria were described, but the registered nurses did estimate their own responsibility for adherence to preventive measures for infection control as being great or very great.

    Relevance to clinical practice. There is a considerable need to improve knowledge, behaviour and emotional response regarding infection prevention measures among healthcare workers. The hospital management are responsible for such improvements and the Multidrug-Resistant Bacteria Attitude Questionnaire is useful in identifying such needs, as it has adequate psychometric properties and is able to discriminate between groups. Evaluation among healthcare workers may indicate where to situate additional training, as this is of clinical significance for safe care.

  • 41.
    Lindstedt, Helena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Habilitation and Disability.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ivarsson, Ann-Britt
    Hälsoakademin, Örebro universitet.
    Individual Goal Attainment Scaling (GAS) and structured long-term follow-up: first measurement (poster)2010Other (Other academic)
  • 42.
    Muntlin Athlin, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    To Receive or Not to Receive Analgesics in the Emergency Department: The Importance of the Pain Intensity Assessment and Initial Nursing Assessment2015In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 16, no 5, p. 743-750Article in journal (Refereed)
    Abstract [en]

    Patients seeking emergency care for abdominal pain still experience poor pain management. Pain intensity is not always seen as a mandatory parameter in the initial nurse assessment. Despite the development of nurse-initiated analgesic protocols, many patients do not receive analgesics in the emergency department. The aim of this study was to describe initial nursing assessment related to pain management and to identify predictors for receiving or not receiving analgesics in the emergency department. The sample consists of 100 patients from an intervention group in a previously undertaken Swedish intervention study. The main findings were that the registered nurses assessed 62 patients as being in need of analgesics, and that 52 of these obtained analgesics. The majority of the patients assessed as not being in need of analgesics did not receive analgesics because they did not want medication. Median value for pain intensity at initial assessment was 6 on the numerical rating scale. The results for the logistic regression (n = 80) showed significant differences between receiving analgesics/not receiving analgesics and the predictor pain intensity (measured at initial nurse assessment). Nurses in emergency departments play a crucial role, in that their initial assessment is of specific importance for the patient's further care and whether the patient may or may not receive analgesics. However, more attention has to be paid to patients' experiences and their expectations regarding the pain management in the emergency department. These complex questions have to be studied further in a more systematic way.

  • 43.
    Muntlin, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Säfwenberg, Urban
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Outcomes of a nurse-initiated intravenous analgesic protocol for abdominal pain in an emergency department: a quasi-experimental study2011In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 48, no 1, p. 13-23Article in journal (Refereed)
    Abstract [en]

    Background: Abdominal pain is one of the most frequent reasons for seeking care in an emergency department. Surveys have shown that patients are not satisfied with the pain management they receive. Reasons for giving inadequate pain management may include poor knowledge about pain assessment, myths concerning pain, lack of communication between the patient and healthcare professional, and organizational limitations.

    Objectives: The aim of the study was to investigate the outcome of nursing assessment, pain assessment and nurse-initiated intravenous opioid analgesic compared to standard procedure for patients seeking emergency care for abdominal pain. Outcome measures were: a) pain intensity, b) frequency of received analgesic, c) time to analgesic, d) transit time, and e) patients’ perceptions of the quality of care in pain management.

    Design: A quasi-experimental design with ABA phases was used.

    Setting: The study was conducted in an emergency department at a Swedish university hospital.

    Participants: Patients with abdominal pain seeking care in the emergency department were invited to participate. A total of 50, 100 and 50 patients, respectively, were included for the three phases of the study. The inclusion criteria were: ongoing abdominal pain not lasting for more than 2 days, ≥18 years of age and oriented to person, place and time. Exclusion criteria were: abdominal pain due to trauma, in need of immediate care and pain intensity scored as 9-10.

    Methods: The patients’ perceptions of the quality of care in pain management in the emergency department were evaluated by means of a patient questionnaire carried out in the three study phases. The intervention phase included education, nursing assessment protocol and a range order for analgesic.

    Results: The nursing assessment and the nurse-initiated intravenous opioid analgesic resulted in significant improvement in frequency of receiving analgesic and a reduction in time to analgesic. Patients perceived lower pain intensity and improved quality of care in pain management.

    Conclusions: The intervention improved the pain management in the emergency department. A structured nursing assessment could also affect the patients’ perceptions of the quality of care in pain management in the emergency department.

  • 44.
    Mårtensson, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Carlsson, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lampic, Claudia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Do nurses and cancer patients agree on cancer patients' coping resources, emotional distress and quality of life?2008In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 17, no 4, p. 350-360Article in journal (Refereed)
    Abstract [en]

    The present study examines differences, associations and agreement in cancer patients' and their nurses' ratings of cancer patients' coping resources, emotional distress and quality of life. The study sample includes 90 individual patient-nurse pairs. The patient and nurse in each pair independently completed the Cancer Behaviour Inventory, the Hospital Anxiety and Depression Scale and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being. The results indicate a distinct pattern in which nurses overestimate patients' emotional distress and underestimate patients' coping resources and quality of life. A nurse who overestimated a patient's emotional distress and underestimated his/her resources for handling the situation was also likely to underestimate the patient's quality of life. Patient-nurse pairs who demonstrated consistent agreement differed from remaining pairs in that they had a larger percentage of nurses with advanced education and previous responsibility for their patients' care and in that they had higher frequencies of patients who had previously received care at the ward > , 5 days. Nurses caring for patients with cancer should be aware of the risk of making systematic misjudgements of patients' status. Increased attention to patients' internal resources may improve nurses' ability to make correct assessments and plan for individualized care.

  • 45.
    Nilsson, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Dept Hlth & Caring Sci, Gavle, Sweden.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation. Univ Gavle, Dept Hlth & Caring Sci, Gavle, Sweden.
    Lindqvist, Ragny
    Univ Gavle, Dept Hlth & Caring Sci, Gavle, Sweden..
    Kristofferzon, Marja-Leena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Dept Hlth & Caring Sci, Gavle, Sweden.
    A comparative correlational study of coping strategies and quality of life in patients with chronic heart failure and the general Swedish population2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 3, p. 157-167Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to compare coping strategies and quality of life (QoL) in patients with chronic heart failure (CHF) with such strategies and QOL in persons from two general Swedish populations and to investigate relationships between personal characteristics and coping strategies. Design: A cross-sectional, comparative and correlational design was used to examine data from three sources. Methods: The patient group (n=124), defined using ICD-10, was selected consecutively from two hospitals in central Sweden. The population group (n=515) consisted of persons drawn randomly from the Swedish population. Data were collected with questionnaires in 2011; regarding QoL, Swedish population reference data from 1994 were used. Results: Overall, women used more coping strategies than men did. Compared with the general population data from SF-36, patients with CHF rated lower QoL. In the regression models, perceived low efficiency in managing psychological aspects of daily life increased use of coping. Other personal characteristics related to increased use of coping strategies were higher education, lower age and unsatisfactory economic situation.

  • 46. Nilsson, Jan
    et al.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Florin, Jan
    Gardulf, Ann
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    A short version of the nurse professional competence scale for measuring nurses' self-reported competence.2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 71, p. 233-239Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Nurse Professional Competence (NPC) Scale with 88-items has been used to measure self-reported competence among nursing students and registered nurses in many national and international nursing research projects. However, a shorter version of the scale with maintained quality has been requested to further enhance its usability.

    OBJECTIVES: To develop and evaluate the construct validity and internal consistency of a shorter version of the NPC Scale.

    DESIGN: A developmental and methodological design.

    PARTICIPANTS AND SETTINGS: The study was based on a sample of 1810 nursing students at the point of graduation from 12 universities in Sweden.

    METHODS: The number of items in the original NPC Scale was reduced using several established research steps and then evaluated for data quality and construct validity using principal component analysis and confirmatory factor analysis. Reliability was measured as internal consistency using Cronbach's alpha.

    RESULTS: The extensive process of reducing the number of items resulted in a version with 35 items. Principal component analysis resulted in six factors explaining 53.6% of the variance: "Nursing Care", "Value-based Nursing Care", "Medical and Technical Care", "Care Pedagogics", "Documentation and Administration of Nursing Care", and "Development, Leadership, and Organization of Nursing Care". All factors showed Cronbach's alpha values of >0.70. The confirmative factor analysis goodness-of-fit indexes were for root mean square error of approximation 0.05 and for comparative fit index 0.89.

    CONCLUSIONS: The NPC Scale Short Form (NPC Scale-SF) 35-items revealed promising results with a six-factor structure explaining 53.6% of the total variance. This 35-item scale can be an asset when used alone and together with other instruments it can provide the possibility of more complex analyses of self-reported competence among nursing students and registered nurses.

  • 47.
    Nilsson, Jan
    et al.
    Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, SE-65188 Karlstad, Sweden.;Japanese Red Cross Inst Humanitarian Studies, Tokyo, Japan..
    Johansson, Eva
    Karolinska Inst, Div Nursing, Dept Neurobiol Care Sci & Soc, SE-14183 Huddinge, Sweden..
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, SE-80176 Gavle, Sweden..
    Florin, Jan
    Dalarna Univ, Sch Educ Hlth & Social Studies, SE-79131 Falun, Sweden..
    Leksell, Janeth
    Dalarna Univ, Sch Educ Hlth & Social Studies, SE-79131 Falun, Sweden..
    Lepp, Margret
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, SE-40530 Gothenburg, Sweden.;Ostfold Univ Coll, Halden, Norway..
    Lindholm, Christina
    Sophiahemmet Univ, SE-11486 Stockholm, Sweden..
    Nordstrom, Gun
    Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, SE-65188 Karlstad, Sweden.;Hedmark Univ Coll, Fac Publ Hlth, Dept Nursing & Mental Hlth, Elverum, Norway..
    Theander, Kersti
    Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, SE-65188 Karlstad, Sweden..
    Wilde-Larsson, Bodil
    Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, SE-65188 Karlstad, Sweden.;Hedmark Univ Coll, Fac Publ Hlth, Dept Nursing & Mental Hlth, Elverum, Norway..
    Gardulf, Ann
    Japanese Red Cross Inst Humanitarian Studies, Tokyo, Japan.;Karolinska Univ Hosp, Karolinska Inst, Unit Clin Nursing Res & Clin Res Immunotherapy, Div Clin Immunol,Dept Lab Med, SE-17177 Stockholm, Sweden..
    Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters2016In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 17, p. 102-108Article in journal (Refereed)
    Abstract [en]

    The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events.

  • 48. Nilsson, Jan
    et al.
    Johansson, Eva
    Egmar, Ann-Charlotte
    Florin, Jan
    Leksell, Janeth
    Lepp, Margret
    Lindholm, Christina
    Nordstrom, Gun
    Theander, Kersti
    Wilde-Larsson, Bodil
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Gardulf, Ann
    Development and validation of a new tool measuring nurses self-reported professional competence-The nurse professional competence (NPC) Scale2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 574-580Article in journal (Refereed)
    Abstract [en]

    Objectives: To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. Design: A methodological study including construction of a new scale and evaluation of its psychometric properties. Participants and settings: 1086 newly graduated nurse students from 11 universities/university colleges. Results: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: "Nursing care", "Value-based nursing care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership in and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition, evidence of known-group validity for the NPC Scale was obtained. Conclusions: The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses.

  • 49.
    Rudberg, Lennart
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nilsson, Sten
    Wikblad, Karin
    Department of Medical Sciences.
    Carlsson, Marianne
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Testicular cancer and testicular self-examination: knowledge and attitudes of adolescent Swedish men.2005In: Cancer Nurs, ISSN 0162-220X, Vol. 28, no 4, p. 256-62Article in journal (Refereed)
  • 50.
    Röndahl, Gerd
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Innala, Sune
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Heterosexual assumptions in verbal and non-verbal communication in nursing2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 4, p. 373-381Article in journal (Refereed)
    Abstract [en]

    Aim: This paper reports a study of what lesbian women and gay men had to say, as patients and as partners, about their experiences of nursing in hospital care, and what they regarded as important to communicate about homosexuality and nursing.

    Background: The social life of heterosexual cultures is based on the assumption that all people are heterosexual, thereby making homosexuality socially invisible. Nurses may assume that all patients and significant others are heterosexual, and these heteronormative assumptions may lead to poor communication that affects nursing quality by leading nurses to ask the wrong questions and make incorrect judgements.

    Method: A qualitative interview study was carried out in the spring of 2004. Seventeen women and 10 men ranging in age from 23 to 65 years from different parts of Sweden participated. They described 46 experiences as patients and 31 as partners.

    Findings: Heteronormativity was communicated in waiting rooms, in patient documents and when registering for admission, and nursing staff sometimes showed perplexity when an informant deviated from this heteronormative assumption. Informants had often met nursing staff who showed fear of behaving incorrectly, which could lead to a sense of insecurity, thereby impeding further communication. As partners of gay patients, informants felt that they had to deal with heterosexual assumptions more than they did when they were patients, and the consequences were feelings of not being accepted as a 'true' relative, of exclusion and neglect. Almost all participants offered recommendations about how nursing staff could facilitate communication.

    Conclusions: Heterosexual norms communicated unconsciously by nursing staff contribute to ambivalent attitudes and feelings of insecurity that prevent communication and easily lead to misconceptions. Educational and management interventions, as well as increased communication, could make gay people more visible and thereby encourage openness and awareness by hospital staff of the norms that they communicate through their language and behaviour.

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