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  • 251.
    Hedlund, Mathilde
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Zetterling, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Ronne-Engström, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Carlsson, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Depression and posttraumatic stress disorder after aneurysmal subarachnoid hemorrhage in relation to lifetime psychiatric morbidity2011Ingår i: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 25, nr 6, s. 693-700Artikel i tidskrift (Refereegranskat)
    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.

  • 252.
    Hedman, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Autonomy and Participation in Care For Older People: Descriptions by Older People, Registered Nurses, Case Managers, First Line Managers and Local Authorities Senior Medicine Advisors2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Overall aim: To describe the essence of autonomy and participation for older people in care, and how to promote this in care for them.

    Method: A descriptive design with a phenomenological approach. Sixteen older people (I) and 13 registered nurses (II) participated in individual face-to-face interviews (I and II). Twelve case/care managers and supervisors participated in a focus group interview, they were grouped by profession, case managers, first line managers and local authority senior medicine advisors, four in each group and interviewed once (III and IV). The data analyses were guided by Giorgi’s descriptive phenomenological method (I and II) and the systematic text condensation by Malterud (III and IV).

    Findings: The informants were in agreement that maintaining older people’s health and wellbeing promote autonomy and participation, and supportive relationships are relevant (I–IV). Older people focused on everyday life experiences they made by choice and managing on their own, as strengthening self-esteem and self-identity (I). The registered nurses focused on caring for frail older people and their need for acknowledgement in everyday care. They noted that of providing choices as enable older people to have joyful everyday life experiences (II). The managers and supervisors focused on informed consent, and legislation, and offered solutions to securing a meaningful everyday life by caring for older people’s wishes and needs. They also spoke of the risk the severe consequences could result from older people’s decision-making and their health conditions (III). Relatives were respected as a resource and attended to in everyday care for older people but the focus was the older person in their present life situation and their individual rights (IV).

    Conclusion: Promoting to autonomy and participation for older people were maintained health and wellbeing, and the possibility to manage on their own terms. Informed consent, shared decision-making, supportive relationships and acknowledgement of relatives in the life-changing situations were ways to promote autonomy and participation. To promote autonomy and participation in care for older people is also to provide for choices that are meaningful to the older person at end of life in a joyful and permissive atmosphere.

    Delarbeten
    1. Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness
    Öppna denna publikation i ny flik eller fönster >>Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness
    Visa övriga...
    2015 (Engelska)Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, s. 824-833Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility - still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase 'ability to act' in different ways, based on older people's descriptions of the meaning of autonomy and participation.

    Nationell ämneskategori
    Omvårdnad
    Forskningsämne
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-266967 (URN)10.1111/scs.12215 (DOI)000368345900024 ()25856656 (PubMedID)
    Tillgänglig från: 2015-11-15 Skapad: 2015-11-15 Senast uppdaterad: 2018-03-28
    2. Caring in nursing homes to promote autonomy and participation
    Öppna denna publikation i ny flik eller fönster >>Caring in nursing homes to promote autonomy and participation
    2019 (Engelska)Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, nr 1, s. 280-292Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BACKGROUND: Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care.

    OBJECTIVE: The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation.

    RESEARCH DESIGN: A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed.

    FINDINGS: The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people.

    DISCUSSION AND CONCLUSION: Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents in nursing homes.

    Nyckelord
    Autonomy, nursing home, older people, participation, phenomenology, registered nurse
    Nationell ämneskategori
    Omvårdnad
    Forskningsämne
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-342895 (URN)10.1177/0969733017703698 (DOI)000458874900027 ()28425315 (PubMedID)
    Tillgänglig från: 2018-02-23 Skapad: 2018-02-23 Senast uppdaterad: 2019-08-01Bibliografiskt granskad
    3. Autonomy and participation in municipal care: managers and supervisors' descriptions
    Öppna denna publikation i ny flik eller fönster >>Autonomy and participation in municipal care: managers and supervisors' descriptions
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nyckelord
    Autonomy Participation Older People Municipal Care Managers
    Nationell ämneskategori
    Omvårdnad
    Forskningsämne
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-347139 (URN)
    Tillgänglig från: 2018-03-26 Skapad: 2018-03-26 Senast uppdaterad: 2018-03-28
    4. Including relatives to promote autonomy and participation for older people:municipal care managers descriptions
    Öppna denna publikation i ny flik eller fönster >>Including relatives to promote autonomy and participation for older people:municipal care managers descriptions
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nyckelord
    Autonomy Participation Older People Relatives Municipal Care Managers
    Nationell ämneskategori
    Omvårdnad
    Forskningsämne
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-347140 (URN)
    Tillgänglig från: 2018-03-26 Skapad: 2018-03-26 Senast uppdaterad: 2018-03-28
  • 253.
    Hedman, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Autonomy and participation in municipal care: managers and supervisors' descriptionsManuskript (preprint) (Övrigt vetenskapligt)
  • 254.
    Hedman, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Including relatives to promote autonomy and participation for older people:municipal care managers descriptionsManuskript (preprint) (Övrigt vetenskapligt)
  • 255.
    Hedman, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Häggström, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Mamhidir, Anna-Greta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Pöder, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Caring in nursing homes to promote autonomy and participation2019Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, nr 1, s. 280-292Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care.

    OBJECTIVE: The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation.

    RESEARCH DESIGN: A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed.

    FINDINGS: The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people.

    DISCUSSION AND CONCLUSION: Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents in nursing homes.

  • 256.
    Hedman, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Pöder, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Mamhidir, Anna-Greta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Nilsson, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Kristofferzon, Marja-Leena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Häggström, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness2015Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, s. 824-833Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility - still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase 'ability to act' in different ways, based on older people's descriptions of the meaning of autonomy and participation.

  • 257.
    Hedström, Mariann
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Distress among Adolescents with Cancer2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The primary aim was to investigate the distress perceived by adolescents with cancer treated in paediatric oncology. In Study I, especially distressing events for children/adolescents with cancer were identified by interviews with children/adolescents/parents and nurses. Data were analysed with content analysis. A range of physical and emotional concerns was identified. Physical concerns are of a rather similar nature across age groups. Emotional concerns vary more between age groups. For children 8-12 years, emotional concerns are rather frequent. In Study II distressing and positive aspects related to some care situations for adolescents with cancer were identified by interviews with adolescents and nurses. Data were analysed with content analysis. A range of negative aspects, e.g. fear of alienation, fear of dying, altered appearance and physical concerns, as well as positive aspects, e.g. positive relations to staff and being well cared for were identified.

    The aspects of distress identified in Studies I and II formed the basis for a structured interview-guide, used in Studies III and IV. Adolescents, recently diagnosed with cancer, physicians and nurses were interviewed by telephone about distress, anxiety, depression and well-being experienced by the adolescents. Adolescent ratings of prevalence, levels and worst aspects of distress do not necessarily agree, however, worry missing school and mucositis are among those rated with the highest prevalence, levels and those perceived as the overall worst. The findings from Study IV demonstrate that physicians and nurses underestimate the distress caused by worry missing school and mucositis. The accuracy of physician and nurse ratings of physical distress is acceptable, however, this is not the case for psychosocial distress. It can be concluded that it is crucial to consider how questions are asked when interpreting the significance of the answers, and that action on adolescent problems in relation to cancer diagnosis and treatment need to rely on direct communication.

    Delarbeten
    1. Distressing events for children and adolescents with cancer: Child, parent, and nurse perceptions
    Öppna denna publikation i ny flik eller fönster >>Distressing events for children and adolescents with cancer: Child, parent, and nurse perceptions
    2003 (Engelska)Ingår i: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 20, nr 3, s. 120-132Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Distressing events for children with cancer (N = 121), 0 to 19 years of age, were investigated. Data were gathered through interviews with 50 children, 65 parents, and 118 nurses. Each participant was asked: "Has there been any especially distressing event for you/your child/the child with regard to disease and treatment?" Data were analyzed by content analysis. The categories that emerged from the analysis were grouped into a physical and an emotional dimension. The most frequently mentioned aspects of distress referred to the physical dimension: pain resulting from diagnostic procedures and treatments, nausea, and fatigue. The most frequently mentioned physical aspect of distress was, for children 0 to 3, 4 to 7, and 8 to 12 years of age, pain resulting from diagnostic procedures and treatments, and for children > or =13 years of age, nausea. The most frequently mentioned aspects of distress referred to the emotional dimension were categorized as confinement, feeling of alienation, and worry before medical procedures. The most frequently mentioned emotional aspect of distress was, for children 0 to 3 years of age, confinement; 4 to 7 years of age, feeling of alienation; 8 to 12 years of age, worry about death; and > or =13 years of age, changed appearance. For children 0 to 3, 4 to 7, and > or =13 years of age, aspects of distress of a physical character were mentioned most frequently. For children 8 to 12 years of age, aspects of distress of an emotional character were mentioned most frequently.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-64356 (URN)10.1053/jpon.2003.76 (DOI)12776260 (PubMedID)
    Tillgänglig från: 2008-10-17 Skapad: 2008-10-17 Senast uppdaterad: 2017-11-30
    2. Distressing and positive experiences and important aspects of care for adolescents treated for cancer: adolescent and nurse perceptions
    Öppna denna publikation i ny flik eller fönster >>Distressing and positive experiences and important aspects of care for adolescents treated for cancer: adolescent and nurse perceptions
    2004 (Engelska)Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 8, nr 1, s. 6-17Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Distressing and positive experiences for adolescents with cancer with regard to being told the diagnosis, receiving chemotherapy and being admitted to the ward, and important aspects of care for adolescents with cancer was investigated. Data were gathered through semi-structured interviews with 23 adolescents and 21 nurses, and analysed by content analysis. The findings indicate that cancer during adolescence is connected with a range of negative experiences such as fears of alienation, fears of altered appearance, fears of dying, and various physical concerns. Positive experiences include positive relations to staff and being well cared for. Important care for adolescents treated for cancer consists mainly of meeting nice, friendly, supportive, and competent staff, who provide them with age-appropriate information. The findings indicate that adolescents with cancer experience a range of negative and positive experiences related to disease and treatment and that good care for adolescents with cancer is a broad, complex, and multidimensional phenomenon.

    Nyckelord
    Adolescent; Cancer; Care; Experiences; Nurse
    Nationell ämneskategori
    Omvårdnad Cancer och onkologi
    Identifikatorer
    urn:nbn:se:uu:diva-92730 (URN)10.1016/j.ejon.2003.09.001 (DOI)
    Tillgänglig från: 2005-03-30 Skapad: 2005-03-30 Senast uppdaterad: 2017-12-14
    3. Perceptions of distress among adolescents recently diagnosed with cancer
    Öppna denna publikation i ny flik eller fönster >>Perceptions of distress among adolescents recently diagnosed with cancer
    2005 (Engelska)Ingår i: Journal of pediatric hematology/oncology (Print), ISSN 1077-4114, E-ISSN 1536-3678, Vol. 27, nr 1, s. 15-22Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    With the goal of studying perceived distress among adolescents recently diagnosed with cancer, 56 adolescents were interviewed by telephone 4 to 8 weeks after diagnosis. The interviews included a structured interview guide, the Hospital Anxiety and Depression Scale, and the subscales Mental Health and Vitality from SF-36. "Losing hair" and "missing leisure activities" were identified as the most prevalent aspects of distress, whereas "missing leisure activities" and "fatigue" were rated with the highest levels of distress. "Worry about not getting well," "mucositis," "nausea," "pain from procedures and treatments," and "worry about missing school" were rated as the overall worst aspects by most adolescents. Twelve percent reached the cutoff score for potential clinical anxiety and 21% for potential clinical depression. Ratings of Mental Health and Vitality were lower than norm values. Prevalence of pain from procedures/treatments was higher among those who scored in the clinical range of depression, and more adolescents who were treated at a local hospital scored in the clinical range of anxiety. The findings show that ratings of prevalence, levels, and aspects perceived as the worst are not necessarily in accordance, that adolescents scoring in the clinical range of psychological distress are in the minority, and that the adolescents experience reduced physical and mental well-being.

    Nyckelord
    Adaptation; Psychological, Adolescent, Anxiety/*epidemiology/psychology, Depression/epidemiology/psychology, Female, Humans, Male, Neoplasms/*psychology, Prevalence, Psychiatric Status Rating Scales, Research Support; Non-U.S. Gov't, Stress; Psychological/epidemiology/etiology
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-70327 (URN)15654273 (PubMedID)
    Tillgänglig från: 2007-03-26 Skapad: 2007-03-26 Senast uppdaterad: 2017-11-21
    4. Accuracy of assessment of distress, anxiety, and depression by physicians and nurses in adolescents recently diagnosed with cancer
    Öppna denna publikation i ny flik eller fönster >>Accuracy of assessment of distress, anxiety, and depression by physicians and nurses in adolescents recently diagnosed with cancer
    Visa övriga...
    2006 (Engelska)Ingår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 46, nr 7, s. 773-9Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background. As staff members prioritize medical resources forpatients, it is imperative to find out whether their assessments ofpatients’ health status agree with patients’ assessments. The degree towhich physicians and nurses can identify the distress, anxiety, anddepression experienced by adolescents recently diagnosed withcancer was examined here. Procedure. Adolescents undergoingchemotherapy (13–19 years, n¼53), physicians (n¼48), and nurses(n¼53) completed a structured telephone interview, 4–8 weeksafter diagnosis or relapse, investigating disease and treatment-relateddistress, anxiety, and depression. Results. The accuracy of staffratings of physical distress could be considered acceptable.However, problems of a psychosocial nature, which were frequentlyoverestimated, were difficult for staff to identify. Staff underestimatedthe distress caused by mucositis and worry about missing schoolmore than they overestimated distress. These aspects were some ofthe most prevalent and overall worst according to the adolescents.Both physicians and nurses overestimated levels of anxiety anddepression. Nurses tended to show higher sensitivity than physiciansfor distress related to psychosocial aspects of distress, whilephysicians tended to show higher accuracy than nurses for physicaldistress. Conclusions. Staff was reasonably accurate at identifyingphysical distress in adolescents recently diagnosed with cancerwhereas psychosocial problems were generally poorly identified.Thus, the use of staff ratings as a ‘‘test’’ to guide specific supportseems problematic. Considering that the accuracy of staff ratingsoutside a research study is probably lower, identification of andaction taken on adolescent problems in relation to cancer diagnosisand treatment need to rely on direct communication.

    Nyckelord
    Adolescent, Adult, Anxiety/*diagnosis/epidemiology/etiology, Comparative Study, Depression/*diagnosis/epidemiology/etiology, Female, Health Status, Humans, Male, Middle Aged, Neoplasms/complications/*psychology, Nurses, Observer Variation, Physicians, Prevalence, Research Support; Non-U.S. Gov't, Self Assessment (Psychology), Sensitivity and Specificity, Stress; Psychological/*diagnosis/epidemiology/etiology, Sweden/epidemiology
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-19352 (URN)10.1002/pbc.20693 (DOI)16333833 (PubMedID)
    Tillgänglig från: 2008-06-24 Skapad: 2008-06-24 Senast uppdaterad: 2017-12-08
  • 258.
    Hedström, Mariann
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Carlsson, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. 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 universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Development of the PHASE-Proxy scale for rating drug-related signs and symptoms in severe cognitive impairment2018Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, nr 1, s. 53-60Artikel i tidskrift (Refereegranskat)
    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.

  • 259.
    Hedström, Mariann
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Skolin, Inger
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Distressing and positive experiences and important aspects of care for adolescents treated for cancer: adolescent and nurse perceptions2004Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 8, nr 1, s. 6-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Distressing and positive experiences for adolescents with cancer with regard to being told the diagnosis, receiving chemotherapy and being admitted to the ward, and important aspects of care for adolescents with cancer was investigated. Data were gathered through semi-structured interviews with 23 adolescents and 21 nurses, and analysed by content analysis. The findings indicate that cancer during adolescence is connected with a range of negative experiences such as fears of alienation, fears of altered appearance, fears of dying, and various physical concerns. Positive experiences include positive relations to staff and being well cared for. Important care for adolescents treated for cancer consists mainly of meeting nice, friendly, supportive, and competent staff, who provide them with age-appropriate information. The findings indicate that adolescents with cancer experience a range of negative and positive experiences related to disease and treatment and that good care for adolescents with cancer is a broad, complex, and multidimensional phenomenon.

  • 260.
    Hedén, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Pöder, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård.
    Ljungman, Gustaf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Parents' Perceptions of Their Child's Symptom Burden During and After Cancer Treatment2013Ingår i: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, nr S3, s. 42-42Artikel i tidskrift (Övrigt vetenskapligt)
  • 261.
    Hedén, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Pöder, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård.
    Ljungman, Gustaf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Parents' Perceptions of Their Child's Symptom Burden During and After Cancer Treatment2013Ingår i: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 46, nr 3, s. 366-375Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context

    Parents’ perceptions of their child’s symptom burden during and after cancer treatment.

    Objectives

    The aim is to describe parents’ perceptions of their child’s symptom burden during and after cancer treatment and to investigate whether parents’ perceptions vary with child characteristics and parent gender.

    Methods

    160 parents (49% fathers) of 89 children answered a modified version of the Memorial Assessment Symptom Scale (MSAS) 10-18 at six assessments from one week after the child’s diagnosis (T1) to 12-18 months after the end of successful treatment (T6).

    Results

    Feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms, and less hair than usual the most prevalent symptom during treatment. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout treatment. The child’s symptom burden decreases over time. There is no difference with regard to reported symptom burden between parents of a daughter or a son, or parents of a child over or under 7 years of age. Mothers’ and fathers’ assessments of the symptom number, total MSAS, and the subscales are associated, but mothers’ assessments are often higher than fathers’.

    Conclusion

    The prevalence and distress of symptoms and symptom burden decrease over time. However, even though the cancer is cured, feeling sad is reported as being prevalent and psychological distress is an issue. A dialogue between staff and the family about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during the disease trajectory.

  • 262.
    Hellerstedt-Börjesson, Susanne
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Arving, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Fjällskog, Marie-Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för onkologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Onkologisk endokrinologi.
    Holmström-Knutsson, Iinger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Women with breast cancer: Experiences and impact of chemotherapy-induced pain on daily life2014Ingår i: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 50, nr S2, s. S108-S108Artikel i tidskrift (Övrigt vetenskapligt)
  • 263.
    Hellman, Jenny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Att vara småbarnsmamma: mödrar till 18-månadersbarn och deras syn på moderskapet2010Självständigt arbete på avancerad nivå (magisterexamen), 15 poäng / 22,5 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Att bli mamma innebär en stor förändring inte bara fysiskt utan även psykiskt och socialt. Det är viktigt att man lyssnar på mammors upplevelser och stödjer dem i deras föräldraskap.

    Syfte: Att undersöka vad mammor till 18 månaders barn har för upplevelser om hur det är att vara småbarnsmamma.

    Metod: Studien inkluderar 409 enkätsvar. Datainsamlingen skedde med hjälp av strukturerade enkäter som samlades in från en större undersökning från barnhälsovård i förändring (BIF). Urvalet är mammor till 18 månaders barn har fått svara på en öppen fråga om hur det är att vara småbarnsmamma. Studien har en deskriptiv design med kvalitativ ansats.

    Resultat: Resultatet visar att mammorna upplevde känslor av kärlek och lycka till det egna barnet men även känslor av trötthet, stress och att känna sig otillräcklig fanns. Mammor upplevde även svårigheter med att kombinera arbetsliv med familjeliv. Resultatet visade även att många av mammorna saknade ett socialt nätverk och stödet från BVC visade sig vara stort.

    Slutsats: Mödrar har olika behov av stöd och bekräftelse. Som distriktssköterska är det en utmaning att svara upp till detta.

  • 264. Hellström-Hyson, Eva
    et al.
    Mårtensson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Kristofferzon, Marja-Leena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    To take responsibility or to be an onlooker: Nursing students' experiences of two models of supervision2012Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 32, nr 1, s. 105-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The present study aimed at describing how nursing students engaged in their clinical practice experienced two models of supervision: supervision on student wards and traditional supervision.

    Background: Supervision for nursing students in clinical practice can be organized in different ways. In the present study, parts of nursing students' clinical practice were carried out on student wards in existing hospital departments. The purpose was to give students the opportunity to assume greater responsibility for their clinical education and to apply the nursing process more independently through peer learning.

    Method: A descriptive design with a qualitative approach was used. Interviews were carried out with eight nursing students in their final semester of a 3-year degree program in nursing. The data were analyzed using content analysis.

    Findings: Two themes were revealed in the data analysis: When supervised on the student wards, nursing students experienced assuming responsibility and finding one's professional role, while during traditional supervision, they experienced being an onlooker and haying difficulties assuming responsibility.

    Conclusions: Supervision on a student ward was found to give nursing students a feeling of acknowledgment and more opportunities to develop independence, continuity, cooperation and confidence.

  • 265.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Biokemisk struktur och funktion.
    Åkerfeldt, Torbjörn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Biokemisk struktur och funktion.
    Gunningberg, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Leo Swenne, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Biokemisk struktur och funktion.
    Serum MMP-9 and TIMP-1 concentrations and MMP-9 activity during surgery-induced inflammation in humans2012Ingår i: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 50, nr 6, s. 1115-1119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

     Background: Matrix metalloproteinase 9 (MMP-9) and the endogenous inhibitor to MMP-9, tissue inhibitor of metalloproteinase 1 (TIMP-1), have important roles in tissue remodelling and are implicated in a number of diseases related to inflammation. The time course in activation and formation of MMPs and TIMPs during an inflammatory reaction is not fully known. This study investigates MMP-9 and TIMP-1 concentrations and MMP-9 activity at different time points after major surgery when a state of noticeable inflammation is expected.

    Methods: Serum MMP-9 and TIMP-1 concentrations and MMP-9 activity were analysed preoperatively and 4 and 30 days postoperatively in patients undergoing elective surgery (coronary artery bypass n=21; orthopaedic surgery, n=29).

    Results: Serum TIMP-1 and MMP-9 activity increased significantly 4 days after surgery (p<0.05 and p<0.01, respectively) and decreased again 30 days after surgery (p<0.01, respectively, compared to 4 days after surgery). Serum MMP-9 increased significantly 4 days after surgery (p<0.05) and was still high 30 days after surgery (p<0.01 compared to before surgery). The calculated MMP-9/TIMP-1 ratio was increased 30 days after surgery compared to before surgery (p<0.01).

    Conclusions: The inflammatory state induced by elective surgery is associated with increased TIMP-1 response and MMP-9 activity in serum within a few days which may be of importance for the postoperative heeling process. The further increase in MMP-9 concentrations at day 30 postoperative did not result in increased MMP-9 activity. Serum MMP-9 concentrations or the calculated MMP-9/TIMP-1 ratio do not entirely represent MMP-9 activity during surgery-induced inflammation.

  • 266. Hemingway, Ann
    et al.
    Aarts, Clara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Koskinen, Liisa
    Campbell, Barbara
    Chassé, France
    A European Union and Canadian Review of Public Health Nursing Preparation and Practice2013Ingår i: Public Health Nursing, ISSN 0737-1209, E-ISSN 1525-1446, Vol. 30, nr 1, s. 58-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: This study explores the preparation and role of the public health nurse (PHN) across European Union (EU) countries (Finland, Sweden, and the United Kingdom) and Canadian provinces (Alberta, New Brunswick, and Prince Edward Island).

    METHODS: A literature review including relevant peer reviewed articles from 2000 on, in conjunction, with critical debate was undertaken. The results were considered in relation to the three essential areas of PHN practice, outlined in the World Health Organization (Moving on from Munich: A reference guide to the implementation of the declaration on nurses and midwives: A force for health, 2001b) recommendations, family oriented care, public health action, and policy making.

    RESULTS: The major challenge the review revealed across a variety of international education and practice environments was the lack of consistent preparation for and engagement with leadership and policy making in practice.

  • 267.
    Henriksson, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Arving, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Igelström, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom.
    Phys-Can Feasibility Study: Perceived Barriers and Facilities to Exercise During Adjuvant Cancer Treatment2014Konferensbidrag (Övrigt vetenskapligt)
  • 268.
    Hjelm, Katarina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Bard, Karin
    University of Linköping, Norrköping, Sweden.
    Apelqvist, Jan
    University of Lund, Lund, Sweden.
    A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden2018Ingår i: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 18, artikel-id 34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Gestational diabetes (GDM) is associated with health risks for both mother and child, and is particularly relevant to migrant women and women of African origin. With today's extensive global migration, contact with the new society and health system confronts the migrant's culture of origin with the culture of the host country. The question is whether immigrants' patterns of beliefs about health, illness, and health-related behaviour change over time, as no previous studies have been found on this topic. The purpose was to explore development over time, during and after pregnancy, of beliefs about health, illness and healthcare in migrant women with GDM born in Africa living in Sweden, and study the influence on self-care and care seeking.

    METHODS: Qualitative prospective study. Semi-structured interviews, with 9 women (23-40 years), on three different occasions: during pregnancy (gestational weeks 34-38), and 3 and 14 months after delivery managed at an in-hospital diabetes specialist clinic in Sweden.

    RESULTS: Beliefs were rather stable over time and mainly related to individual and social factors. GDM was perceived as a transient condition as health professionals had informed about it, which made them calm. None, except one, expressed worries about relapse and the health of the baby. Instead women worried about being unable to live an ordinary life and being bound to lifestyle changes, particularly diet, developing diabetes and needing insulin injections. Over time knowledge of appropriate diet improved, although no advice was experienced given by the clinic after delivery. The healthcare model was perceived as well functioning with easy access but regular follow-ups were requested as many (decreasing over time) were unsure whether they still had GDM and lacked information about GDM and diet. During pregnancy information was also requested about the healthcare system before/after delivery.

    CONCLUSIONS: Beliefs changed to a limited extent prospectively, indicated low risk awareness, limited knowledge of GDM, irrelevant worries about future health, and being unable to live a normal life, associated with problematic lifestyle changes. Beliefs about the seriousness of GDM in health professionals influenced patients' beliefs and health-related behaviour. The healthcare organisation urgently needs to be improved to deliver appropriate and timely information through competent staff.

  • 269.
    Hjorth, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Gastroenterologi/hepatologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna.
    Sjöberg, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna.
    Svanberg, Anncarin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Hematologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Dalarna University, Falun, Sweden.
    Kaminsky, Elenor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Langenskiöld, Sophie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Folkhälsovetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälsoekonomi.
    Rorsman, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Gastroenterologi/hepatologi.
    Nurse-led clinic for patients with liver cirrhosis-effects on health-related quality of life: study protocol of a pragmatic multicentre randomised controlled trial.2018Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 10, artikel-id e023064Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Liver cirrhosis affects health-related quality of life (HRQoL) even in its early stages. Morbidity is especially high when the disease decompensates and self-care actions become essential. Nurse involvement in secondary prevention in other chronic diseases has contributed to better symptom control, less need of inpatient care and improved HRQoL. In order to evaluate the impact of nurse involvement in the follow-up of patients with liver cirrhosis, we decided to compare structured nurse-led clinics, inspired by Dorothea Orem's nursing theory and motivational strategies, with a group of patients receiving standard care. The primary outcome is HRQoL and the secondary outcomes are quality of care, visits to outpatient clinics or hospitals, disease progress and health literacy.

    METHODS AND ANALYSIS: This is a pragmatic, multicentre randomised controlled study conducted at six Swedish hepatology departments. Eligible patients are adults with diagnosed cirrhosis of the liver (n=500). Participants are randomised into either an intervention with nurse-led follow-up group or into a standard of care group. Recruitment started in November 2016 and is expected to proceed until 2020. Primary outcomes are physical and mental HRQoL measured by RAND-36 at enrolment, after 1 and 2 years.

    ETHICS AND DISSEMINATION: The study is ethically approved by the Regional Ethical Review Board in Uppsala. The results shall be disseminated in international conferences and peer-reviewed articles.

    TRIAL REGISTRATION NUMBER: NCT02957253; Pre-results.

  • 270.
    Hofsten, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Gustafsson, Christina
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Fakulteten för utbildningsvetenskaper, Institutionen för pedagogik, didaktik och utbildningsstudier.
    Häggström, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Case seminars open doors to deeper understanding: nursing students' experiences of learning2010Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 30, nr 6, s. 533-538Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    The Case Method is a teaching method in which cases from real life inspire students to actively seek knowledge that they discuss in structured seminars. Case seminars in health education have been evaluated, compared and discussed, but descriptions that can help us understand how students learn in the seminars have not previously been published. In a Swedish nursing programme, where case seminars have been used for several years, students were asked to write about their experiences of learning in the seminars. The aim of the present study was to describe this learning process from the students' point of view.

    METHOD:

    Written data were analysed using content analysis.

    FINDINGS:

    A theme concerning how the Case Method opens doors to deeper understanding was identified as a thread running through different codes and categories. Students described the importance of new perspectives and their wish to participate in discussions with other students. The students indicated that the structure, which involved pre-prepared cases and writing on the white board, positioned their own knowledge in a wider context and that the learning atmosphere enabled everyone to participate.

    CONCLUSIONS:

    The Case Method seems to involve students in a way that deepens their understanding and critical thinking.

  • 271. Holmberg, Karin S. M.
    et al.
    Peterson, Ulla M. C.
    Oscarsson, Marie G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    A two-decade perspective on mothers' experiences and feelings related to breastfeeding initiation in Sweden2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 3, s. 125-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The purpose was to examine mothers' experiences and feelings related to breastfeeding initiation from a two-decade perspective. Methods: A repeated cross-sectional survey was conducted at a maternity ward before and after introduction of Baby Friendly Hospital Initiative (BFHI) and in a follow-up survey. Women participated in 1992 (n = 83), 1993 (n = 74) and 2011 (n = 94). Results: The duration of time at the first suckling differed; in 2011, the baby sucked 24.4 minutes compared to 12.7 minutes in 1992 (p < .001) and 13.6 minutes in 1993 (p < .001). In 1992, 34.6% of the women reported using supplementary formula compared with 5.9% in 1993 and 9.3% in 2011 (p < .001). The mothers' contacts with the child or the father as well as their moods did not vary during the years. Mothers rated their feelings towards breastfeeding as being lower in 2011 than in 1992 and 1993 (p = .008). In 2011, mothers experienced breastfeeding as being more difficult and reported a higher degree of tension, insecurity and anxiety. Conclusions: Supplementation was given to healthy newborn infants, which does not conform to BFHIs intentions. Routines and support in relation to breastfeeding initiation need to be continuously evaluated in order to strengthen and sustain the BFHI.

  • 272.
    Holmstrom, Inger K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Malardalen Univ, Sch Hlth Care & Social Welf, Box 883, SE-72123 Vasteras, Sweden.
    Kaminsky, Elenor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Malardalen Univ, Sch Hlth Care & Social Welf, Box 883, SE-72123 Vasteras, Sweden.
    Höglund, Anna T.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Centrum för forsknings- och bioetik.
    Carlsson, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Univ Gavle, Fac Hlth & Occupat Studies, SE-80176 Gavle, Sweden..
    Nursing students' awareness of inequity in healthcare - An intersectional perspective2017Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 48, s. 134-139Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The overall aim of the present study was to explore awareness of inequity in healthcare and the intersection between different structures of power among nursing students. Another aim was to delineate the knowledge and use of Swedish Healthcare Direct in this group.

    Design: The study had a descriptive design with a quantitative approach.

    Participants: The sample consisted of 157 nursing students from three universities in central Sweden.

    Methods: The students filled out a study specific questionnaire in class. The questionnaire consisted of short descriptions of twelve fictive persons who differed in gender, age, and ethnicity, with questions about their life situation. The mean was calculated for each assessed fictive person for every item. In the next step, the assessments were ranked from the lowest probability to the highest probability. A 'Good life-index' consisting of quality of life, power over own life, and experience of discrimination, was also calculated. Free text comments were analysed qualitatively.

    Results: People with Swedish names were assessed to have the highest probability of having a good life. Among those with Swedish names, the oldest woman was assessed as having the lowest probability of a good life. All students had knowledge about Swedish Healthcare Direct, but more female students had used the service compared to male students.

    Conclusions: The results indicate that the nursing students had awareness of how power and gender, ethnicity and age, are related. Based on the free text comments, the questions and the intersectional perspective seemed to evoke some irritation which points to their sensitive nature. Therefore, the questionnaire could be used as a tool to start a discussion of equity in healthcare and in interventions where the aim is to raise awareness of inequality and intersectionality.

  • 273.
    Hommel, Ami
    et al.
    Skane Univ Hosp, Lund, Sweden.
    Gunningberg, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Idvall, Ewa
    Malmo Univ, Fac Hlth & Soc, Malmo, Sweden.; Skane Univ Hosp, Malmo, Sweden..
    Bååth, Carina
    Karlstad Univ, Dept Hlth Sci, Karlstad, Sweden.; Country Council Va armland, Karlstad, Sweden..
    Sucessful factors to prevent pressure ulcers - An interview study2017Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, nr 1-2, s. 182-189Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM AND OBJECTIVES: The aim of present study was to explore successful factors to prevent pressure ulcers (PU) in hospital settings.

    BACKGROUND: PU prevalence has been recognized as a quality indicator for both patient safety and quality of care in hospital and community settings. Most PU can be prevented if effective measures are implemented and evaluated. The Swedish Association of Local Authorities and Regions (SALAR) initiated nationwide PU prevalence studies in 2011. In 2014, after four years of measurement, the prevalence was still unacceptably high on a national level. The mean prevalence of PU in the spring of 2014 was 14% in hospital settings with a range from 2.7% to 36.4%.

    DESIGN: Qualitative semi-structured interviews were conducted.

    METHODS: A qualitative content analysis, in addition to PARIHS frameworks was used in the analysis of the data text. Individual interviews and focus groups were used to create opportunities for both individual responses and group interactions. The study was conducted at six hospitals during the fall of 2014.

    RESULTS: Three main categories were identified as successful factors to prevent PU in hospitals: creating a good organization, maintaining persistent awareness, and realising the benefits for patients.

    CONCLUSION: The goal for all healthcare personnel must be delivering high-quality, sustainable care to patients. Prevention of PU is crucial in this work. It seems to be easier for small hospitals (with a low number of units/beds) to develop and sustain an effective organization in prevention work.

    RELEVANCE TO CLINICAL PRACTICE: The nurse managers' attitude and crucial to enable the personnel to work actively with PU prevention. Strategies are proposed to advance clinical leadership, knowledge, skills, and abilities for the crucial implementation of PU prevention.

  • 274.
    Hovstadius, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Film som pedagogiskt verktyg: en brygga mellan teori och klinik2013Ingår i: Högre Utbildning, ISSN 2000-7558, E-ISSN 2000-7558, Vol. 3, nr 1, s. 63-68Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    På sjuksköterskeprogrammet, Uppsala universitet, har kliniska avdelningar filmats i syfte att underlätta för studenterna att ta steget från teori till klinik. Förutom film har presentationstext om respektive avdelning lagts ut i studenternas lärplattform så att de innan VFU kunnat ta del av en visuell rundvandring och fakta om den avdelning de skulle praktisera på. Syftet med studien som presenteras här var att undersöka om studenter inför sin VFU hade nytta av film och presentationstext. Enkät besvarades via webben av 52 (73 %). Studenterna uppgav att de i varierande grad hade nytta av presentationstext och film. De kände sig välkomnade, fick en inblick i verksamheten och kunde förbereda sig genom att läsa på i förväg.

  • 275.
    Hovén, Emma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Grönqvist, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Pöder, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Lindahl Norberg, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk psykologi i hälso- och sjukvård. Department of Women's and Children's Health, Karolinska Institutet.
    Impact of a child’s cancer disease on parents’ everyday life: A longitudinal study from Sweden2017Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 56, nr 1, s. 93-100Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A child's cancer disease may disrupt the daily life of the affected family for a long period. The aim was to describe restrictions on parents' leisure activities and work/studies during and after the child's treatment. Methods: This study used data from a cohort of mothers and fathers (n = 246) of children diagnosed with cancer. Data was collected five times from two months after diagnosis to one year after end of treatment. Reports of restrictions were evaluated over time, between mothers and fathers, and in relation to parent-reported child symptom burden (The Memorial Symptom Assessment Scale) and partial post-traumatic stress disorder (PTSD) (The PTSD Checklist-Civilian Version). Results: Two (51%) and four (45%) months after diagnosis, about half reported that their leisure activities were restricted at least some of the time. Corresponding percentages for restrictions on work/ studies were 84% and 77%. One year after end of treatment, the great majority reported that their leisure activities (91%) and/or work/studies (76%) were never/seldom restricted. During treatment, more mothers than fathers reported restrictions on work/studies all/most of the time. After end of treatment, gender was only related to reports of restrictions among parents not reporting partial PTSD. More parents who reported being restricted all/most of the time also reported partial PTSD and/or a greater symptom burden for the child. Conclusion: Parents report frequent restrictions on everyday life during treatment. One year after end of treatment, parents report only a limited impact of the child's cancer on their leisure activities and work/studies. More parents who report restrictions also report partial PTSD and/or a greater child symptom burden. The effect of gender on restrictions varies depending on reports of partial PTSD. Future studies of gender differences regarding the impact of a child's cancer on parents' everyday life should thus consider mothers' and fathers' level of psychological distress.

  • 276.
    Hovén, Emma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Hagström, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Pöder, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Grönqvist, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    von Essen, Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Parents' needs of support following the loss of a child to cancer: a Swedish, prospective, longitudinal, multi-centre study2019Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226XArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Parents' needs of support following the loss of a child to cancer and whether these needs are met are not fully known. This study aimed to describe parents' needs, opportunity, and benefit of support from healthcare professionals and significant others from shortly after, up to five years after bereavement.

    Material and methods: Data were collected at nine months (T5, n = 20), eighteen months (T6, n = 37), and five years after the child's death (T7, n = 38). Parents answered questions via telephone about need, opportunity, and benefit of talking to psychologists, social workers, partners, and friends. Needs were examined in relation to parent and child characteristics, including sex, age, and parent posttraumatic stress symptoms (PTSS).

    Results: The proportion reporting a need of support from psychologists varied from 56% and 46% at T5 to 20% and 6% at T7 (mothers and fathers, respectively). All mothers and 90% of fathers reported a need of support from social workers at T5. At T7, the corresponding percentages were 30% and 6%. More mothers than fathers reported a need of support from friends at T7 (p = .001). The proportion reporting a need of support from psychologists, social workers, and friends decreased over time (all p <= .050). Parents reporting a higher level of PTSS were more likely to report a need of support from social workers at T6 (p = .040) and from psychologists (p = .011) and social workers (p = .012) at T7. Opportunities for support from healthcare professionals varied, most reported need of and opportunity for support from significant others. Almost all reported benefit from received support.

    Conclusion: Bereaved parents need and benefit of support from healthcare professionals and significant others. Results show a need for improved access to psychosocial services, even at five years post bereavement. Large-scale studies are needed to better understand the associations between parent and child characteristics and support needs.

  • 277.
    Hultin, Lisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Karlsson, Ann-Christin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Öhrvall, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Gunningberg, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Information and Communication Technology Can Increase Patient Participation in Pressure Injury Prevention A Qualitative Study in Older Orthopedic Patients2019Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 46, nr 5, s. 383-389Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The aim of this study was to assess the participatory capabilities of hospitalized older adults in response to the Continuous Bedside Pressure Mapping system placed on the beds to prevent pressure injuries. DESIGN: Descriptive study. SUBJECTS AND SETTING: A convenience sample of 31 orthopedic patients were recruited from an orthopedic rehabilitation unit at a university hospital in Uppsala, Sweden, that served patients aged 65 years and older. METHODS: Semistructured interviews were conducted between November 2016 and February 2017, audio-recorded, and transcribed verbatim. Data were analyzed using qualitative content analysis. RESULT: The overall theme from 21 interviews was "A new way of understanding helped patients to recognize vulnerable pressure points and to take action in their own care" from which 2 categories, "awareness" and "action," emerged. The study showed that verbally adapted information combined with using information and communication technology increased most participants' knowledge and as they became aware of increased pressure, they started to take preventative action by changing position. CONCLUSIONS: It is possible for older participants in a rehabilitation unit who had recent orthopedic surgery to understand and use new information and communication technology and should be invited to participate in pressure injury prevention.

  • 278.
    Hultin, Lisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Olsson, Estrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Carli, Cheryl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Gunningberg, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Pressure Mapping in Elderly Care: A Tool to Increase Pressure Injury Knowledge and Awareness Among Staff2017Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 44, nr 2, artikel-id 142-47Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The purpose of this study was to evaluate the use of a pressure mapping system with real-time feedback of pressure points in elderly care, with specific focus on pressure injury (PI) knowledge/attitudes (staff), interface pressure, and PI prevention activities (residents). DESIGN: Descriptive, 1-group pretest/posttest study. SUBJECTS AND SETTING: A convenience sample of 40 assistant nurses and aides participated in the study; staff members were recruited at daytime, and 1 nighttime meeting was held at the facility. A convenience sample of 12 residents with risk for PI were recruited, 4 from each ward. Inclusion criteria were participants older than 65 years, Modified Norton Scale score 20 or less, and in need of help with turning in order to prevent PI. The study setting was a care facility for the elderly in Uppsala, Sweden. METHODS: A descriptive, comparative pretest/posttest study design was used. The intervention consisted of the use of a pressure mapping system, combined with theoretical and practical teaching. Theoretical and practical information related to PI prevention and the pressure mapping system was presented to the staff. The staff (n = 40) completed the Pressure Ulcer Knowledge and Assessment Tool (PUKAT) and Attitudes towards Pressure Ulcer (APuP) before and following study intervention. Residents' beds were equipped with a pressure mapping system during 7 consecutive days. Peak pressures and preventive interventions were registered 3 times a day by trained study nurses, assistant nurses, and aides. RESULTS: Staff members' PUKAT scores increased significantly (P = .002), while their attitude scores, which were high pretest, remained unchanged. Peak interface pressures were significantly reduced (P = .016), and more preventive interventions (n = 0.012) were implemented when the staff repositioned residents after feedback from the pressure mapping system. CONCLUSIONS: A limited educational intervention, combined with the use of a pressure mapping system, was successful as it improved staff members' knowledge about PI prevention, reduced interface pressure, and increased PI prevention activities. As many of the staff members lacked formal education in PI prevention and management, opportunities for teaching sessions and reflection upon PI prevention should be incorporated into the workplace. More research is needed to evaluate the effect of continuous pressure mapping on the incidence of PI.

  • 279.
    Hägglund, Doris
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Olsson, Henny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Leppert, Jerzy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Urinary incontinence: an unexpected large problem among young females. Results from a population-based study1999Ingår i: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 16, nr 5, s. 506-509Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    The International Continence Society has defined urinary incontinence as a condition in which involuntary loss of urine is objectively demonstrable and is a social or hygiene problem. Urinary incontinence is presumably a common health problem among women even in younger ages.

    OBJECTIVES:

    The primary aim was to investigate the prevalence of urinary incontinence (UI) in a female population with a special focus on younger women (18-30 years old). The secondary aim was to investigate the association between UI and number of deliveries, use of contraceptives or oestrogen substitutions, and urinary tract infections (UTIs).

    METHODS:

    A population-based study with a self-administered questionnaire was set in the community of Surahammar, Sweden. Subjects were all women (3493) aged 18-70 years living in Surahammar during 1995. The main outcome measures were the prevalence of UI and variables such as number of deliveries, use of contraceptives or oestrogen substitutions, and UTIs.

    RESULTS:

    Twenty-six per cent of the women reported problems of UI. The prevalence of UI in younger women was 12%. The number of reported complaints of UTIs was significantly higher in the women with UI compared with women without urinary incontinence (wUI). In the younger women UTI, nulliparous or having given birth to one or two children were most frequent in those with UI. The use of contraceptives was more common in younger women without UI (P < 0.05). However, the use of oestrogen was more common in older women in the age group 51-70 years with UI (P < 0.01).

    CONCLUSION:

    Our findings have shown that 26% of the women who took part in the survey reported problems of UI. Among women below 30 years of age, 12% reported complaints of UI. We found a high prevalence of UI in younger women with a UTI, not taking oestrogen, nulliparous or having given birth to one or two children. There are needs for further investigations with a special focus on younger women.

  • 280. Hägglund, Doris
    et al.
    Wadensten, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Andersson, Catarina
    Aflarenko, Margareta
    Effekten av tranbärsjuice och personalutbildning i vårdhygien för att förebygga urinvägsinfektioner inom särskilt boende2009Ingår i: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 29, nr 2, s. 28-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cranberry juice is often given to elderly persons in nursing homes to prevent urinary tract infections; still there is little evidence to support itsuse. Basic hygiene routines are important for preventing urinary tract infections. The aim of this study was to investigate whether cranberry juiceand staff education in hygiene care can prevent symptomatic urinary tract infections among elderly persons living in nursing homes. A quasiexperimentalstudy with three intervention groups and one control group was conducted involving 257 elderly women and men. A total of 48symptomatic urinary tract infections were documented over the six months of the study: 21 (43.7%) in the cranberry group, 11 (22.9%) in thecontrol group, 9 (18.7%) in the cranberry/hygiene care group and 7 (14.5%) in the hygiene care group. These between-group differences werenot statistic significant. Hence, our study showed no preventive effect from cranberry juice, alone or in combination with staff education in hygienecare, on the incidence of symptomatic urinary tract infections. However, more and better research with larger randomised trials or cranberrycapsules is needed to study its potential use to prevent urinary tract infections in elderly persons.

  • 281.
    Hägglund, Doris
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Walker-Engström, Marie-Louise
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Larsson, Gregor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Leppert, Jerzy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Quality of life and seeking help in women with urinary incontinence: A population-based study2001Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 80, nr 11, s. 1051-1055Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    The aims of this population-based study were to compare the quality of life (QoL) in; (a) women with urinary incontinence (UI) and women without urinary incontinence (wUI) in relation to age, (b) women with stress incontinence and women with urge incontinence, and (c) women who had, vs. women who had not, consulted a health care service because of UI.

    METHODS:

    Totally, 787 women who reported symptoms of UI and 787 women who did not report symptoms of UI, aged 18-72 years, were mailed the Short Form-36 QoL questionnaire (SF-36) and a question concerning professional consultation. They were also mailed the Detrusor Instability Score questionnaire, which was used to clarify the women as being stress vs. urge incontinent.

    RESULTS:

    Women with UI had significantly lower scores on all eight dimensions of the SF-36. There were low correlations between age and the QoL scores in women with or without UI. Both women with stress incontinence and women with urge incontinence had significantly lower scores on all eight QoL dimensions compared with the women without UI. However, the absolute difference was smaller for women with stress incontinence. Women with urge incontinence consult health care service more often than women with stress incontinence. Women with UI who had consulted health care had significantly lower QoL scores than women with UI who had not consulted health care in seven out of eight dimensions.

    CONCLUSIONS:

    The QoL, in this female general population, is more affected by women with urge incontinence than women with stress incontinence. Help seeking is associated with substantially lower QoL scores and with urge incontinence.

  • 282.
    Häggström, Elisabeth
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Engström, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Barbro, Barbro Wadensten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    A nine-month intervention programme focusing on empowerment: caregivers' descriptions of changed behaviour and increased room for acting2009Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, nr 6, s. 866-873Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe public nursing home Enrolled Nurses' and Nurses Aides' view of their work and their perceptions of themselves in their professional role while they were receiving a serious of role awareness sessions focusing on empowerment for nine months.

    BACKGROUND: According to several studies, it is typical that women may experience problems and injustices at work. The main focus of the intervention was to help enrolled nurses' and nurses aides' in developing their self-image and professional role.

    DESIGN: This study was descriptive and qualitative in design.

    METHODS: The present study comprises semi-structured interviews conducted with enrolled nurses and nurses aides (n = 14) from public nursing homes at start of the intervention and again nine months following the intervention. The text from the interviews was analysed using latent content analysis.

    RESULTS: The main findings primarily show an improved professional role for the caregivers, as described in the following themes: the move from passivity to activity, the move from complaining to understanding, the move from expectations to frustration and the move from being silent to speaking loud.

    CONCLUSIONS: For caregivers working with older people within public nursing home care, it seems to be a good form of clinical supervision to implement a serious of role awareness sessions in order to improve their professional role.

    RELEVANCE TO CLINICAL PRACTICE: The findings showed that an intervention providing opportunities with focus on empowerment improved the enrolled nurses' and nurses aides' professional role in working with older people. This can be useful information for managers and educators and they may want to adapt it when working in a public nursing home.

  • 283.
    Häggström, Elisabeth
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Hofsten, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Wadensten, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Nurses' options about a web-based distance course in a specialist education programme for the care of older people: a questionnaire study2009Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, nr 3, s. 177-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to investigate students' opinions about a web-based distance learning course that was part of a specialist education programme.

    Background

    Most registered nurses (RNs) who work with older people in Sweden do not have a specialist education in caring for older people. Design.?Survey.

    Method

    The study was a descriptive survey with both qualitative and quantitative questions.

    Results

    The students found the web-based course very useful for their theoretical and professional development. New perspectives on ageing, increased knowledge about analysing and describing theories as well as practising interviews and qualitative analysis as methods were appreciated by the students.

    Conclusions

    One way for RNs in Sweden to get a university specialist education in the care of older people is to have a distance web-based course, as it allows flexibility and improves the students' theoretical and professional knowledge and communication skills. Relevance for clinical practice.?Managers working in care for older people settings and educators will be interested in this study's finding that distance learning is a useful strategy for providing education for RNs who work with older people.

  • 284. Häggström, Elisabeth
    et al.
    Kihlgren, Mona
    Wadensten, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Caregivers working with older people experience work dissatisfaction and low self-esteem orginating from power relations in the municipal care organization2009Artikel i tidskrift (Refereegranskat)
  • 285.
    Häggström, Erika
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
    Rehnman, M
    Gunningberg, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Quality of life and social life situation in Islet transplant patients: Time for a change in outcome measures?2011Ingår i: International Journal of Organ Transplantation Medicin, ISSN 2008-6490, Vol. 2, nr 3, s. 117-125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    One of the overall goals in health care is to prolong life, increase patients’ wellbeing and quality of life. Many of patients with severe insulin-dependent diabetes mellitus experience fear of hypoglycemia (FoH), which forces them to change their lives both physically and socially to avoid episodes of hypoglycemia.

    Objective:

    To investigate the quality of life and the social life situation, with special focus on the consequences of FoH in islet transplanted patients.

    Methods:

    11 patients (4 women and 7 men) were included; they have undergone islet transplantation at Uppsala University Hospital during the period 2001–2009. Short Form 36 (SF-36) and the Swedish version Hypoglycemia Fear Survey (Swe-HFS) were used to investigate quality of life, in relation to FoH. In addition, telephone interviews were conducted to investigate the patients social life situation in relation to FoH, after islet transplantation and were analyzed using a content analysis method.

    Results:

    The mean value for quality of life was lower than that in the normal population. 3 out of 10 patients experienced FoH; one patient declined to answer the questionnaire. 3 predominant themes were revealed; one theme associated with pre-transplant, was "struggle for control of social life situation" and two themes associated with post-transplant, were "regain power and control of social life situation" and "at peace with the balance between the present and the future."

    Conclusion:

    The patients experienced improved control over social life situation while quality of life in relation to FoH may have improved following islet transplantation.

  • 286.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Borneskog, Catrin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Eriksson, Mats
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Sexual behaviour and contraceptive use among Swedish high school students in two cities: Comparisons between genders, study programmes, and over time2011Ingår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 16, nr 1, s. 36-46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To investigate sexual behaviour and contraceptive use among first-year high school students in two Swedish cities in 2009, to compare male and female students, students in theoretical and vocational study programmes, and their sexual behaviour with that reported in 1979, 1989 and 1999. Methods In a cluster sample of 20 classes, students (N387), median age 16 years, completed a questionnaire consisting of 46 questions. Results More girls than boys had experienced petting (p≤0.003) and had received oral sex (p≤0.01). More boys than girls had masturbated (p≤0.0001) and watched pornography (p≤0.0001). The median age at first sexual intercourse was 15 years. Students in vocational programmes were more sexually experienced compared to their theoretical peers. The proportion of students having had sexual intercourse (p≤0.0002), and contraceptive use at first (p≤0.0001) and latest (p≤0.0001) sexual intercourse increased from 1979 to 2009. Alcohol use at first intercourse decreased over the period (p≤0.0001). Conclusion sGirls were more sexually experienced than boys, as were students in vocational programmes compared to their theoretical peers; this should be considered when tailoring sex education and counselling. Over time, an increase in students having had sexual intercourse, and contraceptive use at first and latest sexual intercourse was found.

  • 287.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hanson, Ulf
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Associations between pornography consumption and sexual practices among adolescents in Sweden2005Ingår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 16, nr 2, s. 102-107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pornography consumption and sexual behaviour were studied, with an aim to investigate any associations. Participants were 718 students from 47 high school classes, mean age 18 years, in a medium-sized Swedish city. More men (98%) than women (72%) had ever consumed pornography. More male high consumers than low consumers or women got sexually aroused by, fantasized about, or tried to perform acts seen in a pornographic film (P<0.001). Three-quarters of the sample had had sexual intercourse, of which 71% reported contraceptive use at first intercourse. Anal intercourse was reported by 16%, with infrequent condom use (39%). Intercourse with a friend (adjusted odds ratio (adj. OR) 2.29; 95% confidence interval (CI) 1.27-4.12) was significantly associated with high consumption of pornography among men, while anal intercourse (adj. OR 1.99; 95% CI 0.95-4.16) and group sex (adj. OR 1.95; 95% CI 0.70-5.47) tended to be associated. A significant confounder was early age of sexual debut (adj. OR 1.49; 95% CI 1.18-1.88).

  • 288.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hanson, Ulf
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Associations between pornography consumption and sexual practices among adolescents in Sweden2005Ingår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 16, nr 2, s. 102-107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pornography consumption and sexual behaviour were studied, with an aim to investigate any associations. Participants were 718 students from 47 high school classes, mean age 18 years, in a medium-sized Swedish city. More men (98%) than women (72%) had ever consumed pornography. More male high consumers than low consumers or women got sexually aroused by, fantasized about, or tried to perform acts seen in a pornographic film (P<0.001). Three-quarters of the sample had had sexual intercourse, of which 71% reported contraceptive use at first intercourse. Anal intercourse was reported by 16%, with infrequent condom use (39%). Intercourse with a friend (adjusted odds ratio (adj. OR) 2.29; 95% confidence interval (CI) 1.27-4.12) was significantly associated with high consumption of pornography among men, while anal intercourse (adj. OR 1.99; 95% CI 0.95-4.16) and group sex (adj. OR 1.95; 95% CI 0.70-5.47) tended to be associated. A significant confounder was early age of sexual debut (adj. OR 1.49; 95% CI 1.18-1.88).

  • 289.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Sandberg, Jonas
    Hanson, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    "It's everywhere!" Thoughts and reflections about pornography among young people in Sweden2006Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, nr 4, s. 386-393Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pornography is one of the most sought-after topics on the Internet, and is easily available for anyone, including children and adolescents. At youth centres, nurse-midwives have noticed that young people have different kinds of questions about sexual practices compared with a few years ago. The aim of this study was to gain an understanding of thoughts and reflections about pornography consumption, and its possible influence on sexual practices, among young women and men. The staff at a youth centre in a city in central Sweden asked the visitors if they had seen pornography and if they wanted to be interviewed about their experiences. Ten young women and eight men, aged 16-23 years, participated. In-depth interviews were performed and open-ended questions about pornography and sexuality were posed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. The core category 'Living with the current sexual norm' depicted how pornography created sexual expectations and demands, for instance, to perform certain sexual acts. The informants expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. A moral attitude was described and examples of stereotypic gender roles were given. To deal with the current sexual norm, informants had different individual handling strategies and attitudes to pornography, namely liberal, normalization, distance, feminist or conservative. Limitations of this study were the small sample size and that results from a qualitative research study cannot be generalized. The results contribute to an understanding of how pornographic material can influence young peoples' thoughts, reflections and sexual behaviour. This indicates the importance, for personnel at youth centres and schools, to discuss sexual behaviour and how sexuality is portrayed in pornographic material with young people.

  • 290.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Sandberg, Jonas
    Hanson, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    'It's everywhere!' Young Swedish people's thoughts and reflections about pornography2006Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, nr 4, s. 386-393Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pornography is one of the most sought-after topics on the Internet, and is easily available for anyone, including children and adolescents. At youth centres, nurse-midwives have noticed that young people have different kinds of questions about sexual practices compared with a few years ago. The aim of this study was to gain an understanding of thoughts and reflections about pornography consumption, and its possible influence on sexual practices, among young women and men. The staff at a youth centre in a city in central Sweden asked the visitors if they had seen pornography and if they wanted to be interviewed about their experiences. Ten young women and eight men, aged 16-23 years, participated. In-depth interviews were performed and open-ended questions about pornography and sexuality were posed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. The core category 'Living with the current sexual norm' depicted how pornography created sexual expectations and demands, for instance, to perform certain sexual acts. The informants expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. A moral attitude was described and examples of stereotypic gender roles were given. To deal with the current sexual norm, informants had different individual handling strategies and attitudes to pornography, namely liberal, normalization, distance, feminist or conservative. Limitations of this study were the small sample size and that results from a qualitative research study cannot be generalized. The results contribute to an understanding of how pornographic material can influence young peoples' thoughts, reflections and sexual behaviour. This indicates the importance, for personnel at youth centres and schools, to discuss sexual behaviour and how sexuality is portrayed in pornographic material with young people.

  • 291.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Swedish Teenagers' Attitudes Toward the Emergency Contraceptive Pill2001Ingår i: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 28, nr 4, s. 313-318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To explore knowledge, attitudes toward, and experience with, the emergency contraceptive pill (ECP) among teenagers in Sweden.

    METHODS: A questionnaire with 23 questions concerning the students' demographics, knowledge of, attitudes toward, and experience of the ECP was delivered to a random sample of 20 classes in senior high school in two medium-sized cities in Sweden. The participation rate was 100% (n = 408). Differences in responses between teenagers in the two cities, boys and girls, theoretical and practical classes, or native Swedish and immigrant teenagers were calculated with the Chi-square test.

    RESULTS: The mean age was 16.5 years. Almost half (45.4%) of the teenagers had had sexual intercourse and of those, 28.3% stated that they themselves or their partner had used ECP. Four of five teenagers knew about ECP and where to obtain it if necessary. Many teenagers (67.3%) also knew that ECP prevented implantation. The main sources of information about ECP were youth clinics (n = 179) and friends (n = 159). The attitude toward using ECP in an emergency situation was positive, but the teenagers, especially girls, were restrictive as to whether ECP should be available without a prescription. The girls believed ECP could be used much more, and two-thirds of both sexes thought it could lead to negligence with ongoing contraception. Seventy-seven percent of teenagers preferred turning to a youth clinic when in need of ECP. One in four believed that concerns for side effects could deter them from using ECP.

    CONCLUSIONS: Based on the results in the present study, the importance of counseling in this situation is confirmed. The awareness about ECP was good, but teenagers also expressed concerns about side effects. The girls were more hesitant than the boys about having ECP available over the counter.

  • 292.
    Häggström-Nordin, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Hanson, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Experiences of and attitudes towards pornography among a group of Swedish high school students2009Ingår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, nr 4, s. 277-284Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To investigate consumption of and attitudes toward pornography in relation to demographic factors and relationships to parents among third-year high school students. METHODS: A random sample of 718 students with a mean age 18 years (range 17-21) completed a classroom questionnaire consisting of 89 questions. RESULTS: More students in practical than in theoretical study programmes had parents with a practical profession (p < 0.001). More parents to students attending theoretical programmes owned their housing (p < 0.001). More men than women had ever consumed pornography (98% vs. 72%; p < 0.001). More practical than theoretical students were influenced by watching pornographic films, fantasizing about (p < 0.05) or having performed acts inspired by pornography (p < 0.05). Both theoretical and practical male students had more favourable attitudes toward pornography than either group of female students (p < 0.001; p = 0.037). More female, than male students, were of the opinion that pornography could create uncertainty and demands. CONCLUSION: Students' high school programme choices partly reflect their social background. Pornography was consumed mainly by male students, who also had the most favourable attitudes, while females mainly had negative attitudes. To promote sexual health these differences between genders and study programmes should be taken into consideration in counselling, and in sex- and relationships education.

  • 293.
    Höglund, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Centrum för forsknings- och bioetik.
    Carlsson, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Holmström, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Lännerström, Linda
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Kaminsky, Elenor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    From denial to awareness: a conceptual model for obtaining equity in healthcare2018Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, nr 9Artikel i tidskrift (Refereegranskat)
  • 294.
    Höglund, Anna T.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Centrum för forsknings- och bioetik.
    Carlsson, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Högskolan i Gävle.
    Holmström, Inger K.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Mälardalens högskola.
    Kaminsky, Elenor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Mälardalens högskola.
    Impact of telephone nursing education program for equity in health2016Ingår i: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, nr 1, artikel-id 152Artikel i tidskrift (Refereegranskat)
    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.

  • 295.
    Höglund, Anna T.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Centrum för forsknings- och bioetik.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Hannerfors, Anna Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Knowledge of human papillomavirus and attitudes to vaccination among Swedish high school students2009Ingår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 20, nr 2, s. 102-107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to investigate knowledge of and attitudes to sexually transmitted infection (STI) and STI prevention with special focus on human papillomavirus (HPV) and the new vaccine against HPV, among 16-year-old high school students in a Swedish context. A study-specific questionnaire was distributed to 572 first year high school students from five different high schools in a medium-sized town in Sweden. The students lacked knowledge of HPV and its association with cervical cancer. Similarly, their knowledge of the new vaccine was limited. Their attitude to condom use when having sex with a new partner was positive, but decreased if oral contraceptives were used and if they were vaccinated against an STI. The main source of information was the school, followed by youth clinics and the media. The results highlight the clinical importance for school nurses and personnel at youth clinics to inform adolescents about HPV and its association with cancer.

  • 296.
    Högstedt, Denice
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Sörensson, Martina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Kvinnliga bröstcancerpatienters upplevelser av omhändertagandet under onkologisk behandling2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syfte: Syftet var att undersöka bröstcancerpatienters upplevelse av omhändertagandet i vården i samband med den onkologiska behandlingen. Metod: Studien har genomförts som en kvalitativ studie, baserad på en öppen fråga i en enkätstudie. Urvalet är baserat på det regionala Kvalitetsregistret för bröstcancer i Uppsala/Örebroregionen, sammanlagt 1573 kvinnor erbjöds att delta i studien. Det slutliga deltagarantalet blev 312. Resultat: Bröstcancerpatienter är överlag nöjda med vården i samband med den onkologiska behandlingen. Kontinuitet, information, uppföljning och stöd upplevs vara bristfälligt. Det råder delade meningar om upplevelsen av bemötandet, men det framkommer att ett bra bemötande kännetecknas av lyhördhet och kunnighet medan ett dålig bemötande kännetecknas av stressad och okänslig personal. Planering i samband med behandlingar är viktigt för kvinnorna. Vårdmiljön och atmosfären på sjukhuset kan påverka upplevelsen av omhändertagandet. Ett vanligt förekommande önskemål är att ha en kontaktperson som är ansvarig för vården, som kvinnorna kan vända sig till vid frågor/funderingar. Slutsats: Patienttillfredsställelsen under onkologisk behandling är bland bröstcancerpatienter hög. Kontinuitet, uppföljning, information och stöd är däremot bristfällig och det krävs fler kvalitativa studier i syfte att studera om detta är något unikt för just denna studie eller något som förekommer generellt i den svenska onkologiska vården.

  • 297.
    Høyer, Marie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för onkologi.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Bergkvist, Leif
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Ahlgren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Lidin-Lindqvist, Annika
    Regional Oncologic Center, Uppsala University Hospital.
    Lambe, Mats
    Regional Oncologic Centre, Uppsala University Hospital; Department of medical epidemiology and biostatistics, Karolinska Institutet.
    Lampic, Claudia
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Health-related quality of life among women with breast cancer: a population-based study2011Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, nr 7, s. 1015-1026Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    High incidence rates of breast cancer emphasize the importance of increased knowledge about the health-related quality of life (HRQoL) in this patient group. The aim of the present study was to describe and compare HRQoL among breast cancer patients shortly after diagnosis with normative data from the general population, and to investigate how clinical, demographic, and socio-economic factors and social support are associated with HRQoL.

    Material and methods:

    Participants were identified in a population-based Breast Cancer Quality Register in central Sweden. Of 1573 women newly diagnosed with breast cancer during a one-year period (2007 – 2008), 69% (n =1086) completed a questionnaire including the EORTC QLQ-C30, BR23 and the HADS.

    Results:

    Compared to age-adjusted normative data, breast cancer patients (mean age 62 years, range 25–94), especially younger women (<50 years), experienced clinically meaningful poorer HRQoL. Clinically significant levels of anxiety and depressive symptoms were found among 14% and 6% of the patients, respectively. Factors associated with more problems/symptoms among study participants included chemotherapy, lack of social support, sick leave and a poor financial situation. Adding socio-economic factors diminished the association between age and HRQoL (p > 0.05).

    Conclusion:

    Recently diagnosed breast cancer patients reported poorer HRQoL in several dimensions compared to normative data. In addition to clinical and demographic factors, an unfavorable socio-economic standing was associated with more problems/symptoms. The present findings emphasize the importance of taking a variety of factors into account when assessing HRQoL in the clinical setting.

  • 298.
    Høyer, Marie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Nordin, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Ahlgren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Bergkvist, Leif
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Lambe, Mats
    Regionalt Cancer Center Uppsala Örebro, Uppsala University Hospital; Department of medical epidemiology och biostatistics, Karolinska Institutet.
    Johansson, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för onkologi.
    Lampic, Claudia
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Change in working time in a population-based cohort of patients with breast cancer2012Ingår i: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 30, nr 23, s. 2853-2860Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose:

    We examined changes in working time 16 months after a breast cancer diagnosis and identified factors associated with job discontinuation and/or decreased working time.

    Patients and Methods:

    This was a population-based cohort study with 735 patients identified in the Regional Breast Cancer Quality Register of Central Sweden. The study sample consisted of 505 women (age <63 years at diagnosis) who completed questionnaires at baseline and at follow-up (on average 4 and 16 months after diagnosis, respectively). Clinical register data and questionnaire data on sociodemographic factors were obtained at baseline. Self-reported work-related data were obtained at follow-up. Odds ratios were estimated by using logistic regression models.

    Results:

    Compared with prediagnosis working time, 72% reported no change in working time, 2% reported an increase, 15% reported a decrease, and 11% did not work at follow-up. Chemotherapy increased the likelihood (odds ratio [OR], 2.45; 95% CI, 1.38 to 4.34) of job discontinuation/decreased working time. Among chemotherapy recipients, associated factors included full-time work prediagnosis (OR, 3.25; 95% CI, 1.51 to 7.01), cancer-related work limitations (OR, 5.26; 95% CI, 2.30 to 12.03), and less value attached to work (OR, 3.69; 95% CI, 1.80 to 7.54). In the nonchemotherapy group, older age (OR, 1.09; 95% CI, 1.02 to 1.17) and less value attached to work (OR, 5.00; 95% CI, 2.01 to 12.45) were associated with the outcome.

    Conclusion:

    The majority of women treated for breast cancer returned to their prediagnosis working time. Chemotherapy and cancer-related work limitations are important factors to take into account in identifying women in need of support. Moreover, it is important to consider the woman’s own valuation of labor market participation.

  • 299. Iessa, N.
    et al.
    Star, Kristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Murray, M. L.
    Wilton, L.
    Curran, S.
    Edwards, R.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Aronson, J. K.
    Besag, F.
    Santosh, P.
    Wong, I. C. K.
    An Evaluation of the Evidence of an Association between Montelukast and Suicide: A Publicity Exacerbated Signal?2012Ingår i: Drug Safety, ISSN 0114-5916, E-ISSN 1179-1942, Vol. 35, nr 10, s. 901-901Artikel i tidskrift (Övrigt vetenskapligt)
  • 300.
    Ingvoldstad, Charlotta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Ohman, Susanne Georgsson
    Lindgren, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Implementation of combined ultrasound and biochemistry for risk evaluation of chromosomal abnormalities during the first trimester in Sweden2014Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, nr 9, s. 868-873Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. To investigate how the first trimester risk evaluation for Down syndrome is offered and performed. Setting. Sweden. Sample. All 52 known units working with obstetric ultrasound. Methods. Study-specific questionnaire and descriptive statistical analyses. Main outcome measures. Routines for offering combined ultrasound and biochemistry (CUB), questions about information, questions about tests and analysis used for diagnosis. Results. CUB was performed in 28 600 (26%) of the expected 110 000 pregnancies in Sweden during 2011. Of all pregnant women, 15% were living in a county not offering CUB (only invasive prenatal diagnosis); 44% regardless of age; 15% to women = 33 years; 24% to women = 35 years; and 2% to women = 38 years old. Amniocentesis was the most common method offered when the risk was estimated as high. Of the 47 units that replied, 29 (61.7%) offered only amniocentesis. On the questions about information, 40 (95.2%) stated that they gave verbal information. In addition to verbal information, 17 (40.5%) gave written information. Forty-one of the units (71.9%) stated that the CUB is offered to non-Swedish-speaking women. Conclusion. Without consistent national guidelines, the prenatal diagnostic CUB method is offered in an inequitable manner to pregnant women in Sweden. More than half of all pregnant women live in a county where CUB is not offered or is only offered based on age. The results demonstrate the importance of national consistency before the introduction of new prenatal tests, to enhance equal care for all pregnant women.

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