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Atwine, F. & Hjelm, K. (2017). Health professionals’ knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in ugandans with diabetes: A cross-sectional survey. Pan African Medical Journal, 28, Article ID 256.
Open this publication in new window or tab >>Health professionals’ knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in ugandans with diabetes: A cross-sectional survey
2017 (English)In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 28, article id 256Article in journal (Refereed) Published
Abstract [en]

Introduction: Healthcare-seeking behaviour among persons with diabetes has been investigated to a limited extent, and not from professionals’ perspective. The aim of the study was to describe healthcare professionals’ knowledge, attitudes and practice concerning healthcare-seeking behaviour and the use of complementary and alternative medicine among persons with diabetes. Methods: A cross-sectional, self-administered questionnaire was conducted in western Uganda. Nurses, midwives or nurse assistants 72.2%, physicians 12% and clinical officers 10% volunteered to participate in the study with a total 108 (93% response rate) response rate. Descriptive statistics were used to analyse data with frequencies, percentages and summarized in tables. Results: Most of the healthcare providers perceived more uneducated people to be at risk of developing complications related to diabetes (66.7%) and that most of the patients with diabetes were not knowledgeable about signs and symptoms of diabetes before being diagnosed (75.9%). The main reasons inducing persons with diabetes to seek care outside the health care sector were reported to be seeking a cure for the condition, influence from the popular sector, the accessibility of the place and signs of complications of diabetes related to poor glycaemic control. Healthcare providers had relatively positive attitudes towards using complementary and alternative medicine. Conclusion: Insufficient knowledge about diabetes, compromised healthcare-seeking practices including drug procurement for diabetes seem to be barriers to diabetes management. Patients were thus reported to be burdened with co-morbidities of complications of diabetes related to poor glycaemic control. © Fortunate Atwine et al.

Place, publisher, year, edition, pages
African Field Epidemiology Network, 2017
Keywords
Attitudes; Complementary and alternative medicine; Diabetes; Healthcare providers; Healthcare-seeking behaviour; Knowledge
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-146976 (URN)10.11604/pamj.2017.28.256.11615 (DOI)2-s2.0-85041418852 (Scopus ID)
Note

Funding Agencies|Sida, Styrelsen för Internationellt Utvecklingssamarbete

Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-05-14
Eriksson, H., Milberg, A., Hjelm, K. & Friedrichsen, M. (2016). End of Life Care for Patients Dying of Stroke: A Comparative Registry Study of Stroke and Cancer. PLoS ONE, 11(2), e0147694, Article ID 26845149.
Open this publication in new window or tab >>End of Life Care for Patients Dying of Stroke: A Comparative Registry Study of Stroke and Cancer
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 2, p. e0147694-, article id 26845149Article in journal (Refereed) Published
Abstract [en]

Background

Although stroke is a significant public health challenge and the need for palliative care has been emphasized for these patients, there is limited data on end-of-life care for patients dying from stroke.

Objective

To study the end-of-life care during the last week of life for patients who had died of stroke in terms of registered symptom, symptom management, and communication, in comparison with patients who had died of cancer.

Design

This study is a retrospective, comparative registry study.

Methods

A retrospective comparative registry study was performed using data from a Swedish national quality register for end-of-life care based on WHO`s definition of Palliative care. Data from 1626 patients who had died of stroke were compared with data from 1626 patients who had died of cancer. Binary logistic analyses were used to calculate odds ratios, with 95% CI.

Results

Compared to patients who was dying of cancer, the patients who was dying of stroke had a significantly higher prevalence of having death rattles registered, but a significantly lower prevalence of, nausea, confusion, dyspnea, anxiety, and pain. In addition, the stroke group had significantly lower odds ratios for health care staff not to know whether all these six symptoms were present or not. Patients who was dying of stroke had significantly lower odds ratio of having informative communication from a physician about the transition to end-of-life care and of their family members being offered bereavement follow-up.

Conclusions

The results indicate on differences in end-of-life care between patients dying of stroke and those dying from cancer. To improve the end-of-life care in clinical practice and ensure it has consistent quality, irrespective of diagnosis, education and implementation of palliative care principles are necessary.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2016
Keywords
palliative care;stroke, end-of-life-care;
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-125282 (URN)10.1371/journal.pone.0147694 (DOI)000369552800013 ()26845149 (PubMedID)
Note

Funding agencies: Stroke Riksforbund [2012-00185]; Stahls stiftelse [4813101041]; Forss [479071]

Available from: 2016-02-19 Created: 2016-02-19 Last updated: 2017-11-30
Ring Jacobsson, L., Milberg, A., Hjelm, K. & Friedrichsen, M. (2016). Gaining perspective on own illness - The lived experiences of a patient education program for women with treated coeliac disease.. Journal of Clinical Nursing, 25(9-10), 1229-1237
Open this publication in new window or tab >>Gaining perspective on own illness - The lived experiences of a patient education program for women with treated coeliac disease.
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 9-10, p. 1229-1237Article in journal (Refereed) Published
Abstract [en]

Aims and Objectives

To explore the lived experiences of women with coeliac disease after attending a patient education programme, to gain a broader perspective of its influence.

Background

Adults, particularly women, with coeliac disease report suffering from poor well-being and reduced quality of life in terms of health. Patient education programmes might support and encourage them in the search for possible improvements in lifestyle and in their approach to the disease.

Design

A qualitative phenomenological study.

Methods

Personal narrative interviews with 14 women suffering from coeliac disease who had participated in an educational programme. Data analysis in accordance with Giorgi was performed.

Results

The essential structure of women's lived experiences following their participation in the patient education programme was found to be an interaction with others with the same disease, which left the women feeling individually strengthened. The interaction enabled the participants to acquire a broader view of their life with coeliac disease. As a result, this realigned their sense of self in relation to their own disease.

Conclusion

In coping with coeliac disease, it seems that women need interaction with others with the disease to experience togetherness within a group, get the opportunity to compare themselves with others and to exchange knowledge. The interaction appears to result in that women acquire an overview of life with the disease, develop a greater confidence and dare to try new things in life.

Relevance to clinical practice

When designing a patient education programme it seems important to consider the needs of persons to meet others with the same disease, and to ask them about their need for knowledge, rather than simply assuming that health care professionals know what they need.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Chronic disease ;coeliac disease;nursing;patient education;phenomenology;women′s health
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-123585 (URN)10.1111/jocn.13123 (DOI)000374506500006 ()26814834 (PubMedID)
Note

At the time of the thesis presentation was the publication in the status Manuscript

Available from: 2015-12-29 Created: 2015-12-29 Last updated: 2017-04-21Bibliographically approved
Aho, A.-C., Hultsjö, S. & Hjelm, K. (2016). Health perceptions of young adults living with recessive limb-girdle muscular dystrophy. Journal of Advanced Nursing, 72(8), 1915-1925
Open this publication in new window or tab >>Health perceptions of young adults living with recessive limb-girdle muscular dystrophy
2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 8, p. 1915-1925Article in journal (Refereed) Published
Abstract [en]

AIM:

The aim of this study was to describe health perceptions related to sense of coherence among young adults living with recessive limb-girdle muscular dystrophy.

BACKGROUND:

Limb-girdle muscular dystrophy refers to a group of progressive muscular disorders that may manifest in physical disability. The focus in health care is to optimize health, which requires knowledge about the content of health as described by the individual.

DESIGN:

A descriptive study design with qualitative and quantitative data were used.

METHOD:

Interviews were conducted between June 2012-November 2013 with 14 participants aged 20-30 years. The participants also answered the 13-item sense of coherence questionnaire. Qualitative data were analysed with content analysis and related to self-rated sense of coherence.

FINDINGS:

Health was viewed as intertwined physical and mental well-being. As the disease progressed, well-being was perceived to be influenced not only by physical impairment and mental strain caused by the disease but also by external factors, such as accessibility to support and attitudes in society. Factors perceived to promote health were having a balanced lifestyle, social relations and meaningful daily activities. Self-rated sense of coherence varied. The median score was 56 (range 37-77). Those who scored ≥56 described to a greater extent satisfaction regarding support received, daily pursuits and social life compared with those who scored <56.

CONCLUSION:

Care should be person-centred. Caregivers, with their knowledge, should strive to assess how the person comprehends, manages and finds meaning in daily life. Through dialogue, not only physical, psychological and social needs but also health-promoting solutions can be highlighted.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
chronic diseases, disability, LGMD2, nursing, sense of coherence, SOC-13
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126555 (URN)10.1111/jan.12962 (DOI)000379932000017 ()27005675 (PubMedID)
External cooperation:
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2017-11-30
Rydé, K. & Hjelm, K. (2016). How to support patients who are crying in palliative home care: an interview study from the nurses' perspective.. Primary Health Care Research and Development, 17(5), 479-488
Open this publication in new window or tab >>How to support patients who are crying in palliative home care: an interview study from the nurses' perspective.
2016 (English)In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 17, no 5, p. 479-488Article in journal (Refereed) Published
Abstract [en]

Aim The aim of this study was to explore how nurses can support patients who are crying in a palliative home care context.

BACKGROUND: In palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse's responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons.

METHODS: A qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32-63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis. Findings It was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient's wishes. A few examples of the patients' need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.

Place, publisher, year, edition, pages
Cambridge University Press, 2016
Keywords
crying; home care services; interview; nurses; nursing care; palliative care; qualitative research; social support; terminal care
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126433 (URN)10.1017/S1463423616000037 (DOI)000389211700006 ()26932445 (PubMedID)
Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2017-11-30Bibliographically approved
Hermansen, A., Peolsson, A., Kammerlind, A.-S. & Hjelm, K. (2016). Women’s experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study. Journal of Rehabilitation Medicine, 48(4), 352-358
Open this publication in new window or tab >>Women’s experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study
2016 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 4, p. 352-358Article in journal (Refereed) Published
Abstract [en]

Subjects: Fourteen women aged 39-62 years (median 52 years), were included 1.5 to 3 years after ACDF for cervical degenerative disc disease.

Methods: Individual semi-structured interviews were analyzed by qualitative content analysis with an inductive approach.

Results: The women described their experiences of daily life in five different ways; Experiences of recovery; Experiences of symptoms in daily life influence feelings and thoughts; Making daily life work; Importance of social  and occupational networks; Experiences of the influence of healthcare professionals and interventions on daily life.

Conclusion: This interview study provides insight into women’s daily life after ACDF. While improved after surgery, informants also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge on aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after ACDF.

Place, publisher, year, edition, pages
Uppsala, Sweden: Stiftelsen Rehabiliteringsinformation /Foundation for Rehabilitation Information, 2016
Keywords
Daily life, cervical spine, research interview, content analysis
National Category
Medical and Health Sciences Physiotherapy
Identifiers
urn:nbn:se:liu:diva-117344 (URN)10.2340/16501977-2076 (DOI)000372456100005 ()26999327 (PubMedID)
Note

Funding agencies: NSC FoU-fond; County Council of Ostergotland

Available from: 2015-04-23 Created: 2015-04-23 Last updated: 2017-12-04Bibliographically approved
Hjelm, K. (2015). Bemötande i vård och omsorg, transkulturellt perspektiv. Stockholm: Sveriges landsting och regioner
Open this publication in new window or tab >>Bemötande i vård och omsorg, transkulturellt perspektiv
2015 (Swedish)Book (Other academic)
Abstract [sv]

Utgångspunkten för allt hälso- och sjukvårdsarbete är Hälso- och sjukvårdslagen som anger att vården ska vara individualiserad, genomföras i samråd med den enskilde, bygga på respekt för individens självbestämmande och integritet och meddelas på lika villkor oavsett ras, religion eller politisk åsikt. Tydligt framgår att alla individer är unika och därmed inte nödvändigtvis ska meddelas samma vård.

Inom transkulturell omvårdnad studeras individens förutsättningar för hälsa, reaktioner på och upplevelser av sjukdom eller ohälsa samt effekter av vård och behandling hos individer med olika kulturell bakgrund. Man studerar skillnader och likheter, både mellan och inom olika kulturer, men också mellan olika generationer. Avsikten är att kunna vårda människan som döljs bakom kulturen. Både individens och vårdarens kultur påverkar vårdandet. Eftersom varje människa är unik blir mötet mellan två personer alltid transkulturellt i någon mån.

Exemplen i Vårdhandboken belyser i huvudsak hur personer med olika ursprung uppfattar sjukdomen diabetes och dess hantering.

Bemötande i vården ur transkulturellt perspektiv ska med utgångspunkt i Hälso- och sjukvårdslagen inriktas på att undvika etnocentrism där majoritetskulturens värderingar styr planeringen av insatser. Istället bör man sträva efter kulturrelativism med en transkulturell medvetenhet, vilket innebär att varje unika individs behov och önskemål fokuseras. Kulturellt kompetent vård är skräddarsydd vård.

Place, publisher, year, edition, pages
Stockholm: Sveriges landsting och regioner, 2015
Keywords
Transkulturell omvårdnad, bemötande, migranter, uppfattningar om hälsa, sjukdom och vård
National Category
History of Ideas
Identifiers
urn:nbn:se:liu:diva-123592 (URN)
Note

Vårdhandboken riktar sig i första hand till vårdpersonal, men är användbar också för patienter och anhöriga. Har både alfabetisk detaljerad innehållsförteckning och en utmärkt sökfunktion. Här finns generella metodanvisningar och riktlinjer för t.ex. bemötande, undersökning, provtagning, vårdhygien och smittspridning. Via Fokusområden får man överblick över olika ämnesområden med litteraturreferenser och i förekommande fall hänvisningar till regelverk.

Kapitlet ingår i nationell kvalitetshandbok för evidens-baserat omvårdnadsarbete.

Utgör revidering av tidigare publicerat kapitel.

Available from: 2015-12-29 Created: 2015-12-29 Last updated: 2016-01-11
Hadziabdic, E., Lundin, C. & Hjelm, K. (2015). Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare. BMC Health Services Research, 15(458)
Open this publication in new window or tab >>Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare
2015 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, no 458Article in journal (Refereed) Published
Abstract [en]

Background: Elderly migrants who do not speak the official language of their host country have increased due to extensive international migration, and will further increase in the future. This entails major challenges to ensure good communication and avoid communication barriers that can be overcome by the use of adequate interpreter services. To our knowledge, there are no previous investigations on interpreting practices in multilingual elderly healthcare from different healthcare professionals perspectives. This study examines issues concerning communication and healthcare through a particular focus on interpretation between health professionals and patients of different ethnic and linguistic backgrounds. The central aim of the project is to explore interpretation practices in multilingual elderly healthcare. Methods: A purposive sample of 33 healthcare professionals with experience of using interpreters in community multilingual elderly healthcare. Data were collected between October 2013 and March 2014 by 18 individual and four focus group interviews and analysed with qualitative content analysis. Results: The main results showed that interpreting practice in multilingual elderly healthcare was closely linked to institutional, interpersonal and individual levels. On the organizational level, however, guidelines for arranging the use of interpreters at workplaces were lacking. Professional interpreters were used on predictable occasions planned long in advance, and bilingual healthcare staff and family members acting as interpreters were used at short notice in everyday caring situations on unpredictable occasions. The professional interpreter was perceived as a person who should interpret spoken language word-for-word and who should translate written information. Furthermore, the use of a professional interpreter was not adapted to the context of multilingual elderly healthcare. Conclusion: This study found that interpreter practice in multilingual elderly healthcare is embedded in the organizational environment and closely related to the individuals language skills, cultural beliefs and socio-economic factors. In order to formulate interpreter practice in the context of multilingual elderly healthcare it is important to consider organizational framework and cultural competence, cultural health knowledge, beliefs and customs.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2015
Keywords
Ethnicity; Multilingual elderly healthcare; Interpretation; Interpretation practices; Organization
National Category
Sociology
Identifiers
urn:nbn:se:liu:diva-122194 (URN)10.1186/s12913-015-1124-5 (DOI)000362254600001 ()26444009 (PubMedID)
Note

Funding Agencies|Vetenskapsradet (The Swedish Research Council), Sweden [521-2013-2533]

Available from: 2015-10-26 Created: 2015-10-23 Last updated: 2018-02-20
Ring Jacobsson, L., Milberg, A., Hjelm, K. & Friedrichsen, M. (2015). Experiences, own management and beliefs of residual discomfort among people with coeliac disease: A qualitative content analysis after years of treatment.. Journal of Clinical Nursing
Open this publication in new window or tab >>Experiences, own management and beliefs of residual discomfort among people with coeliac disease: A qualitative content analysis after years of treatment.
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article in journal (Refereed) Submitted
Abstract [en]

xx

Keywords
Coeliac disease, experiences, residual discomfort, qualitative study
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-123589 (URN)
Available from: 2015-12-29 Created: 2015-12-29 Last updated: 2017-12-01
Atwine, F., Hultsjö, S., Albin, B. & Hjelm, K. (2015). Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews. Pan African Medical Journal, 20(76)
Open this publication in new window or tab >>Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews
2015 (English)In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 20, no 76Article in journal (Refereed) Published
Abstract [en]

Introduction: health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The purpose of the study was to describe health-care seeking behaviour and understand reasons for using therapies offered by traditional healers.

Methods: descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.

Results: reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.

Conclusion: the pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care.

Place, publisher, year, edition, pages
Kampala, Uganda: African Field Epidemiology Network (A F E N E T) / Reseau Africain d'Epidemiologie de Terrain, 2015
Keywords
Complementary alternative medicine, diabetes mellitus, health-care seeking behaviour, traditional healers, nursing, Uganda
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-116349 (URN)10.11604/pamj.2015.20.76.5497 (DOI)26090034 (PubMedID)2-s2.0-84925353285 (Scopus ID)
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2015-03-26 Created: 2015-03-26 Last updated: 2017-12-04
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9360-8570

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