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  • 1.
    Berg, Katarina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Kjellgren, Karin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Postoperative recovery from the perspective of day surgery patients: A phenomenographic study2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 12, p. 1630-1638Article in journal (Refereed)
    Abstract [en]

    Background: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patient’s own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home.

    Objectives: To explore day surgery patients’ perceptions of postoperative recovery.

    Design: A qualitative design with a phenomenographic approach was used.

    Methods and settings: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face-to-face at the patients’ homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital.

    Results: The patients perceived postoperative recovery as comprising internal and external prerequisites and implied changes in ordinary life with varying levels of support. The organization at the day surgery unit, with its advantages and disadvantages, was perceived as having an impact on the subsequent recovery trajectory. The results are demonstrated in three descriptive categories: ‘Conditions for recovery at home’, The rollback to ordinary life’ and ‘Being a cog in a flow of care’.

    Conclusions: Postoperative recovery following day surgery implies, from the patients’ perspective, a migration from being a recipient of care at the day surgery unit to playing an active role, with extensive responsibility at home. To manage self-care confidently, postdischarge patients require knowledge and understanding of what constitutes the normal range in recovery following their specific surgical procedure.

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  • 2.
    Brüggemann, A. Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    What contributes to abuse in health care? A grounded theory of female patients’ stories2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 404-412Article in journal (Refereed)
    Abstract [en]

    Background

    In Sweden, 20% of female patients have reported lifetime experiences of abuse in any health care setting. Corresponding prevalence among male patients is estimated to be 8%. Many patients report that they currently suffer from these experiences. Few empirical studies have been conducted to understand what contributes to the occurrence of abuse in health care.

    Objectives

    To understand what factors contribute to female patients’ experiences of abuse in health care.

    Design

    Constructivist grounded theory approach.

    Settings

    Women's clinic at a county hospital in the south of Sweden.

    Participants

    Twelve female patients who all had reported experiences of abuse in health care in an earlier questionnaire study.

    Methods

    In-depth interviews.

    Results

    The analysis resulted in the core category, the patient loses power struggles, building on four categories: the patient's vulnerability, the patient's competence, staff's use of domination techniques, and structural limitations. Participants described how their sensitivity and dependency could make them vulnerable to staff's domination techniques. The participants’ claim for power and the protection of their autonomy, through their competence as patients, could catalyze power struggles.

    Conclusions

    Central to the participants’ stories was that their experiences of abuse in health care were preceded by lost power struggles, mainly through staff's use of domination techniques. For staff it could be important to become aware of the existence and consequences of such domination techniques. The results indicate a need for a clinical climate in which patients are allowed to use their competence.

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  • 3.
    Buck, Harleah G.
    et al.
    Univ S Florida, FL 33612 USA.
    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.
    Chung, Misook L.
    Univ Kentucky, KY USA.
    Donovan, Kristine A.
    Moffit Canc Ctr, FL USA.
    Harkness, Karen
    McMaster Univ, Canada.
    Howard, Allison M.
    Univ S Florida, FL USA.
    Perkiö Kato, Naoko
    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.
    Polo, Randall
    Univ S Florida, FL USA.
    Evangelista, Lorraine S.
    Univ Calif Irvine, CA 92697 USA.
    A systematic review of heart failure dyadic self-care interventions focusing on intervention components, contexts, and outcomes2018In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 77, p. 232-242Article, review/survey (Refereed)
    Abstract [en]

    Background: Having support from an informal carer is important for heart failure patients. Carers have the potential to improve patient self-care. At the same time, it should be acknowledged that caregiving could affect the carer negatively and cause emotional reactions of burden and stress. Dyadic (patient and informal carer) heart failure self-care interventions seek to improve patient self-care such as adherence to medical treatment, exercise training, symptom monitoring and symptom management when needed. Currently, no systematic assessment of dyadic interventions has been conducted with a focus on describing components, examining physical and delivery contexts, or determining the effect on patient and/or carer outcomes. Objective: To examine the components, context, and outcomes of dyadic self-care interventions. Design: A systematic review registered in PROSPERO, following PRISMA guidelines with a narrative analysis and realist synthesis. Data Sources: PubMed, EMBASE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials were searched using MeSH, EMTREE terms, keywords, and keyword phrases for the following concepts: dyadic, carers, heart failure and intervention. Eligible studies were original research, written in English, on dyadic self-care interventions in adult samples. Review methods: We used a two-tiered analytic approach including both completed studies with power to determine outcomes and ongoing studies including abstracts, small pilot studies and protocols to forecast future directions. Results: Eighteen papers - 12 unique, completed intervention studies (two quasi- and ten experimental trials) from 2000 to 2016 were reviewed. Intervention components fell into three groups education, support, and guidance. Interventions were implemented in 5 countries, across multiple settings of care, and involved 3 delivery modes face to face, telephone or technology based. Dyadic intervention effects on cognitive, behavioral, affective and health services utilization outcomes were found within studies. However, findings across studies were inconclusive as some studies reported positive and some non-sustaining outcomes on the same variables. All the included papers had methodological limitations including insufficient sample size, mixed intervention effects and counter-intuitive outcomes. Conclusions: We found that the evidence from dyadic interventions to promote heart failure self-care, while growing, is still very limited. Future research needs to involve advanced sample size justification, innovative solutions to increase and sustain behavior change, and use of mixed methods for capturing a more holistic picture of effects in clinical practice.

  • 4.
    Cacciata, Marysol
    et al.
    Univ Calif Irvine, CA 92697 USA.
    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.
    Lee, Jung-Ah
    Univ Calif Irvine, CA 92697 USA.
    Sorkin, Dara
    Univ Calif Irvine, CA USA.
    Lombardo, Dawn
    Univ Calif Irvine Hlth, CA USA.
    Clancy, Steve
    Univ Calif Irvine, CA USA.
    Nyamathi, Adeline
    Univ Calif Irvine, CA 92697 USA.
    Evangelist, Lorraine S.
    Univ Calif Irvine, CA 92697 USA.
    Effect of exergaming on health-related quality of life in older adults: A systematic review2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 93, p. 30-40Article, review/survey (Refereed)
    Abstract [en]

    Introduction: Exercise through video or virtual reality games (i.e. exergames) has grown in popularity among older adults; however, there is limited evidence on efficacy of exergaming on well-being related to health in this population. This systematic review examined the effectiveness of exergaming on health related quality of life in older adults. Methods: PRISMA guidelines for this systematic review. Several databases were searched using keywords to identify peer-reviewed journal articles in English. Randomized control trials that evaluated the effect of exergaming on health-related quality of life in older adults when compared to a control group and published between January 2007 to May 2017 were included. Results: Nine articles that in total included 614 older adults with varying levels of disability, mean age 73.6 + 7.9 years old, and 67% female were analyzed. Significant improvements in health-related quality of life of older adults engaged in exergaming were reported in three studies. Sample sizes were small in 7 of the studies (N amp;lt; 60). The study participants, exergaming platforms, health-related quality of life instruments, study settings and length, duration and frequency of exergaming varied across studies. Conclusion: Exergaming is a new emerging form of exercise that is popular among older adults. However, findings from this analysis were not strong enough to warrant recommendation due to the small sample sizes and heterogeneity in the study participants, exergaming platforms, health-related quality of life instruments, length, duration and frequency of the intervention and study settings. Further research is needed with larger sample sizes and less heterogeneity to adequately explore the true effects of exergaming on health-related quality of life of older adults. (C) 2019 Elsevier Ltd. All rights reserved.

  • 5.
    De Maria, Maddalena
    et al.
    Univ Roma Tor Vergata, Italy.
    Matarese, Maria
    Campus Biomed Univ Rome, Italy.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Ausili, Davide
    Univ Milano Bicocca, Italy.
    Vellone, Ercole
    Univ Roma Tor Vergata, Italy.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Osokpo, Onome Henry
    Univ Penn, PA 19104 USA.
    Daus, Marguerite Marie
    Univ Penn, PA 19104 USA.
    Riegel, Barbara
    Univ Penn, PA 19104 USA.
    Barbaranelli, Claudio
    Sapienza Univ Rome, Italy.
    Cross-cultural assessment of the Self-Care of Chronic Illness Inventory: A psychometric evaluation2021In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 116, article id 103422Article in journal (Refereed)
    Abstract [en]

    Background: Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions. Objective: The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. Methods: This cross-sectional study enrolled 1629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited. Results: Participants were mostly males (56.3%), older adults (69.8%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [chi(2)(50)=63.495, p = 0.095; RMSEA =0.022, p = 0.999, 90% CI= 0.000 0.038; CFI =0.981; TLI =0.977; SRMR =0.036], self-care monitoring [chi(2) (22)=28.770, p = 0.095; RMSEA = 0.024, p = 0.978, 90% CI =0.000 0.046; CFI= 0.996; TLI=0.995; SRMR= 0.054], and self-care management [chi(2) (51)=91.334, p = 0.001; RMSEA =0.048, p = 0.576, 90% CI =0.031 0.063; CFI = 0.949; TLI= 0.937; SRMR = 0.047 ] scales. Conclusions: These findings suggest that patients in the three countries used an identical cognitive framework or mental model when responding and used the 1-5 Likert response scale in an almost identical way, almost without bias. In spite of sociocultural differences, patients in these countries seem to share the same fundamental view of self-care. The results of the Self-Care of Chronic Illness Inventory will be comparable in these countries. (C) 2019 Elsevier Ltd. All rights reserved.

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  • 6.
    De Smedt, Ruth H E
    et al.
    University of Groningen, The Netherlands.
    Denig, Petra
    University of Groningen, The Netherlands.
    Haaijer-Ruskamp, Flora M
    University of Groningen, The Netherlands.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Self-reported adverse drug events and the role of illness perception and medication beliefs in ambulatory heart failure patients: A cross-sectional survey2011In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 48, no 12, p. 1540-1550Article in journal (Refereed)
    Abstract [en]

    Background: Identifying patients with heart failure (HF) who are at risk of experiencing symptomatic adverse drug events (ADEs) is important for improving patient care and quality of life. Several demographic and clinical variables have been identified as potential risk factors for ADEs but limited knowledge is available on the impact of HF patients beliefs and perceptions on their experience of ADEs. less thanbrgreater than less thanbrgreater thanObjective: The purpose of the study was to identify the relationship between HF patients illness perception and medication beliefs and self-reported ADEs. less thanbrgreater than less thanbrgreater thanDesign: A cross-sectional survey was performed between November 2008 and March 2009. less thanbrgreater than less thanbrgreater thanSettings: One university medical centre, two regional hospitals and 20 general practitioners in the Netherlands participated in the study. less thanbrgreater than less thanbrgreater thanParticipants: 495 patients with HF were included. less thanbrgreater than less thanbrgreater thanMethods: Patients completed the validated Revised Illness Perception Questionnaire (IPQR) and the Beliefs about Medication Questionnaire (BMQ) which collected data on their illness perception and medication beliefs. In addition, data on ADEs as experienced in the previous four weeks were collected through an open-ended question and a symptom checklist. Multivariate logistic regression was performed to identify factors associated with these ADEs. less thanbrgreater than less thanbrgreater thanResults: In total, 332 (67%) patients had experienced ADEs in the previous four weeks, of whom 28% reported dry mouth, 27% dizziness and 19% itchiness as the most prevalent. In the adjusted multivariate analysis, disease-related symptoms (illness identity) (OR for 1-5 symptoms 3.57: 95% CI 2.22-5.75, OR for andgt;5 symptoms 7.37; 95% CI 3.44-15.8), and general beliefs about medication overuse (OR 1.07; 95% CI 1.01-1.13) were independently associated with experiencing ADEs, whereas none of the demographic or clinical factors were significant. less thanbrgreater than less thanbrgreater thanConclusions: HF patients who perceive a high number of disease symptoms and have negative medication beliefs are at higher risk of experiencing self-reported ADEs. We suggest that future studies and interventions to improve ADE management should focus on negative medication beliefs and assisting patients in differentiating disease symptoms from ADEs. (C) 2011 Published by Elsevier Ltd.

  • 7.
    Dragioti, Elena
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Univ Ioannina, Greece.
    Tsartsalis, Dimitrios
    Hippokrateion Hosp, Greece.
    Mentis, Manolis
    Univ Patras, Greece.
    Mantzoukas, Stefanos
    Univ Ioannina, Greece.
    Gouva, Mary
    Univ Ioannina, Greece.
    Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses2022In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 131, article id 104272Article, review/survey (Refereed)
    Abstract [en]

    Background: Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problemswith comprehensive analysis among hospital staff during the COVID-19 pandemic. Objectives: To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic. Design: A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic. Review methods: Systematic searcheswere conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The randomeffects model was used for the meta-analysis, and the I-2 indexwas employed to assess between-study heterogeneity. Publication bias using Egger test and LFK indexwas examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence. Results: Forty-four meta-analyses from1298 individual studieswere included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence: 28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff. Conclusions: The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed. (C) 2022 The Author(s). Published by Elsevier Ltd.

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  • 8.
    Dumarkaite, Austeja
    et al.
    Vilnius Univ, Lithuania; Vilnius Univ, Lithuania.
    Truskauskaite, Inga
    Vilnius Univ, Lithuania.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Jovarauskaite, Lina
    Vilnius Univ, Lithuania.
    Jovaisiene, Ieva
    Vilnius Univ, Lithuania.
    Nomeikaite, Auguste
    Vilnius Univ, Lithuania.
    Kazlauskas, Evaldas
    Vilnius Univ, Lithuania.
    The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial2023In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 138, article id 104408Article in journal (Refereed)
    Abstract [en]

    Background: The COVID-19 pandemic demanded exceptional physical and mental effort from healthcare workers worldwide. Since healthcare workers often refrain from seeking professional psychological support, internet-delivered interventions could serve as a viable alternative option.Objective: We aimed to investigate the effects of a therapist-guided six-week CBT-based internet-delivered stress recovery intervention among medical nurses using a randomized controlled trial design. We also aimed to assess program usability.Methods: 168 nurses working in a healthcare setting (Mage = 42.12, SDage = 11.38; 97 % female) were included in the study. The intervention group included 77 participants, and the waiting list control group had 91 participants. Self-report data were collected online at three timepoints: pre-test, post-test, and three-month follow-up. The primary outcome was stress recovery. Secondary outcomes included measures of perceived stress, anxiety and depression symptoms, psychological well-being, posttraumatic stress and complex posttraumatic stress symp-toms, and moral injury.Results: We found that the stress recovery intervention FOREST improved stress recovery, including psychologi-cal detachment (d = 0.83 [0.52; 1.15]), relaxation (d = 0.93 [0.61, 1.25]), mastery (d = 0.64 [0.33; 0.95]), and control (d = 0.46 [0.15; 0.76]). The effects on psychological detachment, relaxation, and mastery remained stable at the three month follow-up. The intervention was also effective in reducing its users stress (d = -0.49 [-0.80;-0.18]), anxiety symptoms (d = -0.31 [-0.62;-0.01]), depression symptoms (d = -0.49 [-0.80;-0.18]) and increasing psychological well-being (d = 0.53 [0.23; 0.84]) with the effects on perceived stress, depression symptoms, and well-being remaining stable at the three-month follow-up. High user satisfac-tion and good usability of the intervention were also reported.Conclusions: The present study demonstrated that an internet-bas ed intervention for healthcare staff could increase stress recovery skills, promote psychological well-being, and reduce stress, anxiety, and depression symptoms, with most of the effects being stable over three months.Trial registration: NCT04817995 (https://clinicaltrials.gov/ct2/show/NCT04817995). Registration date: March 30, 2021. Date of first recruitment: April 1, 2021.(c) 2022 Elsevier Ltd. All rights reserved.

  • 9.
    Eriksson, Kerstin
    et al.
    Jonköping University, Sweden; Ryhov County Hospital, Sweden.
    Wikström, Lotta
    Jonköping University, Sweden; Ryhov County Hospital, Sweden.
    Fridlund, Bengt
    Jonköping University, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonköping University, Sweden.
    Patients experiences and actions when describing pain after surgery - A critical incident technique analysis2016In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 56, p. 27-36Article in journal (Refereed)
    Abstract [en]

    Background: Postoperative pain assessment remains a significant problem in clinical care despite patients wanting to describe their pain and be treated as unique individuals. Deeper knowledge about variations in patients experiences and actions could help healthcare professionals to improve pain management and could increase patients participation in pain assessments. Objective: The aim of this study was, through an examination of critical incidents, to describe patients experiences and actions when needing to describe pain after surgery. Methods: An explorative design involving the critical incident technique was used. Patients from one university and three county hospitals in both urban and rural areas were included. To ensure variation of patients a strategic sampling was made according to age, gender, education and surgery. A total of 25 patients who had undergone orthopaedic or general surgery was asked to participate in an interview, of whom three declined. Findings: Pain experiences were described according to two main areas: "Patients resources when in need of pain assessment" and "Ward resources for performing pain assessments". Patients were affected by their expectations and tolerance for pain. Ability to describe pain could be limited by a fear of coming into conflict with healthcare professionals or being perceived as whining. Furthermore, attitudes from healthcare professionals and their lack of adherence to procedures affected patients ability to describe pain. Two main areas regarding actions emerged: "Patients used active strategies when needing to describe pain" and "Patients used passive strategies when needing to describe pain". Patients informed healthcare professionals about their pain and asked questions in order to make decisions about their pain situation. Selfcare was performed by distraction and avoiding pain or treating pain by themselves, while others were passive and endured pain or refrained from contact with healthcare professionals due to healthcare professionals large work load. (C) 2015 Elsevier Ltd. All rights reserved.

  • 10.
    Flensner, Gullvi
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Söderhamn, Olle
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lived experience of MS-related fatigue: a phenomenological interview study2003In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 40, no 7, p. 707-717Article in journal (Refereed)
    Abstract [en]

    Fatigue is a major problem among individuals diagnosed with multiple sclerosis (MS), but its meaning in daily living is unclear. The aim was to describe MS-related fatigue as lived by a group of individuals diagnosed with MS. Interviews with nine individuals were analysed from a phenomenological perspective.

    Main findings: MS-related fatigue is living with a time-consuming and all absorbing phenomenon, involving the body and the whole human being. Fatigue is commonly non-constructively perceived and expressed in terms of energy loss, emotional afflictions, dependency and restrictions of life in general, however, it is also constructively perceived and involves a desire to accept life and strive for a better situation.

    Conclusion: MS-related fatigue is a comprehensive phenomenon and its relationship with self-care requires further investigation.

  • 11.
    Funkesson, Kajsa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Äldre - vård - civilsamhälle (ÄVC) .
    Anbäcken, Els-Marie
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Social and Welfare Studies, Äldre - vård - civilsamhälle (ÄVC) .
    Ek, Anna-Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Nurses' reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud study2007In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, no 7, p. 1109-1119Article in journal (Refereed)
    Abstract [en]

    Background: Nurses' clinical reasoning is of great importance for the delivery of safe and efficient care. Pressure ulcer prevention allows a variety of aspects within nursing to be viewed. Objective: The aim of this study was to describe both the process and the content of nurses' reasoning during care planning at different nursing homes, using pressure ulcer prevention as an example. Design: A qualitative research design was chosen. Settings: Seven different nursing homes within one community were included. Participants: Eleven registered nurses were interviewed. Method: The methods used were think-aloud technique, protocol analysis and qualitative content analysis. Client simulation illustrating transition was used. The case used for care planning was in three parts covering the transition from hospital until 3 weeks in the nursing home. Result: Most nurses in this study conducted direct and indirect reasoning in a wide range of areas in connection with pressure ulcer prevention. The reasoning focused different parts of the nursing process depending on part of the case. Complex assertations as well as strategies aiming to reduce cognitive strain were rare. Nurses involved in direct nursing care held a broader reasoning than consultant nurses. Both explanations and actions based on older ideas and traditions occurred. Conclusions: Reasoning concerning pressure ulcer prevention while care planning was dominated by routine thinking. Knowing the person over a period of time made a more complex reasoning possible. The nurses' experience, knowledge together with how close to the elderly the nurses work seem to be important factors that affect the content of reasoning. © 2006 Elsevier Ltd. All rights reserved.

  • 12.
    Götherström, Christine
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hamrin, Elisabeth
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Gullberg, Mats
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Development of a tool for measuring the concept of good care among patients and staff in relation to Swedish legislation1995In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 32, no 3, p. 277-87Article in journal (Refereed)
    Abstract [en]

    An instrument for measuring the concept of good care, in relation to the Swedish Health and Medical Services Act, has been developed and tested in short-term care. The instrument comprises 14 statements on good care. The construct validity was estimated by factor analysis based on the results from 240 patients. Five factors explained 62% of the variance of the 14 variables and covered the following areas: information, security, accessibility, continuity, and influence and respect. Patients (n = 240) and registered nurses (n = 57) showed differences in estimations of the concept of good care on all factors. There were only minor differences, however, within the patient group and the nursing group, respectively, on comparing the two samples. The instrument needs further testing in different care conditions.

  • 13.
    Jaarsma, Tiny
    et al.
    University of Limburg, Maastricht.
    Abu-Saad, H H
    University of Limburg, Maastricht.
    Halfens, R
    University of Limburg, Maastricht.
    Dracup, K
    University of California, Los Angeles.
    'Maintaining the balance'--nursing care of patients with chronic heart failure1997In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 34, no 3, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Nurses in different settings are involved in caring for patients with heart failure. In the clinic, hospital, nursing home or patients' home, the nurse has a role in detecting, identifying and treating heart failure. In order to provide optimal care, literature on possible and effective interventions should be available to nurses. This study gives an overview of nursing care for patients with heart failure as described in practice, literature and standard nursing care plans. Based on interviews of 45 nurses, a review of all pertinent literature published between 1983 and 1993 and a review of standard nursing care plans used in the Netherlands to care for patients with heart failure, four composite themes emerged; namely, basic nursing care, assessment and observation, symptom-relieving interventions, and patient education. Caring for patients with heart failure is very complex and is often aimed at keeping a very delicate balance between, e.g. rest and activity, fluid intake and elimination, and therapeutic cost and benefit. Treatment strategies for optimizing care for these patients are described.

  • 14.
    Jaarsma, Tiny
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic Univ, Australia; Univ Med Ctr Utrecht, Netherlands.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Dunbar, S. B.
    Emory Univ, GA 30322 USA.
    Fitzsimons, D.
    Queens Univ Belfast, North Ireland.
    Lee, C.
    Boston Coll, MA 02167 USA.
    Middleton, S.
    St Vincents Hlth Australia, Australia; Australian Catholic Univ, Australia.
    Vellone, E.
    Univ Roma Tor Vergata, Italy.
    Freedland, K. E.
    Washington Univ, MO 14263 USA.
    Riegel, B.
    Australian Catholic Univ, Australia; Univ Penn, PA 19104 USA.
    Self-care research: How to grow the evidence base?2020In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 105, article id UNSP 103555Article, review/survey (Refereed)
    Abstract [en]

    Background and objective: The number of studies in the area of self-care is growing and international researchers are increasingly developing self-care interventions to improve outcomes of individual patients and communities. However, growth of the evidence is still slow due to challenges with designing and testing self-care interventions. In this article we address major methodological challenges with regard to the definition of self-care, use of theory, and research design, intended to provide guidance to researchers in this field. Method: During the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019 we identified important issues in existing self-care research. Discussion and literature review lead to eight recommendation for future self-care research. Results: In preparation, begin with a theoretically sound definition of self-care. In planning the intervention, build on and extend previous studies. Use theory to develop self-care interventions and consider translational models to guide development, evaluation and implementation of complex self-care interventions. Employ a study design that fits the current phase and objectives of the research and measure self-care and related factors carefully. In reporting, describe the sample and setting sufficiently so that others can draw conclusions about generalizability and applicability to their practice and patient population. In interpretation, describe how the intervention is assumed to work (causal assumptions) and its key components. Conclusion: Our review of existing self-care research clearly illustrates that the recommendations we provide are needed if we are to substantially grow the evidence base supporting self-care. Embracing a core set of principles will allow us to build on each others work. Tweetable abstract: A core set of methodological principles is needed to substantially grow the evidence base supporting self-care. (C) 2020 The Authors. Published by Elsevier Ltd.

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  • 15.
    Johansson, Peter
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Andersson, Gerhard
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lundgren, Johan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    The impact of internet-based cognitive behavioral therapy and depressive symptoms on self-care behavior in patients with heart failure: A secondary analysis of a randomised controlled trial2021In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 116, article id 103454Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with chronic heart failure may require treatment of depressive symptoms to improve self-care behaviour.

    OBJECTIVES: To investigate the impact of internet-based cognitive behavioral therapy (CBT) on self-care behaviour in heart failure patients, and to study the association between changes in depressive symptoms and changes in self-care behaviour.

    DESIGN: A secondary analysis of data collected in a pilot randomized controlled study.

    SETTING: 50 heart failure patients with depressive symptoms were recruited from four hospitals in Sweden.

    METHODS: Patients were randomized to nine weeks of internet-based CBT (n = 25) or to an active control group participating in an online discussion forum (n = 25). In week two and three, those in the internet-based CBT group worked with psychoeducation about heart failure and depression, emphasizing heart failure self-care. During the same weeks those in the on-line discussion forum specifically discussed heart failure self-care. Patient Health Questionnaire-9 was used to measure depressive symptoms at baseline and at the nine-week follow-up. The European Heart Failure Self-care Behaviour Scale-9 was used to measure self-care behaviour (i.e., the summary score and the subscales autonomous based, provider based and consulting behaviour) at baseline, and at the three-week and nine-week follow-ups.

    RESULTS: No significant differences were found in self-care between the patients in the internet-based CBT and the patients in the online discussion group at the three- and nine-week follow-up. Within-group analysis of the changes in the European Heart Failure Self-care Behaviour Scale showed that from baseline to week three, the summary score increased significantly for the online discussion group (p = 0.04), but not for the internet-based CBT group (p = 0.15). At the nine-week follow-up, these scores had decreased. Similarly, consulting behaviour improved at week three for the online discussion group (p = 0.04), but not for the internet-based CBT group (p = 0.22). Provider-based adherence at the nine-week follow-up had increased from baseline in the internet-based CBT group (p = 0.05) whereas it had decreased in the on-line discussion group. Improvement in symptoms of depression was significantly associated with improvement in autonomy-based self-care (r = 0.34, p = 0.03).

    CONCLUSION: Improvement in depressive symptoms was associated with improved autonomous-based self-care. ICBT for depression in HF may benefit aspects of self-care that are vital to improve symptoms and prognosis.

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  • 16.
    Johansson Stark, Åsa
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Ingadottir, Brynja
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Salanterä, Sanna
    Turku University, Finland.
    Sigurdardottir, Arun K
    University of Akureyri, Iceland.
    Valkeapää, Kirsi
    University of Turku, Finland.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement: A multi-national survey2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 11, p. 1491-1499Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Patient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled.

    OBJECTIVES:

    To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions.

    DESIGN:

    A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery.

    SETTINGS:

    Two Finnish, three Icelandic and two Swedish hospitals.

    PARTICIPANTS:

    The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women.

    METHODS:

    Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations.

    RESULTS:

    Patients expected more knowledge than they received (p<0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge.

    CONCLUSIONS:

    In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery.

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  • 17.
    Karlsson, Agneta
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Arman, Maria
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Wikblad, Karin
    Linköping University, Deptartment of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Teenagers with type 1 diabetes - a phenomenological study of the transition towards autonomy in self-management2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, International Journal of Nursing Studies, Vol. 45, no 4, p. 562-570Article in journal (Refereed)
    Abstract [en]

    Background: Becoming autonomous is an important aspect of teenagers’ psychosocial development, and this is especially true of teenagers with type 1 diabetes. Previous studies exploring the everyday problems of teenagers with diabetes have focused on adherence to self-care management, how self-determination affects metabolic control, and the perception of social support.

    Objective: The aim of the study was to elucidate lived experiences, focusing on the transition towards autonomy in diabetes self-management among teenagers with type 1 diabetes.

    Design and method: Data were collected using interviews, and a qualitative phenomenological approach was chosen for the analysis.

    Participants: Thirty-two teenagers (18 females and 14 males) were interviewed about their individual experiences of self-management of diabetes.

    Findings: The lived experiences of the transition towards autonomy in self-management were characterized by the over-riding theme “hovering between individual actions and support of others”. The findings indicate that individual self-reliance and confirmation of others are helpful in the transition process. Growth through individual self-reliance was viewed as a developmental process of making one's own decisions; psychological maturity enabled increased responsibility and freedom; motivation was related to wellbeing and how well the diabetes could be managed. The theme “confirmation of others” showed that parental encouragement increased the certainty of teenagers’ standpoints; peers’ acceptance of diabetes facilitated incorporation of daily self-management activities; support from the diabetes team strengthened teenagers’ self-esteem.

    Conclusion: In striving for autonomy, teenagers needed distance from others, but still to retain the support of others. A stable foundation for self-management includes having the knowledge required to practice diabetes management and handle different situations.

  • 18.
    Lee, Christopher S.
    et al.
    Boston Coll, MA USA.
    Freedland, Kenneth E.
    Washington Univ, MO USA.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Vellone, Ercole
    Tor Vergata Univ Rome, Italy; Wroclaw Med Univ, Poland.
    Page, Shayleigh Dickson
    Univ Penn, PA USA.
    Westland, Heleen
    Univ Med Ctr Utrecht, Netherlands.
    Pettersson, Sara
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    van Rijn, Michelle
    Univ Med Ctr Utrecht, Netherlands.
    Aryal, Subhash
    Univ Penn, PA USA.
    Beliglio, Andrew
    Univ Penn, PA USA.
    Wiebe, Douglas
    Univ Michigan, MI USA.
    Riegel, Barbara
    Univ Penn, PA USA.
    Patterns of self-care decision-making and associated factors: A cross-sectional observational study2024In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 150, article id 104665Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to identify for the first time patterns of self-care decision-making (i.e. the extent to which participants viewed contextual factors influencing decisions about symptoms) and associated factors among community-dwelling adults with chronic illness.Methods: This was a secondary analysis of data collected during the development and psychometric evaluation of the 27-item Self-Care Decisions Inventory that is based on Naturalistic Decision-Making (n = 430, average age = 54.9 +/- 16.2 years, 70.2 % female, 87.0 % Caucasian, average number of chronic conditions = 3.6 +/- 2.8). Latent class mixture modeling was used to identify patterns among contextual factors that influence self-care decision-making under the domains of external, urgency, uncertainty, cognitive/affective, waiting/cue competition, and concealment. Multivariate multinomial regression was used to identify additional socio-demographic, clinical, and self-care behavior factors that were different across the patterns of self-care decision-making.Results: Three patterns of self-care decision-making were identified in a cohort of 430 adults. A 'maintainers' pattern (48.1 %) consisted of adults with limited contextual influences on self-care decision-making except for urgency. A 'highly uncertain' pattern (23.0 %) consisted of adults whose self-care decision-making was largely driven by uncertainty about the cause or meaning of the symptom. A 'distressed concealers' pattern (28.8 %) consisted of adults whose self-care decision-making was highly influenced by external factors, cognitive/affective factors and concealment. Age, education, financial security and specific symptoms were significantly different across the three patterns in multivariate models.Conclusion: Adults living with chronic illness vary in the extent to which contextual factors influence decisions they make about symptoms, and would therefore benefit from different interventions. (c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  • 19.
    Lee, Christopher S.
    et al.
    Boston Coll, MA USA; Australian Catholic Univ, Australia; Boston Coll, MA 02467 USA.
    Westland, Heleen
    Univ Med Ctr Utrecht, Netherlands.
    Faulkner, Kenneth M.
    Boston Coll, MA USA; SUNY Stony Brook, NY USA.
    Iovino, Paolo
    Australian Catholic Univ, Australia; Univ Roma Tor Vergata, Italy.
    Thompson, Jessica Harman
    Boston Coll, MA USA; Univ Kentucky, KY USA.
    Sexton, Jessica
    Boston Coll, MA USA.
    Farry, Elizabeth
    Unsolicited Advisors, Hopkinton, MA, USA.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic Univ, Australia.
    Riegel, Barbara
    Australian Catholic Univ, Australia; Univ Penn, PA USA.
    The effectiveness of self-care interventions in chronic illness: A meta-analysis of randomized controlled trials2022In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 134, article id 104322Article in journal (Refereed)
    Abstract [en]

    Objective: To characterize and explain variation in the comparative effectiveness of self-care interventions on relevant outcomes of chronic illness compared with controls. Design: Meta-analysis and meta-regression. Methods: Data extraction was framed within the context of a previously-published scoping review of randomized trials designed to enhance self-care in type 2 diabetes mellitus, heart failure, hypertension, asthma, coronary artery disease, and chronic obstructive pulmonary disease (published between 2008 and 2019). Data were pooled using random-effects meta-analyses. Meta-regression was used to test the effect of potential moderators on trial effectiveness. Results: 145 trials involving 36,853 participants were included. Overall, the effect size of self-care interventions on improving outcomes was small (Hedges g = 0.29 (95% CI = 0.25-0.33), p &lt; 0.001) with statistically significant heterogeneity across trials (Q = 514.85, p &lt; 0.001, I2 = 72.0%). A majority of trials (n = 83, 57.2%) were rated as having a high risk of bias. There was no statistically significant difference in trial effectiveness based on the use of theory, specific components of self-care addressed, the number of modes of delivery, the number of behavioral change techniques, specific modes of delivery, specific behavioral change techniques, intervention duration, total number of hours of intervention, or either participant age or gender.Conclusions: Self-care interventions are modestly effective in improving outcomes. Poor trial quality limits the strength of conclusions in this area of science. There is much to be done to enhance the design, conduct and reporting of self-care trials in order to gain more insight into the effectiveness of self-care interventions.

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  • 20.
    Lovén Wickman, Ulrica
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Department of Primary Health Care in County Council of Kalmar, Sweden.
    Yngman Uhlin, Pia
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Operations management Region Östergötland, Research and Development Unit.
    Hjortswang, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Gastroentorology.
    Wenemark, Marika
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Stjernman, Henrik
    Department of Medicine, County Hospital Ryhov, Region Jönköping, Sweden.
    Riegel, Barbara
    School of Nursing, University of Pennsylvania, United States.
    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.
    Development of a self-care questionnaire for clinical assessment of self-care in patients with inflammatory bowel disease: A psychometric evaluation2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89Article in journal (Refereed)
    Abstract [en]

    Background

    Patients with inflammatory bowel disease have lifelong needs to learn how to manage their symptoms and life situation. The range of actions that patients take in order to manage daily life and maintain health is referred to as self-care. Assessment of self-care in patients with inflammatory bowel disease could allow targeted support and education by health careprofessionals. There are no existing measures assessing self-care in patients with inflammatory bowel disease.

    Objectives

    The aim was to develop and evaluate the self-care questionnaire for assessment of self-care among patients with inflammatory bowel disease.

    Methods

    Qualitative and quantitative methods were used to develop the inflammatory bowel disease self-care questionnaire. The development and evaluation process was performed in three phases: (1) item generation based on interviews with patients with inflammatory bowel disease (n = 20), (2) content validation in a panel of experts (n = 6) and patients (n = 100) assessed with the content validity index, cognitive interviews and quantifying and ranking the items to determine the usability of the questionnaire, and (3) final evaluation through a pilot study (n = 93) with test-retest evaluation (n = 50). An expert review group of three nurses and one physician continuously discussed the result during the development process.

    Results

    A total of 91 patients with Crohn's disease and 102 with ulcerative colitis participated. The final self-care questionnaire consists of 22 items. Assessment of content validity indicated that the items were adequate and easy to understand. Test-retest reliability was confirmed with intraclass correlations above 0.6 after a three week interval, for all items except one.

    Conclusion

    An inflammatory bowel disease-specific self-care questionnaire was developed using structured methods. The evaluation indicated good validity and reliability. The questionnaire may be a useful tool to assess the ability of patients with inflammatory bowel disease to perform routine self-care.

  • 21.
    McCreaddie, May
    et al.
    Nursing Studies, Health in Social Sciences, University of Edinburgh, Teviot Row, Edinburgh, UK.
    Wiggins, Sally
    Department of Psychology, University of Strathclyde, Glasgow, UK.
    Reconciling the good patient persona with problematic and non-problematic humour: A grounded theory2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 8, p. 1079-1091Article in journal (Refereed)
    Abstract [en]

    Background

    Humour is a complex phenomenon, incorporating cognitive, emotional, behavioural, physiological and social aspects. Research to date has concentrated on reviewing (rehearsed) humour and ‘healthy’ individuals via correlation studies using personality-trait based measurements, principally on psychology students in laboratory conditions. Nurses are key participants in modern healthcare interactions however, little is known about their (spontaneous) humour use.

    Aims

    A middle-range theory that accounted for humour use in CNS-patient interactions was the aim of the study. The study reviewed the antecedents of humour exploring the use of humour in relation to (motivational) humour theories.

    Participants and setting

    Twenty Clinical Nurse Specialist–patient interactions and their respective peer groups in a country of the United Kingdom.

    Method

    An evolved constructivist grounded theory approach investigated a complex and dynamic phenomenon in situated contexts. Naturally occurring interactions provided the basis of the data corpus with follow-up interviews, focus groups, observation and field notes. A constant comparative approach to data collection and analysis was applied until theoretical sufficiency incorporating an innovative interpretative and illustrative framework. This paper reports the grounded theory and is principally based upon 20 CNS–patient interactions and follow-up data. The negative case analysis and peer group interactions will be reported in separate publications.

    Findings

    The theory purports that patients’ use humour to reconcile a good patient persona. The core category of the good patient persona, two of its constituent elements (compliance, sycophancy), conditions under which it emerges and how this relates to the use of humour are outlined and discussed. In seeking to establish and maintain a meaningful and therapeutic interaction with the CNS, patients enact a good patient persona to varying degrees depending upon the situated context. The good patient persona needs to be maintained within the interaction and is therefore reconciled with potentially problematic or non-problematic humour use. Humour is therefore used to deferentially package concerns (potentially problematic humour) or affiliate (potentially non-problematic humour). This paper reviews the good patient persona (compliance, sycophancy), potentially problematic humour (self-disparaging, gallows) and briefly, non-problematic humour (incongruity).

    Conclusions

    The middle-range theory differentiates potentially problematic humour from non-problematic humour and notes that how humour is identified and addressed is central to whether patients concerns are resolved or not. The study provides a robust review of humour in healthcare interactions with important implications for practice. Further, this study develops and extends humour research and contributes to an evolved application of constructivist grounded theory.

  • 22.
    Moser, Debra K.
    et al.
    University of Kentucky, KY 40506 USA.
    Suk Lee, Kyoung
    University of Wisconsin, WI 53706 USA.
    Wu, Jia-Rong
    University of N Carolina, NC 27515 USA.
    Mudd-Martin, Gia
    University of Kentucky, KY 40506 USA.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Huang, Tsuey-Yuan
    Chang Gung University of Science and Technology, Taiwan.
    Fan, Xui-Zhen
    Shandong University, Peoples R China.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Lennie, Terry A.
    University of Kentucky, KY 40506 USA.
    Riegel, Barbara
    University of Penn, PA 19104 USA.
    Identification of symptom clusters among patients with heart failure: An international observational study2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 10, p. 1366-1372Article in journal (Refereed)
    Abstract [en]

    Background: Virtually all patients with heart failure experience multiple symptoms simultaneously, yet clinicians and researchers usually consider symptoms in isolation. Recognizing and responding early to escalating symptoms is essential to preventing hospitalizations in heart failure, yet patients have considerable difficulty recognizing symptoms. Identification of symptom clusters could improve symptom recognition, but cultural differences may be present that must be considered. Objectives: To identify and compare symptom clusters in heart failure patients from the United States, Europe and Asia. Design: Cross-sectional, observational study. Settings: In- and out-patient settings in three regions of the world: Asia (i.e., China and Taiwan); Europe (i.e., the Netherlands and Sweden); and the United States. Participants: A total of 720 patients with confirmed heart failure. Propensity scoring using New York Heart Association Classification was used to match participants from each of the three regions. Methods: Symptoms were identified using the Minnesota Living with Heart Failure Questionnaire. To identify symptom clusters we used cluster analysis with the hierarchical cluster agglomerative approach. We used the Euclidean distance to measure the similarity of variables. Proximity between groups of variables was measured using Wards method. The resulting clusters were displayed with dendrograms, which show the proximity of variables to each other on the basis of semi-partial R-squared scores. Results: There was a core group of symptoms that formed two comparable clusters across the countries. Dyspnea, difficulty in walking or climbing, fatigue/increased need to rest, and fatigue/low energy were grouped into a cluster, which was labeled as a physical capacity symptom cluster. Worrying, feeling depressed, and cognitive problems were grouped into a cluster, which was labeled as an emotional/cognitive symptom cluster. The symptoms of edema and trouble sleeping were variable among the countries and fell into different clusters. Conclusion: Despite the diversity in cultures studied, we found that symptoms clustered similarly among the cultural groups. Identification of similar symptoms clusters among patients with heart failure may improve symptom recognition in both patients and healthcare providers.

  • 23.
    Nilsson, Lena
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US.
    Lindblad, Marlene
    Swedish Red Cross Univ, Sweden.
    Johansson, Nathalie
    Dalarna Univ, Sweden; Orsundsbro Hlth Ctr, Sweden.
    Safstrom, Lisa
    Dalarna Univ, Sweden; Heby Home Hlth Care, Sweden.
    Schildmeijer, Kristina
    Linnaeus Univ, Sweden.
    Ekstedt, Mirjam
    Linnaeus Univ, Sweden; Karolinska Inst, Sweden.
    Unbeck, Maria
    Dalarna Univ, Sweden; Karolinska Inst, Sweden.
    Exploring nursing-sensitive events in home healthcare: A national multicenter cohort study using a trigger tool2023In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 138, article id 104434Article in journal (Refereed)
    Abstract [en]

    Background: The provision of home healthcare is increasing in response to the growing aging population with the need for chronic disease management in their homes. Safety work differs from hospital care. The incidence of ad-verse events in home healthcare is sparsely studied but is estimated to occur in-one third of patients, and most are deemed preventable. Although nursing care is crucial for risk assessment and preventive work in the home environment, the role of registered nurses in the prevention of no-harm incidents and adverse events has not re-ceived sufficient scientific attention. Objectives: To explore nursing-sensitive events in patients receiving home healthcare. Design, setting and participants: A Swedish national multicenter study based on a structured record review of 600 randomly chosen healthcare records from 10 organizations in different regions of the country. Methods: Ten trained teams, each including physician(s) and registered nurses, undertook a review based on the Global Trigger Tool method. The review covered a maximum of 90 days from admission to home healthcare. First, each record was screened for the presence of 38 predefined triggers. In the second step, every potential event was assessed according to preventability, types of events, severity, time of occurrence, consequences of the event, and potential contributing causes. Results: In total, 699 events were identified in the study. Of these, 495 (74.0%) were classified as nursing-sensitive (227 no-harm incidents and 268 adverse events) and affected 267 (44.5%) patients, with a mean of 1.9 events per patient. The majority (n = 367, 73.1%) were considered preventable. The most prominent types of nursing -sensitive event were falls (n = 138, 27.9%), pressure ulcers (n = 62, 12.5%), healthcare-associated infections (n = 58, 11.7%) and medication management (n = 50, 10.1%). Concerning severity, 45.9% were classified as no-harm incidents and another 36.6% resulted in temporary harm that required extra healthcare resources: 226 hospital days, 66 physician visits in outpatient care, and 99 in home healthcare. All severity types occurred from day 1, except death, which included only one patient. The most frequent contributing factors were deficien-cies in nursing care, treatment & diagnosis, with the subgroups nursing care, observation, treatment & follow-up, followed by deficiencies in the organization. Conclusions: Nursing-sensitive events in home healthcare are common, often preventable, and occur from the start of the care period. This study contributes to increased knowledge of patient safety shortcomings and points to the important role that registered nurses play in patient safety work.(c) 2022 Elsevier Ltd. All rights reserved.

  • 24.
    Olsson, Henny M
    et al.
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Gullberg, Mats T
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nursing education and importance of professional status in the nurse role. Expectations and knowledge of the nurse role1988In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 25, no 4, p. 287-293Article in journal (Refereed)
    Abstract [en]

    Development of the nursing profession is an essential goal of nursing education. One way to reach the goal is by clarifying professional status, a status which for the most part is transferred through tacit knowledge. The goals of any nursing education do not include the entire body of tacit knowledge. The development requires recognition of professional status. Over time, significant changes in distribution of nurses' conceptions about professional status are described. The authors contend that conceptions of the importance of professional status are assimilated during work experience. The necessity and importance of role modelling, role repetition and interactions with a professional group are supported by findings from the literature and the authors' current research.

  • 25.
    Riegel, Barbara
    et al.
    Univ Penn, PA 19104 USA; Australian Catholic Univ, Australia.
    Dunbar, Sandra B.
    Emory Univ, GA 30322 USA.
    Fitzsimons, Donna
    Queens Univ Belfast, North Ireland.
    Freedland, Kenneth E.
    Washington Univ, MO 63110 USA.
    Lee, Christopher S.
    Boston Coll, MA 02167 USA.
    Middleton, Sandy
    St Vincents Hlth Australia, Australia; Australian Catholic Univ, Australia.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Vellone, Ercole
    Univ Roma Tor Vergata, Italy.
    Webber, David E.
    Int Self Care Fdn, England.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Univ Med Ctr Utrecht, Netherlands.
    Self-care research: Where are we now? Where are we going?2021In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 116, article id 103402Article in journal (Refereed)
    Abstract [en]

    Background and objective: The beneficial effects of self-care include improved well-being and lower morbidity, mortality, and healthcare costs. In this article we address the current state of self-care research and propose an agenda for future research based on the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019. The vision of this Center is a world where self-care is prioritized by individuals, families, and communities and is the first line of approach in every health care encounter. The mission of the Center is to lead the self-care research endeavor, improving conceptual clarity and promoting interdisciplinary work informed by a shared vision addressing knowledge gaps. A focused research agenda can deepen our theoretical understanding of self-care and the mechanisms underlying self-care, which can contribute to the development of effective interventions that improve outcomes. Methods: During conference discussions, we identified seven major reasons why self-care is challenging, which can be grouped into the general categories of behavior change and illness related factors. We identified six specific knowledge gaps that, if addressed, may help to address these challenges: the influence of habit formation on behavior change, resilience in the face of stressful life events that interfere with self-care, the influence of culture on self-care behavioral choices, the difficulty performing self-care with multiple chronic conditions, self-care in persons with severe mental illness, and the influence of others (care partners, family, peer supporters, and healthcare professionals) on self-care. Plans to achieve results: To achieve the vision and mission of the Center, we will lead a collaborative program of research that addresses self-care knowledge gaps and improves outcomes, create a supportive international network for knowledge transfer and support of innovations in self-care research, and support and train others in self-care research. Beyond these specific short-term goals, important policy implications of this work are discussed. (c) 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

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  • 26.
    Riegel, Barbara
    et al.
    Univ Penn, PA 19104 USA.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Recognizing the Complexity of Self-Care2021In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 116, article id 103908Article in journal (Other academic)
    Abstract [en]

    n/a

  • 27.
    Riegel, Barbara
    et al.
    School of Nursing, University of Pennsylvania, Philadelphia, USA.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Self-care in long term conditions: Old news or new thinking?2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 90, p. A1-A1Article in journal (Other academic)
    Abstract [en]

    n/a

    Download full text (pdf)
    fulltext
  • 28.
    Riegel, Barbara
    et al.
    Univ Penn, PA 19104 USA; Australian Catholic Univ, Australia.
    Westland, Heleen
    Univ Med Ctr Utrecht, Netherlands.
    Freedland, Kenneth E.
    Washington Univ, MO 63110 USA.
    Lee, Christopher S.
    Australian Catholic Univ, Australia; Boston Coll, MA 02167 USA.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Vellone, Ercole
    Univ Roma Tor Vergata, Italy.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Univ Med Ctr Utrecht, Netherlands.
    Operational definition of self-care interventions for adults with chronic illness2022In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 129, article id 104231Article in journal (Other academic)
    Abstract [en]

    n/a

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  • 29.
    Riegel, Barbara
    et al.
    Univ Penn, PA 19104 USA; Australian Catholic Univ, Australia.
    Westland, Heleen
    Univ Med Ctr Utrecht, Netherlands.
    Iovino, Paolo
    Univ Roma Tor Vergata, Italy; Australian Catholic Univ, Australia.
    Barelds, Ingrid
    Univ Med Ctr Utrecht, Netherlands.
    Slot, Joyce Bruins
    Univ Med Ctr Utrecht, Netherlands.
    Stawnychy, Michael A.
    Univ Penn, PA 19104 USA.
    Osokpo, Onome
    Univ Penn, PA 19104 USA.
    Tarbi, Elise
    Univ Penn, PA 19104 USA.
    Trappenburg, Jaap C. A.
    Univ Med Ctr Utrecht, Netherlands.
    Vellone, Ercole
    Univ Roma Tor Vergata, Italy.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Jaarsma, Tiny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Australian Catholic Univ, Australia; Univ Med Ctr Utrecht, Netherlands.
    Characteristics of self-care interventions for patients with a chronic condition: A scoping review2021In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 116, article id 103713Article, review/survey (Refereed)
    Abstract [en]

    Background: Self-care is a fundamental element of treatment for patients with a chronic condition and a major focus of many interventions. A large body of research exists describing different types of selfcare interventions, but these studies have never been compared across conditions. Examination of heterogeneous interventions could provide insights into effective approaches that should be used in diverse patient populations. Objectives: To provide a comprehensive and standardized cross-condition overview of interventions to enhance self-care in patients with a chronic condition. Specific aims were to: 1) identify what self-care concepts and behaviors are evaluated in self-care interventions; 2) classify and quantify heterogeneity in mode and type of delivery; 3) quantify the behavior change techniques used to enhance self-care behavior; and 4) assess the dose of self-care interventions delivered. Design: Scoping review Data sources: Four electronic databases & ndash; PubMed, EMBASE, PsychINFO and CINAHL & ndash; were searched from January 2008 through January 2019. Eligibility criteria for study selection: Randomized controlled trials (RCTs) with concealed allocation to the intervention were included if they compared a behavioral or educational self- care intervention to usual care or another self-care intervention and were conducted in adults. Nine common chronic conditions were included: hypertension, coronary artery disease, arthritis, chronic kidney disease, heart failure, stroke, asthma, chronic obstructive lung disease, and type 2 diabetes mellitus. Diagnoses that are psychiatric (e.g. schizophrenia), acute rather than chronic, or benefitting little from self-care (e.g. dementia) were excluded. Studies had to be reported in English with full-text available. Results: 9309 citations were considered and 233 studies were included in the final review. Most studies addressed type 2 diabetes mellitus ( n = 85; 36%), hypertension ( n = 32; 14%) or heart failure ( n = 27; 12%). The majority (97%) focused on healthy behaviors like physical activity (70%), dietary intake (59%), and medication management (52%). Major deficits found in self-care interventions included a lack of at-tention to the psychological consequences of chronic illness, technology and behavior change techniques were rarely used, few studies focused on helping patients manage signs and symptoms, and the inter-ventions were rarely innovative. Research reporting was generally poor. Conclusions: Major gaps in targeted areas of self-care were identified. Opportunities exist to improve the quality and reporting of future self-care intervention research. Registration: The study was registered in the PROSPERO database (#123,719). (c) 2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • 30.
    Rytterström, Patrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Cedersund, Elisabet
    Linköping University, Department of Social and Welfare Studies, Äldre - vård - civilsamhälle (ÄVC) . Linköping University, Faculty of Arts and Sciences.
    Arman, Maria
    Karolinska Institutet, Stockholm.
    Care and caring culture as experienced by nurses working in different care environments: A phenomenological-hermeneutic study2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 5, p. 689-698Article in journal (Refereed)
    Abstract [en]

    Aim: The aim is to understand and develop the concept of care and caring Culture and to do so based on the empirical/phenomenological standpoint of nurses lived experiences of working in different environments.

    Background: Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the caring culture as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means.

    Method: A phenomenological-hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working oil different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses I year later for validation of the findings.

    Findings: Thematic analyses revealed five themes: you have to adapt to the existing care Culture: seeing the invisible: being Yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as "homelike", nurses may act in a way that reflects their own values.

    Discussion: The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring Culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring.

  • 31.
    Sandberg, Jonas
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Linköping University, Faculty of Health Sciences.
    Lundh, Ulla
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nolan, Mike
    School of Nursing and Midwifery, University of Sheffield, Samuel Fox House, Northern General Hospital, Herries Road, Sheffield, UK.
    Moving into a care home: the role of adult children in the placement process2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 3, p. 353-362Article in journal (Refereed)
    Abstract [en]

    Admission of an older person to a care home is widely recognised as a very stressful period for the family and one which, despite community care policy, is likely to be an increasingly common experience. Although there is a growing research base in this area, there have been few studies on the role of adult children in supporting their parents during this difficult transition. This paper reports on the third stage of a grounded theory study conducted in Sweden which explored the part played by adult children in the placement process. Data were collected from 13 adult children using in-depth semi-structured interviews and the results are compared with themes previously derived from interviews with 26 spouse carers. The analysis reveals important overlaps and differences and suggests the need for further research exploring the dynamics of the placement process.

  • 32.
    Sandberg, Jonas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric. Linköping University, Faculty of Health Sciences.
    Nolan, M.R.
    Gerontological Nursing, University of Sheffield, United Kingdom.
    Lundh, Ulla
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    'Entering a New World': empathic awareness as the key to positive family/staff relationships in care homes2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 5, p. 507-515Article in journal (Refereed)
    Abstract [en]

    Despite an almost universal policy of community care, placing a relative in a care home will be an increasingly common event as population ageing continues. Studies suggest that most families wish to remain involved in care following placement but that they often experience difficulties in establishing relationships with staff. This paper reports on the fifth phase of a Swedish study exploring the experience of placement from a temporal perspective and including the views of all the key actors (relatives, staff in the community, staff in care homes). The focus here is placed on the perceptions of care home staff and their perceived role in relation to spouses who have recently placed a partner. The study adopted a grounded theory approach and data were collected from in-depth interviews with 16 staff members of varying grades and positions. Analysis of the data suggested 3 levels of awareness amongst staff: empathic awareness, guarded awareness and limited awareness. The characteristics of empathic awareness are outlined and its implications briefly considered.

  • 33.
    Santos, Gabrielle Cecile
    et al.
    HES So Univ Appl Sci & Arts Western Switzerland F, Switzerland; Univ Lausanne, Switzerland; Lausanne Univ Hosp, Switzerland.
    Liljeroos, Maria
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Uppsala Univ, Sweden.
    Dwyer, Andrew A.
    Boston Coll, MA 02467 USA.
    Jaques, Cecile
    Lausanne Univ Hosp, Switzerland.
    Girard, Josepha
    HES So Univ Appl Sci & Arts Western Switzerland F, Switzerland.
    Strömberg, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Hullin, Roger
    Lausanne Univ Hosp, Switzerland; Univ Lausanne, Switzerland.
    Schaefer-Keller, Petra
    HES So Univ Appl Sci & Arts Western Switzerland F, Switzerland.
    Symptom perception in heart failure & ndash; Interventions and outcomes: A scoping review2021In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 116, article id 103524Article, review/survey (Refereed)
    Abstract [en]

    Background: Symptom perception in heart failure has recently been described as essential in the self-care process bridging self-care maintenance and self-care management. Accordingly, symptom perception ap-pears to be critical for improving patient outcomes such as decreased hospital readmission and increased survival. Objectives: To explore what interventions have been reported on heart failure symptom perception and to describe outcomes responsive to symptom perception. Design: We conducted a scoping review using PRISMA Extension for Scoping Reviews. Data sources: Structured searches of Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, Joanna Briggs Institute and Grey literature databases. Review methods: Two authors independently screened references for eligibility. Eligible articles were writ-ten in English, French, German, Swedish, Italian or Spanish and concerned symptom perception in adults with heart failure. Data were extracted and charted in tables by three reviewers. Results were narratively summarized. Results: We identified 99 eligible studies from 3055 references. Seven interventional studies targeted symptom perception as the single intervention component. Mixed results have been found: while some reported decreased symptom frequency, intensity and distress, enhanced health-related quality of life, improved heart failure self-care maintenance and management as well as a greater ability to mention heart failure symptoms, others found more contacts with healthcare providers or no impact on anxiety, heart failure self-care nor a number of diary reported symptoms. Additional interventional studies in-cluded symptom perception as one component of a multi-faceted intervention. Outcomes responsive to symptom perception were improved general and physical health, decreased mortality, heart failure de-compensation, as hospital/emergency visits, shorter delays in seeking care, more consistent weight moni-toring, improved symptom recognition as well as self-care management, decreased hospital length of stay and decreased costs. Conclusions: While many studies allowed to map a comprehensive overview of interventions supporting symptom perception in heart failure as well as responsiveness to outcomes, only a few single compo-nent intervention studies targeting symptom perception have been reported and study designs preclude assessing intervention effectiveness. With regard to multiple component interventions, the specific im-pact of symptom perception interventions on outcomes remains uncertain to date. Well-designed studies & nbsp; are needed to test the effectiveness of symptom perception interventions and to elucidate relationships with outcomes. (c) 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/ )

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  • 34.
    Snyder, Hannah
    et al.
    Linköping University, Department of Management and Engineering, Logistics & Quality Management. Linköping University, Faculty of Science & Engineering.
    Engström, Jon
    Linköping University, Department of Management and Engineering, Business Administration. Linköping University, Faculty of Science & Engineering.
    The Antecedents, Forms and Consequences of Patient Involvement: A Narrative Review of the literature2016In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 53, p. 351-378Article, review/survey (Refereed)
    Abstract [en]

    Objectives

    Despite the centrality of patient involvement in the policy and rhetoric of health care, the theoretical and empirical basis for patient involvement is lacking at the micro-level of practice. The purpose of this narrative review is to provide an overview and synthesize the current empirical research related to patient involvement at the micro-level of health care.

    Design

    Narrative review

    Data sources: A database search was conducted (in Pubmed, CINAHL, Academic Search Premier, EconLit and PsycINFO) for articles published between 1990 and April 2015 in the field of patient involvement in health care. Out of 4238 references, 214 articles were eligible for this review.

    Review methods We analyzed our sample using thematic analysis.

    Results

    The reviewed articles revealed nine themes for patient involvement, concerning enablers; empowerment, patient education, communication for involvement, staff training, service systems, types; decision making, delivery, development, and consequences of patient involvement. The themes were synthesized into a tentative model that described patient-involvement research.

    Conclusions

    Our narrative review includes a wide variety of empirical studies on patient involvement in decision-making, delivery and development, and provides an integrative perspective suggesting that patient involvement should be viewed not only as isolated activities, but also as a result of educating and preparing patients, staff and systems.

  • 35.
    Söderhamn, O
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Lindencrona, C
    Vänersborg.
    Ek, Anna-Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Ability for self-care among home dwelling elderly people in a health district in Sweden2000In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 37, no 4, p. 361-368Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the ability for self-care among home dwelling elderly in the community in a health district in western Sweden. Two self-report instruments plus a number of self-care related questions were distributed by mail to an age stratified random sample and finally completed by a total of 125 subjects. Bivariate and multivariate statistical methods were used in the analyses. The results showed that self-care ability and self-care agency decreased for respondents 75 + years of age. Self-care ability was predicted by three productive means for self-care and four risk factors.

  • 36.
    Unbeck, Maria
    et al.
    Danderyd Hospital, Sweden.
    Sterner, Eila
    Karolinska University Hospital, Sweden; Sophiahemmet University of Coll, Sweden.
    Elg, Mattias
    Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology. Jonköping Academic Improvement Health and Welf, Sweden.
    Fossum, Bjoom
    Sophiahemmet University of Coll, Sweden; Danderyd Hospital, Sweden.
    Thor, Johan
    Jonköping Academic Improvement Health and Welf, Sweden; Karolinska Institute, Sweden.
    PukkHarenstam, Karin
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Editorial Material: Choose your tool wisely: U charts are more informative than run charts with or without tests of significance. A comment on Unbeck et al. (2014), Unbeck et al. (2013) and Kottner (2014) Response in INTERNATIONAL JOURNAL OF NURSING STUDIES, vol 52, issue 1, pp 484-4852015In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 52, no 1, p. 484-485Article in journal (Other academic)
    Abstract [en]

    n/a

  • 37.
    Unbeck, Maria
    et al.
    Karolinska Institute, Sweden .
    Sterner, Eila
    Karolinska Institute, Sweden .
    Elg, Mattias
    Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology.
    Fossum, Bjoorn
    Sophiahemmet University of Coll, Sweden .
    Thor, Johan
    Jonköping Academic Improvement Health and Welf, Sweden .
    Pukk Harenstam, Karin
    Karolinska Institute, Sweden .
    Design, application and impact of quality improvement theme months in orthopaedic nursing: A mixed method case study on pressure ulcer prevention2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 4, p. 527-535Article in journal (Refereed)
    Abstract [en]

    Background: While there is growing awareness of quality problems in healthcare systems, it remains uncertain how best to accomplish and sustain improvement over time. less thanbrgreater than less thanbrgreater thanObjective: To report on the design and application of quality improvement theme months in orthopaedic nursing, and evaluate the impact on pressure ulcer as an example. less thanbrgreater than less thanbrgreater thanDesign: Retrospective mixed method case study with time series diagrams. less thanbrgreater than less thanbrgreater thanSetting: An orthopaedic department at a Swedish university hospital. less thanbrgreater than less thanbrgreater thanMethod: The interventions were led by nursing teams and focused on one improvement theme at a time in two-month cycles, hence the term improvement theme months. These included defined objectives, easy-to-use follow-up measurement, education, changes to daily routines, "reminder months" and data feedback. The study draws on retrospective record data regarding one of the theme topics, pressure ulcer risk assessment and prevalence, in 2281 orthopaedic admissions during January 2007-October 2010 through point prevalence measurement one-day per month. Data were analysed in time series diagrams and through comparison to annual point prevalence data from mandatory county council-wide measurements prior to, during and after interventions from 2003 to 2010. By using document analysis we reviewed concurrent initiatives at different levels in the healthcare organisation and related them to the improvement theme months and their impact. less thanbrgreater than less thanbrgreater thanResults: The 46 monthly point prevalence samples ranged from 28 to 66 admissions. Substantial improvements were found in risk assessment rates for pressure ulcers both in the longitudinal follow-up (p andlt; 0.001) and in the annual county council-wide measurements. A reduction in pressure ulcer rate was observed in the annual county council-wide measurements. In the longitudinal data, wider variation in the pressure ulcer rate was seen (p andlt; 0.067); however, there was a significant decrease in pressure ulcer rates during the final ten-month period in 2010, compared to the baseline period in 2007 (p = 0.004). Improvements were moderate the first years and needed reinforcement to be maintained. less thanbrgreater than less thanbrgreater thanConclusions: The theme month design and the way it was applied in this case showed potential, contributing to reduced pressure ulcer prevalence, as a way to conduct quality improvement initiatives in nursing. For sustainable improvement, multi component interventions are needed with regular monitoring and reminder efforts.

  • 38.
    Unbeck, Maria
    et al.
    Danderyd Hospital, Sweden .
    Sterner, Eila
    Karolinska University Hospital, Sweden Sophiahemmet University of Coll, Sweden .
    Elg, Mattias
    Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology.
    Fossum, Bjoorn
    Sophiahemmet University of Coll, Sweden Danderyd Hospital, Sweden .
    Thor, Johan
    Jonköping Academic Improvement Health and Welf, Sweden Karolinska Institute, Sweden .
    Pukk Harenstam, Karin
    Karolinska Institute, Sweden Karolinska University Hospital, Sweden .
    Editorial Material: The value of Statistical Process Control in quality improvement contexts: Commentary on Unbeck et al. (2013) Response2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 2, p. 348-349Article in journal (Other academic)
    Abstract [en]

    n/a

  • 39.
    Westergren, A.
    et al.
    Department of Nursing, Faculty of Medicine, Lund University, P.O. Box 198, SE-221 00 Lund, Sweden.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Ohlsson, O.
    Department of Internal Medicine, Central Hospital Kristianstad, NE Skåne Health Care District, Sweden.
    Lorefält, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Hallberg, I.R.
    Department of Nursing, Faculty of Medicine, Lund University, P.O. Box 198, SE-221 00 Lund, Sweden.
    Eating difficulties, assisted eating and nutritional status in elderly (=65 years) patients in hospital rehabilitation2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 3, p. 341-351Article in journal (Refereed)
    Abstract [en]

    This study describes frequencies and associations between eating difficulties, assisted eating and nutritional status in 520 elderly patients in hospital rehabilitation. Eating difficulties were observed during a meal and nutritional status was assessed with Subjective Global Assessment form. Eighty-two percent of patients had one or more eating difficulties, 36% had assisted eating and 46% malnutrition. Three components of eating were focused upon ingestion, deglutition, and energy (eating and intake). Deglutition and ingestion difficulties and low energy were associated with assisted eating, and low energy associated with malnutrition. Underestimation of low energy puts patients at risk of having or developing malnutrition. © 2002 Elsevier Science Ltd. All rights reserved.

  • 40.
    Wiman, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Wikblad, K.
    Department of Medical Sciences, The Fend Centre for European Diabetes Nursing Research, Uppsala University, Sweden.
    Idvall, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Trauma patients' encounters with the team in the emergency department-A qualitative study2007In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, no 5, p. 714-722Article in journal (Refereed)
    Abstract [en]

    Background: Encounters in emergency departments have been described from different perspective and with different research approaches. On reviewing the literature, along with medical skills, interpersonal skills such as the ability to create a relationship with the patient was considered significant. Patients exposed to high-energy violence arrive at the emergency department in a vulnerable condition. Apart from their physical condition, they might be in shock and frightened by the experiences of the injury. The team at the emergency department is responsible for a complex situation and has to quickly establish rapport, gather information, assess the physical condition, and design a treatment plan. Aim: The aim of this study was to explore trauma patients' conceptions of the encounter with the trauma team. Design and method: A qualitative inductive design was used and data were collected by semi-structured interviews. The interviews were transcribed verbatim and analysed according to contextual analysis. Participants: Twenty-three trauma patients with minor injuries, 17 from a university hospital and six from a county hospital with minor injuries, were included in the study. Findings: The main findings were three main categories, labelled modes of being with the patients: the instrumental, the attentive and the uncommitted mode. All encounters contained the instrumental mode and mostly there were a combination of instrumental mode and attentive mode. The patients were satisfied with these modes, which created emotions of confidence, comfort and satisfaction. The uncommitted mode occurred in some encounters together and generated emotions of abandonment, dissatisfaction. Conclusion: The main conclusion is that a high-quality encounter in trauma care is likely to be received from caregivers who can shift their mode of being with the patient between the instrumental and the attentive mode as the patient/situation demands. That is, flexibility between the physical and psycho-social care. © 2006.

  • 41.
    Yu, Doris S F
    et al.
    Chinese University of Hong Kong.
    Lee, Diana T F
    Chinese University of Hong Kong.
    Thompson, David R
    Australian Catholic University.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Woo, Jean
    Chinese University of Hong Kong.
    Leung, Edward M F
    United Christian Hospital, Hong Kong.
    Psychometric properties of the Chinese version of the European Heart Failure Self-care Behaviour Scale.2010In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 48, no 4, p. 458-467Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Effective self-care is the cornerstone of the successful management of heart failure (HF). The European Heart Failure Self-care Behaviour Scale is a brief, reliable and valid scale to measure this important construct among patients with HF. Although the EHFScBS has been translated to different languages, no Chinese version is available. Indeed, previous findings investigating the psychometric properties of EHFScBS indicated ambiguity of the conceptual structure of this scale. AIM: The aim of this study was to translate the European Heart Failure Self-care Behaviour Scale (EHFScBS) into Chinese and to test its psychometric properties in the Chinese patients with HF. METHODS: The EHFScBS (English Version) was translated to Chinese using Brislin's forward and backward translation method. Panel review was used to examine its semantic equivalence and content validity. The EHFScBS (Chinese Version) was then tested with a convenience sample of 143 Chinese HF patients who attended a specialist clinic from January to September 2007. RESULTS: The content validity index (CVI) of the EHFScBS (Chinese version) was satisfactory (Item CVI=0.96; Scale CVI=0.89), with Cronbach's alpha 0.82. Convergent validity was supported by a moderate relationship, statistical significant with a measure for social support (r=-0.36, p<0.001). However, the findings did not support the hypothesised three-factor structure of the EHFScBS (Chinese Version). Instead, all items except one fit well a two-factor structure to measure help-seeking and regimen-complying behaviours. CONCLUSION: The adequate psychometric properties and clear conceptual structure of EHFScBS (Chinese Version) warrant its use in Chinese patients with HF.

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