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Wahren, Lis Karin
Alternative names
Publications (10 of 32) Show all publications
Törnvall, E., Wahren, L. K. & Wilhelmsson, S. (2009). Advancing nursing documentation an intervention study using[X]patients with leg ulcer as an example. International Journal of Medical Informatics, 78(9), 605-617
Open this publication in new window or tab >>Advancing nursing documentation an intervention study using[X]patients with leg ulcer as an example
2009 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 78, no 9, p. 605-617Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to implement and evaluate a standardised nursing record, using patients with leg ulcer as an example, regarding the content of the nursing record and district nurses experiences of documentation. Method: This was a prospective, stratified and randomised intervention study, with one intervention group and one control group. A standardised nursing wound care record was designed and implemented in the electronic patient record in the intervention group for a period of 3 months. Pre- and post-intervention audits of nursing records [n = 102 and n = 92, respectively] were carried out and 126 district nurses answered questionnaires pre-intervention and 83 post-intervention. Result: The standardised nursing wound care record led to more informative, comprehensive and knowledge-intensive documentation according to the audit and district nurses opinions. Furthermore, the district nurses self-reported knowledge of nursing documentation increased in the intervention group. When the standardised nursing wound care record was not used, the documentation was mostly incomplete with a lack of nursing relevance. There were no differences in the district nurses experiences of documentation in general between the two groups. Conclusion: Using the standardised nursing wound care record improved nursing documentation meeting legal demands, which should increase the safety of patient. There was however a discrepancy between the nurses stated knowledge and how they carried out the documentation. Regular in-service training together with use of evidence based standardised nursing records, as a link to clinical reasoning about nursing care, could be ways effecting change.

Keywords
Nursing records, Community health nursing, Primary health care, Medical records computerized, Wound care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13021 (URN)10.1016/j.ijmedinf.2009.04.002 (DOI)
Available from: 2008-03-14 Created: 2008-03-14 Last updated: 2017-12-13
Sund-Levander, M., Grodzinsky, E. & Wahren, L. K. (2007). Gender differences in predictors for survival in elderly nursing-home residents: A 3-year follow-up. Scandinavian Journal of Caring Sciences, 21(1), 18-24
Open this publication in new window or tab >>Gender differences in predictors for survival in elderly nursing-home residents: A 3-year follow-up
2007 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 1, p. 18-24Article in journal (Refereed) Published
Abstract [en]

This study focus on predicting factors of survival possible to modify by nursing care, and the incidence and mortality rate of nursing-home-acquired pneumonia, allocated to 1, 2 and 3 years of follow ups. The residents consisted of 156 women and 78 men living in special housing for the elderly. Data on chronic disease and medication were obtained at baseline, and activities of daily living (ADL) status, nutritional status and body temperature were assessed. The incidence of pneumonia was noted prospectively for 1 year and retrospectively for the following 2 years. Predictive factors for survival were explored by Cox hazard regression analysis. The results showed that age, functional and cognitive impairment were predictors of mortality irrespective of gender, while poor nutritional status in women and chronic obstructive pulmonary disease, heart disease and medication with sedatives in men were gender-specific predictors. ADL correlated positively with dementia and negatively with S-albumin irrespective of gender, while malnutrition correlated positively with ADL in women and positively with chronic obstructive pulmonary disease in men. To promote the quality of daily living in elderly individuals, it is of importance to improve the capabilities in daily functions and nutritional status, especially in women with functional impairment, and to prevent anxiety particularly in men. The findings also clarify that pneumonia is as common as cerebral vascular insult and heart failure as cause of death in this population.

Keywords
activities of daily living, gender, malnutrition, nursing care, pneumonia, survival
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13666 (URN)10.1111/j.1471-6712.2007.00431.x (DOI)
Available from: 2004-12-19 Created: 2004-12-19 Last updated: 2017-12-13
Törnvall, E., Wahren, L. K. & Wilhelmsson, S. (2007). Impact of primary care management on nursing documentation. Journal of Nursing Management, 15(6), 634-642
Open this publication in new window or tab >>Impact of primary care management on nursing documentation
2007 (English)In: Journal of Nursing Management, ISSN 0966-0429, Vol. 15, no 6, p. 634-642Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to investigate whether perceptions of electronic nursing documentation and its performance differed because of primary health care management.

Background: Success in leading people depends on the manager's personality, the context and the people who are led. Close proximity to clinical work, with manager and personnel sharing the same profession, promotes the authority to carry out changes.

Methods: This study comprised a postal questionnaire to district nurses and an audit of nursing records from two primary health care organizations, one with a uniprofessional (nursing) organization, and one with multidisciplinary health care centres with general practitioners and/or another profession as managers.

Results: Uniprofessional nurse management increased district nurses' positive perceptions of nursing documentation but did not affect documentation performance, which was inadequate regardless of management type.

Conclusions: Positive perceptions of nursing documentation are bases for further development to a nursing documentation including a holistic view of the patient.

Keywords
district nurses, electronic patient record, nurse management, nursing documentation, primary health care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13019 (URN)10.1111/j.1365-2834.2007.00729.x (DOI)
Available from: 2008-03-14 Created: 2008-03-14 Last updated: 2009-08-21
Stening, K., Eriksson, O., Wahren, L. K., Berg, G., Hammar, M. & Blomqvist, A. (2007). Pain sensations to the cold pressor test in normally menstruating women: Comparison with men and relation to menstrual phase and serum sex steroid levels. American Journal of Physiology. Regulatory Integrative and Comparative Physiology, 293(4)
Open this publication in new window or tab >>Pain sensations to the cold pressor test in normally menstruating women: Comparison with men and relation to menstrual phase and serum sex steroid levels
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2007 (English)In: American Journal of Physiology. Regulatory Integrative and Comparative Physiology, ISSN 0363-6119, E-ISSN 1522-1490, Vol. 293, no 4Article in journal (Refereed) Published
Abstract [en]

The role of gonadal hormones on pain sensations was investigated in normally menstruating women (n = 16) using the cold pressor test. Tolerance time, pain threshold, and pain intensity were examined once a week during a 4-wk period, and serum concentrations of 17β-estradiol and progesterone were determined at each test session, which were classified into the early follicular phase, late follicular phase, early luteal phase, and late luteal phase, as determined by the first day of menses and the actual hormone levels recorded. A group of men (n = 10) of the same age interval was examined for comparison. The data show that pain threshold was reduced during the late luteal phase compared with the late follicular phase, and hormone analyses showed significant positive correlation between the progesterone concentration and lowered pain threshold and increasing pain intensity. Hormone analysis also showed an interaction between S-estradiol and S-progesterone on pain intensity, demonstrating that the increased perceived pain intensity that was associated with high progesterone concentrations was significantly reduced with increasing levels of estradiol. While no statistically significant sex differences in pain measurements were found, women displayed much more pronounced, and statistically significant, session-to-session effects than men, with increased pain threshold and decreased pain intensity with each test session. Hence, these data suggest that the changes in the serum concentration of gonadal hormones that occur during the menstrual cycle influence pain sensations elicited by noxious tonic cold stimulation and show that adaptation to the cold pressor test may be sex dependent. © 2007 the American Physiological Society.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-39946 (URN)10.1152/ajpregu.00127.2007 (DOI)51815 (Local ID)51815 (Archive number)51815 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Raak, R. & Wahren, L. K. (2006). Health experiences and employment status in subjects with chronic back pain: a long-term perspective. Pain Management Nursing, 7(2), 64-70
Open this publication in new window or tab >>Health experiences and employment status in subjects with chronic back pain: a long-term perspective
2006 (English)In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 7, no 2, p. 64-70Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to describe health experiences, focused on gender and return to work, in subjects with chronic low back pain in a long-term perspective. The convenient sample consisted of 12 subjects who had attended a pain rehabilitation program 6 years earlier. Typed interviews were transcribed, and a content analysis approach was used. Five categories were found: coping, root causes, control/influence, pain, and sleep. The interviews showed that the subjects expressed well-being, although pain had become part of their daily life. However, both gender and well-being group differences were identified. The women and the group with reduced well-being used the root causes category in a higher degree than the men and the well-being group did. The conclusion is that there are differences according to both gender and return to work within the subjects with chronic pain and that these differences are related to both root causes and coping pattern.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-34264 (URN)10.1016/j.pmn.2006.02.001 (DOI)21169 (Local ID)21169 (Archive number)21169 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Raak, R. & Wahren, L. K. (2006). Health related quality of life in subgroups of WAD (Whiplash associated disorder) individuals with respect to cold hyperalgesia in quantitative sensory testing (QST). In: EFIC Pain in Europe V,2006.
Open this publication in new window or tab >>Health related quality of life in subgroups of WAD (Whiplash associated disorder) individuals with respect to cold hyperalgesia in quantitative sensory testing (QST)
2006 (English)In: EFIC Pain in Europe V,2006, 2006Conference paper, Published paper (Other academic)
Abstract [en]

 Background and aims The term Whiplash associated disorders (WAD) includes a wide range of complaints, with neck pain as predominating symptom. Living with long term pain influences quality of life. In previous studies of other chronic pain patients, subgrouping has been made according to cold pain thresholds measured in QST. The aims of the present study are threefold, (1) to evaluate thermal pain thresholds and health related quality of life in WAD patients compared to healthy pain-free individuals, (2) to explore whether subgrouping of the WAD patients was possible according to cold pain thresholds (CPT), and (3) to explore differences between the subgroups. Methods: Thermal pain thresholds were measured using QST. The SF-36 was used to assess health related quality of life. Results: WAD patients showed significantly decreased CPT (p=0.007) and lower scores on the SF-36 in all scales when compared with healthy pain-free individuals. After analyzing clusters (K-means algorithm) two subgroups of WAD emerged, slightly cold pain sensitive and highly pain sensitive. The slightly pain sensitive group differed significantly from the highly sensitive group on in the Role Emotional scale of SF-36 (p=0.025). Conclusions: Cold pain hyperalgesia seems to be a determinant for subgrouping of WAD patients, with respect to health related quality of life, and might be the result of central sensitization or peripheral mechanisms or as a result of personal characteristics. These group differences might be of importance when guiding patients to treatment interventions as well as when exposing subjects to cold in the clinical situation.    

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-36023 (URN)29447 (Local ID)29447 (Archive number)29447 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-09-21Bibliographically approved
Sund-Levander, M., Grodzinsky, E., Loyd, D. & Wahren, L. K. (2005). Errors in body temperature assessment related to individual variation, measuring technique and equipment. International journal of nursing practice, 10(5), 216-223
Open this publication in new window or tab >>Errors in body temperature assessment related to individual variation, measuring technique and equipment
2005 (English)In: International journal of nursing practice, ISSN 1322-7114, Vol. 10, no 5, p. 216-223Article in journal (Refereed) Published
Abstract [en]

Errors in body temperature measurement might seriously influence the evaluation of an individual's health condition. We studied individual variation, measurement technique and the equipment used when assessing body temperature. In the first part of the study, three volunteers performed repeated measurements for five mornings. In the second part, the morning rectal, oral, ear and axillary temperatures were measured once in 84 men and women (19–59 years). The repeated measurements showed a daily temperature difference of 0.1–0.4°C in rectal and oral temperatures, 0.2°C−1.7°C in the ear and 0.1–0.9°C in the axillary temperatures. In the sample of 84 subjects, men and postmenopausal women had a lower mean body temperature compared to premenopausal women. The mean deviation between rectal temperature, and oral, ear and axillary temperatures, respectively, was > 0.5°C, with a large individual variation. In conclusion, in order to improve the evaluation of body temperature, the assessment should be based on the individual variation, the same site of measurement and no adjustment of oral, ear or axillary temperatures to the rectal site.

Keywords
body temperature, gender, individual variation, repeated measurements, standardized
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13664 (URN)10.1111/j.1440-172X.2004.00483.x (DOI)
Available from: 2004-12-19 Created: 2004-12-19 Last updated: 2009-06-04
Raak, R. & Wahren, L. K. (2005). Headache and coping in a female working population. Scandinavian Journal of Caring Sciences, 19(4), 325-329
Open this publication in new window or tab >>Headache and coping in a female working population
2005 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 325-329Article in journal (Refereed) Published
Abstract [en]

Tension-type headache is a common disorder amongst working people and, because of its very high prevalence, represents one of the most costly ailments in modern society. To study the frequency of tension-type headache in a working female population and to investigate how females who have experienced tension-type headache cope with pain compared with the way healthy pain-free subjects cope with stress. A total of 400 females working at a university hospital in Sweden were asked about their experience of headache in the previous 3 months. Instruments used were a specific Headache Questionnaire, the Jalowiec Stress-coping Questionnaire and Coping Strategy Questionnaire. Before the study, approval from the board of directors and the employees’ council was obtained. About 257 females (64.3%) answered the questionnaire and 78% of them (n = 199) reported that they had experienced headache in the previous 3 months. About 90% of the participants had never had an appointment with a doctor concerning headache and 57% reported a relationship between stress and headache. Regarding pain-coping strategy, increased pain behaviour was the most frequent strategy used. With regard to stress-coping style, a significant difference in the use of emotive style was found between females reporting headache and females not reporting headache. The results indicate that prevention programmes emphasizing stress management and coping may influence the experience of tension-type headache.

Keywords
Employee, Females, Stress, Tension-type headache
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-50347 (URN)10.1111/j.1471-6712.2005.00347.x (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
Edvarsson, M., Sund-Levander, M., Wahren, L. K. & Grodzinsky, E. (2004). Comparison of levels for immuniglobulin A, G, M and complement factors C3 and C4 in individuals 80 years and older, with current refrernce values. In: : . Paper presented at IFBLS 26th World Congress, 14-18 June 2004, Stockholm, Sweden.
Open this publication in new window or tab >>Comparison of levels for immuniglobulin A, G, M and complement factors C3 and C4 in individuals 80 years and older, with current refrernce values
2004 (English)Conference paper, Oral presentation only (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-102299 (URN)
Conference
IFBLS 26th World Congress, 14-18 June 2004, Stockholm, Sweden
Available from: 2013-12-05 Created: 2013-12-05 Last updated: 2014-01-08
Törnvall, E., Wilhelmsson, S. & Wahren, L. K. (2004). Electronic nursing documentation in primary health care. Scandinavian Journal of Caring Sciences, 18(3), 310-317
Open this publication in new window or tab >>Electronic nursing documentation in primary health care
2004 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 3, p. 310-317Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe and analyse nursing documentation based on an electronic patient record (EPR) system in primary health care (PHC) with emphasis on the nurses' opinions and what, according to the nursing process and the use of the keywords, the nurses documented. The study was performed in one county council in the south of Sweden and included 42 Primary Health Care Centres (PHCC). It consisted of a survey, an audit of nursing records with the Cat-ch-Ing instrument and calculation of frequencies of keywords used during a 1-year period. For the survey, district nurses received a postal questionnaire. The results from the survey indicated an overall positive tendency concerning the district nurses' opinions on documentation. Lack of in-service training in nursing documentation was noted and requested from the district nurses. All three parts of the study showed that the keywords nursing interventions and status were frequently used while nursing diagnosis and goal were infrequent. From the audit, it was noted that medical status and interventions appeared more often than nursing status. The study demonstrated limitations in the nursing documentation that inhibited the possibility of using it to evaluate the care given. In order to develop the nursing documentation, there is a need for support and education to strengthen the district nurses' professional identity. Involvement from the heads of the PHCC and the manufactures of the EPR system is necessary, in cooperation with the district nurses, to render the nursing documentation suitable for future use in the evaluation and development of care.

Keywords
district nurse, documentation, electronic patient record, nursing process, audit, primary health care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13018 (URN)10.1111/j.1471-6712.2004.00282.x (DOI)
Available from: 2008-03-14 Created: 2008-03-14 Last updated: 2009-08-21
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