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  • 1.
    Ahlander, Britt-Marie
    et al.
    Ryhov County Hospital, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Maret, Eva
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Ericsson, Elisabeth
    University of Örebro, Sweden.
    Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging: the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ)2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 6, p. 1368-1380Article in journal (Refereed)
    Abstract [en]

    Aim. To develop and validate a new instrument measuring patient anxiety during Magnetic Resonance Imaging examinations, Magnetic Resonance Imaging-Anxiety Questionnaire. Background. Questionnaires measuring patients anxiety during Magnetic Resonance Imaging examinations have been the same as used in a wide range of conditions. To learn about patients experience during examination and to evaluate interventions, a specific questionnaire measuring patient anxiety during Magnetic Resonance Imaging is needed. Design. Psychometric cross-sectional study with test-retest design. Methods. A new questionnaire, Magnetic Resonance Imaging-Anxiety Questionnaire, was designed from patient expressions of anxiety in Magnetic Resonance Imaging-scanners. The sample was recruited between October 2012-October 2014. Factor structure was evaluated with exploratory factor analysis and internal consistency with Cronbachs alpha. Criterion-related validity, known-group validity and test-retest was calculated. Results. Patients referred for Magnetic Resonance Imaging of either the spine or the heart, were invited to participate. The development and validation of Magnetic Resonance Imaging-Anxiety Questionnaire resulted in 15 items consisting of two factors. Cronbachs alpha was found to be high. Magnetic Resonance Imaging-Anxiety Questionnaire correlated higher with instruments measuring anxiety than with depression scales. Known-group validity demonstrated a higher level of anxiety for patients undergoing Magnetic Resonance Imaging scan of the heart than for those examining the spine. Test-retest reliability demonstrated acceptable level for the scale. Conclusion. Magnetic Resonance Imaging-Anxiety Questionnaire bridges a gap among existing questionnaires, making it a simple and useful tool for measuring patient anxiety during Magnetic Resonance Imaging examinations.

  • 2.
    Aho, Anna-Carin
    et al.
    Linnéuniversitetet, Växjö, Sweden.
    Hultsjö, Sally
    Ryhovs sjukhus, Landstinget i Jönköping, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Health perceptions of young adults living with recessive limb-girdle muscular dystrophy2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 8, p. 1915-1925Article in journal (Refereed)
    Abstract [en]

    AIM:

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

    BACKGROUND:

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

    DESIGN:

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

    METHOD:

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

    FINDINGS:

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

    CONCLUSION:

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

  • 3.
    Allvin, R.
    et al.
    Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden, Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Berg, Katarina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Idvall, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Nilsson, U.
    Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden, Department of Cardiothoracic Surgery, Örebro University Hospital, Örebro, Sweden, Department of Health Sciences, Örebro University, Örebro, Sweden.
    Postoperative recovery: A concept analysis2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 57, no 5, p. 552-558Article in journal (Refereed)
    Abstract [en]

    Aim. This paper presents a concept analysis of the phenomenon of postoperative recovery. Background. Each year, millions of patients throughout the world undergo surgical procedures. Although postoperative recovery is commonly used as an outcome of surgery, it is difficult to identify a standard definition. Method. Walker and Avant's concept analysis approach was used. Literature retrieved from MEDLINE and CINAHL databases for English language papers published from 1982 to 2005 was used for the analysis. Findings. The theoretical definition developed points out that postoperative recovery is an energy-requiring process of returning to normality and wholeness. It is defined by comparative standards, achieved by regaining control over physical, psychological, social and habitual functions, and results in a return to preoperative level of independence/dependency in activities of daily living and optimum level of psychological well-being. Conclusion. The concept of postoperative recovery lacks clarity, both in its meaning in relation to postoperative recovery to healthcare professionals in their care for surgical patients, and in the understanding of what researchers in this area really intend to investigate. The theoretical definition we have developed may be useful but needs to be further explored. © 2007 The Authors. Journal compilation 2007 Blackwell Publishing Ltd.

  • 4.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Sweden.
    Tingström, Pia
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, p. 1500-1514Article in journal (Refereed)
    Abstract [en]

    Aim

    To evaluate the effects of a self-care promoting problem-based learning programme for people with rheumatic diseases in terms of health-related quality of life, empowerment, and self-care ability.

    Background

    Individuals with rheumatoid arthritis express a great need for education and support in adapting to the disease, but the average qualities of studies about patient education interventions are not high. There is no evidence of long-term benefits of patient education.

    Design

    Randomized controlled trial.

    Methods

    A randomized controlled design was selected with test at baseline, 1-week and 6-month post-interventions after completed the 1-year programme. The tests consisted of validity and reliability tested instruments. The participants were randomly assigned in spring 2009 to either the experimental group (n = 54) or the control group (n = 148). The programme was running alongside the standard care the participants received at a rheumatology unit. Parametric and non-parametric tests were used in the analyses.

    Results

    The participants in the experimental group had statistically significant stronger empowerment after participation in the self-care promoting problem-based learning programme compared with the control group, at the 6-month post-intervention. Approximately, two-thirds of the participants in the experimental group stated that they had implemented lifestyle changes due to the programme.

    Conclusion

    The self-care promoting problem-based learning programme enabled people with rheumatic diseases to improve their empowerment compared with the control group. It is important to continue to develop problem-based learning in patient education to find the very best way to use this pedagogical method in rheumatology care.

  • 5.
    Baggens, Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    What they talk about: Conversations between child health centre nurses and parents2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 36, no 5, p. 659-667Article in journal (Refereed)
    Abstract [en]

    Background. The voluntary child health promotion programme reaches virtually all children in Sweden and each child will visit the child health centre about 20 times until it has reached school age. The practical responsibility for the tasks at the child health centre resides mainly with the nurse. The nurse’s talk is the main instrument used to carry out health examinations, detect health problems and developmental deviations, pass on information and give individual advice and support to families.

    Aim. The aim of the study is to explore the content of the conversations and analyse its relationship to both the child health promotion programme and the question of which party decides what is talked about in these encounters.

    Methods. The empirical study, approved by the Committee for Ethics in Medical Investigation, was conducted at three child health centres in medium-sized towns in Sweden. Data collection consisted of audiotapes of 44 visits to these child health centres. The tape-recorded conversations were transcribed verbatim and constitute the material. The analysis was content-orientated and was performed in four steps: coding and generating topics, categorization of topics, identifying the initiator and searching for regularities.

    Results/Conclusion. The results showed that the most common issues discussed concerned the child’s development (mainly physical aspects), situational matters and questions about procedures and routines. The nurses initiated most of the topics discussed and her dominance was established with the help of the official child health promotion programme. The findings evoke ideas about what possibilities the parents have of making their voices heard during the conversations. The conclusion is that the findings indicate a need for further research on nurse-parent/child communication during visits to the child health centre to acquire knowledge about the interactional consequences in the conversation when some topics are discussed but others are not.

  • 6.
    Bergdahl, Elisabeth
    et al.
    Research and Development Unit, FOU nu, SLSO, Stockholm, Sweden / Faculty of Professional Studies, Nursing Science, Nord University, Bodö, Norway.
    Berterö, Carina M
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Concept analysis and the building blocks of theory: misconceptions regarding theory development.2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 10, p. 2558-2566Article in journal (Refereed)
    Abstract [en]

    AIM: The purpose of this article is to discuss the attempts to justify concepts analysis as a way to construct theory - a notion often advocated in nursing.

    BACKGROUND: The notion that concepts are the building blocks or threads from which theory is constructed is often repeated. It can be found in many articles and well-known textbooks. However, this notion is seldom explained or defended. The notion of concepts as building blocks has also been questioned by several authors. However, most of these authors seem to agree to some degree that concepts are essential components from which theory is built.

    DESIGN: Discussion paper.

    DATA SOURCES: Literature was reviewed to synthesize and debate current knowledge.

    IMPLICATIONS FOR NURSING: Our point is that theory is not built by concepts analysis or clarification and we will show that this notion has its basis in some serious misunderstandings. We argue that concept analysis is not a part of sound scientific method and should be abandoned.

    CONCLUSION: The current methods of concept analysis in nursing have no foundation in philosophy of science or in language philosophy. The type of concept analysis performed in nursing is not a way to 'construct' theory. Rather, theories are formed by creative endeavour to propose a solution to a scientific and/or practical problem. The bottom line is that the current style and form of concept analysis in nursing should be abandoned in favour of methods in line with modern theory of science.

  • 7.
    Bergman, E.
    et al.
    County Hospital Ryhov, Jönköping, Sweden.
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    You can do it if you set your mind to it: A qualitative study of patients with coronary artery disease2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 36, no 6, p. 733-741Article in journal (Refereed)
    Abstract [en]

    Aims of the study. To gain increased knowledge and understanding of what it means to be afflicted with coronary artery disease (CAD) and how it affects the life/ lifestyle of the individual. Background. Research has documented that education, counselling and behavioural interventions are important elements of cardiac rehabilitation and compliance with treatment. Compliance is generally better with medical treatment than with recommended lifestyle changes. Another influencing aspect is locus of control, i.e. people's own understanding of control is the foundation for the decisions patients make more or less consciously regarding compliance with caring/nursing, treatment and lifestyle changes. Methods. Eight individuals with diagnosed coronary artery disease were interviewed about their life situation, and the opportunities and obstacles they encountered in making lifestyle changes. These interviews were transcribed and then analysed using a hermeneutic approach. Findings. The findings included three areas: (1) The causes of coronary artery disease describing different factors, such as heredity, lifestyle and demands. (2) Difficulties in the work of rehabilitation, which was explained in terms of informants' feelings of confusion, uncertainty and sadness. (3) Successful rehabilitation consisted of two factors: the personality of the individual patient and external support. Conclusions. Patients may comply well with follow-up visits but less with lifestyle changes. By identifying different 'characteristics', 'prerequisites' and 'difficulties' that describe patients' compliance, it should be possible to make treatment more individual. Nurses have a significant role in supporting these patients since they are more accessible than physicians. Nurses also have a responsibility to work together with patients to empower them, in order to make their lifestyle changes and self-care activities manageable.

  • 8. Björkström, ME
    et al.
    Johansson, IS
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology.
    Athlin, EE
    Swedish nursing students' attitudes to and awareness of research and development within nursing2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 41, no 4, p. 393-402Article in journal (Refereed)
    Abstract [en]

    Background. Nurses' attitudes towards research have been illuminated in many studies. However, there is still a need for more knowledge about the attitudes and awareness of undergraduate nursing students. Aim. To investigate Swedish undergraduate nursing students' attitudes towards and awareness of research and development within nursing, and to illuminate factors that may have an impact on their attitudes and awareness. Methods. A questionnaire consisting of three parts: demographic data, attitude scale, and research awareness was used. Parametric and nonparametric statistics were used. Two hundred and one students participated in the study and the response rate was 77%. Cronbach's alpha test on the seven factors was between 0.52 and 0.80. Results. Most of the students had positive attitudes towards nursing research. More than half (60%) of the students expected to make use of nursing research sometime in the future and about 25% had never read any of the scientific nursing journals. The majority (77%) of the students were acquainted with at least one Swedish researcher, but few had attended a doctoral dissertation. Students with an interest in some particular development or research area in nursing were significantly more positive and expected to make use of nursing research more frequently. Other variables that were found to have some impact upon attitudes were gender, age and additional academic studies. Conclusion. Nursing students had an overall positive attitude towards nursing research and their interest in a particular development or research area was the most important variable for their attitudes and expected use of nursing research in the future. Therefore, it would seem to be important to encourage the students' interest in specific development/research areas of nursing during their education. In spite of the nursing students' positive attitudes to nursing research, the study demonstrates the theory-practice gap is still present to some degree.

  • 9. Björkström, Monica
    et al.
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Swedish nurses' attitudes towards research and development within nursing2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 5, p. 706-714Article in journal (Refereed)
    Abstract [en]

    Aim of the study. The aim was to develop and test an assessment instrument in order to study attitudes towards research and development within nursing among randomly selected professional nurses, registered nurses (RNs). Background. The investigation was initiated because of the development within nursing and nursing education in Sweden towards better knowledge about research for the last four decades. Methods. A questionnaire was designed, consisting of three parts: (1) demographic data, (2) attitude scale and (3) research awareness. Appropriate psychometric statistics were used such as factor analysis and parametric as well as nonparametric statistics to compare groups. The form was distributed to 407 randomly selected RNs. Results. The response rate was 71% (n = 289). The respondents were from four different examination years, representing four different nursing education systems in Sweden. Factor analysis (Maximum Likelihood and Oblimin rotation) gave seven factors with a total variance of 58% and Cronbach's a between 0╖60 and 0╖84. The factors were labelled 'Research language', 'Need of research knowledge', 'Participation', 'The Profession', 'Meaningfulness', 'Study literature' and 'Developing -Resources'. The results indicated that the respondents in general had positive attitudes towards nursing research. There were significant differences between the examined groups. The group examined in 1966 appeared as the least positive group. Forty-six per cent never or seldom utilized nursing research findings in their daily practice. About half of the respondents never read research reports. Conclusion. The results indicated that the new instrument is sensitive for measuring professional nurses' attitudes towards research and development in nursing. Even if the respondents had a positive attitude towards research and development, there was a poor application in their daily work. Further, the respondent's age, the year of RN examination and acquisition of research skills seemed to be of importance for the attitudes.

  • 10.
    Boman, Erika
    et al.
    Aland University of Appl Science, Finland; University of Coll Southeast Norway, Norway.
    Lundman, Berit
    Umeå University, Sweden.
    Nygren, Bjoern
    Umeå University, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Santamaki Fischer, Regina
    Umeå University, Sweden; Abo Akad University, Finland.
    Inner strength and its relationship to health threats in ageing-A cross-sectional study among community-dwelling older women2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2720-2729Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the relationship between inner strength and health threats among community-dwelling older women. Background: Inner strength is described as a resource that promotes experiences of health, despite adversities. Inner strength and its dimensions (i.e. connectedness, creativity, firmness and flexibility) can be assessed using the Inner Strength Scale (ISS). Exploring attributes of weaker inner strength may yield valuable information about areas to focus on in enhancing a persons inner strength and may ultimately lead to the perception of better health. Design: Cross-sectional questionnaire survey. Methods: The study is based on responses from 1270 community-dwelling older women aged 65 years and older; these were collected in the year 2010 and describe the situation that still exists today for older women. The questionnaire included the ISS, background characteristics and explanatory variables known to be health threats in ageing. Data were analysed using descriptive and inferential statistics. Results: Poorer mental health was related to weaker inner strength in total and in all the dimensions. Symptoms of depressive disorders and feeling lonely were related to three of the dimensions, except firmness and creativity respectively. Furthermore, poor physical health was associated with the dimensions firmness and flexibility. Other health threats were significantly related to only one of the dimensions, or not associated at all. Conclusion: Mental ill health has overall the strongest association with weaker inner strength. Longitudinal studies are recommended to confirm the results. However, the ISS does not only estimate inner strength but can also be a tool for discovering where (i.e. dimension) interventions may be most profitable.

  • 11.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Albers, J
    County Hospital Ryhov.
    Mårtensson, Jan
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Obstructive sleep apnoea syndrome - Patients' perceptions of their sleep and its effects on their life situation2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 57, no 3, p. 318-327Article in journal (Refereed)
    Abstract [en]

    Title. Obstructive sleep apnoea syndrome - patients' perceptions of their sleep and its effects on their life situation Aim. This paper reports a descriptive study of how untreated patients with obstructive sleep apnoea syndrome perceived their sleep situation and how the syndrome affected their life situation. Background. Obstructive sleep apnoea syndrome is a prevalent problem independently associated with an increased risk for hypertension, cardiovascular disease, chronic heart failure and mortality. Increased consumption of healthcare resources can often be seen among patients over a long period of time since many have been undiagnosed and untreated. Methods. A phenomenographic approach was employed. Data were collected by interviews during 2005 with 20 purposively selected participants with untreated obstructive sleep apnoea syndrome. Findings. Participants described loud snoring, frequent awakenings, dyspnoea, frustration over nocturia, fear of dying during sleep and partners' anxiety about the apnoea, as being night-time effects of obstructive sleep apnoea syndrome. They described dry and sore throats, tiredness and daytime sleepiness, shame about falling asleep and snoring, thoughts about complications and depressed mood as daytime effects. Needs, such as increased alertness, improved ability to concentrate, improved relationship, adequate information as well as effective treatment, were described. Participants tried self-care strategies such as information-seeking about sleep disturbances and treatment, adapted sleeping routines, change of bedroom arrangements, adapted daily schedules, hyperactivity and avoidance of difficult situations. Conclusion. The perceived effects and needs, as well as tried self-care actions by the patients with obstructive sleep apnoea syndrome in this study, could be used to identify and evaluate concerns of other patients with obstructive sleep apnoea syndrome waiting for treatment. © 2007 The Authors.

  • 12.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Patients with congestive heart failure and their conceptions of their sleep situation2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 4, p. 520-529Article in journal (Refereed)
    Abstract [en]

    Aim. To describe, from a nursing perspective, how patients with CHF conceived their sleep situation.

    Background.  Sleep disturbances are very common in patients with congestive heart failure (CHF). Polysomnographic studies have shown that the total duration of sleep is shorter and the sleep structure disturbed, with frequent arousals and sleep stage changes.

    Methods.  A qualitative descriptive design inspired by a phenomenographic approach was employed. Conceptions were collected through interviews with 20 strategically chosen CHF patients.

    Findings.  The findings showed that the patients’ sleep was affected by their daily activities, the disease itself and cardiac symptoms. The sleep disturbances gave effects such as fatigue, listlessness, loss of concentration and loss of temper. These effects led to a need for daytime sleep, seclusion, counselling and information. Patients handled their sleep disturbances through coping mechanisms related to developed patterns of daily life and through support from their psychosocial environment.

    Conclusions. Through an increased awareness of the causes of sleep disturbances in CHF patients, nurses can more effectively meet their caring needs and reduce the psychological stressors that patients develop. Information and education, both to patients and the next of kin, about the disease and the sleep situation, especially good sleeping habits, can help patients to better cope with sleep disturbances.

  • 13.
    Eckerblad, Jeanette
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Nursing Science.
    Theander, Kersti
    Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, Karlstad, Sweden.
    Ekdahl, Anne
    Geriatric Medicine, Department of Research and Education, Helsingborg Hospital, Sweden; Division of Clinical Geriatrics, Departmentof Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm,Sweden .
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Symptom trajectory and symptom burden in older people with multimorbidity, secondary outcome from the RCT AGe-FIT study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2773-2783Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of this study was to follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment.

    Background

    Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health-related quality of life. There is a need to move from a single-disease model and address the complexity of older people living with multimorbidity.

    Design

    Secondary outcome data from the randomized controlled Ambulatory Geriatric Assessment Frailty Intervention Trial (AGe-FIT).

    Methods

    Symptom trajectory of 31 symptoms was assessed with the Memorial Symptom Assessment Scale. Data from 247 participants were assessments at baseline, 12 and 24 months, 2011–2013. Participants in the intervention group received care from an ambulatory geriatric care unit based on comprehensive geriatric assessment in addition to usual care.

    Results

    Symptom prevalence and symptom burden were high and stayed high over time. Pain was the symptom with the highest prevalence and burden. Over the 2-year period 68–81% of the participants reported pain. Other highly prevalent and persistent symptoms were dry mouth, lack of energy and numbness/tingling in the hands/feet, affecting 38–59% of participants. No differences were found between the intervention and control group regarding prevalence, burden or trajectory of symptoms.

    Conclusions

    Older community-dwelling people with multimorbidity had a persistent high burden of symptoms. Receiving advanced interdisciplinary care at an ambulatory geriatric unit did not significantly reduce the prevalence or the burden of symptoms.

  • 14.
    Edell-Gustafsson, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Arén, Claes
    Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Hamrin, Elisabeth
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Hetta, Jerker
    Department of Psyehiatry, Uppsala University, Akademiska Hospital, Uppsala, Sweden.
    Nurses´ notes on sleep pattern in patients undergoing artery bypass surgery: a retrospective valuation of patient records1994In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 20, p. 331-336Article in journal (Refereed)
    Abstract [en]

    In this study, patient records from 80 male patients, aged 43-76, undergoing first-time coronary artery bypass surgery were evaluated with regard to nurses' documentation on sleep during the first four postoperative days. This documentation was classified into descriptions of quality and quantity of sleep. Notations on sleep were found in 69-86% of patient records each night, and was most common the second night. Descriptions of both quality and quantity of sleep occurred in only 12 out of 320 patient-nights. Notes regarding duration of sleep were found for 146 patient-nights (45.6%), of which 103 (32.2%) contained sleep disturbances. Information on quality of sleep was given for 116 patient-nights (36.3%), with only 38 patient-nights (11.9%) of sleep disturbances. For 72 patient-nights, documentation of the patients' sleep was lacking. Frequent awakening was the most common sleep disturbances noted during all but the first night, when continuous awakening dominated. We conclude that the nurses' documentation regarding sleep and sleep disturbances varied over a wide range, with a mixture of quantitative and qualitative information, and that more structured descriptions are needed.

  • 15.
    Edéll-Gustafsson, Ulla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Insufficient sleep, cognitive anxiety and health transition in men with coronary artery disease: A self-report and polysomnographic study2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 37, no 5, p. 414-422Article in journal (Refereed)
    Abstract [en]

    Aims. To explore possible links between sleep quality, cognitive anxiety and the effects of sleep disturbances on health, daytime functioning and quality of life, for assessment in a larger study. Hypotheses were: (a) patients with coronary artery disease have insufficient sleep as measured by self-reported sleep and by polysomnography, (b) self-reported sleep is associated with polysomnographically measured sleep, (c) reduced sleep quality is associated with physical and mental health, and interferes with quality of life as measured by means of interviews and polysomnography, (d) reduced sleep quality is associated with reduced resilience to stress. Background. It has become increasingly evident that poor sleep with sleep initiation difficulties is an independent risk factor for cardiac events among men, and requires more attention in clinical nursing practice. Design. Descriptive, correlative and explorative study. Sample. Forty-four men, aged 45-70, about to undergo coronary artery bypass surgery at a Swedish University Hospital. Research methods. Interviews and 24-hour continuous ambulatory polysomnography were performed. For the interviews, the Uppsala Sleep Inventory, Spielberger State Anxiety Scale and the Nottingham Health Profile instruments were used. Results. Seventeen patients (38╖6%) had insufficient sleep and 12 had sleep initiation difficulties. Logistic regressions revealed that reduced stage 3-4 sleep predicted poorer overall health, initiation of sleep difficulties, predicted insufficient sleep and involuntary thoughts predicted fragmented sleep. Poorer quality of life was predicted by reduced deep sleep. Independent predictors for emotional distress were sleep efficiency below 85%, fragmented sleep and a daytime nap longer than 15 minutes. Conclusions. Objective sleep was associated with several subjective sleep variables. The results provide empirical support for significant variables included in a theoretical framework relating to sleep quality, cognitive anxiety, health and quality of life. A larger study is recommended that includes both men and women.

  • 16.
    Edéll-Gustafsson, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Hetta, J
    Arén, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Sleep and qulity of life assessment in patients undergoing coronary artery bypass grafting.1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 29, p. 1213-1220Article in journal (Refereed)
  • 17.
    Edéll-Gustafsson, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Hetta, Jerker
    Göteborg.
    Fragmented sleep and tiredness in males and females one year after percutaneous transluminal coronary angioplasty (PTCA)2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 2, p. 203-211Article in journal (Refereed)
    Abstract [en]

    Aim. Reported sleep quality was examined in relation to anxiety, depression, selected psycho-physiological sleep disturbing symptoms, daytime dysfunctions according to poor sleep, and quality of life 1 year after percutaneous transluminal coronary angioplasty (PTCA). Furthermore, females were compared with age-matched males to examine any differences in sleep quality, psycho-physiological symptoms and quality of life. Study design. A descriptive comparative study. Sample. Twenty-two females, mean age 62.7 (SD 5.7) and 70 men, mean age 60.4 (SD 6.7), were consecutively recruited. Method. A mailed questionnaire was distributed, including the Uppsala Sleep Inventory, Spielberger State Anxiety scale, Zung's Self-rating Depression Scale and the Nottingham Health Profile instrument. Results. Forty-six per cent of the patients had a history of myocardial infarction and 40.2% hypertension. Seventy-two per cent of the patients were anxious and 30.4% depressed. Difficulty in getting to sleep was related to intrusive thoughts with increased feelings of anxiety and sensitivity. Difficulty in maintaining sleep was the most common sleep complaint (42.4%) and physical tiredness/fatigue was the greatest consequence of disturbed sleep (51.1%). Those with pain, palpitations or respiratory nocturnal sleep-disturbing symptoms were characterised by shorter sleep duration, emotional distress, cognitive dysfunction, tiredness and reduced quality of life. Greater difficulties initiating sleep and worse health related quality of life were revealed in females compared with aged-matched males. Conclusion. fragmented sleep is a problem partly because of psycho-physiological symptoms 1 year after PTCA, with reduced resilience to stress, increasing vulnerability or diminished coping ability and poorer quality of life.

  • 18.
    Edéll-Gustafsson, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hetta, Jerker
    Sleep Disorders Unit, University Hospital, Uppsala.
    Arén, Claes
    Östergötlands Läns Landsting, Heart Centre, Department of Cardiology Thoracic Radiology.
    Sleep and quality of life assessment in patients undergoing coronary artery bypass grafting1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 29, no 5, p. 1213-1220Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine sleep before and after coronary artery bypass grafting (CABG) as well as measuring of quality of life (QoL), and to see if changes in subjectively rated sleep can be shown objectively by polysomnographic recordings. Sample: A consecutive sample of 38 male patients, aged 45-68, underwent CABG, Twenty-two patients were graded in New York Heart Association (NYHA) classes III or IV, and 16 in class I-II before surgery.

    METHODS: 24-hour polysomnographic recordings, using the Oxford Medilog 9000 recorder, were performed 2 days prior to surgery, on the first 2 post-operative days and 1 month after surgery. The Nottingham Health Profile instrument (NHP) was used to measure QoL before and after surgery.

    RESULTS: Following surgery there was a profound decrease in sleep at night, and an increase in daytime sleep. During the second post-operative recording period nocturnal sleep duration was reduced to 253.6 +/- 94.1 minutes, with suppressed stages 3 and 4 sleep and lack, or slight recovery, of REM sleep. Even though there were evident changes in both the distribution and nature of sleep at night, daytime sleep increased and the total duration of sleep during the 24-hour period was not significantly changed. The total sleep time was 421.1 +/- 76.8 minutes before surgery, 483.2 +/- 201.2 in the first period, 433.2 +/-201.4 minutes in the second 24-hour period post-operatively and 443.2 +/- 44.0 minutes at the 1-month follow-up. The NHP instrument demonstrated that 6 months after surgery the quality of life was significantly improved. Polysomnographically measured slow wave sleep was compared with the sleep section in the NHP instrument both before surgery and at 1 month post-operatively.

    CONCLUSIONS: In the immediate period following CABG, there is a change in distribution of sleep, with reduction in nocturnal sleep duration and an increase in daytime sleep, which had almost returned to pre-operative values 1 month after surgery. QoL scores were improved 6 months after surgery. This study demonstrates the importance of careful assessment of sleep and sleep disturbances for more individualized nursing care in order to promote sleep in the immediate post-operative period.

  • 19.
    Efraimsson, E.
    et al.
    School of Health Sciences, University College of Boras, Boras, Sweden, School of Health Sciences, University College of Boras, Allegatan 1, Boras, S-501 90, Sweden.
    Sandman, P.-O.
    Department of Nursing, Umea University, Umea, Sweden.
    Hydén, Lars-Christer
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medicine and Health Sciences, Health and Society.
    Holritz, Rasmussen B.
    Holritz Rasmussen, B., Department of Nursing, Umea University, Umea, Sweden.
    How to get one's voice heard: The problems of the discharge planning conference2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 53, no 6, p. 646-655Article in journal (Refereed)
    Abstract [en]

    Aims. This paper reports a study describing how patients, relatives and healthcare professionals dealt with the variety of problems and responsibilities that occur in discharge planning conferences and especially how they managed to do this given the institutional frame that surrounded the meeting. Background. In Sweden, the aim of a discharge planning conference is to co-ordinate social and healthcare resources as patients are discharged from hospitals. Patients, relatives and hospital staff, along with healthcare professionals responsible for outpatient care, assemble to achieve an individual care plan. One of the explicit principles informing the discharge planning conference is to increase patients' influence on decision-making. However, research points at shortcomings in this respect. Method. A discourse analysis was conducted using transcriptions of eight video-recorded discharge planning conferences. The selected patients were eight older women expected to be discharged from hospital. Other participants were staff nurses, social workers and occasionally relatives, an occupational therapist, district nurse or home care aide. Findings. Participants adopted different roles as persons/patients, relative/next of kin and healthcare professionals/institutional representatives during the discharge planning conference, which they simultaneously struggled to act upon. The findings are presented under the categories 'ss14Clashing roles and perspectives' and 'ss18Facing the institutional frame'. Conclusions. The performance of the discharge planning conference in its present form interferes with a caring perspective that protects patients' integrity and gives prominence to their life worlds. Moreover, it does not satisfy patients' and relatives' right to expect proceedings that enhance their possibility to express their personal wishes in a dignified manner. © 2006 Blackwell Publishing Ltd.

  • 20.
    Ekman, I.
    et al.
    The Sahlgrenska Academy at Göteborg University, Sweden.
    Schaufelberger, M.
    The Sahlgrenska Academy at Göteborg University, Sweden.
    Kjellgren, Karin
    The Sahlgrenska Academy at Göteborg University, Sweden.
    Swedberg, K.
    The Sahlgrenska Academy at Göteborg University, Sweden.
    Granger, B. B.
    Duke School of Nursing, Durham, North Carolina, USA.
    Standard medication information is not enough: poor concordance of patient and nurse perceptions2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 2, p. 181-186Article in journal (Refereed)
    Abstract [en]

    AIM:

    This paper is a report of a study to describe patient and nurse perceptions of patient satisfaction with information about the medicines at two heart failure clinics after medication up-titration and information-giving.

    BACKGROUND:

    Chronic heart failure is a major cause of hospitalization. Poor adherence to medications increases mortality and heart failure-related hospitalizations. To achieve mutual goal-setting (concordance) regarding medication-taking behaviours, health providers need to understand patient information needs regarding the prescribed medicines.

    METHODS:

    A convenience sample of 56 patients with chronic heart failure referred for an up-titration of medicines and information-giving about the condition and treatment completed the Satisfaction about Information about Medicines Scale at their first and last visits. Nurses completed the same questionnaire after each patient's final visit, assessing the patient's need for further information. The data were collected between 2002 and 2004.

    RESULTS:

    Patient scores indicated statistically significantly more satisfaction with their information at the final visit compared with the first visit (P = 0.005). However, at the programme conclusion, nurses (n = 7) rated patients to be appropriately informed while patients reported a persistent need for further information (P = 0.011).

    CONCLUSION:

    Further research should evaluate more advanced pedagogical strategies such as how to address patients' expectations about the effect of medicines when actual effects of the treatment are related to mortality and morbidity at the population level and may not result directly in symptom relief at an individual level.

  • 21.
    Engstrom, BL
    et al.
    Kristianstad Univ, Dept Hlth Sci, S-29188 Kristianstad, Sweden Halmstad Univ, Sch Social & Hlth Sci, Halmstad, Sweden Linkoping Univ, Dept Med & Care, Linkoping, Sweden.
    Fridlund, B
    Kristianstad Univ, Dept Hlth Sci, S-29188 Kristianstad, Sweden Halmstad Univ, Sch Social & Hlth Sci, Halmstad, Sweden Linkoping Univ, Dept Med & Care, Linkoping, Sweden.
    Women's views of counselling received in connection with breast-feeding after reduction mammoplasty2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 32, no 5, p. 1143-1151Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to generate a theoretical model of the experiences of women, who had undergone reduction mammoplasty, of counselling received in connection with breast-feeding. Data were collected through interviews with 12 breast-reduced women who had given birth to a child, and the material was analysed by means of the grounded theory method. Written permission to post notices at the child welfare centres had been obtained from the primary care managers. The women themselves applied for participation in the study. The results showed that their need for counselling from somebody who listened attentively to them and gave advice in connection with breast-feeding, was considerable. The women could have a feeling of self-reliance, ambivalence, acceptance or guilt, depending on the extent to which they perceived to have received counselling from their family members. At the same time, their experiences of the encounter with the nursing staff were of crucial importance. Lack of active listening and counselling from the nursing staff can be counterbalanced by support from relatives. However, when such support is not forthcoming, the nursing staff must be able to support the women in their role of a mother, which requires that education and supervision are given to the staff. The findings of the study can be used as a basis for further research into the need for support of the families concerned.

  • 22.
    Eriksson, Kerstin
    et al.
    Jonköping University, Sweden; Ryhov County Hospital, Sweden.
    Wikstrom, 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; Kalmar County Hospital, Sweden.
    Broström, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonköping University, Sweden.
    Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery-A quantitative study with repeated measures2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2664-2675Article in journal (Refereed)
    Abstract [en]

    Aim: To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery. Background: Previous research has indicated that average self-rated pain reflects patients ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients physical recovery for the next day. Design: Descriptive, quantitative repeated measures. Methods: General and orthopaedic inpatients (n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool "Postoperative Recovery Profile" were used. Because few suffered severe pain, general and orthopaedic patients were analysed together. Results: Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings (NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings (NRS 4-6), day 2, as it significantly predicted more items in recovery. Conclusion: Pain intensity reflected general and orthopaedic patients physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients pain and impact on recovery, patients need for support becomes visible which is valuable during hospital stays.

  • 23.
    Fejes, Andreas
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Arts and Sciences.
    Governing Nursing Through Reflection: A Discourse Analysis of Reflective Practices2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 64, no 3, p. 243-250Article in journal (Refereed)
    Abstract [en]

    Aim: This paper is a report of a study analysing reflection as discourse and a technology of confession which produces a certain desirable subjectivity within nursing practice.

    Background: Reflection and reflective practice are common themes in nursing practices and in the literature on nursing. These practices are often construed as positive and empowering, and more critical analyses of them are needed.

    Method: A Foucauldian-inspired discourse analysis based on the concepts of governmentality and technologies of the self was conducted. Interview transcripts from 42 managers, supervisors, teachers and participants in an in-service programme to prepare health care assistants to become Licensed Practice Nurses in the elder care sector were analysed.

    Findings: Reflection as confession operates as a governing technology within the nursing practice analysed. Programme participants are encouraged to reflect and scrutinize themselves about their work as a way to improve their competencies and practice. Through appraisals, they are invited to reflect about themselves as way to achieve their desires. In this way, active, responsible, problem-solving, self-governing practitioners are constructed.

    Conclusion: Through a Foucauldian reading of reflective practices it is possible to illustrate that reflection is not a neutral or apolitical practice. Instead, it is a governing practice that does something, in discursive terms, to nursing subjectivity - something that can create a space for reflection about what reflection discursively does to subjectivity.

  • 24.
    Fex, Angelika
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Flensner, Gullvi
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Söderhamn, Olle
    Department of Nursing, Health and Culture, University West, Sweden/Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Norway.
    Self-Care Agency and Perceived Health Among Persons Using Advanced Medical Technology at Home2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 4, p. 806-815Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study of self-care agency and perceived health in a group ofpersons using advanced medical technology at home.

    Background. An increasing number of persons are using medical technology for self-care. Few studies describe daily life in this context at an overriding level, irrespective of the specific sort of technology. A connection between self-care, perceived health and sense of coherence has previous been implied.

    Methods. A descriptive, comparative, cross-sectional quantitative design was used. Data were collected from a questionnaire in the winter 2009/2010. The questionnaire addressed perceiveed health and daily life with medical technology, and applied Swedish versions of the Appraisal of Self-care Agency scale and the 13-item version of Antonovsky’s sense of coherence scale.

    Results. The questionnaire was answered by 180 adults performing self-care at home involving long-term oxygen, a ventilator, peritoneal or blood dialysis. Health-related and technology-related variables in daily life were rated as satisfactory to a high extent. Perceived health was rated significantly lower among participants using long-term oxygen. Sufficient sense of coherence and knowledge of how to use technology, close contacts with other persons, and not feeling helpless contributed positively as factors for self-care agency. Positive factors for perceived health were being satisfied with life, having an active life, and not feeling helpless, while age was a negative factor.

    Conclusion. Daily life is manageable for persons using these types of technology. Long-term oxygen treatment and advanced age can be seen as risk factors for perceiving ill health.

  • 25.
    Flensner, Gullvi
    et al.
    Department of Nursing, University of Trollhättan/Uddevalla, Vänersborg, Sweden.
    Lindencrona, Catharina
    The National Board of Health and Welfare, Stockholm, Sweden.
    The cooling-suit: case studies of its influence on fatigue among eight individuals with multiple sclerosis2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 37, no 6, p. 541-550Article in journal (Refereed)
    Abstract [en]

    Aim of the study. To study if the use of a cooling-suit by individuals with multiple sclerosis (MS) influenced their experience of fatigue and consequent restrictions in daily life.

    Background.  The majority of MS patients consider fatigue as one of their most disabling symptoms and as having a significant impact on their daily lives. Fatigue often increases in a warm environment. A cooling-suit has been reported as a practical method of cooling, but the effect on fatigue has not yet been studied.

    Research methods.  Eight individuals used a cooling-suit in their own homes during a test-period. In a single case–control design, their experience of fatigue was studied before and after. Quantitative and qualitative methods were used: self-assessments using the Fatigue Impact Scale (FIS), open-ended interviews and semi-structured diaries.

    Results.  All study participants reported a reduction in fatigue during the test period. On the FIS, they scored reductions in the physical, cognitive and psycho-social dimensions of daily life. They experienced fatigue less often and for shorter periods. In their diaries and interviews they described decreased muscular strain, less sense of fatigue in relation to intake of food and positive effects on cognitive, social or affective problems related to fatigue.

    Discussion.  The cooling-suit is a practical method for cooling. It gives freedom and flexibility and can be used regardless of setting. Nurses who meet heat-sensitive individuals with MS have the opportunity to give information on cooling methods, including how to use a cooling-suit. In this pilot study we found that individuals with MS who suffered from fatigue reported a number of improvements in quality of daily life.

    Conclusions.  The result indicates that use of a cooling-suit by individuals with MS may decrease their sense of fatigue. In this sample positive outcomes on daily life situations were reported. Further studies are needed to support these results.

  • 26.
    Fluur, Christina
    et al.
    Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Bolse, Kärstin
    Halmstad University, Sweden.
    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.
    Thylén, Ingela
    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.
    Spouses' reflections om implantable cardioverter defibrillator treatment with focus on the future and the end-of-life: a qualitative content analysis2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 8, p. 1758-1769Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore future reflections of spouses living with an implantable cardioverter defibrillator recipient with focus on the end-of-life phase in an anticipated palliative phase.

    Background

    A history of or risk for life-threatening arrhythmias may require an implantable cardioverter defibrillator. Despite the life-saving capacity of the device, eventually life will come to an end. As discussion about preferences of shock therapy at end-of-life phase seldom takes place in advance, the implantable cardioverter defibrillator recipients may face defibrillating shocks in the final weeks of their lives, adding to stress and anxiety in patients and their families.

    Design

    Qualitative study with in-depth interviews analysed with a content analysis.

    Methods

    Interviews were performed with 18 spouses of medically stable implantable cardioverter defibrillator recipients during 2011–2012.

    Results

    The spouses described how they dealt with changes in life and an uncertain future following the implantable cardioverter defibrillator implantation. Six subcategories conceptualized the spouses’ concerns: Aspiring for involvement; Managing an altered relationship; Being attentive to warning signs; Worries for deterioration in the partner's health; Waiting for the defibrillating shock; and Death is veiled in silence.

    Conclusion

    Despite the partner's serious state of health; terminal illness or death and the role of the device was seldom discussed with healthcare professionals or the implantable cardioverter defibrillator recipient. Open and honest communication was requested as important to support coping with an unpredictable life situation and to reduce worries and uncertainty about the future and end-of-life.

  • 27.
    Hamrin, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    30th anniversary commentary on Hamrin E. (1982) attitudes of nursing staff in general medical wards towards activation of stroke patients. Journal of Advanced Nursing 7, 33-422006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 53, no 1, p. 43-44p. 43-44Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 28.
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology.
    Tribute to Professor James P. Smith, OBE Formerly Editor-in-Chief, Journal of Advanced Nursing Newly appointed Founding Editor, Journal of Advanced Nursing2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 31, no 1, p. 3-6Article in journal (Other academic)
  • 29.
    Hjelm, Katarina G
    et al.
    Department of Community Medicine, University of Lund, Sweden.
    Bard, Karin
    Department of Health Science and Social Work, University of Växjö, Sweden.
    Nyberg, Per
    Department of Neuroscience, University of Lund, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, University of Lund, Malmö , Sweden.
    Beliefs about health and diabetes in men of different ethnic origin2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 50, no 1, p. 47-59Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reports the findings of a study exploring the health and illness beliefs of men with diabetes, who were from different cultural backgrounds and living in Sweden.

    BACKGROUND: No studies have been reported that have focused on the beliefs about health and illness in men with diabetes mellitus of different ethnic origin. Beliefs may affect self-care and care-seeking behaviour.

    METHOD: An explorative study design and purposive sampling procedure was used. Focus-group interviews were held with 35 men with diabetes and aged between 39 and 78 years. Fourteen participants were born in Arabic countries, 10 in former Yugoslavia and 11 in Sweden.

    FINDINGS: Important factors for health were the ability to be occupied/employed and economically independent and, especially among Arabs and former Yugoslavians, sexual functioning. Swedes focused on heredity, lifestyle and management of diabetes, while non-Swedes claimed the influence of supernatural factors and emotional stress related to the role of being an immigrant and migratory experiences as factors related to development of diabetes and having a negative influence on health. Swedes and Arabs described health as "freedom from disease" in contrast to many former Yugoslavians who described health as "wealth and the most important thing in life". Knowledge about diabetes was limited among the men studied, but Arabs showed an active information-seeking behaviour compared with Swedes and former Yugoslavians. Non-Swedish respondents, particularly Arabs, had sought help from health care professionals to a greater extent than Swedes, who were more likely to use self-care measures.

    CONCLUSION: Being occupied/employed and having knowledge about the body and management of diabetes are important for positive health development. There are dissimilarities in beliefs about health and diabetes that influence self-care behaviour and health care seeking. Men's cultural backgrounds and spiritual beliefs need to be considered in diabetes care.

  • 30.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hjelm, Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 3, p. 279-288Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration.

    METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis.

    FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

    CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.

  • 31.
    Idvall, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Gunningberg, Lena
    Uppsala universitet.
    Evidence for elective replacement of peripheral intravenous catheter to prevent thrombophlebitis: A systematic review2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 55, no 6, p. 715-722Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports a review of the scientific evidence for elective replacement of peripheral intravenous catheters in adults in the absence of any clinical complications, with the aim being to reduce the incidence and severity of thrombophlebitis. Background. The incidence of thrombophlebitis associated with peripheral intravenous catheters has been reported to range from 5.3% to 77.5%. Many factors that increase the risk for thrombophlebitis have been reported, of which time in situ is one. In Sweden, the recommended guideline is elective replacement of peripheral intravenous catheters every 12-24 hours. Method. A systematic literature review was carried out in 2005 using the Cochrane Library, OvidMedline and CINAHL databases and hand searching of reference lists and with keywords catheterization, peripheral, thrombophlebitis and parenteral nutrition. The review included randomized controlled trials of elective replacement of peripheral intravenous catheters in adults. Three reviewers assessed the data found according to predetermined criteria. Finding. Three randomized control trials met the inclusion criteria and were retrieved for critical appraisal. The samples in two of the trials included patients requiring total parenteral nutrition. Patients in the third trial were receiving crystalloid and drugs. Time intervals for elective replacement varied. Study quality and relevance were rated as 'medium' in two of the trials and as 'low' in the third trial. Conclusion. Limited scientific evidence suggests that elective replacement of peripheral intravenous catheters reduces the incidence and severity of thrombophlebitis. © 2006 The Authors.

  • 32.
    Ingadottir, Brynja
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. University of Iceland, Reykjavik, Iceland.
    Blondal, Katrin
    University of Iceland, Reykjavik, Iceland.
    Jaarsma, Tiny
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Nursing Science.
    Thylen, Ingela
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Perceptions about traditional and novel methods to learn about post-operative pain management: - a qualitative study.2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2672-2683Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the perceptions of surgical patients about traditional and novel methods to learn about post-operative pain management.Background: Patient education is an important part of post-operative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice.Design: A qualitative design with a vignette and semi-structured interviews used for data collection.Methods: A purposeful sample of 13 post-surgical patients, who had been discharged from hospital, was recruited during 2013 - 2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about post-operative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach.Findings: Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualised the factors affecting patients' perceptions: 1) 'Trusting the source', sub-categorised into 'Being familiar with the method' and 'Having own prejudgments'; and 2) 'Being motivated to learn' sub-categorised into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'.Conclusion: In order to implement successfully novel educational methods into post-operative care, healthcare professionals need to be aware of the factors influencing patients' perceptions abouthow to learn, such as trust and motivation.

  • 33.
    Jaarsma, Tiny
    et al.
    University of Limburg, Maastricht.
    Dassen, T
    University of Groningen, The Netherlands.
    The relationship of nursing theory and research: the state of the art1993In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 18, no 5, p. 783-787Article in journal (Refereed)
    Abstract [en]

    Recently, the relationship between theory and research has received more attention. It seems that in the past 10 to 15 years more research studies have been published that are more or less conceptualized within (nursing) theories. However, it is not always clear how the theory has been used. The purpose of this study was to analyse the role of theory in nursing practice research. To this end, papers published in six nursing journals between 1986 and 1990 have been studied. It can be concluded that, in comparison with earlier analyses, the use of theories in nursing research studies has increased (from 13% to 21%), but the use of nursing theories has not become more frequent. However, the testing of nursing theories is minimal. On the other hand, research results are being cumulated progressively in regard to theory or to other research.

  • 34.
    Jaarsma, Tiny
    et al.
    University of Limburg, Maastricht.
    Kastermans, M
    University of Groningen.
    Dassen, T
    University of Groningen.
    Philipsen, H
    University of Limburg, The Netherlands.
    Problems of cardiac patients in early recovery1995In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 21, no 1, p. 21-27Article in journal (Refereed)
    Abstract [en]

    Most studies of the problems and information needs of patients describe these only for the period of hospitalization. In this study, however, the authors focused on the first 6 months after discharge. Eighty-two cardiac patients, admitted to a university hospital with a myocardial infarction (MI) or for coronary artery bypass surgery (CABS), were interviewed 6 months after discharge. Questions required them to describe problems they experienced in early recovery and what information they needed. All but one of the 82 patients stated they had experienced problems during the first 6 months after discharge. Most problems described concerned: emotional reactions (59%), their change in physical condition (59%), deleterious effects of treatment (56%) and convalescence (54%). Topics on which most patients needed additional or different information were: deleterious effects of the treatment (26%), physical condition (24%), risk factors (24%), convalescence (24%) and knowledge of the disease (24%).

  • 35.
    Johansson, Ingrid
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hildingh, Cathrine
    Halmstad universitet.
    Wenneberg, Stig
    Örebro universitet.
    Fridlund, Bengt
    Växjö universitet.
    Ahlström, Gerd
    Jönköping.
    Theoretical model of coping among relatives of patients in intensive care units: A simultaneous concept analysis2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 5, p. 463-471Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area. Background. When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery. Method. Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home. Findings. The theoretical model was developed in 2004-2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated. Conclusion. This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used. © 2006 The Authors.

  • 36.
    Källman, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bergstrand, Sara
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care.
    Engström, Maria
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Lindberg, Lars-Göran
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Lindgren, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Different lying positions and their effects on tissue blood flow and skin temperature in older adult patients2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 1, p. 133-144Article in journal (Refereed)
    Abstract [en]

    Aim. To report a study to compare the effects of different lying positions on tissue blood flow and skin temperature in older adult patients. This article reports the evaluation of study design and procedures. Background. To reduce risk of pressure ulcers, repositioning of immobile patients is a standard nursing practice; however, research into how different lying positions effect tissue microcirculation is limited. Design. Descriptive comparative design. Methods. From MarchOctober 2010, 20 inpatients, aged 65 years or older, were included in the study. Tissue blood flow and skin temperature were measured over bony prominences and in gluteus muscle in four supine and two lateral positions. Results. The blood flow over the bony prominence areas was most influenced in the superficial skin and especially in the 30 degrees lateral position, where the blood flow decreased significantly in comparison with the supine positions. There were significant individual differences in blood flow responses, but no common trend was identified among the patients considered at risk for pressure ulcer development. The study procedure worked well and was feasible to perform in an inpatient population. Conclusion. The lying positions seem to influence the tissue blood flow over the bony prominences in different ways in older adult inpatients, but further study is needed to confirm the results and to make recommendations to clinical practice. The study procedure worked well, although some minor adjustments with regard to heat accumulation will be made in future studies.

  • 37.
    Kärner, Anita
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Tingström, Pia
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Bergdahl, Björn
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences.
    Incentives for lifestyle changes in patients with coronary heart disease2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 51, no 3, p. 261-275Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports a study exploring how patients in the rehabilitation phase of coronary heart disease experience facilitating and constraining factors related to lifestyle changes of importance for wellbeing and prognosis.

    Background. Lifestyle change is important but complex during rehabilitation after a myocardial infarction or angina pectoris. The intentions to perform behaviours and to experience control over facilitators and constraints are important determinants of behaviour.

    Methods. A total of 113 consecutive patients below 70 years of age (84 men and 29 women) were interviewed within 6 weeks of a cardiac event and again after 1 year. Interview transcriptions and notes taken by hand were qualitatively analysed using the phenomenographic framework. The distribution of statements among the categories identified was quantitatively analysed. The data were collected in 1998–2000.

    Findings. Four main categories portrayed patients' experiences of facilitating or constraining incentives for lifestyle changes. 'Somatic incentives' featured bodily signals indicating improvements/illness. 'Social/practical incentives' involved shared concerns, changed conditions including support/demand from social network, and work/social security issues. Practical incentives concerned external environmental factors in the patients' concrete context. 'Cognitive incentives' were characterized by active decisions and appropriated knowledge, passive compliance with limited insights, and routines/habits. 'Affective incentives' comprised fear of and reluctance in the face of lifestyle changes/disease, lessened self-esteem, and inability to resist temptations. Cognitive incentives mostly facilitated physical exercise and drug treatment. Social/practical incentives facilitated physical exercise and diet change. Physical exercise and diet changes were mainly constrained by somatic, social, and affective incentives.

    Conclusion. The results illustrate important incentives that should be considered in contacts with patients and their families to improve the prospects of positively affecting co-operation with suggested treatment and lifestyle changes.

  • 38.
    Leksell, J.K.
    et al.
    Högskolan Dalarna, Health and Caring Sciences, Falun, Sweden, Högskolan Dalarna, Health and Caring Sciences, S-791 88 Falun, Sweden.
    Johansson, I.
    Örebro University Hospital, Örebro, Sweden.
    Wibell, L.B.
    Uppsala University Hospital, Uppsala, Sweden.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Power and self-perceived health in blind diabetic and nondiabetic individuals2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 4, p. 511-519Article in journal (Refereed)
    Abstract [en]

    Aims. The aims of this study were: (1) to explore perceptions of power in blind individuals and relate presence or absence of power to self-perceived health and (2) to compare self-perceived health in blind individuals with that of the general population. Background. The theoretical framework of this study was Barrett's Power theory, which is based on The Rogerian nursing theory. Power is defined as being aware of what one is choosing to do, feeling free to doing it, and do it intentionally. Methods. Thirty-nine blind subjects at three adjacent ophthalmology centres agreed to participate in the study. Of those 23 had become blind because of late complications of diabetes. Power was explored during semi-structured interviews and self-perceived health was measured with the Swedish health-related quality of life questionnaire. Data on socio-economic, rehabilitative and diabetes-related variables were also collected. Findings. Power was experienced by 19 of the 39 respondents and was more frequently found in nondiabetic subjects than in diabetic subjects. Those experiencing power reported a better emotional and general health compared with individuals lacking power. The perception of having power was not significantly related to any other of the studied variables. When compared with age- and gender-matched controls from the general population, nondiabetic blind subjects scored higher in positive feelings and lower in physical functioning. In contrast diabetic subjects experienced poorer general health, less satisfaction with physical health and more negative feelings, but they reported that they did not experience limitation as a result of these emotions. Conclusion. One way of improving health in diabetic blind individuals could be to increase the subject's perception of power.

  • 39.
    Lindgren, Margareta
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Krantz, Ann-Margret
    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.
    A risk assessment scale for the prediction of pressure sore development: reliability and validity2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 38, no 2, p. 190-199Article in journal (Refereed)
    Abstract [en]

    Background. The ability to assess the risk of a patient developing pressure sores is a major issue in pressure sore prevention. Risk assessment scales should be valid, reliable and easy to use in clinical practice.

    Aim.  To develop further a risk assessment scale, for predicting pressure sore development and, in addition, to present the validity and reliability of this scale.

    Methods. The risk assessment pressure sore (RAPS) scale, includes 12 variables, five from the re-modified Norton scale, three from the Braden scale and three from other research results. Five hundred and thirty patients without pressure sores on admission were included in the study and assessed over a maximum period of 12 weeks. Internal consistency was examined by item analysis and equivalence by interrater reliability. To estimate equivalence, 10 pairs of nurses assessed a total of 116 patients. The underlying dimensions of the scale were examined by factor analysis. The predictive validity was examined by determination of sensitivity, specificity and predictive value.

    Results.  Two variables were excluded as a result of low item–item and item–total correlations. The average percentage of agreement and the intraclass correlation between raters were 70% and 0·83, respectively. The factor analysis gave three factors, with a total variance explained of 65·1%. Sensitivity, specificity and predictive value were high among patients at medical and infection wards.

    Conclusions.  The RAPS scale is a reliable scale for predicting pressure sore development. The validity is especially good for patients undergoing treatment in medical wards and wards for infectious diseases. This indicates that the RAPS scale may be useful in clinical practice for these groups of patients. For patients undergoing surgical treatment, further analysis will be performed.

  • 40.
    Lindgren, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Krantz, Ann-Margret
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    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.
    Pressure ulcer risk factors in patients undergoing surgery2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 50, no 6, p. 605-612Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports a study to identify risk factors associated with pressure ulcer development among a mixed group of adult patients undergoing surgery. Background. Few studies have been carried out with patients undergoing surgery to assess the risk of pressure ulcer development, and so there is a little knowledge of the risk factors for this group. However, studies among non-surgical patients have shown that nutritional predictors such as low serum albumin level and low body mass index (BMI) are of great importance. An additional predictive factor may be low blood pressure. It is important to study these predictors further among patients undergoing surgery, using techniques such as multiple regression techniques, designed to identify the most important predictors for pressure ulcer development. Methods. A prospective comparative study was carried out in 1996-1998 with 286 adult patients undergoing surgical treatment. The data were collected from patient records by Registered Nurses preoperatively, for seven days postoperatively and thereafter once a week for up to 12 weeks. Perioperative data were also collected. The Risk Assessment Pressure Sore Scale was used, and data were collected on general physical condition, activity, mobility, moisture, food intake, fluid intake, sensory perception, friction and shear, body temperature and serum albumin. Results. Forty-one (14.3%) patients developed pressure ulcers during the observation period. The most common type was non-blanchable erythema. Those who developed pressure ulcers were significantly older, weighed less, and had a lower BMI and serum albumin. More women than men developed pressure ulcers. Risk factors identified in multiple stepwise regression analyses were female gender, American Society of Anaesthesiologists (ASA) status or New York Heart Association (NYHA) status and food-intake. Conclusion. Special attention, with regard to risk of pressure ulcer development, should be paid to patients undergoing surgery who have low ASA or NYHA scores, low food intake and/or are women. © 2005 Blackwell Publishing Ltd.

  • 41.
    Lundh, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sandberg, Jonas
    Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Linköping University, Faculty of Health Sciences.
    Nolan, Mike
    Gerontological Nursing, School of Nursing and Midwifery, University of Sheffeld, Sheffeld, England.
    'I don't have any other choice': spouses' experiences of placing a partner in a care home for older people in Sweden2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 32, no 5, p. 1178-1186Article in journal (Refereed)
    Abstract [en]

    The main aim of this paper is to consider the experiences of Swedish spouses who have placed a partner in a care home for older people. Data were gathered from semi-structural interviews with 14 spouses (11 wives and 3 husbands) who had been involved in a care home placement within the previous 6 months. The results reported here are from the first component of a larger grounded theory study, the aim of which is to explore, describe and understand the experience of care home placement from a variety of perspectives and to identify the implications for policy and practice in Sweden. The focus here is on the experience of spouses, relating to the decision-making process, the move into care and subsequent contact with the care home. Four themes emerged from the data – making the decision, making the move, adjusting to the move and reorientation. The results show a lack of planning for the elder person’s entry to a care home, and professional dominance of this stage of the process. The largely ambivalent emotional responses to the move that spouses experience and the difficulties in initiating and sustaining relationships with staff in the home are discussed in the light of previous research.

  • 42. Luttik, Marie Louise
    et al.
    Jaarsma, Tiny
    Lesman, Ivonne
    Sanderman, Robbert
    Hagedoorn, Mariët
    Quality of life in partners of people with congestive heart failure: gender and involvement in care.2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 7, p. 1442-51Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study conducted to investigate quality of life in partners of people with congestive heart failure in comparison to individuals living with a healthy partner. BACKGROUND: Congestive heart failure is a chronic debilitating disease with severe symptoms and complex treatment. The support of partners is essential in the management of congestive heart failure. Living with a chronic illness generally affects the quality of life of patients and their partners. METHOD: Data were collected using a cross-sectional, comparative design between October 2002 and February 2005 with 303 partners of people with congestive heart failure. Reference data were collected in 304 age- and gender-matched individuals living with a healthy partner, drawn from the general population. All respondents completed questionnaires at home on quality of life and general well-being. Analysis of variance was used to analyse the data. FINDINGS: Overall, differences in quality of life between partners of people with heart failure and matched controls were small. However, substantial variation in the quality of life of partners was found by exploring the role of gender and involvement in care. Quality of life scores varied strongly for male and female partners who had to perform caregiving tasks. The performance of these caregiving tasks was negatively associated with the quality of life of female partners but not with that of male partners. CONCLUSION: Female partners especially should not be overlooked when they become involved in personal care tasks. Nurses should not be reluctant to involve male partners in caring for women with heart failure.

  • 43.
    Löfmark, A
    et al.
    Gävle.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Facilitating and obstructing factors for development of learning in clinical practice - a student perspective.2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 1, p. 43-50Article in journal (Refereed)
    Abstract [en]

    Aim of the study. The aim of this study was to provide information on what the student nurses found facilitating and obstructing for their learning during clinical practice. Background. Earlier studies of experiences of learning in clinical practice have shown that factors as the possibilities of variations of experiences, the culture of the workplace, and communication between the educational institution and health care facilities are of importance. Less is known about the opportunities which students are given in order to practise the skills that the), will be expected to perform as new graduate nurses. Methods. The experiences of 47 degree student nurses from two colleges in Sweden were gathered in weekly diaries during their final period of clinical practice. A content analysis technique was used to analyse their diaries. Results. The students emphasized responsibility and independence, opportunities to practise different tasks, and receiving feedback as facilitating factors. Other perceived promoting factors included perceptions of control of the situation and understanding of the 'total picture'. Examples of obstructing factors were the nurses as supervisors not relying on the students, supervision that lacked continuity and lack of opportunities to practise. Perception of their own insufficiency and low self-reliance were drawbacks for some students. Conclusions. Recommended proposals are presented to lecturers and supervising staff concerning organizational and educational changes, and changes of attitudes for elucidating the students' experiences of different facilitating and obstructing factors. Changes may contribute to making easier the students' transition into the nursing profession.

  • 44.
    Nordgren, S.
    et al.
    School of Social and Health Sciences, Halmstad University, Halmstad, Sweden, School of the Health Care Programme, Sodra Vardskolan, Halmstad, Sweden, Åsgårdsvagen 14 A, SE-30241 Halmstad, Sweden.
    Fridlund, B.
    Patients' perceptions of self-determination as expressed in the context of care2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 35, no 1, p. 117-125Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to describe patients' perceptions of how self-determination finds expression in the context of care. Background. Self-determination is an important concept within health care as well as an important patient right. New legislation on patient rights in Sweden and Europe is aimed at increased patient self-determination. Design and method. Data were collected through semi-structured, tape-recorded interviews with 17 strategically chosen patients within somatic care and analysed using a method inspired by phenomenography. Results. The analysis found three descriptive categories of the informants' perceptions: trusting, accepting and a feeling of powerlessness. The patients expressed a great sense of trust and confidence in the care provided and they accepted the health care procedures. At the same time, they expressed a feeling of powerlessness because of not being part of decision-making, as well as lacking knowledge and information about treatment strategies. The patients wished to have the right of more self-determination but lacked the strength and knowledge to be able to influence their own care. Conclusions. Patients' perceptions of self-determination suggest that, in their encounters with the professional care, knowledge is expressed as power. The feeling of a lack of self-determination can be reduced by help and support from a nurse who allocates time for communication in order to learn the patient's needs and reach a mutual understanding.

  • 45.
    Näsström, Lena
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Luttik, Marie Louise
    Hanze University of Applied Sciences Groningen, Research Group Nursing Diagnostics, Groningen, the Netherlands.
    Idvall, Ewa
    Department of Care Science, Malmö University, and Department of Intensive Care and Perioperative Medicine, Skåne University Hospital, Sweden.
    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.
    Exploring partners’ perspectives on participation in heart failure home-care: A mixed method design2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 5, p. 1208-1219Article in journal (Refereed)
    Abstract [en]

    Previous research has shown that partners are involved in the care of patients with heart failure. The aim of this study was to gain a better understanding of the partners ‘perspectives on participation in the care for patients with heart failure receiving structured home-care. A parallel convergent mixed method design with data from interviews analyzed with content analysis and questionnaires statistically analyzed (n=15). Results were analyzed with regard to whether they were comparable and convergent, expanded the understanding, or were inconsistent. Partners scored that they were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation; adapting to the caring needs and illness trajectory, mastering caregiving demands, interacting with health care providers, and gaining knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context.

  • 46. Nätterlund, Birgitta
    et al.
    Ahlström, Gerd
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Experience of social support in rahabilitation: a phenomenological study1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, p. 1332-1340Article in journal (Refereed)
  • 47.
    Ockander, Marlene
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum.
    Long-term sickness absence: Women's opinions about health and rehabilitation2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 50, no 5, p. 508-517Article in journal (Refereed)
    Abstract [en]

    Aims. This paper reports a study to identify associations between ideas of health and rehabilitation in groups of women having first-hand experience of long-term sickness absence. Background. As a central part of their work, nurses have to be able to understand people in distress. When someone is unable to work because of illness, nurses are one of the central professional categories involved in their rehabilitation. Methods. Data were collected by Q-sort grid and biographical interviews from 82 women aged 30-49 years who had either been absent from work because of sickness for 60 days or more, or were receiving a disability pension. The data were first analysed by patterns and structures obtained from a modified factor analysis. The second phase of the analysis dealt with relocating the results from the statistical analyses to their social context. Results. Six opinions representing different conceptions of health, illness, and rehabilitation were identified. These ranged from reflecting high levels of trust in the health care system to reliance on 'nature's course' and emphasizing the meaning of 'feeling all right'. Conclusions. For women on long-term sick leave, it is reasonable to expect that their communication with rehabilitation professionals will be founded in a mutual understanding of basic concepts. However, the disparate opinions about health and rehabilitation identified in this study show that future studies need to investigate the prospective value of this categorization to see whether and how these conceptions affect rehabilitation practices. © 2005 Blackwell Publishing Ltd.

  • 48.
    Röndahl, Gerd
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Bruhner, Elisabeth
    Uppsala University Hospital.
    Lindhe, Jenny
    Uppsala University Hospital.
    Heteronormative communication with lesbian families inantenatal care, childbirth and postnatal care2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 9Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study of lesbian parents' experience of antenatal care, childbirth and postnatal care.

    Background. In a strictly heteronormative-based care system, 'parents' naturally implies a man and a woman, and all communication and routines are based on heterosexual couples.

    Method. A qualitative interview study was carried out in 2008. Ten mothers, eight of whom were in a relationship with another woman, participated. The participants had experience from several care facilities from three different cities in central Sweden.

    Findings. Most participants had positive experiences but also complained that the focus was not always on the pregnancy and that no parenthood education had been offered. Heteronormativity was communicated by midwives and nursing staff throughout the process – from antenatal care to postnatal care, via forms, journals, verbal communication and orientation visits. This was experienced as embarrassing for the participant parents, and they also described encountering what they interpreted as embarrassment on the part of care providers. Participants called for increased knowledge about lesbian parenting, since they believed this would influence and facilitate communication, not least with midwives in antenatal care.

    Conclusion. Midwives educated in lesbian issues could ask questions and communicate in a more neutral way at the first meeting, and thereby make prospective parents feel less insecure. Special parenthood education groups for lesbians are recommended so that lesbian couple can meet others with similar experiences and so that the focus will be on prospective parenthood and not on their sexual orientation.

  • 49.
    Shorey, Shefaly
    et al.
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
    Ng, Yvonne Peng Mei
    Department of Neonatology, National University Health System, Singapore.
    Danbjørg, Dorthe Boe
    Centre for Innovative Medical Technology, Institute of Clinical Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
    Dennis, Cindy-Lee
    Department of Psychiatry, University of Toronto, Ontario, Canada.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Effectiveness of the ‘Home-but not Alone’ mobile health application educational programme on parental outcomes: a randomized controlled trial, study protocol2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 1, p. 253-264Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to describe a study protocol that evaluates the effectiveness of the ‘Home-but not Alone’ educational programme delivered via a mobile health application in improving parenting outcomes.

    Background: The development in mobile-based technology gives us the opportunity to develop an accessible educational programme that can be potentially beneficial to new parents. However, there is a scarcity of theory-based educational programmes that have incorporated technology such as a mobile health application in the early postpartum period.

    Design: A randomized controlled trial with a two-group pre-test and post-test design.

    Methods: The data will be collected from 118 couples. Eligible parents will be randomly allocated to either a control group (receiving routine care) or an intervention group (routine care plus access to the ‘Home-but not Alone’ mobile health application. Outcome measures comprise of parenting self-efficacy, social support, parenting satisfaction and postnatal depression. Data will be collected at the baseline (on the day of discharge) and at four weeks postpartum.

    Discussion: This will be an empirical study that evaluates a theory-based educational programme delivered via an innovative mobile health application on parental outcomes. Results from this study will enhance parenting self-efficacy, social support and parenting satisfaction, which may then reduce parental risks of postnatal depression.

  • 50. Shuldham, Caroline
    et al.
    Theaker, Chris
    Jaarsma, Tiny
    Cowie, Martin R
    Evaluation of the European Heart Failure Self-care Behaviour Scale in a United Kingdom population.2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 1, p. 87-95Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to test the internal consistency, reliability and validity of the 12-item European Heart Failure Self-care Behaviour Scale in an English-speaking sample in the United Kingdom. BACKGROUND: The European Heart Failure Self-care Behaviour Scale quantifies the measures patients take to manage their heart failure. Produced in the Netherlands and Sweden, it has been translated into English. METHODS: A convenience sample of 183 patients (response rate 85%) with heart failure (New York Heart Association, Class I-IV) was recruited from an outpatient clinic between July 2004 and July 2005. Mainly men (n = 143), they had a mean age of 65.6 years (sd = 12.3). They completed the Minnesota Living with Heart Failure Questionnaire, the Self-Care of Heart Failure Index, and the European Heart Failure Self-care Behaviour Scale during their clinic visit. The latter questionnaire was repeated at home within 2 weeks. RESULTS: The scale was reliable but internal consistency was only moderate (Cronbach's alpha = 0.69) and lower than in other European populations. It appears to be repeatable in the short-term. Comparison with the Self-Care of Heart Failure Index raised questions about whether the two questionnaires measured the same concept. Variance in self-care was not explained by gender, age or severity of heart failure. CONCLUSION: As self-care is an important component in the life of patients with heart failure, further exploration of the methods for measuring patients' self-care behaviours is warranted to enable healthcare staff to assess patients effectively. This would also help in understanding the applicability of tools in a range of patients, cultures and settings.

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