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  • 101. Dahlkvist, Eva
    et al.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skovdahl, Kirsti
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Is There a Caring Perspective in Garden/Patio Design in Elderly Care?: A Description and a Comparison of Residents’ and Staff Members’ Perceptions of These Outdoor Spaces2014In: Journal of Housing for the Elderly, ISSN 0276-3893, E-ISSN 1540-353X, Vol. 28, no 1, p. 85-106Article in journal (Refereed)
    Abstract [en]

    This article aims to describe the characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of outdoor spaces. The aim was also to investigate factors related to residents' satisfaction with and stays in the garden/patio. The result showed that many gardens/patios had several recommended design elements and, at the same time, obvious deficiencies. The residents (n = 415) valued various aspects of the garden/patio more highly than did the staff (n = 667). Managers responsible for residential living homes for elderly people should take measures to ameliorate deficiencies and deficient elements in design and accessibility that are lacking so that the garden/patio can be used as an important health promotion resource in the care of elderly people. Residents and staff are important actors in such development work.

  • 102.
    Dahlström, Malin
    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, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Adolfson, Therése
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Patienters definitioner och upplevelser av bemötandet på Mag-tarmmottagningen i Enköping: En kvalitativ studie2009Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Studiens syfte var att undersöka hur patienterna på Mag-tarmmottagningen i Enköping definierade bemötande, hur de upplevde att de blivit bemötta av vårdpersonalen och vilka faktorer som var betydande för hur bemötandet upplevdes. Studien har en explorativ design med en kvalitativ ansats. Semistrukturerade kvalitativa intervjuer hölls med nio patienter. Datainsamlingen pågick under tre veckors tid och intervjuerna med deltagarna genomfördes dels på plats på mottagningen och dels via telefon. Resultatet visade att deltagarna definierade ett gott bemötande som att vårdpersonalen var lyhörda, hade en social kompetens samt att personalen visade att de hade tid för dem och att de kunde hjälpa dem snabbt och effektivt. Samtliga studiedeltagare uppgav att de upplevde att de fått ett positivt bemötande av vårdpersonalen. Flera faktorer spelade en roll i hur de upplevde bemötandet, såsom: individanpassad vård, information, kontinuitet, kunskap, social kompetens, stress och trygghet. Slutsats: Studiedeltagarna är tillfredställda med det bemötande de fått av personalen på mag-tarmmottagningen och faktorer som haft betydelse för detta bemötande var individanpassad vård, information, kontinuitet, kunskap, social kompetens, stress och trygghet. Bemötande är ett komplext begrepp och det är viktigt att vårdpersonalen har förmågan att anpassa sig till patientens individuella behov för att ett bra bemötande och en god vård ska kunna uppnås.

  • 103. Danielsson, M
    et al.
    Berglund T,
    Forsberg, M
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Rogala, C
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sexuell och reproduktiv hälsa.2009In: Socialstyrelsen - Folkhälsorapport kapitel 9, 2009, p. 261-289Chapter in book (Other academic)
  • 104.
    Danielsson, Maria
    et al.
    Swedish National Board of Health and Welfare, Stockholm, Sweden.
    Berglund, Torsten
    Swedish Institute for Communicable Disease Control, Solna, Sweden.
    Forsberg, Margareta
    Administration for Allocation of Social Welfare, City of Gothenburg, Sweden.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Rogala, Christina
    RFSU, Stockholm, Sweden.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sexual and reproductive health Health in Sweden: The National Public Health Report 2012. Chapter 92012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 9, p. 176-196Article in journal (Refereed)
  • 105.
    Dannberg, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Operationssjuksköterskors upplevelser av att vårda patienter som lider av extrem svår fetma2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Att vårda patienter som lider av extremt svår fetma på en operationsavdelning kan vara en utmaning. Detta har visats genom tidigare studier som lyfter fram att medicintekniskutrustning, instrument och operationsmaterial inte är utvecklade för dessa patienters storlek och vikt. Syftet med studien var att studera hur operationssjuksköterskor upplever att vårda patienter som lider av extrem svår fetma. Metoden är en kvalitativ intervjustudie med en beskrivande design. Resultatet visar att operationssjuksköterskorna (n=6) känner oro för patientsäkerheten, när det gäller den perioperativa vården av patienterna på operationsbordet. Bordet upplevs för smalt i förhållande till patienternas storlek och det gör det svårt att få patienten i rätt position. Ergonomin för operationssjuksköterskorna upplevs dålig men vid förflyttning finns det hjälpmedel och extra hjälp att tillgå. De upplever att det är komplext att vårda patienter med extremt svår fetma. Operationssjuksköterskorna önskar uppföljning av patienterna för att kunna utveckla vården. Det goda teamarbetet gör vårdnaden av dessa patienter till en positiv upplevelse. Operationssjuksköterskorna berörs av patienterna och önskar mer utbildning för att få förståelse för patienterna och sjukdomen.

    Slutsats: Att vårda patienter som lider av extrem svår fetma kräver optimal utrustning och ergonomiska förutsättningar. Det krävs specialkompetens, teamarbete och regelbundna uppdateringar. Operationssjuksköterskorna som vårdar dessa patienter värnar om dem, de blir berörda och agerar skyddande. Resultatet av denna studie kan ligga till grund för att utveckla vården för patienter som lider av extrem svår fetma som genomgår operationen Duodenal Switch.

    Nyckelord: Extrem svår fetma, Operationssjuksköterska, Överviktskirurgi, Vårda, Attityder

  • 106.
    Delbaere, I.
    et al.
    Vives Univ Coll, Nursing Midwifery, Kortrjik, Belgium..
    Vanderplancke, T.
    Vives Univ Coll, Nursing Midwifery, Kortrjik, Belgium..
    Bogaerts, A.
    KHLim Univ Coll, Nursing Midwifery, Hasselt, Belgium..
    Provoost, V.
    Univ Ghent, BioEth, B-9000 Ghent, Belgium..
    De Sutter, P.
    Univ Ghent, Obstet, B-9000 Ghent, Belgium..
    Tyden, Tanja
    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, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Fertility awareness in the Flemish population: optimism can be disadvantageous2015In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 30, no Suppl. 1, p. 23-23Article in journal (Other academic)
  • 107.
    Demmelmaier, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Physiotherapists' telephone consultations regarding back pain: a method to analyze screening of risk factors2010In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, no 7, p. 468-475Article in journal (Refereed)
    Abstract [en]

    Background and aims

    There is a gap between guidelines and clinical management of risk factors for prolonged disability in back pain. The aims of this study were; 1) to evaluate the inter-rater reliability of a research protocol designed to analyse screening of physical and psychosocial risk factors for prolonged disability in back pain during telephone consultations, and; 2) to describe the overall content and the nature and extent of physical and psychosocial risk factors assessed by physiotherapists in telephone consultations for diagnostic screening of patients with back pain. 

    Method

     The material consisted of 17 initial telephone consultations regarding back pain recorded by five physiotherapists. A research protocol covering eight evidence-based risk factors was developed. Three raters performed separate analyses according to the protocol.

    Results

    Intraclass correlation of how many risk factors that were investigated was 0.82 (p<0.001.) Kappa values (pair-wise) of which risk factors that were screened were 0.79, 0.73 and 0.66 (p<0.001). A median of 2 risk factors were screened in each consultation; most frequent was signs of spinal pathology/radiating pain, followed by sick leave, disability, coping with pain and negative beliefs. Rating of pain intensity, depression and expectations of long-term pain were not screened.

    Conclusions

    The method of analysis appears reliable. It will be used in an intervention study that evaluates to what extent physiotherapists can learn to screen in concordance with guidelines in initial telephone consultations.

  • 108.
    Demmelmaier, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: Four quasi-experimental single subject studies2012In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 28, no 5, p. 359-372Article in journal (Refereed)
    Abstract [en]

    The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. A quasi-experimental single-subject design over 36 weeks was used, with repeated measurements during baseline, intervention, and postintervention phases. Four physiotherapists in primary health care audiorecorded a total of 63 consultations with patients. The tailored intervention included individual goal setting, skills training, and feedback on performance. The primary outcome was the number of assessed prognostic factors (0–10). Changes were seen in all four participants. The amount of assessed prognostic factors increased from between 0 and 2 at baseline to between 6 and 10 at postintervention. Time spent on assessment of psychosocial factors increased, and time spent on discussions about biomedical pain symptoms decreased. Knowledge and biopsychosocial attitudes toward back pain were congruent with guidelines at inclusion and did not change markedly during the intervention. Self-efficacy for assessment of cognitive and emotional prognostic factors increased during the study phases. The results suggest that a tailored skills training intervention using behaviour change techniques, such as individual goal setting, skills training, and feedback on performance, is effective in producing change in specific clinical behaviours in physiotherapists.

  • 109.
    Demmelmaier, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    The associations between pain intensity, psychosocial variables, and pain duration/recurrence in a large sample of persons with nonspecific spinal pain2008In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 24, no 7, p. 611-619Article in journal (Refereed)
    Abstract [en]

    Objectives: The aims of this study were: (1) to describe and compare pain intensity, disability, cognitive, physical, behavioral, and environmental variables in 4 predefined categories, on the basis of duration and recurrence of nonspecific spinal pain; and (2) to compare disability, cognitive, physical, behavioral, and environmental variables in these 4 predefined categories, after controlling for pain intensity.

    Methods: Postal questionnaires were sent to a random sample of 5000 persons, aged 20 to 50 years, in Sweden. The response rate was 39%. One thousand and twenty-four participants reporting spinal pain were divided into 4 predefined categories (n=100, 215, 172, and 537) based on duration and recurrence of pain. Multivariate analyses of variance and covariance were performed to investigate differences between the 4 pain duration/recurrence groups.

    Results: The first analyses revealed that the 4 pain duration/recurrence groups differed in pain intensity, disability, 7 cognitive variables, and perceived social support. After controlling for pain intensity, small but significant group differences were identified in depression, catastrophizing, pain expectations, and perceived social support. Higher levels of catastrophizing and pain expectations and lower levels of perceived social support were seen in groups with longer duration of pain.

    Discussion: After controlling for pain intensity, categories based on pain duration/recurrence differed in 3 cognitive variables and perceived social support. Pain expectations, catastrophizing and perceived social support were related to longer duration of pain. Between-group differences were small and pain duration/recurrence was not an important explanatory factor.

  • 110.
    Demmelmaier, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Biopsychosocial predictors of pain, disability, health care consumption, and sick leave in first-episode and long-term back pain: A longitudinal study in the general population2010In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 17, no 2, p. 79-89Article in journal (Refereed)
    Abstract [en]

    Background: Long-term outcome in back pain is related mainly to cognitive factors such as pain-related beliefs and expectations. Most research has been performed on patient samples.

    Purpose: This study aimed at investigating changes over time in reported back pain, pain intensity, disability, health care consumption and sick leave as well as biopsychosocial factors over a 12 month-period. A second aim was to identify predictors of reported pain, pain intensity, disability, health care consumption and sick leave.

    Method: As parts of a large back pain sample from a general population (n = 1024), two groups – one with first-episode pain (n = 77) and one with long-term pain (n = 302) – responded twice to a self-administered questionnaire. Among participants reporting pain at both assessments, changes over time were analysed and predictive models were tested.

    Results: Generally, the results demonstrated overall stability in the self-reports over time. However, reported pain decreased in both groups, while pain catastrophizing and pain expectations increased in the first-episode group. Pain intensity and disability were predicted in regression models including four cognitive factors and initially reported levels of pain intensity and disability.

    Conclusion: The significance of pain-related beliefs and expectations both in early and later stages of a back pain condition is pointed out. The results in this study based on a sample from the general population are in line with previous research on patient samples.

  • 111.
    Denison, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sandborgh, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Musculoskeletal pain in primary health care: subgroups based on pain intensity, disability, self-efficacy, and fear-avoidance variables2007In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 8, no 1, p. 67-74Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to identify and describe subgroup profiles based on self-reported pain intensity, disability, self-efficacy, fear of movement/(re)injury, and catastrophizing in patients with musculoskeletal pain. Two primary health care samples (n = 215 and n = 161) were used. Self-report questionnaires were completed at the start of physical therapy treatment. Cluster analysis was used to generate subgroups. Three subgroups were identified in sample 1 and replicated in sample 2. These were labeled "High self-efficacy-Low fear-avoidance," "Low self-efficacy-Low fear-avoidance," and "Low self-efficacy-High fear-avoidance." The subgroups differed significantly in work-status in both samples (P < .001), but not in age, gender, or duration of pain. The results show the presence of subgroups based on pain intensity, disability, self-efficacy, fear of movement/(re)injury, and catastrophizing. The profile patterns suggest that different management strategies may be relevant in each subgroup.

    Perspective

     This article presents subgroups of patients with musculoskeletal pain with different profiles in pain intensity, disability, and psychosocial variables possible to modify by physical therapy management. The results could potentially aid clinicians in tailoring assessment and treatment approaches to each subgroup.

  • 112.
    Djerf, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Åslin Hägg, Helén
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Nyblivna föräldrars tankar kring föräldraledighet, amning, föräldrautbildning samt barn- och mödravården2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to find out what new parents think about parental leave, parental education, the child welfare center and the prenatal clinic. The main focus was on what role the care system played and to what extent the father was involved. Eleven parents were interviewed and the findings were analysed and put into different themes. The result showed that most of the parents were satisfied with the care given at the child welfare center and the prenatal clinic. The participants also thought they were well treated by the nurses and midwives during the encounters. Both parents felt equaly involved while talking to the midwife. All of the parents wanted to have parental leave to some extent and the main reason was that they wanted to spend time with their child. In half of the cases mothers used the greater part of the parental leave. Both breast-feeding and economical aspects were mentioned to be reasons for this. The participants felt that the child welfare center and the prenatal clinic strongly recommended breast-feeding which contributes to the fact that breast-feeding still is a key aspect in the decision on which parent who is going to stay at home with the child during the fist period. All of the parents thought that the visit to the delivery department was the best part during the parental education, they also appreciated meeting other people in the same situation. The general information given during the regular meetings were things that many of the participants already knew and could for that reason have been more detailed.

  • 113.
    Drevin, Jennifer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Measuring Pregnancy Planning and the Effect of Childhood Abuse on Reproductive Health2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The London Measure of Unplanned Pregnancy (LMUP) and the Swedish Pregnancy Planning Scale (SPPS) are two measurements of pregnancy planning. Adverse childhood experiences (ACEs) and childhood abuse are stressful events that have been suggested to have both short- and long-term effects.

    Study I investigated the psychometric properties of the LMUP and the SPPS and compared their assessments. Questionnaire data from 2,314 pregnant women showed medium-high construct validity and high test-retest reliability for both measurements. The convergent validity of LMUP was low. The assessments of the LMUP and the SPPS corresponded substantially.

    Study II explored how the SPPS was interpreted and what women considered when responding to it. Twenty-five pregnant women were interviewed. Women responding to the SPPS took into account their life situation, intentions, desires, timing, actions to prepare for, or avoid, pregnancy, having discussed becoming pregnant with their partner, and reactions after learning of the pregnancy.

    Study III analysed the association between ACEs and pregnancy-related pain. Pregnant women (n = 142) responded to questionnaires in early and late pregnancy, respectively, and reported their pain intensities and pain distributions. Greater exposure to ACEs was associated with higher pain distribution and women exposed to ACEs reported higher worst pain intensities compared to non-exposed.

    Study IV investigated effects of childhood emotional, physical and sexual abuse on pregnancy planning. The effect of a potential collider-stratification bias were also studied. Questionnaire data from 76,197 pregnant Norwegian women showed separate but no joint effects of the categories on having an unplanned pregnancy and a collider-stratification bias could not explain the effects.

    The LMUP and the SPPS measure somewhat different aspects of pregnancy planning and there is a substantial agreement between their assessments. Both the LMUP and the SPPS showed good validity and test-retest reliability. However, the LMUP would likely benefit from item reduction and the SPPS poorly captures any health-related changes made in and the preconception period.

    The results suggest that childhood abuse and ACEs have an effect on pregnancy planning and pregnancy-related pain. The findings suggest that preventing child abuse could have a positive effect on later reproductive health.

    List of papers
    1. Measuring pregnancy planning: A psychometric evaluation and comparison of two scales
    Open this publication in new window or tab >>Measuring pregnancy planning: A psychometric evaluation and comparison of two scales
    2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2765-2775Article in journal (Refereed) Published
    Abstract [en]

    Aims: To psychometrically test the London Measure of Unplanned Pregnancy and compare it with the Swedish Pregnancy Planning Scale. Background: The incidence of unplanned pregnancies is an important indicator of reproductive health. The London Measure of Unplanned Pregnancy measures pregnancy planning by taking contraceptive use, timing, intention to become pregnant, desire for pregnancy, partner agreement, and pre-conceptual preparations into account. It has, however, previously not been psychometrically evaluated using confirmatory factor analysis. The Likert-scored single-item Swedish Pregnancy Planning Scale has been developed to measure the woman's own view of pregnancy planning level. Design: Cross-sectional design. Methods: In 2012-2013, 5493 pregnant women living in Sweden were invited to participate in the Swedish Pregnancy Planning study, of whom 3327 (61%) agreed to participate and answered a questionnaire. A test-retest pilot study was conducted in 2011-2012. Thirty-two participants responded to the questionnaire on two occasions 14 days apart. Data were analysed using confirmatory factor analysis, Cohen's weighted kappa and Spearman's correlation. Results: All items of the London Measure of Unplanned Pregnancy contributed to measuring pregnancy planning, but four items had low item-reliability. The London Measure of Unplanned Pregnancy and Swedish Pregnancy Planning Scale corresponded reasonably well with each other and both showed good test-retest reliability. Conclusion: The London Measure of Unplanned Pregnancy may benefit from item reduction and its usefulness may be questioned. The Swedish Pregnancy Planning Scale is time-efficient and shows acceptable reliability and construct validity, which makes it more useful for measuring pregnancy planning.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2017
    Keywords
    antenatal care, confirmatory factor analysis, instrument development, midwives, nursing, pregnancy planning, psychometrics, reproducibility of results, reproductive health, unplanned pregnancy
    National Category
    Nursing
    Identifiers
    urn:nbn:se:uu:diva-339704 (URN)10.1111/jan.13364 (DOI)000418363000027 ()28620936 (PubMedID)
    Available from: 2018-01-26 Created: 2018-01-26 Last updated: 2019-03-21Bibliographically approved
    2. 'How planned was your current pregnancy?' - What pregnant women take into account when responding to the Swedish Pregnancy Planning Scale
    Open this publication in new window or tab >>'How planned was your current pregnancy?' - What pregnant women take into account when responding to the Swedish Pregnancy Planning Scale
    (English)Manuscript (preprint) (Other academic)
    Keywords
    Pregnancy planning, measurement, unplanned pregnancy, unintended pregnancy, reproductive health
    National Category
    Medical and Health Sciences
    Research subject
    Obstetrics and Gynaecology
    Identifiers
    urn:nbn:se:uu:diva-379621 (URN)
    Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-03-21
    3. Adverse childhood experiences influence development of pain during pregnancy.
    Open this publication in new window or tab >>Adverse childhood experiences influence development of pain during pregnancy.
    Show others...
    2015 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 8, p. 840-846Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To investigate the association between adverse childhood experiences (ACE) and pain with onset during pregnancy.

    DESIGN: Cross-sectional study.

    SETTING: Eighteen antenatal clinics in southern Mid-Sweden.

    SAMPLE: Of 293 women invited to participate, 232 (79%) women agreed to participate in early pregnancy and were assessed in late pregnancy.

    METHODS: Questionnaires were distributed in early and late pregnancy. The questionnaires sought information on socio-demography, ACE, pain location by pain drawing and pain intensity by visual analogue scales. Distribution of pain was coded in 41 predetermined areas.

    MAIN OUTCOME MEASURES: Pain in third trimester with onset during present pregnancy: intensity, location and number of pain locations.

    RESULTS: In late pregnancy, 62% of the women reported any ACE and 72% reported any pain location with onset during the present pregnancy. Among women reporting any ACE the median pain intensity was higher compared with women without such an experience (p = 0.01). The accumulated ACE displayed a positive association with the number of reported pain locations in late pregnancy (rs  = 0.19, p = 0.02). This association remained significant after adjusting for background factors in multiple regression analysis (p = 0.01). When ACE was dichotomized the prevalence of pain did not differ between women with and without ACE. The subgroup of women reporting physical abuse as a child reported a higher prevalence of sacral and pelvic pain (p = 0.0003 and p = 0.02, respectively).

    CONCLUSIONS: Adverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.

    National Category
    Obstetrics, Gynecology and Reproductive Medicine
    Identifiers
    urn:nbn:se:uu:diva-256150 (URN)10.1111/aogs.12674 (DOI)000357983900005 ()25965273 (PubMedID)
    Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2019-03-21Bibliographically approved
    4. Childhood abuse and unplanned pregnancies: A cross-sectional study of women in the Norwegian Mother and Child Cohort Study
    Open this publication in new window or tab >>Childhood abuse and unplanned pregnancies: A cross-sectional study of women in the Norwegian Mother and Child Cohort Study
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Keywords
    Childhood abuse, reproductive health, unplanned pregnancy, unintended pregnancy
    National Category
    Medical and Health Sciences
    Research subject
    Obstetrics and Gynaecology
    Identifiers
    urn:nbn:se:uu:diva-379622 (URN)
    Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-03-21
  • 114.
    Drevin, Jennifer
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Sophiahemmet Univ, Dept Hlth Promoting Sci, Uppsala, Sweden.
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Measuring pregnancy planning: A psychometric evaluation and comparison of two scales2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2765-2775Article in journal (Refereed)
    Abstract [en]

    Aims: To psychometrically test the London Measure of Unplanned Pregnancy and compare it with the Swedish Pregnancy Planning Scale. Background: The incidence of unplanned pregnancies is an important indicator of reproductive health. The London Measure of Unplanned Pregnancy measures pregnancy planning by taking contraceptive use, timing, intention to become pregnant, desire for pregnancy, partner agreement, and pre-conceptual preparations into account. It has, however, previously not been psychometrically evaluated using confirmatory factor analysis. The Likert-scored single-item Swedish Pregnancy Planning Scale has been developed to measure the woman's own view of pregnancy planning level. Design: Cross-sectional design. Methods: In 2012-2013, 5493 pregnant women living in Sweden were invited to participate in the Swedish Pregnancy Planning study, of whom 3327 (61%) agreed to participate and answered a questionnaire. A test-retest pilot study was conducted in 2011-2012. Thirty-two participants responded to the questionnaire on two occasions 14 days apart. Data were analysed using confirmatory factor analysis, Cohen's weighted kappa and Spearman's correlation. Results: All items of the London Measure of Unplanned Pregnancy contributed to measuring pregnancy planning, but four items had low item-reliability. The London Measure of Unplanned Pregnancy and Swedish Pregnancy Planning Scale corresponded reasonably well with each other and both showed good test-retest reliability. Conclusion: The London Measure of Unplanned Pregnancy may benefit from item reduction and its usefulness may be questioned. The Swedish Pregnancy Planning Scale is time-efficient and shows acceptable reliability and construct validity, which makes it more useful for measuring pregnancy planning.

  • 115.
    Drevin, Jennifer
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Annerbäck, Eva-Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Peterson, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Butler, Stephen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Tydén, Tanja
    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, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Berglund, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Uppsala University, National Centre for Knowledge on Men.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Adverse childhood experiences influence development of pain during pregnancy.2015In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 8, p. 840-846Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the association between adverse childhood experiences (ACE) and pain with onset during pregnancy.

    DESIGN: Cross-sectional study.

    SETTING: Eighteen antenatal clinics in southern Mid-Sweden.

    SAMPLE: Of 293 women invited to participate, 232 (79%) women agreed to participate in early pregnancy and were assessed in late pregnancy.

    METHODS: Questionnaires were distributed in early and late pregnancy. The questionnaires sought information on socio-demography, ACE, pain location by pain drawing and pain intensity by visual analogue scales. Distribution of pain was coded in 41 predetermined areas.

    MAIN OUTCOME MEASURES: Pain in third trimester with onset during present pregnancy: intensity, location and number of pain locations.

    RESULTS: In late pregnancy, 62% of the women reported any ACE and 72% reported any pain location with onset during the present pregnancy. Among women reporting any ACE the median pain intensity was higher compared with women without such an experience (p = 0.01). The accumulated ACE displayed a positive association with the number of reported pain locations in late pregnancy (rs  = 0.19, p = 0.02). This association remained significant after adjusting for background factors in multiple regression analysis (p = 0.01). When ACE was dichotomized the prevalence of pain did not differ between women with and without ACE. The subgroup of women reporting physical abuse as a child reported a higher prevalence of sacral and pelvic pain (p = 0.0003 and p = 0.02, respectively).

    CONCLUSIONS: Adverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.

  • 116.
    Duc, Duong M.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Hanoi Sch Publ Hlth, Fac Social Sci Behav & Hlth Educ, 138 Giang Vo St, Hanoi, Vietnam.
    Bergström, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). UCL, Inst Global Hlth, London, England..
    Eriksson, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Selling, Katarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Ha, Bui Thi Thu
    Faculty of Social Science - Behaviours and Health Education, Hanoi School of Public Health, Hanoi, Vietnam.
    Wallin, Lars
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam2016In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, article id 31572Article in journal (Refereed)
    Abstract [en]

    Background: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low-and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. Objective: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. Designs: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). Results: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. Conclusions: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

  • 117.
    Ebben, Remco H. A.
    et al.
    HAN Univ Appl Sci, Res Dept Emergency & Crit Care, Fac Hlth & Social Studies, Nijmegen, Netherlands.
    Siqeca, Flaka
    Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Acad Ctr Nursing & Midwifery, Leuven, Belgium;Univ Prishtina, Pristina, Kosovo.
    Madsen, Ulla Riis
    Holbaek Cent Hosp, Holbek, Region Sjaellan, Denmark.
    Vloet, Lilian C. M.
    HAN Univ Appl Sci, Res Dept Emergency & Crit Care, Fac Hlth & Social Studies, Nijmegen, Netherlands;Radboud Univ Nijmegen, Med Ctr, IQ Healthcare, Radboud Inst Hlth Sci, Nijmegen, Netherlands.
    van Achterberg, Theo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Acad Ctr Nursing & Midwifery, Dept Publ Hlth & Primary Care, Leuven, Belgium.
    Effectiveness of implementation strategies for the improvement of guideline and protocol adherence in emergency care: a systematic review2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 11, article id e017572Article, review/survey (Refereed)
    Abstract [en]

    Objective Guideline and protocol adherence in prehospital and in-hospital emergency departments (EDs) is suboptimal. Therefore, the objective of this systematic review was to identify effective strategies for improving guideline and protocol adherence in prehospital and ED settings. Design Systematic review. Data sources PubMed (including MEDLINE), CINAHL, EMBASE and Cochrane. Methods We selected (quasi) experimental studies published between 2004 and 2018 that used strategies to increase guideline and protocol adherence in prehospital and in-hospital emergency care. Pairs of two independent reviewers performed the selection process, quality assessment and data extraction. Results Eleven studies were included, nine of which were performed in the ED setting and two studies were performed in a combined prehospital and ED setting. For the ED setting, the studies indicated that educational strategies as sole intervention, and educational strategies in combination with audit and feedback, are probably effective in improving guideline adherence. Sole use of reminders in the ED setting also showed positive effects. The two studies in the combined prehospital and ED setting showed similar results for the sole use of educational interventions. Conclusions Our review does not allow firm conclusion on how to promote guideline and protocol adherence in prehospital emergency care, or the combination of prehospital and ED care. For ED settings, the sole use of reminders or educational interventions and the use of multifaceted strategies of education combined with audit and feedback are all likely to be effective in improving guideline adherence.

  • 118.
    Ehrsson, Ylva Tiblom
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Stenhammar, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Åkerud, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Self-reported sexually transmitted infections among female university students.2016In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 1, p. 45-49Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate the occurrence of self-reported sexually transmitted infections (STIs) and associated factors among female university students requesting contraceptive counselling.

    MATERIAL AND METHODS: Cross-sectional study. Female university students (n = 353) completed a waiting-room questionnaire in connection with contraceptive counselling at a Student Health Centre in Uppsala, Sweden.

    RESULTS: Ninety-three (26.3%) female students had experienced an STI. The three most frequently reported STIs were chlamydia trachomatis, condyloma, and genital herpes. The experience of an STI was significantly associated with the total number of sexual partners (OR 1.060, 95% CI 1.030-1.091, P < 0.001), being heterosexual (OR 4.640, 95% CI 1.321-16.290, P = 0.017), having experienced an abortion (OR 2.744, 95% CI 1.112-6.771, P = 0.028), not being HPV-vaccinated (OR 2.696, 95% CI 1.473-4.935, P = 0.001), and having had intercourse on first night without using a condom (OR 2.375, 95% CI 1.182-4.771, P = 0.015).

    CONCLUSIONS: Contraceptive counselling should also include information about primary and secondary prevention of STI, such as the importance of correct use of a condom and STI testing, to prevent a further spread of STIs.

  • 119.
    Ekbom, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Närståendes upplevelse av närvaro under livsuppehållande behandling av anhörig2008Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka närståendes upplevelser av att närvara vid livsuppehållande behandling av anhörig. Kvalitativ metod har använts. telefonintervjuer gjordes med 23 närstående under perioden februari-juni månad 2008. Intervjuerna bandades och skrevs ut ordagrant och analyserades med innehållsanaly. efter analys av insamlat material utvanns två kategorier: positiva och negativa känslor och kunnig och trevlig personal. Resultatet av studien visar att vara närvarande hade stor känslomässig betydelse för närstående. Oavsett vad deras anhörige utsattes för under behandlingen upplevdes den som positiv. Närstående såg att personalen gjorde allt de kunde och att personalen visste vad de skulle göra. Föräldrar till barn och ungdom såg det som en självklarhet att vara med i akutrummet medan den något äldre generationen gärna ville vara med men trodde inte att det var möjligt. Studien visar också att det har betydelse för de närstående att ha perosnal vid sin sida under livsuppehållande behandling av anhörig. Slutsatsen av denna studie avslöjar att närstående stödjer valmöjligheten att få närvara under livsuppehållande behandling av anhörig och att personalen bör se till närståendes behov.

  • 120.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engblom, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sex education in Swedish schools as described by young women2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 3, p. 210-224Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate sex education in Swedish schools regarding content, satisfaction, and suggested improvements, as described by teenagers and young adults. Methods: Waiting-room survey conducted among 225 female patients (aged 13-25) at youth and student health clinics in one large-, and one medium-sized Swedish city. Results: Most participants (97%, n = 218) had received sex education in school, of varying content and quality. Sixty percent thought basic body development was sufficiently covered. Insufficiently covered topics included sexual assault (96%), sexual harassment (94%), pornography (90%), abortion (81%), emergency contraception (80%), fertility (80%), and pregnancy (59%). Thirty percent received no information about chlamydia, and almost half reported that condyloma and human papillomavirus had not been addressed. The youngest respondents (13-19 years) were significantly more likely to have been told about emergency contraception, homosexuality, bisexuality, and transsexuality. Nearly half (46%) considered ''acceptable'' the knowledge gained from sex education provided at school whereas more than a third considered it ''poor'' or ''very poor''. Suggested improvements included more information, more discussion, greater emphasis on sexual diversity, and more knowledgeable teachers. Conclusions: Content and quality of sex education varied greatly. Most respondents thought many topics were insufficiently covered, sex education should be more extensive, and teachers better educated.

  • 121.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Advance provision of emergency contraceptive pills reduces treatment delay: a randomized controlled trial among Swedish teenage girls2008In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 87, no 3, p. 354-359Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate an intervention involving advance provision of emergency contraceptive pills (ECP) to Swedish teenage girls. MATERIAL AND METHODS: Some 420 girls aged 15-19, requesting ECP at a local youth clinic were randomly assigned to intervention group (IG) (n=214) or control group (CG) (n=206). Both groups received ECP on request. The IG received one extra dose of ECP, condoms and an information leaflet regarding ECP and condom use. Main outcome measures were differences between IG and CG regarding ECP use, time span between unprotected intercourse and ECP intake, contraceptive use, and sexual risk taking. Questionnaires were completed at the initial visit, and the girls were followed up by structured telephone interviews 3 and 6 months later. RESULTS: At the 3-month follow-up, girls in the IG were almost twice as likely to have used ECP compared to girls in the CG (IG: 24.0%, CG: 13%, p=0.02), and they used it sooner after unprotected intercourse (mean time IG: 13.61 h, CG: 25.47 h, p=0.007). Significant differences persisted 6 months after the intervention (ECP use IG: 31%, CG: 19%, p=0.01; and mean time IG: 15.59 h, CG: 26.38 h, p=0.006). No significant differences were found in the use of regular hormonal contraceptives or condoms at either follow-up. About 40% of the girls in both groups had risked pregnancy during the follow-up period, but only half of these had used ECP. CONCLUSIONS: This intervention shortened the time interval from unprotected intercourse to pill intake without jeopardising contraceptive use and without increasing sexual risk taking.

  • 122.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Swedish teenager perceptions of teenage pregnancy, abortion, sexual behavior, and contraceptive habits: a focus group study among 17-year-old female high-school students2005In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 84, no 10, p. 980-986Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sweden has the highest abortion numbers among the Nordic countries. Since 1995, the abortion rate among teenagers has increased by nearly 50%. We therefore undertook a study where the overall aim was to gain a deeper understanding on which factors female teenagers believe may explain the increasing numbers of teenage abortions. Teenagers' perceptions of teenage pregnancy, abortion, sexual behavior, and contraceptive habits were investigated. METHODS: Six focus group interviews with 17-year-old Swedish girls were conducted. The interviews were tape-recorded, transcribed verbatim, and analyzed by manifest content analysis. RESULTS: Negative attitudes toward teenage pregnancy and supportive attitudes toward abortion were expressed. Risk-taking behaviors such as negligence in contraceptive use and intercourse under the influence of alcohol were suggested as main reasons behind the increasing numbers of abortions among Swedish teenagers. The contemporary, sexualized, media picture was believed to influence adolescents' sexual behavior, and liberal attitudes toward casual sex were expressed. Girls were perceived as more obliged than boys in taking responsibility for contraceptive compliance and avoidance of pregnancy. The apprehension that hormonal contraceptives cause negative side-effects was widely spread, and the participants were found to have a somewhat limited knowledge of abortion. The majority were unsatisfied with the quality of sexual education provided by the schools. CONCLUSION: Possible reasons for increased abortion numbers among teenagers in Sweden could be liberal attitudes toward casual sex in combination with negligence in contraceptive use, use of alcohol followed by sexual risk-taking, fear of hormonal contraceptives, and a deterioration of sexual education in the schools.

  • 123.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Tyden, Tanja
    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, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Kihlbom, Ulrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Swedish parents’ interest in preconception genetic carrier screening2016In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 4, p. 289-294Article in journal (Refereed)
    Abstract [en]

    Introduction: Genetic technologies advance rapidly. It is possible to undergo genetic carrier screening before pregnancy to examine genetic risks to future offspring. We aimed to investigate parents’ interest and motives towards preconception genetic carrier screening (PCS) as well as factors associated with interest in PCS.

    Material and methods: Our study sample consists of 777 parent couples within the longitudinal Swedish Pregnancy Planning study. Women responded to questionnaires at three occasions: in early pregnancy, late pregnancy, and one year after childbirth. Male partners responded to one questionnaire one year after childbirth.

    Results: One-third of the parents were positive (30% versus 34% of women and men, respectively), less than a third were negative (26% versus 28%), and 45% versus 38% were uncertain about whether to consider PCS before a future pregnancy. No differences in PCS interest were found between women and men (P = 0.091), but a higher proportion of women were concerned about negative consequences (53% versus 46%, P < 0.003) and were ‘opposed to such a way of child selection’ (31.8% versus 25.2%,P = 0.002). Factors associated with PCS interest were experiences of prenatal diagnostics and positive attitudes towards finding out or choosing sex of one’s child (women), and prenatal diagnostics, self-rated poor health, and pregnancy planning (men).

    Conclusion: Both women and men had relatively high uncertainty towards PCS, but women were more concerned about negative consequences. The future extent of the clinical utility of PCS is currently unknown, but parents’ interests and doubts are important aspects to consider.

  • 124.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    An illusion of power: Qualitative Perspectives On Abortion Decision-Making Among Teenage Women In Sweden2009In: Perspectives on sexual and reproductive health, ISSN 1538-6341, E-ISSN 1931-2393, Vol. 41, no 3, p. 173-180Article in journal (Refereed)
    Abstract [en]

    CONTEXT:Swedish law permits abortion at the request of a pregnant woman untilthe 18th week of gestation. However, the extent to which the decision istruly the woman's own is subject to debate; women are often influenced,directly or indirectly, by the attitudes of their partners, family andfriends or by social norms. METHODS: Individual in-depth interviewsabout the pregnancy and the abortion decision were conducted 3-4 weekspostabortion with 25 women aged 16-20 at different periods in 2003, 2005and 2007. Interviews were audio-taped, transcribed verbatim andanalyzed using latent content analysis. RESULTS: The main reasons forunplanned pregnancy were underestimation of pregnancy risk andinconsistent contraceptive use. Pregnancy prevention was perceived asthe woman's responsibility. The abortion decision was accompanied bymixed emotions, and was seen as a natural yet difficult choice. Socialnorms and the negative attitudes of family and friends stronglyinfluenced the decision. Partners and parents were regarded as the mostimportant sources of support. After the abortion, the women feltpressured by contraceptive counselors to use highly effectivecontraceptives despite their previous negative experiences or worriesabout side effects. CONCLUSIONS: Swedish teenagers' basic right todecide whether to have an abortion may be limited by societal norms anddisapproval of teenage childbearing. Given the perception that women areresponsible for contraception, programs need to emphasize thatpregnancy prevention is a shared responsibility; greater efforts toinclude males in prevention practices are needed.

  • 125.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Preventing pregnancy: A girls' issue. Seventeen-year-old Swedish boys' perceptions on abortion, reproduction and use of contraception2007In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 12, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Objective To gain deeper understanding of how teenage males view abortion, adolescent   fatherhood, sexual behavior, and use of contraception.  Method We conducted six focus-group interviews with 17-year-old boys (n 1⁄4 40). The interviews were tape-recorded, transcribed verbatim, and analyzed using manifest content analysis.  Results Adolescent fatherhood was considered to be a catastrophe and abortion a moral   dilemma. Most participants agreed that the unrestricted right to decide on abortion rests upon the girl, but some were frustrated by not having any legal right to influence the decision. Contraceptive failure was viewed as common and mainly due to the influence of alcohol or in relation to unplanned sex. Boys perceived girls as having a greater responsibility in avoiding pregnancy, and they often put a blind trust in the girls’ use of hormonal contraceptives or initiation of emergency contraception. Several groups had insufficient knowledge about fetal development and other aspects of reproduction. Many were unsatisfied with the sex education they had received at school, but still considered it to be an important counterweight to other sources of information concerning sex, such as  pornography.  Conclusion Equal responsibility among boys and girls regarding reproductive issues is still a challenge, but nevertheless an important key to the prevention of unwanted pregnancies.

  • 126.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Exposing oneself and one's partner to sexual risk-taking as perceived by young Swedish men who requested a Chlamydia test2011In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, no 2, p. 100-107Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore young men's perceptions of (i) the risk for themselves and their partners in connection with unprotected intercourse, and (ii) the main barriers to practising safe sex. Methods: Qualitative latent content analysis of interviews involving 22 Swedish males aged 16-20, who requested a Chlamydia test. Results:The main categories identified were: (1) Low perceived threat regarding sexual risk-taking - personal consequences in focus. Threats could be both immediate and distant with varying preventative strategies. The young men worried more about their personal consequences than about the consequences for their partner. They were confident that an unintended pregnancy would be terminated, leading to decreased motivation for sharing pregnancy-preventing practices with their partner. (2) Perceived barriers to practising safe sex. Main barriers to condom use were interference with spontaneity, pleasure reduction, fear of loosing one's erection, and embarrassment or distrust. Other obstacles were the girl's use of hormonal contraception, and difficulties in communicating about safe sex. Conclusion The young men did not seem to worry about risks when having unprotected sex. To protect men's - and women's - sexual and reproductive health, efforts are needed to increase the former's contraceptive responsibilities and awareness of consequences related to unprotected sex.

  • 127.
    Ekstrand, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Larsson, Margareta
    Sexual risk taking for self and partner as perceived by young men in Sweden: - a suggestion for a modified Health Belief ModelManuscript (Other academic)
  • 128.
    Eldh, Ann Catrine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Patientdelaktighet -: dåtid, nutid och framtid2018In: Delaktighet och patientmedverkan / [ed] Ann Catrine Eldh, Lund: Studentlitteratur , 2018Chapter in book (Other academic)
  • 129.
    Englund, Nina
    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, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sjuksköterskors upplevelser av att ge stöd till anhöriga inom palliativ hemsjukvård2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to investigate nurses' experiences in supporting next of kin to patients in palliative home care.

    The design was descriptive with a qualitative approach. The informants were strategically selected and consisted of five nurses, working in a palliative home care team in Uppland, in Sweden. Tape-recorded personal interviews were analysed with a qualitative content analysis.

    The nurses experienced that their work felt meaningful and developing. To work in a team was a very positive aspect. Difficulties that appeard involved adjusting to different situations. The nurses supported next of kin mainly by communicating and conversing, and mediating safety. It was important to as well both verbally and practically show next of kin that there was also time for this.

    Since palliative care in the home is getting more common, and since it cannot happen without the effort of next of kin, it is very important to develop and optimize the nurses' support to them. This studie can give insight in the problems that exist in this support, but also give insight about the organizational and personal achievements that work.

  • 130.
    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.

  • 131.
    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.

  • 132.
    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.

  • 133.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Sweden; Nursing Department, Medicine and Health College, Lishui University, China.
    Löfmark, Anna
    Vae, Karen Johanne Ugland
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Sweden.
    Nursing students' perceptions of using the Clinical Education Assessment tool AssCE and their overall perceptions of the clinical learning environment: A cross-sectional correlational study2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 51, p. 63-67Article in journal (Refereed)
    Abstract [en]

    Background: Clinical education is a vital part of nursing students' learning; the importance of assessment tools and feedback in stimulating student learning has been stressed, but this needs to be studied in more detail.

    Objectives: To examine relationships between nursing students' perceptions of using an Assessment tool in Clinical Education (AssCE) during their mid-course discussion and final assessment, the content discussed during these meetings between the student, preceptor and nurse teacher and the students' overall perception of the clinical learning environment.

    Design: A cross-sectional, correlational design was used.

    Setting and Participants: A convenience sample of 110 nursing students from one Norwegian university college with two campuses.

    Methods: Data were collected with self-developed questionnaires and analysed using logistic regression with SASS and the PROCESS macro for mediation analysis.

    Results: There was a positive relationship between nursing students' perceptions of using the assessment tool AssCE and their overall perception of the clinical learning environment. This relationship was, in turn, mediated by the content discussed during the formative mid-course discussion and summative final assessment.

    Conclusions: Our conclusion is that the assessment tool AssCE supported students' clinical learning and that this relationship, in turn, was mediated by the degree to which the conversation during the assessment meeting focused on the student's knowledge, skills and professional judgement.

  • 134.
    Engström, Maria
    et al.
    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.
    Ernesater, Annica
    Flackman, Birgitta
    Mamhidir, Anna-Greta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    District nurses' self-reported clinical activities, beliefs about and attitudes towards obesity management2013In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 26, no 4, p. 198-203Article in journal (Refereed)
    Abstract [en]

    Aim: To describe district nurses' self-reported clinical activities, beliefs about and attitudes towards obesity management; and to examine associations between the variables. Background: Obesity is increasing worldwide and primary care could play a central role in the management. Methods: Questionnaire data were collected from 247 nurses in 33 centres. Results: The most common activities performed weekly were; advice about physical activity (40.1%) and general lifestyle advice (34.8%). However, nearly one third seldom/never performed these activities. Approximately half seldom/never performed BMI assessment and even fewer waist circumference (78.1%). Values for the factors Importance of obesity and Personal effectiveness were skewed towards a positive view and Negative view close to neutral. Multivariate analysis revealed that nurses with specialized tasks, longer working experience and higher perceived personal effectiveness performed more clinical activities. Conclusion: Managers need to make efforts to engage all personnel in obesity management; and strategies to increase self-efficacy are called for.

  • 135.
    Engström, Maria
    et al.
    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.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Working life and stress symptoms among caregivers in elderly care with formal and no formal competence2011In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 6, p. 732-741Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the present study was to describe and compare caregivers with formal and no formal competence on job satisfaction, psychosomatic health, structural and psychological empowerment and perceptions of care quality. A further aim was to study relationships among study variables.

    Methods: A convenience sample of 572 caregivers in elderly care participated.

    Results: Caregivers with no formal competence perceived higher workload, more communication obstacles, less competence, poorer sleep and more stress symptoms than did their colleagues. Linear regression analyses revealed that the factor self-determination was an explanatory variable of stress levels among caregivers with no formal competence, and self-determination and impact among caregivers with formal competence. Linear regression analysis revealed that different dimensions in structural and psychological empowerment explained the variance in staff job satisfaction, perceived stress symptoms and quality of care.

    Conclusions: No formal competence seems to be a risk factor for psychosomatic health problems.

    Implications for nursing management: Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers’ self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.

  • 136.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Westerberg Jacobson, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Staff assessment of structural empowerment and ability to work according to evidence-based practice in mental health care2015In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, no 6, p. 765-774Article in journal (Refereed)
    Abstract [en]

    AIM: To study associations between staff members' self-rated structural empowerment in mental health care, organisational type, and the ability and willingness to work according to evidence-based practice.

    METHOD: Questionnaire data were collected from 253 mental health staff members.

    RESULT: Multivariate logistic regressions analyses revealed that participants who scored higher on opportunity (OR 2.5) and were employed by the county council (OR 1.9) vs. the municipality were more likely to report high evidence-based practice ability. A generalised estimating equation taking into account unknown correlations within units found opportunity and resources to be significant predictors of evidence-based practice ability. Regarding evidence-based willingness, increased odds were found for higher scores of opportunity (OR 2.2) and being employed by the county council (OR 2.9). The generalised estimating equation also found resources to be a significant predictor of evidence-based willingness. In both organisations, the values for empowerment were moderate.

    CONCLUSION: Structural conditions such as access to opportunities and resources are important for creating supporting structures for practice to be evidence-based.

    IMPLICATIONS FOR NURSING MANAGEMENT: Our results emphasise the managers' essential role in creating empowering structures, and especially access to opportunities and resources, for their staff to carry out evidence-based practice.

  • 137. Engström, Åsa
    et al.
    Boström, Jonas
    Karlsson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Women's Experiences of Undergoing Total Knee Joint Replacement Surgery2017In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 32, no 2, p. 86-95Article in journal (Refereed)
    Abstract [en]

    Purpose

    The purpose of the study was to describe women's experiences of undergoing total knee joint replacement surgery.DesignA qualitative approach was used.

    Method

    A content analysis of the text from interviews with five women was conducted.

    Findings

    The time before surgery was marked by the experience of constant pain, which affected the women negatively in their everyday lives. During surgery, the information provided by the staff gave each woman a sense of security; the women handed over responsibility to the staff and experienced a sensation of relief. The postoperative period was characterized by a feeling of joy when the surgery was over, although a rough and tedious rehabilitation phase then began. Challenges in everyday life were a factor for motivation and confidence, although postoperative pain was experienced as discouraging.

    Conclusion

    Support from health care staff is an important factor for coping with everyday life during the preoperative, perioperative and postoperative phases of undergoing knee joint replacement.

  • 138.