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  • 1.
    Aasa, Agneta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hovbäck, Malin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Det preoperativa informationssamtalets betydelse för patientens delaktighet i sin vård inom kolorektalkirurgi2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: ERAS (Enhanced Recovery After Surgery) är ett standardiserat multimodalt vårdprogram vid elektiv kolorektalkirurgi, som syftar till snabbare återhämtning och kortare vårdtider genom ett tvärprofessionellt samarbete.  En vecka innan planerad operation träffar sjuksköterskan patienten för ett samtal om vårdförloppet.

     

    Syfte: Att identifiera och beskriva patientens upplevelse av sjuksköterskans ERAS- samtal och dess betydelse för patientens delaktighet i sin vård. 

     

    Metod: Datainsamlingen skedde genom kvalitativa intervjuer. Tolv patienter, nio män och tre kvinnor har intervjuats. De ljudinspelade samtalen har transkriberats ordagrant och analyserats med hjälp av tolkande fenomenologisk analys (Interpretative Phenomenological Analysis).

     

    Resultat: Analysarbetet resulterade i fem olika teman; bli sedd, trygghet, tillit, ansvar samt delaktighet. Alla teman relaterar till varandra och illustrerar en positiv och en negativ sida av den upplevda erfarenheten. Tillsammans bildar en helhet av upplevelsen; ERAS- samtalet och dess betydelse för patientens delaktighet.

     

    Konklusion: Resultatet visar att patienterna känner sig sedda under informationssamtalet. Det är viktigt att bekräfta patienten och knyta an mer till informationssamtalet under vårdtiden för att patienterna ska vara delaktiga och ta eget ansvar. Tilliten till vårdpersonalen har betydelse för att patienterna ska känna trygghet. Studien visar att ERAS- samtalet upplevs strukturerat och individuellt men informationen måste följa patienterna under hela vårdtillfället.

  • 2.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, SE-55185, Jönköping, Sweden..
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Maret, Eva
    Department of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, SE-14186, Stockholm, Sweden..
    Ericsson, Elisabeth
    Faculty of Medicine and Health, School of Health Science, Örebro University, SE-701 82, Örebro, Sweden..
    Positive effect on patient experience of video-information given prior to cardiovascular magnetic resonance imaging, a clinical trial.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1250-1261Article in journal (Refereed)
    Abstract [en]

    Aims: To evaluate the effect of video information given before cardiovascular magnetic resonance imaging on patient anxiety and to compare patient experiences of cardiovascular magnetic resonance imaging versus myocardial perfusion scintigraphy. To evaluate if additional information has an impact on motion artefacts.less thanbr /greater thanBackground: Cardiovascular magnetic resonance imaging and myocardial perfusion scintigraphy are technically advanced methods for the evaluation of heart diseases. Although cardiovascular magnetic resonance imaging is considered to be painless, patients may experience anxiety due to the closed environment.less thanbr /greater thanDesign: A prospective randomized intervention study, not registered.less thanbr /greater thanMethods: The sample (n=148) consisted of 97 patients referred for cardiovascular magnetic resonance imaging, randomized to receive either video information in addition to standard text-information (CMR-video/n=49) or standard text-information alone (CMR-standard/n=48). A third group undergoing myocardial perfusion scintigraphy (n=51) was compared with the cardiovascular magnetic resonance imaging-standard group. Anxiety was evaluated before, immediately after the procedure and one week later. Five questionnaires were used: Cardiac Anxiety Questionnaire, State-Trait-Anxiety Inventory, Hospital-Anxiety and Depression-scale, MRI-Fear-Survey-Schedule and the MRI-Anxiety-Questionnaire. Motion artefacts were evaluated by three observers, blinded to the information given. Data were collected between April 2015 and April 2016. The study followed the CONSORT guidelines RESULT: The CMR-video group scored lower (better) than the cardiovascular magnetic resonance imaging-standard group in the factor Relaxation (p=0.039) but not in the factor Anxiety. Anxiety levels were lower during scintigraphic examinations compared to the CMR-standard group (pless than0.001). No difference was found regarding motion artefacts between CMR-video and CMR-standard.less thanbr /greater thanConclusion: Patient ability to relax during cardiovascular magnetic resonance imaging increased by adding video information prior the exam, which is important in relation to perceived quality in nursing. No effect was seen on motion artefacts.less thanbr /greater thanRelevance To Clinical Practice: Video information prior to examinations can be an easy and time effective method to help patients cooperate in imaging procedures.

    The full text will be freely available from 2018-11-17 10:44
  • 3.
    Ahlberg, Mona
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Bäckman, Carl
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Jones, Christina
    Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.
    Walther, Sten
    Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center.
    Moving on in life after intensive care - partners' experience of group communication2015In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, no 5, p. 256-263Article in journal (Refereed)
    Abstract [en]

    Background:Partners have a burdensome time during and after their partners’ intensive care period. They may appear to be coping welloutwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited.

    Aim:The aim of this study was to describe the experience of participating in group communication with other partners of former intensivecare patients.

    Design:The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive careunit (ICU) patients was evaluated.

    Methods:A strategic selection was made of adult partners to former adult intensive care patients (n=15), 5 men and 10 women, aged37–89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote,in a notebook, about their feelings of participating in group communications. To deepen the understanding of the impact of the sessions, six ofthe partners were interviewed. Content analysis was used to analyse the notebooks and the interviews.

    Findings:Three categories were identified: (1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, (2)Confirmation, consciousness through insight and reflection and (3) The meeting design, group constellation and recommendation to participatein group communication.

    Conclusion:Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategiesto ever-changing circumstances. Group communications contributed to togetherness and confirmation. To share experiences with others is oneway for partners to be able to move forward in life.

    Relevance to clinical practice:Group communication with other patients’ partners eases the process of going through the burden ofbeing a partner to an intensive care patient. Group communications needs to be further developed and evaluated to obtain consensus andevidence for the best practice.

  • 4.
    Ahldén, Ingegerd
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Dahlgren, Lars Owe
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Parents' Expectations About Participating in Antenatal Parenthood Education Classes2012In: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 21, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    Our objective was to assess parents' expectations about participating in antenatal parenthood education classes and to determine whether their expectations might be related to gender, age, and educational level. Data from 1,117 women and 1,019 partners residing in three cities in Sweden were collected with a questionnaire in a cross-sectional study. Participants believed that antenatal education classes would help them to feel more secure as parents and to be better oriented toward childbirth. Men had more positive expectations about the childbirth than the women. The participants mostly wanted help in preparing for parenthood and in learning infant care skills, followed by help in preparing for childbirth. The participants' expectations were affected by gender, age, and educational level. The expectant parents appeared to want more focus on preparation for parenthood than on childbirth.

  • 5.
    Ahldén, Maria KC
    et al.
    Oslo University, Norway.
    Helén, Rönning
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Jönköping University.
    Agren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Facing the unexpected - A content analysis of how dyads face the challenges of postoperative heart failure2014In: Clinical Nursing Studies, ISSN 2324-7940, Vol. 2, no 2, p. 74-83Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to identify the challenges, strategies and needs of dyads who are dealing with postoperative heart failure.

    Background: An increasing number of patients with postoperative heart failure are living with their partner as primary caregiver. Heart failure is known to reduce quality of life but little is known about the strategies dyads use to cope with postoperative heart failure or what kind of support they need.

    Methods: Data were collected through semi-structured dialogue guides. Content analysis was performed to derive the main themes and categories of the data.

    Results: Three main themes were derived from the data; Everyday challenges, Strategies to deal with everyday challenges and Factors facilitating everyday life.

    Conclusions: Dyads living with postoperative heart failure find the change in everyday life challenging, but have strategies to handle the situation and know what kind of help they need. With the right help from health care, quality of life and self-care can be improved.

  • 6.
    Ahlgren, Thorbjörn
    et al.
    Luppen kunskapscentrum.
    Näslund, Johan
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Kartläggning av barn i behov av stöd år 2002: Eksjö kommun2003Report (Other academic)
    Abstract [sv]

    Följande rapport bygger på enkätsvar från olika myndigheter i Eksjö kommun som har rapporterat de barn/ungdomar i åldern 0-18 år som man i sin verksamhet kommer i kontakt med och som man känner oro för, p.g.a. en ogynnsam utveckling. Tjugo förutbestämda kriterier användes för att beskriva orsaken till myndighetens oro. Myndigheterna har också rapporterat om de insatser som görs redan idag samt om man bedömer att det kan bli aktuellt med ytterligare insatser nu eller i framtiden.

    Totalt inrapporterades 842 barn och ungdomar. Socialförvaltningen rapporterade 78 barn och ungdomar, Barnavårdscentralen 30 barn och skolan 689 barn och ungdomar. Av 45 enkätsvar framgår det inte vem som är rapportör. Vid bearbetningen av insamlat material har 10 enkätsvar uteslutits eftersom de inte var tillräckligt ifyllda. 103 enkätsvar uteslöt för att de flerrapporterade barn och/eller ungdomar och 17 enkätsvar uteslöts eftersom de rapporterade ungdomar som inte är skrivna i Eksjö kommun. Slutligen kom 712 barn och ungdomar att ingå i kartläggningen. Detta är drygt 18,8 % av alla aktuella barn och ungdomar. Av dessa är en klar majoritet pojkar (446 dvs. 62,6 %). För hela målgruppen främst tre huvudorsaker som ger anledning till oro hos berörda myndigheter. Det är;

    1. Föräldrarna brister i omsorgen, i stödet till den unge eller möjligheten att ge stimulans pågrund av sociala, mentala, fysiska eller psykiska handikapp och/eller missbruksproblem. För130 (av 712) barn och ungdomar anser man att det är huvudorsaken till oro.
    2. Barn/ungdomar som är introverta (tysta, blyga, nedstämda, mutister). För 69 av (712) barnoch ungdomar är det huvudorsaken till att man känner oro.
    3. Föräldrars separation eller ständiga konflikter påverkar den unge negativt. För 66 av (712)barn och ungdomar är det huvudorsaken till att man känner oro.

    Resultatredovisningen visar att skolan är den myndighet vars insatser dominerande är det också så att olika insatser inom skolan dominerar. Vanligast är undervisning i liten grupp och olika typer av specialundervisning. Olika typer av anpassad studiegång är också en vanlig insats att möta barn och ungdomar med olika svårigheter. Även olika psykosociala åtgärder förekommer också t.ex. stödsamtal med skolsköterska eller kurator. Vanligast av socialförvaltningens insatser är kontaktperson/familj.

    Berörda myndigheter uppmanas också att föreslå olika typer av nya insatser för de rapporterade barnen och ungdomarna. Även här dominerar olika typer av skolinriktade insatser. Vanliga förslag är undervisning i liten grupp och/eller olika typer av specialundervisning. När socialförvaltningen anses vara ansvarig myndigheter för önskade insatser föreslår rapporterande myndigheter allt från olika typer av familjestöd till direkta förslag till omhändertagande och placering på behandlingshem.

  • 7.
    Aho, Anna Carin
    et al.
    Linnaeus Univ, Dept Hlth & Caring Sci, Vaxjo, Sweden.
    Hultsjö, Sally
    Cty Hosp, Psychiat Clin, Jonkoping, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 22, p. 2083-2091Article in journal (Refereed)
    Abstract [en]

    To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. Methods: A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Result: Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. Conclusion: In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Implications for Rehabilitation Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

  • 8.
    Aho, Anna-Carin
    et al.
    Linnéuniversitetet, Växjö, Sweden.
    Hultsjö, Sally
    Ryhovs sjukhus, Landstinget i Jönköping, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Health perceptions of young adults living with recessive limb-girdle muscular dystrophy2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 8, p. 1915-1925Article in journal (Refereed)
    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.

  • 9.
    Alehagen, Siw
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hägg, Monica
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Kalén-Enterlöv, Maria
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, AnnaKarin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Experiences of community health nurses regarding father participation in child health care2011In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 15, no 3, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Traditionally child health care (CHC) has been an arena where mothers and nurses meet, but in recent years fathers are entering CHC with increasing frequency. The aim of this study was to describe nurses’ experiences of fathers’ participation in CHC. Nine Swedish nurses working in CHC were interviewed and asked to give a description of their experiences from meetings with fathers in CHC. Phenomenology according to Giorgi was used for the analysis and the essence of the findings was that father participation was seen from the perspective of mother participation and was constantly compared to mother participation in CHC. The essence is explicated in the following themes: participation through activities; equal participation although diverse; influence of structures in society; and strengthening participation. Clinical implications include the need for creating a separate identity in CHC for fathers and more communication directed at fathers.

  • 10.
    Allemann, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Sund-Levander, Märta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Nurses' actions in response to nursing assistants' observations of signs and symptoms of infections among nursing home residents2015In: Nursing Open, ISSN 2054-1058, Vol. 2, no 3, p. 97-104Article in journal (Refereed)
    Abstract [en]

    Aims

    To describe what nurses do during episodes of suspected infection in elderly nursing home residents and if these actions are linked to who is initiating an episode and whether the episode is considered an infection or not.

    Design

    Prospective descriptive study. Data were collected in 2008–2010.

    Methods

    Summarized and categorized documentation by nursing assistants and nurses was used for summative content analysis.

    Results

    Nurses' actions seem to be related to who initiated the episode and if the episodes are categorized as ‘non-infection’, ‘possible infection’ or ‘infection’. Actions could be ‘observation’, ‘screenings’, ‘engaged in waiting’, ‘follow-ups’, ‘nurse-prescribed actions’, ‘diagnosing’, ‘contacting the physician’, ‘carrying out an action prescribed by the physician’, ‘contacting an ambulance or arranging an emergency visit to the hospital’ and ‘prescribing screening’. As NAs often initiate episodes of suspected infection by observing changed conditions, it seems important to include the NA in the decision-making process as these observations could detect possible early signs and symptoms of infections.

  • 11.
    Anderson, Peter
    et al.
    Newcastle University, England; Maastricht University, Netherlands.
    Coulton, Simon
    University of Kent, England.
    Kaner, Eileen
    Newcastle University, England.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Kloda, Karolina
    Pomeranian Medical University, Poland.
    Reynolds, Jillian
    Hospital Clin Barcelona, Spain.
    Segura, Lidia
    Govt Catalonia, Spain.
    Wojnar, Marcin
    Medical University of Warsaw, Poland.
    Mierzecki, Artur
    Pomeranian Medical University, Poland.
    Deluca, Paolo
    Kings Coll London, England.
    Newbury-Birch, Dorothy
    University of Teesside, England.
    Parkinson, Kathryn
    Newcastle University, England.
    Okulicz-Kozaryn, Katarzyna
    State Agency Prevent Alcohol Related Problems, Poland.
    Drummond, Colin
    Kings Coll London, England; South London and Maudsley NHS Fdn Trust, England.
    Gual, Antoni
    Hospital Clin Barcelona, Spain.
    Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial2017In: Annals of family medicine (online), ISSN 1544-1709, E-ISSN 1544-1717, Vol. 15, no 4, p. 335-340Article in journal (Refereed)
    Abstract [en]

    PURPOSE We aimed to test whether 3 strategies-training and support, financial reimbursement, and an option to direct screen-positive patients to an Internet-based method of giving brief advice-have a longer-term effect on primary care clinicians delivery of screening and advice to heavy drinkers operationalized with the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) tool. METHODS We undertook a cluster randomized factorial trial with a 12-week implementation period in 120 primary health care units throughout Catalonia, England, Netherlands, Poland, and Sweden. Units were randomized to 8 groups: care as usual (control); training and support alone; financial reimbursement alone; electronic brief advice alone; paired combinations of these conditions; and all 3 combined. The primary outcome was the proportion of consulting adult patients (aged 18 years and older) receiving intervention-screening and, if screen-positive, advice-at 9 months. RESULTS Based on the factorial design, the ratio of the log of the proportion of patients given intervention at the 9-month follow-up was 1.39 (95% CI, 1.03-1.88) in units that received training and support as compared with units that did not. Neither financial reimbursement nor directing screen-positive patients to electronic brief advice led to a higher proportion of patients receiving intervention. CONCLUSIONS Training and support of primary health care units has a lasting, albeit small, impact on the proportion of adult patients given an alcohol intervention at 9 months.

  • 12.
    Andersson, Elenor
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Johansson, Malin
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    "Jag var där och jag var närvarande": Förstagångspappors erfarenheter av delaktighet i samband med förlossnings- och BB-vistelsen2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Idag uppmuntras pappor att vara närvarande och aktiva under graviditet och förlossning, något som påverkar hela familjen positivt. Delaktighet kan upplevas och uttryckas på olika sätt. Studier har visat att pappor inte varit så delaktiga som de önskat och haft svårt att hitta sin roll. Syfte: Identifiera och beskriva förstagångspappors erfarenheter av delaktighet under normal förlossning och BB-vistelse. Metod: En kvalitativ studie med induktiv ansats valdes. Fjorton intervjuer utfördes där materialet analyserades utifrån tematisk analys enligt Braun & Clarke. Fynd: Två huvudteman och sju underteman identifierades. Första huvudtemat var aktivt agerande med undertemana praktisk och verbalt agerande, rollen som ställföreträdare, involveras till handling. Andra huvudtemat var aktiv närvaro med undertemana finnas med, känslomässigt deltagande, deltagande i en livshändelse, bli sedd och bekräftad. Papporna vill vara delaktiga och upplever det positivt att bli involverade av barnmorskan till att delta aktivt. Delaktigheten stärks av att papporna blir sedda och bekräftade av barnmorskorna som blivande och nyblivna pappor. Delaktigheten riskerar att utebli om papporna inte får den information de behöver eller då de inte själva efterfrågar den. Konklusion: Förstagångspappors erfarenheter av delaktighet kan innebära både ett aktivt agerande och en aktiv närvaro.

  • 13.
    Andersson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Kroon, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Nationell kartläggning av farmakologiska rutiner och information i samband med tonsilloperation av barn och ungdomar2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Tonsilloperation är den vanligaste kirurgin som utförs på barn och ungdomar. Operationen medför långvarig smärta samt hög frekvens av illamående. I Sverige år 2012 kontaktade nästan en fjärdedel av alla föräldrar till barn som genomgått tonsillkirurgi sjukvården p.g.a. ej acceptabel smärta.

    Syfte: Syftet var att i en nationell studie kartlägga farmakologiska rutiner och informationen i samband med tonsilloperation hos barn och ungdomar.

    Metod: Kvantitativ deskriptiv studie, vilket utfördes som en enkätstudie där populationen var 52 öron-näs hals-kliniker i Sverige. Respondenter var öronläkare, öronsjuksköterska, anestesiläkare och anestesisjuksköterska (totalt 163 enkäter).

    Resultat: Svarsfrekvensen var 88 % från totalt 47 kliniker. Till största del gavs informationen till barn och föräldrar muntligt och skriftligt. Webbsidan Tonsilloperation.se utnyttjades som informationsmedel hos mindre än 50 % av klinikerna. Vanligast var intravenös anestesiinduktion och inhalationsanestesi som underhåll. Steroider användes för att förebygga illamående. Drygt 40 % av klinikerna hade skriftliga riktlinjer för postoperativ smärtbehandling till inneliggande patienter och till hemmet. Den farmkologiska behandlingen bestod huvudsakligen av paracetamol (70 % doserade enligt FASS) och NSAID. Åttio procent av klinikerna använde Citodon®, få ordinerade klonidin (11 %) och opioider (12 %).

    Konklusion: Resultaten visar på behov av evidensbaserade riktlinjer av farmakologisk behandling i samband med tonsilloperation. Utökat teamarbete gällande perioperativt omhändertagande i samband med tonsilloperation skulle höja vårdkvalitén.

  • 14.
    Andersson, Elin
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Kroon, Anna
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Nationell kartläggning av farmakologiska rutiner och information i samband med tonsilloperation2012In: Nationellt kvalitetsregister Öron-, Näs- och Halssjukvård: Årsrapport 2012, Nationellt kvalitetsregister för Öron-, Näs- och Halssjukvård. , 2012, p. 77-81Chapter in book (Other academic)
    Abstract [sv]

    Studien är en del i ett större nationellt projekt med syfte att kartlägga smärtbehandling vid tonsillkirurgi i samband med utformning av nationella farmakologiska riktlinjer. De vanligaste postoperativa komplikationerna vid tonsillkirurgi är postoperativt illamående och kräkningar (PONV), smärta, blödning och dehydrering. Tonsillkirurgin utförs idag antingen som dagkirurgiskt ingrepp eller som slutenvårdsingrepp med en vårdtid på ca ett dygn. Därmed sker den postoperativa vården i hemmet. Ett flertal studier har beskrivit patienternas upplevelse av höggradig smärta efter tonsillkirurgi. Obehandlad smärta leder till svårigheter att svälja och därmed otillräckligt dryckes- och matintag, vilket leder till dehydrering, ökad blödningsbenägenhet, sämre läkningsförmåga samt negativa  postoperativa beteendeförändringar hos barnet.

    Syftet var att i en nationell studie kartlägga farmakologiska rutiner och informationen i samband med tonsilloperation hos barn och ungdomar.

  • 15.
    Andersson, Frieda
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Patient safety in nursing homes in Sweden: nurses´views on safety and their role2017In: Journal of Health Services Research and Policy, ISSN 1355-8196, E-ISSN 1758-1060, Vol. 22, no 4, p. 204-210Article in journal (Refereed)
    Abstract [en]

    Objective: Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method: Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results: Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment. Barriers to patient safety were described as lack of sufficient resources; lack of communication and negative attitudes to incident reporting. To a great extent, nurses' work for patient safety consists of efforts to compensate for defects and ensure good health care in their daily work, since work with patient safety is not a management priority. Conclusion: Patient safety needs to be clarified and prioritized in nursing homes, and there is a need to understand nurses' role among other care givers and the need for shared routines among care givers

  • 16.
    Andersson, Johanna
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Wiström, Ulrica
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Ta tag i min hand, hjälp mig ut: Sjuksköterskors erfarenheter av stödjande samtal inom psykiatrisk öppenvård2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In Sweden, 20- 40 percent of people live with a mental illness. The treatment of mental illness is based on a humanistic approach, focusing on health promotion by supporting and strengthening the individual through supportive conversations.

    Purpose; The purpose of this study was to describe nurses' experiences of supportive conversations in their work with psychiatric outpatients.

    Method; A qualitative study was conducted, in which data were collected using semi-structured interviews with nurses in outpatient psychiatric care. Data were analyzed by conventional content analysis. The study included a total of 12 nurses.

    Results; Supporting conversations was described by nurses as an important and fundamental part of the relationship between nurse and patient in psychiatric outpatients. Experience and availability were described as significant factors for supporting conversations.

    Conclusion; Nurses experienced that content for supporting conversations and aims were indistinct. Indistinct guidelines for supportive conversations may lead to nurses becoming stressed. Routine and structure are important factors that may result in nurses working better under pressure and feeling more confident in supporting conversations.

  • 17.
    Andersson, Madelene
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Samuelsson, Kristian
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Kärlek till droger eller begär efter kärlek: En litteraturstudie om erfarenheter av omvårdnad hos patienter med en beroendesjukdom2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: 425 000 people are today living with a substance-related addictive disorder in Sweden. A large percentage of these people also live with concurrent somatic diseases which means that this group of people often encounter the somatic health-care system.

    Aim: The study aimed to highlight the experience of nursing in somatic care in patients with a substance-related addictive disorder.

    Design: The study was conducted as a literature review with a systematic approach.

    Method: The literature search was conducted through three databases: CINAHL, PsycINFO and PubMed, which resulted in eleven articles, all with a qualitative approach. The articles were checked for accuracy and the material was analyzed with inspiration from Graneheim and Lundmans (2004) concept analysis.

    Findings: Three themes were identified: disrespectful treatment, care on different terms and good nursing relationship. Main findings revealed that the patients experienced nursing staff as suspicious, blaming and showing a lack of dedication. The result demonstrates that the patients with a substance-related addictive disorder received inferior care than other inpatients in the nursing wards. Good experiences were manifested by the staff showing concern, confirmation and maintained a person-centered care.

    Conclusion: Inpatients with a substance-related addictive disorder tend to experience disrespected treatment and discrimination compared to other inpatients. Enhanced awareness is needed among health professionals to erase the stereotypical perceptions and by that create conditions for a good caring relationship.

  • 18.
    Andersson, Sten-Ove
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Centre for Defence Medicine, Swedish Armed Forces, Göteborg, Sweden.
    Lundberg, Lars
    Centre for Defence Medicine, Swedish Armed Forces, Göteborg, Sweden/Borås University, School of Health Sciences,Borås Sweden.
    Jonsson, Anders
    Centre for Defence Medicine, Swedish Armed Forces, Göteborg, Sweden/Borås University, School of Health Sciences,Borås Sweden.
    Tingström, Pia
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Doctors’ and Nurses’ Perceptions of Military Pre-hospital Emergency Care2014Manuscript (preprint) (Other academic)
    Abstract [en]

    The aim of this study was to identify physicians’ and nurses’ perceptions of military prehospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The aim is to identify the area of knowledge, pre-hospital care in a military environment, in terms of expressions from doctors and nurses focussing on the variation in how learning of pre-hospital care is perceived. The result of the study is a set of descriptive categories on a collective level, showing the variation in how doctors and nurses perceived the phenomenon of military pre-hospital emergency care. The results after predeployment training can be categorized as (1) to learn military medicine, (2) to take care of the casualty and (3) to have safety awareness. The results after an international mission can be categorized as (1) to collaborate with others, (2) to deliver general health care, and (3) to improve competence in military medicine. Possible implications of the results from the present study are the following; (I) better conditions for doctors and nurses to provide appropriate military medical care by clarification and better understanding of professions in the mission area (doctors, nurses, officers), since they may have different goals for their actions, (II) to pay attention to all aspects of military health care during predeployment training, including general health care in the mission area, (III) to implement new knowledge in military medicine in the predeployment training, and (IV) to train for the reality all doctors and nurses are about to meet. These results indicate  that the training should be developed in order to optimize the prepare physicians and nurses for international assignments. This may result in increased safety for the provider of care, while at the same time minimizing suffering and enhancing the possibility of survival of the injured.

  • 19.
    Andersson, Thomas
    et al.
    Department of Surgery, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.
    Falk, Kristin
    Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden.
    Bjerså, Kristofer
    Department of Surgery, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.
    Forsberg, Anna
    Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden.
    Health Is Belonging: Lived Experiences during Recovery after Pancreaticoduodenectomy.2012In: ISRN Nursing, ISSN 2090-5483, E-ISSN 2090-5491, Vol. 2012, p. 602323-Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the lived experience of the symptoms, health, and illness reported by patients recovering after pancreaticoduodenectomy ad modum Whipple due to pancreatic or periampullary cancer. Thirteen patients with pancreatic or periampullary cancer who underwent pancreaticoduodenectomy ad modum Whipple between 2006 and 2008 were interviewed during postoperative recovery. Data were analysed using the phenomenological-hermeneutic method. The structural analysis of patient experiences revealed that recovery after pancreaticoduodenectomy was described as recapturing everyday life, being healthy, and looking to the future. Participants experienced symptoms but did not dwell on them, instead they stated that their general health was good. They strived to regain their former precancer selves and be a part of as well as contribute to the social context. Overall, the participants' view of the future was positive, and improvement in their health generated further confidence and encouragement. This study suggests that persons recovering from pancreaticoduodenectomy ad modum Whipple due to a pancreatic or periampullary tumour experience health despite postoperative symptoms. They manage their symptoms by means of different strategies and express a positive view of the future. Nurses working with such patients should adopt a person-centred approach focusing on patient perspectives, participation, and possibilities.

  • 20.
    Andreae, Christina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Appetite in patients with heart failure: Assessment, prevalence and related factors2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Appetite is an important component in nutrition for maintaining the food intake needed by the body. Decreased appetite is a common clinical problem in patients with heart failure. It has a negative impact on food intake and possibly on malnutrition and health outcomes. There is a lack of evidence on how to assess appetite in heart failure. Furthermore, there are knowledge gaps about factors associated with appetite and which role appetite plays for health status in heart failure.  

    Aim: The overall aim of the thesis was to investigate appetite in patients with heart failure. Four studies were conducted with the goal to evaluate the psychometric properties of the Council on Nutrition Appetite Questionnaire (CNAQ) (I) and to explore the prevalence of decreased appetite and related factors associated with appetite in patients with heart failure (II-IV).  

    Methods: A multicenter study was conducted in three outpatient heart failure clinics in the center of Sweden during 2009-2012. Data were collected through a baseline measurement (I-IV) and an 18-month follow-up (IV). The first study was a psychometric evaluation study (I), while the other studies had an observational cross-sectional design (II-III) and an observational prospective design (IV). One hundred and eighty-six patients diagnosed with heart failure and experiencing heart failure symptoms participated at baseline. At the 18-month follow-up study (IV), one hundred and sixteen participants from the baseline participated. Data were collected from medical records (pharmacological treatment, comorbidity, left ventricle ejection fraction, time of diagnosis), self-reported questionnaires (demographic background data, appetite, symptoms of depression, health status, sleep, self-reported physical activity), objective measurements (anthropometric assessment of body size, blood samples, six minutes’ walk test, and physical activity measured with an actigraph) and clinical assessment (New York Heart Association (NYHA) functional classification, and cognitive assessment). The main outcome variables included appetite (I, II and IV) and health status (III). Descriptive and inferential statistics were used in the studies (I-IV).  

    Results: The majority of the participants had moderate heart failure symptoms, i.e., NYHA class II (n=114, 61%). Most of the participants were men (n=130, 70%). Mean age was 70,7 years, (SD=11,0), and mean BMI was 28.7 (SD=5.3). The CNAQ showed acceptable psychometric properties for assessing appetite in patients with heart failure (I). This thesis shows that 38% of the participants experienced an appetite level that put them at risk of weight loss (I). It was shown that factors such as biological, medical, psychological (II) and physical activity/exercise capacity (IV) are associated with appetite. Also, appetite was associated with impaired health status. However, this association was found to be moderated by symptoms of depression (III). Neither appetite nor physical activity changed during the 18-month follow-up (IV).  

    Conclusion: Decreased appetite is a serious phenomenon that needs attention in the care of patients with heart failure. Health care professionals can now use a validated and simple appetite instrument to assess appetite in heart failure. In addition, attention should be paid to elderly patients and those who have symptoms of depression, sleep problems, impaired cognitive function and impaired physical activity, as well as to patients on suboptimal medical treatment. Higher appetite was shown to contribute to a better health status, but this was only evident in patients without symptoms of depression. Therefore, special attention should be paid to symptoms of depression, as this risk factor affected the association between appetite and health status. This thesis enhances the understanding of the magnitude of the problem with decreased appetite in heart failure both in numbers and factors. New priorities in nutrition care and new ideas can be established, both in practice and in research, in order to improve a nutrition care that is vital for patients with heart failure.  

    List of papers
    1. Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure
    Open this publication in new window or tab >>Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure
    2015 (English)In: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 21, no 12, p. 954-958Article in journal (Refereed) Published
    Abstract [en]

    Background: Decreased appetite in heart failure (HF) may lead to undemutrition which could negatively influence prognosis. Appetite is a complex clinical issue that is often best measured with the use of self-report instruments. However, there is a lack of self-rated appetite instruments. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are validated instruments developed primarily for elderly people. Yet, the psychometric properties have not been evaluated in HF populations. The aim of the present study was to evaluate the psychometric properties of CNAQ and SNAQ in patients with HE Methods and Results: A total of 186 outpatients with reduced ejection fraction and New York Heart Association (NYHA) functional classifications II-IV were included (median age 72 y; 70% men). Data were collected with the use of a questionnaire that included the CNAQ and SNAQ. The psychometric evaluation included data quality, factor structure, construct validity, known-group validity, and internal consistency. Unidimensionality was supported by means of parallel analysis and confirmatory factor analyses (CFAs). The CFA results indicated sufficient model fit. Both construct validity and known-group validity were supported. Internal consistency reliability was acceptable, with ordinal coefficient alpha estimates of 0.82 for CNAQ and 0.77 for SNAQ. Conclusions: CNAQ and SNAQ demonstrated sound psychometric properties and can be used to measure appetite in patients with HF.

    Place, publisher, year, edition, pages
    CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2015
    Keywords
    Appetite; heart failure; outpatient; psychometrics
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-123773 (URN)10.1016/j.cardfail.2015.10.006 (DOI)000366230900004 ()26497759 (PubMedID)
    Note

    Funding Agencies|Center for Clinical Research and Sormland County Council, Sweden; Swedish Heart and Lung Foundation; King Gustaf V and Queen Victorias Freemason Foundation; Medical Research Council of Southeast Sweden; Canadian Institutes of Health Research

    Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2018-03-14
    2. Prevalence and associated factors for decreased appetite among patients with stable heart failure
    Open this publication in new window or tab >>Prevalence and associated factors for decreased appetite among patients with stable heart failure
    2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 11-12, p. 1703-1712Article in journal (Refereed) Published
    Abstract [en]

    Aims and objectivesTo explore the prevalence of decreased appetite and factors associated with appetite among patients with stable heart failure. BackgroundDecreased appetite is an important factor for the development of undernutrition among patients with heart failure, but there are knowledge gaps about prevalence and the factors related to appetite in this patient group. DesignObservational, cross-sectional study. MethodsA total of 186 patients with mild to severe heart failure were consecutively recruited from three heart failure outpatient clinics. Data were obtained from medical records (heart failure diagnosis, comorbidity and medical treatment) and self-rated questionnaires (demographics, appetite, self-perceived health, symptoms of depression and sleep). Blood samples were taken to determine myocardial stress and nutrition status. Heart failure symptoms and cognitive function were assessed by clinical examinations. The Council on Nutrition Appetite Questionnaire was used to assess self-reported appetite. Bivariate correlations and multivariate linear regression analyses were conducted to explore factors associated with appetite. ResultsSeventy-one patients (38%) experienced a loss of appetite with a significant risk of developing weight loss. The final multiple regression model showed that age, symptoms of depression, insomnia, cognitive function and pharmacological treatment were associated with appetite, explaining 27% of the total variance. ConclusionIn this cross-sectional study, a large share of patients with heart failure was affected by decreased appetite, associated with demographic, psychosocial and medical factors. Relevance to clinical practiceLoss of appetite is a prevalent problem among patients with heart failure that may lead to undernutrition. Health care professionals should routinely assess appetite and discuss patients experiences of appetite, nutrition intake and body weight and give appropriate nutritional advice with respect to individual needs.

    Place, publisher, year, edition, pages
    WILEY-BLACKWELL, 2016
    Keywords
    age; appetite; cognitive function; depression; heart failure; insomnia; outpatient; pharmacological treatment
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-128929 (URN)10.1111/jocn.13220 (DOI)000375866200022 ()26879764 (PubMedID)
    Note

    Funding Agencies|Centre for Clinical Research Sormland, Uppsala University, Eskilstuna, Sweden; Swedish Heart and Lung Foundation; King Gustaf V and Queen Victorias Freemason Foundation; Medical Research Council of Southeast Sweden

    Available from: 2016-06-09 Created: 2016-06-07 Last updated: 2018-03-14
    3. Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure
    Open this publication in new window or tab >>Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure
    Show others...
    2018 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 2, p. E15-E20Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Decreased appetite and depressive symptoms are clinical problems in patients with heart failure. Both may result in impaired health status.

    OBJECTIVE: The aims of this study were to investigate the association between appetite and health status in patients with heart failure and to explore whether depressive symptoms moderate this association.

    METHODS: In this cross-sectional study, patients with heart failure (n = 186; mean age, 71 years), New York Heart Association class II to IV, participated. Data on appetite (Council of Nutrition Appetite Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and health status (EQ-5D 3-level scale [EQ-5D-3L] descriptive system, EQ-5D-3L index, and EQ Visual Analog Scale) were collected by self-rating questionnaires. Pearson correlation was used to investigate the association between appetite and health status. Multiple regression was performed to examine whether depressive symptoms moderate the association between appetite and health status.

    RESULTS: There was a significant association between appetite and health status for EQ-5D-3L descriptive system, mobility (P < .001), pain/discomfort (P < .001), and anxiety/depression (P < .001). This association was also shown in EQ-5D-3L index (P < .001) and EQ Visual Analog Scale (P < .001). Simple slope analysis showed that the association between appetite and health status was only significant for patients without depressive symptoms (B = 0.32, t = 4.66, P < .001).

    CONCLUSIONS: Higher level of appetite was associated with better health status. In moderation analysis, the association was presented for patients without depressive symptoms. Decreased appetite is an important sign of poor health status. To improve health status, health professionals should have greater attention on appetite, as well on signs of depressive symptoms.

    Place, publisher, year, edition, pages
    Wolters Kluwer, 2018
    Keywords
    appetite, association, depression, health status, heart failure, nutritional status
    National Category
    Cardiac and Cardiovascular Systems
    Identifiers
    urn:nbn:se:liu:diva-139105 (URN)10.1097/JCN.0000000000000428 (DOI)000440241700003 ()28574973 (PubMedID)2-s2.0-85020167287 (Scopus ID)
    Available from: 2017-07-01 Created: 2017-07-01 Last updated: 2018-08-16Bibliographically approved
  • 21.
    Andreae, Christina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    The relationship between physical activity and appetite in heart failure – A cross sectional study2017Conference paper (Refereed)
    Abstract [en]

    Background: Physical activity and appetite are important for maintaining physical health. Yet, sedentary lifestyle and poor appetite are frequently observed in the heart failure (HF) population. However, the relationships between these phenomena are not yet clearly understood. 

    Purpose: To investigate the relationship between physical activity and appetite in patients with stable HF.

    Methods: In this cross sectional study, a consecutive sample of 186 patients with confirmed HF with NYHA class II-IV (median age 72y, 70% men, NYHA class II 61%) participated in the study. Patients were recruited from three HF outpatient clinics in central Sweden. Physical activity measures included total energy expenditure (TEE), active energy expenditure (AEE) above 3 METs, average daily METs and number of steps per day during four days using a validated multi-sensor wearable armband (SenseWear®, Body Monitoring System). Patients also self-reported their physical activity on a ten point numeric rating scale, from extremely low (1) to extremely high (10). Self-reported appetite was measured by Council on Nutrition Appetite Questionnaire (CNAQ), an 8-item instrument (score range 8-40) where CNAQ ≤28 indicate poor appetite. Associations between physical activity and appetite were analyzed by Spearman correlation while differences in physical activity between poor vs good appetite were analyzed using Mann Whitney U test.

    Results: There was a significant positive relationship between physical activity and appetite assessed by TEE (rs=.184, p=.012), AEE of moderate intensity >3 METs (rs=.262, p=.000), number of steps (rs=.292, p=.000), average METs intensity (rs=.249, p=.001), and self- reported physical activity (rs=.191, p =.009). Levels of physical activity in the low appetite group differed significantly from the group with better appetite, this was seen in all physical dimensions, TEE (U=3225, z=-2.26, p=.024), AEE (U=2902, z=-3.178, p=.001), number of steps (U=2706, z=-3.734, p=.000), average METs intensity (U=3128, z=-2.541, p=.011), levels of self-reported physical activity (U=3185, z=-2.47, p=.013).

    Conclusion: This study shows that physical activity is associated with appetite and that levels of physical activity differs between patients with poor and good appetite. These findings has implications for both research and practice and underlines the importance in monitoring both physical activity and appetite. Further research is needed to determine whether interventions targeting physical activity also improve appetite and vice versa in the HF population.

  • 22.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hjelm, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Factors influencing nutritional status in chronic heart failure2011Conference paper (Refereed)
  • 23.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Evangelista, Lorraine L
    Sue and Bill Gross School of Nursing, University of California, Irvine, CA,.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Physical activity and appetite in patients with stable heart failure – A cross sectional study2017Conference paper (Refereed)
  • 24.
    Andreae, Christina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Evangelista, Lorraine
    Sue and Bill Gross School of Nursing, University of California, Irvine, CA.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Sedentary lifestyle is associated with poor appetite in patients with heart failure.2017Conference paper (Refereed)
  • 25.
    Andregård, Anna-Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jangland, Eva
    Uppsala University, Sweden.
    The tortuous journey of introducing the Nurse Practitioner as a new member of the healthcare team: a meta-synthesis2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 1Article, review/survey (Refereed)
    Abstract [en]

    The aim of this study was to explore the obstacles to and the opportunities for achieving optimal interprofessional team collaboration with the introduction of the nurse practitioner (NP). A team approach can contribute importantly to sustainable and safe patient care, and NPs have been added to the healthcare team in many countries. Following the international trend towards the development of the acute care NP, the role has recently been initiated in surgical care in Sweden. The introduction of an advanced nursing role into existing organisations raises questions about how the role will be developed and what its effects will be on collaboration between the different professions. We conducted a systematic review of qualitative studies using the meta-ethnographic approach developed by Noblit and Hare. Literature in the field of nursing was searched on PubMed and CINAHL, and empirical qualitative studies from outpatient and inpatient care in seven countries were included. The studies were appraised according to national guidelines and templates and were analysed and synthesised according to the meta-ethnographic approach. A total of 26 studies were included in the synthesis. The analysis revealed four themes: (i) a threat to professional boundaries, (ii) a resource for the team, (iii) the quest for autonomy and control, and (iv) necessary properties of a developing interprofessional collaboration. Based on these themes, the synthesis was created and presented as a metaphorical journey. The implementation of a new nursing role in a traditional healthcare team is a complex process influenced by many factors and can be described as a tortuous journey towards a partially unknown destination. The synthesised obstacles and opportunities drawn from international studies may help healthcare organisations and new NPs prepare for, and optimise, the implementation of a new nursing role.

  • 26. Andréasson, S
    et al.
    Gullberg, Mats T
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Olsson, Henny M
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Hamrin, Elisabeth
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Medical laboratory technologists' perception of professional self. A study of Swedish MLTs employed in clinical chemistry1992In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 6, no 2, p. 67-74Article in journal (Refereed)
    Abstract [en]

    The subjective perception of professional self was studied for a sample of Medical Laboratory Technologists (MLTs) employed in Clinical Chemistry in Sweden. The sample (N = 488) consisted of a randomized tenth of members of their trade union. A mailed questionnaire with 21 items concerning self-description compared with peers in a seven-point Likert type scale was completed by 332 (68%). There was no significant overall difference concerning the four principal types of workplace: Clinical Chemistry, Blood Serology, Primary Care and Clinical Chemistry/Blood Serology. The main difference was found between those in managerial posts (N = 72) and the other MLTs (N = 260). Factor analysis showed three principal components, labelled Professionalism, Work Ethic, and Empathy, but also a different composition of variables of the components for the manager group compared with the non-manager group.

  • 27.
    Angelhoff, Charlotte
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    What about the parents?: Sleep quality, mood, saliva cortisol response and sense of coherence in parents with a child admitted to pediatric care2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Parents experience many stressful situations when their child is ill and needs medical care, irrespective of the child’s age, diagnosis or the severity of the illness. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, to care for their ill child, and to cope with the challenges they face.

    The overall aim of this thesis was to evaluate sleep, mood, cortisol response, and sense of coherence (SOC) in parents caring for children in need of medical care, and to identify factors that may influence parents’ sleep.

    This thesis includes four original studies; two of these are quantitative, prospective, descriptive and comparative studies including parents (n=82) accommodated in six pediatric wards with their ill child, using questionnaires and sleep logs to measure sleep, mood and SOC, and saliva cortisol to measure cortisol response. A follow-up was performed four weeks later at home, after hospital discharge. The other two studies are qualitative, inductive and explorative interview studies, including parents (n=12) staying overnight with their preterm and/or ill infant in three neonatal intensive care units, and parents (n=15) with a child receiving hospital-based home care in two pediatric outpatient clinics. The interviews were analyzed with a phenomenographic method.

    Being together with one’s family seems beneficial for sleep and may decrease stress. The ability to stay with the child, in the hospital or at home, was highly appreciated by the parents. When caring for a child with illness, parents’ sleep quality was sufficient in the hospital; however, sleep quality improved further (p<0.05) at home after discharge. The parents reported frequent nocturnal awakenings in the hospital caused by the child, medical treatment and hospital staff. Concern and anxiety about the child’s health, and uncertainty about the future were stressors affecting the parents’ sleep and mood negatively. The parents had lower (p=0.01) morning awakening cortisol levels in the pediatric ward compared to at home, and parents accommodated for more than one night had lower (p<0.05) post-awakening cortisol levels compared to parents staying their first night.

    The findings of this thesis conclude that being together as a family is important for the parents’ sleep. The ability to be accommodated in the hospital and gather the family around the child may have given the parents time for relaxation and recovery, that in turn may lead to a less stressful hospital stay. When it is beneficial for the child, the whole family should be included in the pediatric care. Moreover, pediatric nurses must acknowledge parents’ sleep, in hospital and at home. Medical treatment and care at night should be scheduled and sleep promoted for the parents in order to maintain health and well-being in the family.

    List of papers
    1. Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study
    Open this publication in new window or tab >>Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study
    Show others...
    2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 5-6, p. 717-727Article in journal (Refereed) Published
    Abstract [en]

    AIMS AND OBJECTIVES:

    To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.

    BACKGROUND:

    Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis.

    DESIGN:

    A phenomenographic study with an inductive and exploratory design.

    METHODS:

    Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January-March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography.

    FINDINGS:

    Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness.

    CONCLUSION:

    Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation.

    RELEVANCE FOR CLINICAL PRACTICE:

    Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2015
    Keywords
    family nursing; family-centred care; kangaroo mother care; neonatal intensive care; nursing; siblings; skin-to-skin care
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-115549 (URN)10.1111/jocn.12654 (DOI)000350354700010 ()25041598 (PubMedID)
    Funder
    Medical Research Council of Southeast Sweden (FORSS)Östergötland County Council
    Available from: 2015-03-16 Created: 2015-03-16 Last updated: 2017-12-04
    2. Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.
    Open this publication in new window or tab >>Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.
    2015 (English)In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 64, no 5, p. 372-380Article in journal (Refereed) Published
    Abstract [en]

    Background: Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves.

    Objectives: The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services.

    Method: This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC.

    Results: Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep.

    Discussion: Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

    Place, publisher, year, edition, pages
    Lippincott-Ravn Publisher, 2015
    Keywords
    children, chronic illness, home care services, parents, qualitative research, sleep
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-121085 (URN)10.1097/NNR.0000000000000108 (DOI)000361361000006 ()26325279 (PubMedID)
    Projects
    Parents’ stress and sleep quality when their children need medical care
    Funder
    Östergötland County CouncilMedical Research Council of Southeast Sweden (FORSS)
    Available from: 2015-09-07 Created: 2015-09-07 Last updated: 2017-12-04Bibliographically approved
    3. Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward
    Open this publication in new window or tab >>Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward
    2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 3-4, p. e544-e550Article in journal (Refereed) Published
    Abstract [en]

    Aims and objectives

    To describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.

    Background

    Frequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.

    Methods

    This was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.

    Results

    The parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.

    Conclusion

    Parents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.

    Relevance to Clinical Practice

    The healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2018
    Keywords
    adolescents, child, child nursing, children’s nurses, family nursing, family-centred care, hospitalised child, paediatrics, parent, sleep
    National Category
    Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-143585 (URN)10.1111/jocn.14092 (DOI)000425733600018 ()28960555 (PubMedID)2-s2.0-85037348121 (Scopus ID)
    Note

    Funding agencies: Medical Research Council of Southeast Sweden [FORSS-159681]; Region of Ostergotland, Sweden

    Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-06-01Bibliographically approved
  • 28.
    Angelhoff, Charlotte
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Edéll-Gustafsson, Ulla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Mörelius, Evalotte
    Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Parental mood when staying overnight at hospital with their sick child2015Conference paper (Refereed)
    Abstract [en]

    Parental mood when staying overnight at hospital with their sick child

    Objective

    to describe mood in parents, staying with their sick children overnight at the hospital.

    Methodology

    A descriptive design, including 75 parents staying overnight at hospital with their sick child, was used. The parents filled out Mood-scale the morning after staying overnight at the hospital. The Mood-scale is a validated and reliable self-administered instrument measuring six dimensions of mood; control, calmness, social orientation, pleasantness, activation, and extraversion (Sjöberg L, 1979). The study is a part of a larger project, with focus on mood, stress and sleep in parents staying with their sick children overnight at the hospital.

    Results

    The result will describe how parents report their total mood and how they report the different dimensions when they stay with their sick children overnight at the hospital. A comparison will be made between the parent´s mood and gender and the child´s age. Data is under analysis and will be presented as preliminary data.

     

    Conclusion

    According to UNICEF Convention on the Rights of the Child, children in hospital have the right to have their parents with them at all times and parents should be offered accommodation and be encouraged to stay. However, the hospital environment, in combination with having a sick child, might affect the parent´s mood, which in turn might affect the ability to handle the situation and the child´s care. Therefore it is of importance to study parental mood and find ways to help the families during their hospital stay.

  • 29.
    Angelhoff, Charlotte
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Arts and Sciences.
    Edéll-Gustafsson, Ulla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Perceptions of sleep quality and stress by parents of children enrolled in hospital organized home-care2013In: Nordic Advances in Health Care Sciences Research, Lund, 2013: Abstract book / [ed] Gerd Ahlström, Lena von Koch, 2013, p. 56-56Conference paper (Other academic)
    Abstract [en]

    Introduction

    Caring for a sick child creates much greater demands for parents than those associated with raising a healthy child. Parents of chronically ill children reports higher levels of parental stress as a consequence of the substantial social, emotional and personal demands associated with caring. Sleep quality is an important aspect of wellbeing and is strongly related to stress and quality of life. In some Swedish counties families are offered hospital organized home-care for sick children. Caring for a child at home gives the family the opportunity to be together in an environment they know well and where they can feel comfortable and secure. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation and support their child. No other study is found about how parents sleep when their child is enrolled in hospital organized home-care.

     

    Aim

    To explore parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care.

     

    Material

    Fifteen parents (11 mothers and 4 fathers) with children enrolled in hospital organized home-care from one university hospital and one general hospital in South-eastern Sweden were included. The children ranged in age 0-12 years.

     

    Method

    Parents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both.

     

    Results

    Four descriptive categories in the phenomenon of parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care were identified; Routines helps to manage the situation, Time for oneself and the partner, Feelings of isolation and Need of support

     

    Conclusion

    Sleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.

  • 30.
    Angelhoff, Charlotte
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Edéll-Gustfsson, Ulla
    Linköping University, Department of Medical and Health Sciences.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies.
    Parents´ perception of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care services2015In: The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development: ICCD 2015 Jerusalem Israel / [ed] Kerem, Eitan, Jerusalem: Paragon Israel , 2015Conference paper (Refereed)
    Abstract [en]

    Background: Caring for a sick child creates great demands for the parents. Sleep is an important aspect of wellbeing and is strongly related to stress and quality of life. Caring for a child at home gives the family the opportunity to be together in a familiar environment, but includes several sleep disturbances during the night which affects the ability to handle the situation.

    Aim: To describe parents’ perceptions of circumstances influencing their own sleep, living with a child enrolled in Hospital-Based Home Care Services.

    Method: This is a phenomenographic study with an inductive, exploratory design, using semi-structured interviews with main and follow-up questions. Fifteen parents with children enrolled in Hospital-Based Home Care Services were included.

    Findings: The outcome space consists of four descriptive categories: s; Sleep influence mood and mood influences sleep, Support and safeness influence sleep, The child´s needs and routines influence sleep, and Me-time influences sleep.

    Discussion: Parents to children in Hospital-Based Home Care Services perceive their sleep differently depending on how safe they feel with the situation. Troubling thoughts, bedtime worries, anxiety and stress affect sleep negatively. Safeness is prerequisite for sleep. Shared responsibility and social support help the parents to cope with the daily life and thus facilitate sleep. The parents adjust their routines after the cild´s needs to find time for sleep and relaxation. Me-time and physical activity was perceived as important tools to improve coping and sleeping.

  • 31.
    Angelhoff, Charlotte
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Edéll-Gustfsson, Ulla
    Linköping University, Department of Medical and Health Sciences.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies.
    Perceptions of sleep by parents of children in hospital organized home-care2014In: Programbok Barnveckan 2014, Malmö, 7-11 april,  2014, 2014, p. 33-33Conference paper (Refereed)
    Abstract [en]

    Introduction

    Caring for a sick child creates great demands for the parents. Sleep is an important aspect of wellbeing and is strongly related to stress and quality of life. Caring for a child at home gives the family the opportunity to be together in a familiar environment. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation.

     

    Aim

    To explore parents’ perceptions of sleep living with a child enrolled in hospital-organized home-care.

     

    Material

    Fifteen parents with children enrolled in hospital-organized home-care were included.

     

    Method

    Interviews with open-ended questions, analysed with a phenomenographic method.

     

    Results

    Four descriptive categories were identified; Anxiety, stress and demands affects sleep negatively’, ‘When I get support I feel safe’, ‘Routines optimizes time for sleep’, and ‘Time for oneself is important for relaxation’

     

    Conclusion

    Sleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.

  • 32.
    Angelhoff, Charlotte
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care.
    Edéll-Gustfsson, Ulla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.2015In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 64, no 5, p. 372-380Article in journal (Refereed)
    Abstract [en]

    Background: Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves.

    Objectives: The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services.

    Method: This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC.

    Results: Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep.

    Discussion: Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

  • 33.
    Armuand, Gabriela
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Wettergren, L.
    Karolinska Inst, Sweden.
    Nilsson, J.
    Karolinska Inst, Sweden.
    Rodriguez-Wallberg, K.
    Karolinska Inst, Sweden; Karolinska Univ Hosp Huddinge, Sweden.
    Lampic, C.
    Karolinska Inst, Sweden.
    Threatened fertility: A longitudinal study exploring experiences of fertility and having children after cancer treatment2018In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 27, no 2, article id e12798Article in journal (Refereed)
    Abstract [en]

    Infertility is a recognised potential sequel of cancer treatment which impacts negatively on the quality of survival. The aim of this study was to explore how men and women experience the threat of infertility by cancer treatment and individuals thoughts about having children after cancer during the first 2years following diagnosis. Nine women and seven men (aged 24-41) participated in two interviews in this longitudinal interview study, after the initiation of cancer treatment and 2years thereafter. The interviews focused on participants thoughts and feelings about threatened fertility and having children. The interviews were analysed with qualitative content analysis with a particular focus on identifying experiences over time. The Traits-Desires-Intentions model was used to reflect upon the study findings. The analysis resulted in the identification of four themes: Continue calmly on chosen path, Abandoning plans for children, Avoiding the subject of fertility and Struggling towards life goals. The results emphasise the need to offer individualised fertility-related treatment communication and counselling, both at the time of cancer diagnosis and also in connection with follow-up care. Appropriate fertility-related communication should be included in young cancer patients survivor care plans.

  • 34.
    Aronsson, Patrik
    et al.
    Department Pharmacology, Institution of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Booth, Shirley
    Department Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden; School of Education, University of the Witwatersrand, Johannesburg, South Africa.
    Hägg, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Kjellgren, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    Zetterqvist, Ann
    Department Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Tobin, Gunnar
    Department Pharmacology, Institution of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Reis, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    The understanding of core pharmacological concepts among health care students in their final semester2015In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, no 1, article id 235Article in journal (Refereed)
    Abstract [en]

    Background

    The overall aim of the study was to explore health care students´ understanding of core concepts in pharmacology.

    Method

    An interview study was conducted among twelve students in their final semester of the medical program (n = 4), the nursing program (n = 4), and the specialist nursing program in primary health care (n  = 4) from two Swedish universities. The participants were individually presented with two pharmacological clinically relevant written patient cases, which they were to analyze and propose a solution to. Participants were allowed to use the Swedish national drug formulary. Immediately thereafter the students were interviewed about their assessments. The interviews were audio-recorded and transcribed verbatim. A thematic analysis was used to identify units of meaning in each interview. The units were organized into three clusters: pharmacodynamics, pharmacokinetics, and drug interactions. Subsequent procedure consisted of scoring the quality of students´ understanding of core concepts. Non-parametric statistics were employed.

    Results

    The study participants were in general able to define pharmacological concepts, but showed less ability to discuss the meaning of the concepts in depth and to implement these in a clinical context. The participants found it easier to grasp concepts related to pharmacodynamics than pharmacokinetics and drug interactions.

    Conclusion

    These results indicate that education aiming to prepare future health care professionals for understanding of more complex pharmacological reasoning and decision-making needs to be more focused and effective.

  • 35.
    Ask, Per
    et al.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Hult, Peter
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Arts and Sciences.
    Fjallbrant, T
    Wranne, Bengt
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Bioacoustic techniques is applicable to primary health care2001In: PROCEEDINGS OF THE 23RD ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, VOLS 1-4: BUILDING NEW BRIDGES AT THE FRONTIERS OF ENGINEERING AND MEDICINE, 2001, Vol. 23, p. 1911-1914Conference paper (Refereed)
    Abstract [en]

    The stethoscope has been used diagnostically for nearly two hundred years to assess the heart function. We can envision the intelligent stethoscope which combines the advantages of the traditional instrument with advanced functionality for analysis of the signal and other information support. The bioacoustic technique is basically simple and robust and fits therefore into a scenario where investigations are performed in a distributed health care system as in primary health care or even home health care. We have focused on detection of respiratory sounds and third heart sounds. The later is performed with a new wavelet technique which makes it possible to automatically detect and identify the sounds and possibly relate them to myocardial insufficiency.

  • 36.
    Atwine, Fortunate
    et al.
    School of Health and Caring Science, Linnaeus University, Vaxjo, Sweden; Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Health professionals’ knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in ugandans with diabetes: A cross-sectional survey2017In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 28, article id 256Article in journal (Refereed)
    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.

  • 37.
    Augutis, M
    et al.
    Department of Public Health and Research, Sundsvall Hospital, Sundsvall, Sweden.
    Abel, R
    Orthopädische Universitätsklinik, Heidelberg-Schlierbach, Germany.
    Levi, Richard
    Karolinska Institute and Rehab Station Stockholm, Sweden.
    Pediatric spinal cord injury in a subset of European countries.2006In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 44, no 2, p. 106-112Article in journal (Refereed)
    Abstract [en]

    Study design:Postal survey.Setting:A total of 19 countries in Europe.Objectives:Firstly, to collect information about incidence and systems of care for pediatric spinal cord injury (pedSCI); including prevention, initial care and follow-up in a subset of European countries. Secondly, to initiate a network of involved professionals for exchange of information and development of research and care programs.Methods:A short semi-structured questionnaire was sent to respondents working with spinal cord injury (SCI) in 19 countries in Europe.Results:Only in Portugal and Sweden, is the incidence of pedSCI (fatal injuries included) established, that is 27 children/million children/year and 4.6 children/million children/year, respectively. For the other countries, the estimated incidence of pedSCI (nonfatal injuries) varied from 0.9 to 21.2 children/million children/year in the age group of 0–14 years. Although the incidence varies considerably, pedSCI is rare throughout Europe. The management differs between the countries depending on the age of the child and the local organization of health care.Conclusions:The survey confirms that pedSCI is rare. In order to establish high-quality standardized care, further integration of knowledge in this area is needed throughout Europe. The contacts initiated by this survey may be used to create an international network serving as a reference for health professionals, researchers and families, thereby possibly alleviating some of the unwanted variations of care identified in this study.Spinal Cord (2006) 44, 106–112. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101793andlt;/highlightandgt;; published online 30 August 2005 [ABSTRACT FROM AUTHOR]

  • 38.
    Augutis, M
    et al.
    FoU, Sundsvall Hospital, Sundsvall, Sweden.
    Levi, Richard
    Rehab Station Stockholm and Karolinska Institute, Stockholm, Sweden.
    Pediatric spinal cord injury in Sweden: incidence, etiology and outcome.2003In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 41, no 6, p. 328-336Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN:: Retrospective descriptive study. OBJECTIVES:: To assess incidence, causes and early outcome of traumatic spinal cord injury (SCI) among children in Sweden, thereby identifying high-risk groups and situations as a basis for preventative measures and improved care. METHODS:: Data from population registers, County Habilitation Centers as well as from informal sources were used to estimate the incidence of SCI in Sweden during the years 1985-1996 among children aged 0-15 years. Contacts with the treating hospitals, reviews of medical records and/or personal interviews were used to verify primary data. In total, 92 children were thus identified. RESULTS:: The incidence was found to be 4.6/million children/year (95% CI 3.6-5.5). When excluding prehospital fatalities, the incidence was 2.4 (95% CI 1.8-3.1). The main cause of injury among fatalities was traffic accidents. Associated injuries occurred in 41% of the children. Among survivors (10-15 years), sports-related injuries (43%) were as common a cause as traffic accidents (39%). The survivors were treated in 18 different hospitals. CONCLUSION:: Pediatric SCI in Sweden is rare, presumably because of effective primary prevention. Preventative measures should be further differentiated for each age group of children in accordance with their differing risk profiles. In contrast to the effective preventative measures that have been implemented in Sweden, care of these patients is still too fractionated and decentralized for sufficient specialization to emerge.Spinal Cord (2003) 41, 328-336. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101478andlt;/highlightandgt; [ABSTRACT FROM AUTHOR]

  • 39.
    Augutis, Marika
    et al.
    Karolinska Institute, Sweden.
    Levi, Richard
    Karolinska Institute, Sweden.
    Asplund, Kenneth
    Mid-Sweden University, Sundsvall, Sweden.
    Berg-Kelly, Kristina
    Karolinska Institute, Sweden.
    Psychosocial aspects of traumatic spinal cord injury with onset during adolescence: a qualitative study.2007In: Journal of Spinal Cord Medicine (JSCM), ISSN 1079-0268, E-ISSN 2045-7723, Vol. 30 Suppl 1, p. S55-S64Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVE: Spinal cord injury (SCI) occurring during adolescence poses additional challenges because of the concurrent age

  • 40.
    Avander, Karin
    et al.
    Sahlgrens University Hospital, Sweden.
    Heikki, Anna
    Sahlgrens University Hospital, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. University of Gothenburg, Sweden.
    Engstrom, My
    University of Gothenburg, Sweden.
    Trauma Nurses Experience of Workplace Violence and Threats: Short- and Long-Term Consequences in a Swedish Setting2016In: JOURNAL OF TRAUMA NURSING, ISSN 1078-7496, Vol. 23, no 2, p. 51-57Article in journal (Refereed)
    Abstract [en]

    Violence in health care is increasing globally and Sweden is no exception. Still, this topic is sparsely studied in the Swedish trauma care setting. This focus group study examined nurses experience of violence and threats, and their consequences. The content analysis revealed two main categories, threatening situations and consequences, which led to a change in priorities in nursing care in order to avoid a potential violent situation. Furthermore, negative stress among the staff and greater vigilance and unwillingness to be near the patient resulted in altered communication and, in the end, a decreased quality of nursing care.

  • 41.
    Aviles, Paula
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Ljungberg, Isabella
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Naturbaserad terapi och dess betydelse för personer med psykisk ohälsa: En litteraturstudie om naturen som en resurs inom vård och behandling2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The positive impact of nature on health has been highlighted since ancient times. The scientific research about nature-based therapy has increased during the last decades and has presented positive effects for patients with different diagnoses. More than one third of the European Union population suffers from some kind of mental illness and many lack adequate treatment. Nursing care of mental illness should according to guidelines include a person-centered approach and knowledge about the significance of the care environment.

    Aim: To describe the impact of nature-based therapy for people with mental illness.

    Method: A general literature study with a systematic approach was conducted. The search for articles was made in PubMed, Cinahl, AMED, PsykInfo and Scopus. The quality of the selected articles were examined and analyed using qualitative content analysis.

    Results: Nature-based therapy had a positive impact on health for people with mental illness. The result was based on 17 articles and four categories were identified: nature as a refuge, the importance of social context, altered view of life situation and improvement of symptoms and its consequences.

    Conclusion: The findings conclude that nature-based therapy can have an impact on recovery and daily function for persons with mental illness. The study also revealed that nursing care with a salutogenic approach in a therapeutic nature environment leads to an increased mental health.

  • 42.
    Ax, Anna-Karin
    et al.
    Linköping University, Department of Medicine and Care.
    Johansson, Erica
    Linköping University, Department of Medicine and Care.
    Identifiering av upplevelse av smärta hos patienter med cancer som får palliativ vård: en litteraturstudie2006Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    One third of all Swedish people will suffer in cancer. Pain is a common symptom in cancer patients. The pain is subjective and includes several dimensions. The dimensions of pain are the physical, psychological, social and spiritual. This is a literature review and the aim with this study was to identify the pain experience in patients with cancer receiving palliative care. Nineteen articles were analysed. The result shows that the physical pain was experienced as chronicle or episodic pain.

    Psychological pain included fear, distress and anxiety. Social pain was a result of loss of relationships and ability to take part of activities. Spiritual pain was expressed as feelings of meaningless, hopelessness and fear for the future. Different kinds of dimensions cooperate with each other. They can strengthen each other and one dimension of pain can lead to another. The articles that have been analysed focus on several dimension of pain. To be able to relieve the pain and other symptoms, the nurse needs to have a holistic view of patients and to be aware of how all dimensions of pain that is expressed by the patient.

  • 43.
    Axelsson, Malin
    et al.
    Högskolan Väst, Avd för specialistsjuksköterskeutbildning.
    Emilsson, Maria
    Högskolan Väst, Avd för specialistsjuksköterskeutbildning.
    Brink, Eva
    Högskolan Väst, Avd för specialistsjuksköterskeutbildning.
    Lundgren, J.
    University of Gothenburg, Department of Psychology.
    Torén, K.
    University of Gothenburg, Sahlgrenska Academy, Department of Community Medicine.
    Lötvall, J.
    University of Gothenburg, Sahlgrenska Academy, Department of Internal Medicine.
    Personality, adherence, asthma control and health-related quality of life in young adult asthmatics2009In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 103, no 7, p. 1033-1040Article in journal (Refereed)
    Abstract [en]

    Background

    Striving for improved adherence and asthma control is of vital concern in today's asthma management. Several influential factors have been identified, but the importance of personality traits has been insufficiently explored. The aim was first to determine whether personality traits in young adult asthmatics are related to asthma control and health-related quality of life (HRQL), and second to examine the influences of personality traits on adherence to regular asthma medication treatment.

    Methods

    Young adult asthmatics, 22 years of age (n = 268) completed questionnaires. Statistical analyses were performed.

    Results

    The personality traits Negative Affectivity and Impulsivity correlated negatively with asthma control, whereas in women Hedonic Capacity correlated positively with asthma control. Negative Affectivity, Impulsivity, Hedonic Capacity, Alexithymia and asthma control predicted the mental dimension of HRQL. Asthma control and physical activity predicted the physical dimension of HRQL. Among respondents with regular asthma medication (n = 109), Impulsivity correlated negatively with adherence. In men, Antagonism and Alexithymia were associated with low adherence. Additionally, Alexithymia, Hedonic Capacity and Negative Affectivity showed non-linear relationships with adherence, meaning that initially increased scores on these personality traits scales were associated with increased adherence but higher scores did not increase adherence. Respondents who were prescribed a single inhaler combining ICS and LABA reported higher adherence than those with monotherapies.

    Conclusion

    These data suggest that personality can influence how asthma patients adhere to asthma medication treatment, and report their control and HRQL. Tools determining personality traits may be useful in the future in individualizing management of asthma patients.

  • 44.
    Backman, Carl G.
    et al.
    Vrinnevi Hosp Norrkoping, Sweden.
    Ahlberg, Mona
    Vrinnevi Hosp Norrkoping, Sweden.
    Jones, Christina
    Univ Liverpool, England.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Group meetings after critical illness-Giving and receiving strength2018In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 46, p. 86-91Article in journal (Refereed)
    Abstract [en]

    Introduction: An increasing number of intensive care patients are surviving critical illness, but many develop mental, cognitive and physical impairments after discharge. Adapting to a new life situation, often with major challenges, implies the need of support. Therefore, it is important to develop interventions aimed at promoting recovery. Objective: The aim was to describe former intensive care patients feelings of sharing their experience of critical illness with other former patients. Method: Former intensive care patients (n = 17) participated in group meetings and wrote about their thoughts in a notebook after each group meeting. To deepen the understanding of the former patients experience 11 of the former patients were interviewed. The notes in the notebooks and the interviews were analysed using qualitative content analysis. Findings: Meeting others revealed to the former patients new dimensions of being critically ill, and they both gave and received strength from each other. The meetings were meaningful as they gained insight into other patients lives, and realised what it meant to survive intensive care. Conclusions: The group meetings meant sharing experiences and understanding the process of survival after critical illness. Giving and receiving strength from others helped the participants to go further. (C) 2017 Elsevier Ltd. All rights reserved.

    The full text will be freely available from 2019-03-28 10:30
  • 45.
    Barbabella, Francesco
    et al.
    Linnaeus Univ, Sweden; Italian Natl Inst Hlth and Sci Ageing, Italy.
    Poli, Arianna
    Linköping University, Department of Social and Welfare Studies, Division Ageing and Social Change. Linköping University, Faculty of Arts and Sciences. Italian Natl Inst Hlth and Sci Ageing, Italy.
    Hanson, Elizabeth
    Linnaeus Univ, Sweden; Swedish Family Care Competence Ctr, Sweden; Eurocarers, Germany.
    Andreasson, Frida
    Linnaeus Univ, Sweden; Swedish Family Care Competence Ctr, Sweden.
    Salzmann, Benjamin
    Italian Natl Inst Hlth and Sci Ageing, Italy; Wir Pflegen eV, Germany.
    Doehner, Hanneli
    Eurocarers, Germany; Wir Pflegen eV, Germany.
    Papa, Roberta
    Italian Natl Inst Hlth and Sci Ageing, Italy.
    Efthymiou, Areti
    Eurocarers, Germany; Cyprus Univ Technol, Cyprus.
    Valenza, Silvia
    Italian Natl Inst Hlth and Sci Ageing, Italy.
    Pelliccioni, Giuseppe
    Italian Natl Inst Hlth and Sci Ageing, Italy.
    Lamura, Giovanni
    Italian Natl Inst Hlth and Sci Ageing, Italy.
    Usage and Usability of a Web-based Program for Family Caregivers of Older People in Three European Countries: A Mixed-Methods Evaluation2018In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 36, no 5, p. 232-241Article in journal (Refereed)
    Abstract [en]

    InformCare is a European Web platform that supports informal caregivers of older people by providing access to online information and professional and peer support. The aim of this study was to assess the usage and usability of a psychosocial Web-based program carried out in three European countries (Italy, Sweden, and Germany). A mixed-methods sequential explanatory design was adopted, comprising baseline and postintervention assessments, as well as combined thematic content analysis of results and focus group findings. A convenience sample of 118 caregivers was enrolled, of whom 94 used the services offered by the program at least once. The subsamples in the three countries used the platform in different ways, with a predominance of passive strategies (eg, seeking information and reading other peoples comments) for Italian caregivers, and more active usage by Swedish and German caregivers. The usability assessment showed that the platform was perceived well by Italian and German caregivers, whereas technical problems affected the Swedish samples experiences. Focus group data highlighted user satisfaction with the online support and reliability of the environment. Recommendations for practitioners are to ensure digital training for caregivers who have lower confidence in use of the Internet, to involve different healthcare professionals in the provision of professional support, and to adequately manage online community building.

  • 46.
    Barimani, M.
    et al.
    Karolinska Institute, Sweden.
    Forslund Frykedal, Karin
    Linköping University, Department of Behavioural Sciences and Learning, Education, Teaching and Learning. Linköping University, Faculty of Educational Sciences.
    Rosander, Michael
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Berlin, A.
    Karolinska Institute, Sweden.
    Childbirth and parenting preparation in antenatal classes2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 57Article in journal (Refereed)
    Abstract [en]

    Objectives: to describe topics (1) presented by midwives during antenatal classes and the amount of time spent on these topics and (2) raised and discussed by first-time parents and the amount of time spent on these topics. Design: qualitative; data were gathered using video or tape recordings and analysed using a three-pronged content analysis approach, i.e., conventional, summative, and directed analyses. Setting and participants: 3 antenatal courses in 2 antenatal units in a large Swedish city; 3 midwives; and 34 course participants. Findings: class content focused on childbirth preparation (67% of the entire antenatal course) and on parenting preparation (33%). Childbirth preparation facilitated parents understanding of the childbirth process, birthing milieu, the partners role, what could go wrong during delivery, and pain relief advantages and disadvantages. Parenting preparation enabled parents to (i) plan for those first moments with the newborn; (ii) care for/physically handle the infant; (iii) manage breastfeeding; (iv) manage the period at home immediately after childbirth; and (v) maintain their relationship. During the classes, parents expressed concerns about what could happened to newborns. Parents questions to midwives and discussion topics among parents were evenly distributed between childbirth preparation (52%) and parenting preparation (48%). Key conclusions: childbirth preparation and pain relief consumed 67% of course time. Parents particularly reflected on child issues, relationship, sex, and anxiety. Female and male participants actively listened to the midwives, appeared receptive to complex issues, and needed more time to ask questions. Parents appreciated the classes yet needed to more information for managing various post-childbirth situations. Implications for practice: while midwifery services vary among hospitals, regions, and countries, midwives might equalise content focus, offer classes in the second trimester, provide more time for parents to talk to each other, allow time in the course plan for parents to bring up new topics, and investigate: (i) ways in which antenatal course development and planning can improve; (ii) measures for evaluating courses; (iii) facilitator training; and (iv) parent satisfaction surveys.

  • 47.
    Barimani, Mia
    et al.
    Karolinska Institutet, Division for Reproductive Health, Women's and Children's Health, Sweden.
    Vikström, Anna
    Karolinska Institutet, Neurobiologi, Vårdvetenskap och Samhälle (NVS), Sektionen för omvårdnad, Sweden.
    Rosander, Michael
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Forslund Frykedal, Karin
    Linköping University, Department of Behavioural Sciences and Learning, Education, Teaching and Learning. Linköping University, Faculty of Educational Sciences.
    Berlin, Anita
    Karolinska Institutet, Neurobiologi, Vårdvetenskap och Samhälle (NVS), Sektionen för omvårdnad.
    Facilitating and inhibiting factors in transition to parenthood – ways in which health professionals can support parents2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 3, p. 537-546Article in journal (Refereed)
    Abstract [en]

    Background

    The transition to parenthood is an overwhelming life event. From a theoretical perspective, transition to parenthood is a developmental transition that contains certain phases and patterns.

    Aim

    This study aim was twofold (i) discover, describe and comprehend transitional conditions that parents perceive as facilitating and inhibiting during transition to parenthood and to (ii) use that knowledge to develop recommendations for professional interventions that support and facilitate transition to parenthood.

    Design

    Meleis transition theory framed the study's deductive qualitative approach – from planning to analysis.

    Methods

    In a secondary analysis, data were analysed (as per Meleis transition theory) from two studies that implemented interviews with 60 parents in Sweden between 2013 and 2014. Interview questions dealt with parents’ experiences of the transition to parenthood – in relation to experiences with parent-education groups, professional support and continuity after childbirth.

    Ethical issues

    A university research ethics board has approved the research.

    Results

    These factors facilitated transition to parenthood: perceiving parenthood as a normal part of life; enjoying the child's growth; being prepared and having knowledge; experiencing social support; receiving professional support, receiving information about resources within the health care; participating in well-functioning parent-education groups; and hearing professionals comment on gender differences as being complementary. These factors inhibited transition to parenthood: having unrealistic expectations; feeling stress and loss of control; experiencing breastfeeding demands and lack of sleep; facing a judgmental attitude about breastfeeding; being unprepared for reality; lacking information about reality; lacking professional support and information; lacking healthcare resources; participating in parent-education groups that did not function optimally; and hearing professionals accentuate gender differences in a problematic way.

    Conclusion

    Transition theory is appropriate for helping professionals understand and identify practices that might support parents during transition to parenthood. The study led to certain recommendations that are important for professionals to consider.

  • 48.
    Benson, Lydia
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Litström, Emma
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Att förebygga hypotermi hos bukkirurgiska patienter: En systematisk litteraturöversikt och metaanalys2017Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hypotermi definieras som kärntemperatur under 36,0°C. Vid anestesi

    störs den fysiologiska regleringen av temperatur vilket är en av orsakerna till att

    risken för hypotermi under operation är stor. Peroperativt sker 90 % av

    värmeförlusterna från huden. Patientens riskfaktorer, anestesins längd och

    operationstid har betydelse i utveckling av hypotermi. Patienter som genomgår

    öppna bukoperationer som varar länge har hög risk för att utveckla hypotermi,

    bland annat på grund av stor exponerad kroppsyta.

    Syfte: Att utvärdera olika metoder för att förebygga peroperativ hypotermi hos

    sövda patienter som genomgår bukkirurgi.

    Metod: Systematisk litteraturstudie med metaanalys. Sökningar har gjorts i

    databaserna PubMed, CINAHL och SCOPUS.

    Resultat: Totalt 21 studier har inkluderats. Alla studier hade hypoterma patienter

    någon gång under det peroperativa förloppet, oavsett uppvärmningsmetod. Vid

    jämförelse av temperatur vid operationsslut uppvisades positivt resultat för både

    uppvärmd koldioxid och varmluftstäcke.

    Konklusion: Aktiv uppvärmning med varmluftstäcke tycks vara mest effektivt

    och är gold standard men trots aktiv uppvärmning blir många patienter hypoterma

    peroperativt. Det finns flera alternativ som visat sig vara lika effektiva som

    varmluftstäcke, så som värmelampor, eldriven värmemadrass och aktiv värmning

    med varmvatten. Troligen behövs en kombination av värmande metoder för att

    undvika hypotermi.

  • 49.
    Berben, L.
    et al.
    University of Basel, Switzerland .
    Bogert, L
    University of Basel, Switzerland .
    Leventhal, M. E.
    University of Basel, Switzerland .
    Fridlund, Bengt
    Hälsohögskolan i Jönköping.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Norekvål, T. M.
    Haukeland University Hospital, Norway .
    Smith, K.
    Ninewells Hospital, UK .
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Thompson, David
    Australian Catholic University, Melbourne.
    De Geest, Sabine
    University of Basel, Switzerland .
    Which interventions are used by health care professionals to enhance medication adherence in cardiovascular patients? A survey of current clinical practice2011Conference paper (Refereed)
  • 50.
    Bergstrand, Sara
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Preventing pressure ulcers by assessment of the microcirculation in tissue exposed to pressure2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to combine optical methods into a system with the ability to simultaneously measure blood flow changes at different tissue depths. The goal of such a system was to reveal vascular mechanisms relevant to pressure ulcer etiology under clinically relevant conditions and in relation to the evaluation of pressure-redistribution support surfaces.

    This thesis consists of four quantitative, cross-sectional studies measuring blood flow responses before, during, and after pressure exposure of the sacral tissue. Two optical methods – photoplethysmography and laser Doppler flowmetry – were combined in a newly developed system that has the ability to discriminate blood flows at different tissue depths. Studies I and II explored blood flow responses at different depths in 17 individuals. In Study I the blood flow was related to tissue thickness and tissue compression during pressure exposure of ≥ 220 mmHg. In Study II, the sacral tissue was loaded with 37.5 mmHg and 50.0 mmHg, and the variation in blood flow was measured. Studies III and IV included 42 healthy individuals < 65 years, 38 healthy individuals ≥ 65 years, and 35 patients ≥ 65 years. Study III included between-subject comparisons of blood flow and pressure between individuals in the three study groups lying in supine positions on a standard hospital mattress. Study IV added within-subject comparisons while the individual was lying on four different types of mattress. The studies explored the vascular phenomena pressure-induced vasodilation (PIV) and reactive hyperemia (RH).

    The most common blood flow response to tissue exposure in this thesis was PIV, although a decrease in blood flow (a lack of PIV) was observed in some individuals. The patients tended to have higher interface pressure during pressure exposure than the healthy groups but no differences in blood flow responses were seen. Our results showed that pressure levels that are normally considered to be harmless could have a significant effect on the microcirculation in different tissue structures. Differences in individual blood flow responses in terms of PIV and RH were seen, and a larger proportion of individuals lacked these responses in the deeper tissue structures compared to more superficial tissue structures.

    This thesis identified PIV and RH that are important vascular mechanisms for pressure ulcer development and revealed for the first time that PIV and RH are present at different depths under clinically relevant conditions. The thesis also identified a population of individuals not previously identified who lack both PIV and RH and seem to be particularly vulnerable to pressure exposure. Further, this thesis has added a new perspective to the microcirculation in pressure ulcer etiology in terms of blood flow regulation and endothelial function that are anchored in clinically relevant studies. Finally, the evaluation of pressureredistribution support surfaces in terms of mean blood flow during and after tissue exposure was shown to be unfeasible, but the assessment of PIV and RH could provide a new possibility for measuring individual physiological responses that are known to be related to pressure ulcer development.

    List of papers
    1. Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
    Open this publication in new window or tab >>Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
    2010 (English)In: MICROCIRCULATION, ISSN 1073-9688, Vol. 17, no 4, p. 311-319Article in journal (Refereed) Published
    Abstract [en]

    Pandgt;Objective: The aim was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure and compression in elderly individuals using a newly developed optical probe prototype. Methods: The tissue blood flow and tissue thickness in the sacral area were measured during load in 17 individuals using laser Doppler flowmetry and photoplethysmography in a combined probe, and digital ultrasound. Results: The mean age was 68.6 +/- 7.0 years. While loading, the mean compression was 60.3 +/- 11.9%. The number of participants with existing blood flow while loading increased with increased measurement depth. None had enclosed blood flow deep in the tissue and at the same time an existing more superficial blood flow. Correlation between tissue thickness and BMI in unloaded and loaded sacral tissue was shown: r = 0.68 (P = 0.003) and r = 0.68 (P = 0.003). Conclusions: Sacral tissue is highly compressed by external load. There seems to be a difference in responses to load in the different tissue layers, as occluded blood flow in deeper tissue layers do not occur unless the blood flow in the superficial tissue layers is occluded.

    Place, publisher, year, edition, pages
    Taylor and Francis, 2010
    Keywords
    pressure ulcer, photoplethysmography, laser Doppler flowmetry, non-invasive, tissue blood flow
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-56449 (URN)10.1111/j.1549-8719.2010.00027.x (DOI)000277123800008 ()
    Note
    This is an electronic version of an article published in: Sara Bergstrand, Toste Länne, Maria Linden and Margareta Lindgren, Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype, 2010, MICROCIRCULATION, (17), 4, 311-319. MICROCIRCULATION is available online at informaworldTM: http://dx.doi.org/10.1111/j.1549-8719.2010.00027.x Copyright: Taylor and Francis http://www.tandf.co.uk/journals/default.asp Available from: 2010-05-17 Created: 2010-05-17 Last updated: 2017-03-27
    2. Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
    Open this publication in new window or tab >>Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
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    2009 (English)In: Skin research and technology, ISSN 0909-752X, E-ISSN 1600-0846, Vol. 15, no 2, p. 139-147Article in journal (Refereed) Published
    Abstract [en]

    Background/purpose: This study has evaluated a multi-parametric system combining laser Doppler flowmetry and photoplethysmography in a single probe for the simultaneous measurement of blood flow at different depths in the tissue. This system will be used to facilitate the understanding of pressure ulcer formation and in the evaluation of pressure ulcer mattresses.

    Methods: The blood flow in the tissue over the sacrum was measured before, during and after loading with 37.5 mmHg, respectively, 50.0 mmHg. The evaluation of the system consisted of one clinical part, and the other part focusing on the technicalities of the probe prototype.

    Results: An increase in blood flow while loading was the most common response, but when the blood flow decreased during loading it was most affected at the skin surface and the blood flow responses may be different due to depths of measurement. Reactive hyperaemia may occur more frequently in the superficial layers of the tissue.

    Conclusion: The study showed that the new system is satisfactory for measuring tissue blood flow at different depths. The laser Doppler complements the photoplethysmography, and further development of the system into a thin flexible probe with the ability to measure a larger area is required.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2009
    Keywords
    pressure ulcers, blood flow, photoplethysmography, laser Doppler flowmetry, non-invasive
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18018 (URN)10.1111/j.1600-0846.2008.00337.x (DOI)
    Note

    This is the authors’ version of the following article: Sara Bergstrand, Lars-Göran Lindberg, Anna-Christina Ek and Margareta Lindgren, Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques, 2009, SKIN RESEARCH AND TECHNOLOGY, (15), 2, 139-147. which has been published in final form at: http://dx.doi.org/10.1111/j.1600-0846.2008.00337.x Copyright: Blackwell Publishing Ltd http://www.blackwellpublishing.com/

    Available from: 2009-05-26 Created: 2009-05-04 Last updated: 2017-12-13Bibliographically approved
    3. Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
    Open this publication in new window or tab >>Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
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    2014 (English)In: Microcirculation, ISSN 1073-9688, E-ISSN 1549-8719, Vol. 21, no 8, p. 761-771Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.

    METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.

    RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.

    CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2014
    Keywords
    Pressure ulcer, photoplethysmography, laser Doppler flowmetry, non-invasive, tissue blood flow
    National Category
    Nursing Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-109950 (URN)10.1111/micc.12160 (DOI)000344789400010 ()25100630 (PubMedID)
    Available from: 2014-08-29 Created: 2014-08-29 Last updated: 2017-12-05Bibliographically approved
    4. Microcirculatory responses of sacral tissue in healthy individuals and inpatients on different pressure-redistribution mattresses
    Open this publication in new window or tab >>Microcirculatory responses of sacral tissue in healthy individuals and inpatients on different pressure-redistribution mattresses
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    2015 (English)In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 24, no 8, p. 346-358Article in journal (Refereed) Published
    Abstract [en]

    Objective: The aim of this study was to explore the interaction between interface pressure and pressure-induced vasodilation and reactive hyperemia with different pressureredistribution mattresses.

    Method: A cross-sectional study was performed with a convenience sample of 42 healthy individuals between 18 and 64 years of age, 38 healthy individuals 65 years or older, and 35 inpatients 65 years or older at a university hospital in Sweden. Blood flow was measured at depths of 1 mm, 2 mm, and 10 mm using a combined system of laser Doppler flowmetry and photoplethysmography. The blood flow, interface pressure and skin temperature were measured in the sacral tissue before, during, and after load while lying on one standard hospital mattress and three different pressure-redistribution mattresses.

    Results: There were significant differences between the three foam mattresses with regard to average sacral pressure, peak sacral pressure, and local probe pressure with the lowest values at the visco-elastic foam/air mattress (23.5 ± 2.5 mmHg, 49.3 ± 11.1 mmHg, 29.2 ± 14.0 mmHg respectively). A greater proportion of subjects had affected blood flow in terms of lack of pressure-induced vasodilation on the visco-elastic foam/air mattress compared to the alternating pressure mattress at tissue depths of 2 mm (39.0% vs. 20.0%, respectively) and 10 mm (56.9 % vs. 35.1%, respectively). Eleven individuals, including subjects in all three subject groups were identified with no pressure-induced vasodilation or reactive hyperemia in any mattress, and this was considered a high-risk blood flow response.

    Conclusion: Interface pressure magnitudes considered not harmful during pressure-exposure lying on different pressure-redistribution mattresses can affect the microcirculation in different tissue structures. Despite having the lowest pressure values compared to the other mattresses, the visco-elastic foam/air mattress had the highest proportion of subjects with decreased blood flow indicating a more affected blood flow. Three young healthy individuals were identified with the high-risk blood flow response, indicating an innate vulnerability to pressure exposure and may not benefit from pressure-redistribution mattresses. Finally it was shown that the evaluation of pressure-redistribution support surfaces in terms of mean blood flow during and after tissue exposure is not feasible but assessment of pressure-induced vasodilation and reactive hyperemia could be a new possibility to assess individualized physiological measurements of mechanisms known to be related to pressure ulcer development.

    Keywords
    interface pressure, pressure-induced vasodilation, pressure ulcer, reactive hyperemia, tissue blood flow
    National Category
    Nursing Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-109951 (URN)10.12968/jowc.2015.24.8.346 (DOI)000359210200004 ()
    Note

    Vid tiden för disputationen var publikationen ett manuskript ("Exploring pressure-induced microcirculatory responses in sacral tissue in healthy individuals and inpatients on different pressure-redistribution mattresses")

    Funding text: None declared. The study was funded by the Swedish Research Council, the Faculty of Health Sciences at Linkoping University, Region of Ostergotland., King GustafV and Queen Victoria's Freemason Foundation, NovaMedTech, and the European Union Regional Development Fund.

    Available from: 2014-08-29 Created: 2014-08-29 Last updated: 2017-12-05Bibliographically approved
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