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  • 1.
    Andersson, Thomas
    et al.
    Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Falk, Kristin
    Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Olsén, Monika Fagevik
    Department of Surgery and Department of Physical Therapy, Sahlgrenska University Hospital; Department of Gastrosurgical Research and Education, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Effects of chewing gum against postoperative ileus after pancreaticoduodenectomy: a randomized controlled trial2015In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 8, no 37, article id 25886536Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Postoperative ileus is common after surgery. One non-pharmacological intervention that has shown promising results in reducing the duration of postoperative ileus is chewing gum after surgery. However, this has not been investigated in upper gastrointestinal surgery such as pancreatic surgery. Hence the aim of this study was to investigate the effects of chewing gum treatment on patients undergoing pancreaticoduodenectomy ad modum whipple due to pancreatic or periampullary cancer.

    METHODS: This study was conducted as a phase III trial that was terminated early. Patients diagnosed with pancreatic tumours scheduled for pancreaticoduodenectomy ad modum whipple were included. The treatment group received chewing gum postoperatively and standard care. Controls received glucose solution and standard care. Chewing gum and glucose were used four times a day during the whole hospital stay. Time to first flatus and stool was defined as the primary outcome. The secondary outcome was start with clear liquids, start with liquid diet and length of hospital stay.

    RESULTS: No statistically significant differences could be observed between the chewing gum intervention group and the control group. However, a numerical difference in mean time was observed in first flatus, first stool, start of clear fluids, and start of liquid diet and length of hospital stay in favour of the intervention group.

    CONCLUSIONS: Although this study did not find statistically significant differences favouring the use of chewing gum for postoperative ileus, a positive trend was observed of a reduction of the impact of postoperative ileus among patients after pancreatic surgery. It also contributes valuable methodological experience that is important for future studies of chewing gum interventions during recovery after pancreatic surgery.

    TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02319512 , publication date 2014-12-17.

  • 2.
    Andersson, Thomas
    et al.
    Department of Surgery, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.
    Falk, Kristin
    Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden.
    Bjerså, Kristofer
    Department of Surgery, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden.
    Forsberg, Anna
    Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden.
    Health Is Belonging: Lived Experiences during Recovery after Pancreaticoduodenectomy.2012In: ISRN Nursing, ISSN 2090-5483, E-ISSN 2090-5491, Vol. 2012, p. 602323-Article in journal (Refereed)
    Abstract [en]

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

  • 3.
    Avander, Karin
    et al.
    Sahlgrens University Hospital, Sweden.
    Heikki, Anna
    Sahlgrens University Hospital, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. University of Gothenburg, Sweden.
    Engstrom, My
    University of Gothenburg, Sweden.
    Trauma Nurses Experience of Workplace Violence and Threats: Short- and Long-Term Consequences in a Swedish Setting2016In: JOURNAL OF TRAUMA NURSING, ISSN 1078-7496, Vol. 23, no 2, p. 51-57Article in journal (Refereed)
    Abstract [en]

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

  • 4.
    Bergström, Annika
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Håkansson, Åsa
    Skanes Univ Hosp, Sweden.
    Warrén Stomberg, Margareta
    Univ Gothenburg, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Univ Gothenburg, Sweden.
    Comfort Theory in Practice-Nurse Anesthetists Comfort Measures and Interventions in a Preoperative Context2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 2, p. 162-171Article in journal (Refereed)
    Abstract [en]

    Purpose: The Comfort Theory proposes a systematic work approach to respond to patients holistic needs. The usefulness of the Comfort Theory in the perioperative setting should be investigated. The aim of this study was to describe and analyze the nurse anesthetists comfort measures in the preoperative context on the basis of the Comfort Theory Design: Qualitative observational study Methods: Semi-structured, clinical observation data collection in the preoperative context and deductive thematic analysis Findings: The nurse anesthetists comfort measures in the preoperative phase in the operating room department aim to ensure the patients needs of relief, ease and transcendence in the physical, psycho-spiritual, environmental and socio-cultural contexts Conclusions: The application of the Comfort Theory to daily work in the preoperative phase is of value for the nurse anesthetist in becoming more aware of the individual holistic needs of the patient and in this way adapting and initiating comfort measures and interventions.

  • 5.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Avdelningen för Kirurgi, Sahlgrenska Akademin, Göteborgs Universitet.
    Specialistsjuksköterska med inriktning mot kirurgisk vård2014In: Att bli specialistsjuksköterska eller barnmorska: utbildningar för framtiden / [ed] Lena Nordgren, Sofia Almerud Österberg, Lund: Studentlitteratur AB , 2014, 1, p. 107-126Chapter in book (Other academic)
    Abstract [sv]

    Behovet av specialistutbildade sjuksköterskor ökar. I den här boken presenteras tolv utbildningar som leder till en examen som specialistsjuksköterska eller barnmorska. Vidare ger boken en inblick i vad de olika yrkena innebär. Boken presenterar arbetsplatser och karriärvägar och ger också konkreta exempel på vad specialistsjuksköterskor eller barnmorskor kan komma att möta en vanlig dag på jobbet. Därutöver presenteras Högskoleverkets examensmål för respektive inriktning samt länkar till fastställda kompetensbeskrivningar.

    Boken, som är skriven av sjuksköterskor med mångårig klinisk erfarenhet från olika specialistområden, riktar sig i första hand till grundutbildade sjuksköterskor som funderar på att fortbilda sig och erbjuder en inblick i såväl utbildning som yrke.

    De utbildningar som finns beskrivna är: Ambulanssjukvård, Anestesisjukvård, Barn och ungdom, Barnmorska, Distrikt, Intensivvård, Onkologisk vård, Kirurgisk vård, Medicinsk vård, Operationssjukvård, Psykiatrisk vård samt Vård av äldre.

  • 6.
    Bjerså, Kristofer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden .
    Andersson, T.
    Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    High frequency TENS as a complement for pain relief in postoperative transition from epidural to general analgesia after pancreatic resection2014In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 20, no 1, p. 5-10Article in journal (Refereed)
    Abstract [en]

    Aim: This study investigated the effect of high frequency transcutaneous electric nerve stimulation (TENS) as a pain relieving complementary therapy at the transition from epidural (EDA) to general analgesia after pancreatic surgery by horizontal, abdominal incision. Method: Fifty-five consecutive patients undergoing pancreatic resection were enrolled in the study and randomly assigned to active or sham TENS treatment. Twenty subjects were included in the analysis. Pain, quality of recovery and additional analgesia consumption were measured during the 24hof transition from EDA to general analgesia. Results: Additional analgesic consumption and pain estimations at 24hafter EDA termination differed between the two groups, but was not statistically significant. Conclusion: This study did not find support to reject use of high frequency TENS as complement during transition from EDA to general analgesia after major abdominal surgery with horizontal incision.

  • 7.
    Bjerså, Kristofer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Biorserud, Christina
    Institute Clin Science, Sweden.
    Fagevik Olsen, Monika
    Institute Clin Science, Sweden; University of Gothenburg, Sweden.
    Therapeutic ultrasound treatment for excessive skin on the upper arms due to extensive weight loss after bariatric surgery: A single blind, randomised, controlled trial2015In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 49, no 6, p. 353-357Article in journal (Refereed)
    Abstract [en]

    Background: Excessive skin is a side-effect of massive weight loss. The only evidence-based treatment for excessive skin is plastic surgery. Non-invasive treatments, therefore, need to be evaluated. The aim of this study was to investigate effects of therapeutic ultrasound treatment on excess skin on the upper arms after bariatric surgery. Method: Fourteen patients were randomised to receive five treatments, each lasting for 30 minutes with active ultrasound treatment by CellsonicTM (Cellsonic Ltd) on one arm. The other arm served as control. The effect was evaluated objectively by measuring arm volume, circumference, and ptosis, and subjectively by a questionnaire where the patients assessed the effect of the treatment and amount and/or discomfort of the excess skin. Result: No statistical differences were observed in the objectively measured variables. Some patients reported perceived effects and a majority reported positive experiences of the treatment. No side-effects were reported. Conclusion: This study could not find any objectively measured effect of ultrasound treatment on excessive skin after bariatric surgery. However, participants experienced relief of symptoms associated with excess skin, such as pain, looseness, and decreased skin burst, which indicates that ultrasonic treatment of patients with excessive skin should be further investigated.

  • 8.
    Bjerså, Kristofer
    et al.
    Department of Surgery, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Forsberg, Anna
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Fagevik Olsén, Monika
    Institute of Neuroscience and Physiology, Sahlgrenska academy, University of Gothenburg; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Perceptions of complementary therapies among Swedish registered professions in surgical care2011In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 17, no 1, p. 44-49Article in journal (Refereed)
    Abstract [en]

    There is increasing interest in complementary and alternative medicine (CAM) among healthcare professions. However, no studies have been conducted in Sweden or in a surgical context. The aim of this study is to describe different perceptions of complementary therapies among registered healthcare professions in Swedish surgical care. Sixteen interviews were conducted with registered physicians, nurses, physiotherapists and clinical dieticians at a Swedish university hospital. Analysis was made with a phenomenographic research approach. The findings showed variations in perceptions of the definition of complementary therapies. A constructive approach toward use was observed, but there was a conflict in matters of indications and contraindications, and also criticism over a lack of knowledge. There was seen to be a need for education to be able to act professionally. Scepticism over high costs of treatment was highlighted. In conclusion, a need for policies on management, education and research in the field of CAM should be addressed.

  • 9.
    Bjerså, Kristofer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden.
    Jildenstaal, Pether
    Gothenburg University, Sweden.
    Jakobsson, Jan
    Karolinska Institute, Sweden.
    Egardt, Madelene
    Sahlgrens University Hospital, Sweden.
    Fagevik Olsen, Monika
    Gothenburg University, Sweden.
    Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study2015In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 16, no 6, p. 944-950Article in journal (Refereed)
    Abstract [en]

    The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. The effects on pain at rest, following short walk, and after deep breath were assessed by visual analog scale (VAS) grading. Number of patients assessed was lower than calculated because of change in clinical routine. Pain scores overall were low. A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p < .05). This controlled pilot study indicates benefits of TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery. (C) 2015 by the American Society for Pain Management Nursing

  • 10.
    Bjerså, Kristofer
    et al.
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Sachs, Chatharina
    Scandinavian College of Osteopathy, Gothenburg, Sweden; University of Wales, Cardiff, UK.
    Hyltander, Anders
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Department of Surgery, Östra Sjukhuset, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Fagevik Olsén, Monika
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Department of Surgery, Sahlgrenska University Hospital; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Osteopathic intervention for chronic pain, remaining thoracic stiffness and breathing impairment after thoracoabdominal oesophagus resection: A single subject design study2013In: International Journal of Osteopathic Medicine, ISSN 1746-0689, E-ISSN 1878-0164, Vol. 16, no 2, p. 68-80Article in journal (Refereed)
    Abstract [en]

    Background

    Thoracic surgery can cause negative effects such as chronic pain, impaired thorax movement and/or impaired breathing. There are indications that manual therapies, such as osteopathy, may be beneficial for these conditions.

    Objective

    To investigate effects of osteopathic intervention on chronic pain and remaining limitations to thoracic range of motion and breathing in patients who had undergone thoracoabdominal resection of the oesophagus.

    Design

    In a single-subject research design (Aa-B-Ab), 8 participants with chronic postoperative thoracic pain, stiffness and/or breathing impairment after standardized oesophagus resection were given 10 sessions of osteopathic treatment of 45 min. Expiratory vital capacity, thorax mobility, pain experience, and subjective perception of treatment were measured on three occasions during each phase. The two-standard deviation band method was used to indicate significant change.

    Results

    A significantly increased range of motion in the thorax was observed in thoracic excursion and in lateral flexion. A positive change in pain was also noted. The results in expiratory vital capacity were contradictory. The participants were generally positive toward the treatment given.

    Conclusion

    Osteopathic intervention may affect thoracic impairment and pain among people with chronic pain and impaired thoracic range of motion after thoracoabdominal resection of the oesophagus

  • 11.
    Bjerså, Kristofer
    et al.
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Stener Victorin, Elisabet
    Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Fagevik Olsén, Monika
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals.2012In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 12, p. 1-10, article id 42Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals.

    METHOD: A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included.

    RESULT: A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were positive to learning such therapy. Communication about CAM between patients and the health care professions was found to be rare.

    CONCLUSION: There is a lack of knowledge about CAM and research about it among registered health care professions in Swedish surgical care. However, in contrast to previous studies the results revealed that the majority perceived it as important to gain knowledge in this field.

  • 12.
    Dillström, Maria
    et al.
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Engström, My
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Patients' experience of acute unplanned surgical reoperation.2017In: Journal of Surgical Research, ISSN 0022-4804, E-ISSN 1095-8673, Vol. 209, p. 199-205Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Undergoing surgery always involves various risks of complications, often depending on the type of surgery. Because of complications, a second surgical intervention, a reoperation, must occasionally be done, which in turn often causes an extended hospital stay, a longer recovery phase, greater suffering for the patient, and higher health care costs. Even though complications after general surgery are relatively common, little is known regarding patient experience of a reoperation. Knowledge of this could impact on care models in the future. The aim of this study was to describe patients' experience of acute, unplanned reoperation during a planned hospital stay.

    MATERIALS AND METHODS: A purposive sampling strategy was used, and 16 patients were included, all who had undergone acute unplanned reoperation during a planned hospital stay. Semi-structured interviews were used to collect data, and a content analysis with an inductive approach was used for data analysis.

    RESULTS: The analysis resulted in two main themes: (1) health professionals' importance, having its foundation in categories trust and information, and (2) reaction, based on the categories anxiety and sadness.

    CONCLUSIONS: Unplanned reoperation caused psychological, social, and existential reactions. Health care professionals were perceived as important because good communication, accurate information, their presence, and creating feelings of confident and safe care were meaningful factors for the patients as they managed the situation.

  • 13.
    Fagevik Olsén, Monika
    et al.
    Sahlgrenska Academy, University of Gothenburg, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Undergraduate physical therapy students´ experiences of supervision during bachelor thesis course2017In: Global Journal of Medical, Physical and Health Education, ISSN 2449-1802, Vol. 5, no 1, p. 183-190Article in journal (Refereed)
    Abstract [en]

    Studies evaluating scientific supervision at the undergraduate level are few and heterogeneous. The aim of this study was to further explore undergraduate students´ experiences of and thoughts about scientific supervision. The sample of informants consisted of 13 physical therapy students from two Swedish universities. Data collection was done using semi-structured interviews covering the areas of supervision and collaboration. Data analysis was performed according to qualitative content analysis. Three theme emerged from the interviews- the role of the supervisor, the student's perception of uncertainty and structure of the supervision. Physical therapy students´ experience of their supervision was dependent on the supervisors’ attributes, both favourable and unfavourable, difficulties with communication, being disregarded and affected by the supervisors’ personal views. This was also put in the context of the current form of supervision, as individual and group supervision brought both positive and negative factors to the experience of the process.

  • 14.
    Magidy, Mahnaz
    et al.
    Akademiska sjukhus, Uppsala, Sweden.
    Warren-Stomberg, Margareta
    University of Gothenburg, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Assessment of post-operative pain management among acutely and electively admitted patients - a Swedish ward perspective2016In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 22, no 2, p. 283-289Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectivesSwedish health care is regulated to involve the patient in every intervention process. In the area of post-operative pain, it is therefore important to evaluate patient experience of the quality of pain management. Previous research has focused on mapping this area but not on comparing experiences between acutely and electively admitted patients. Hence, the aim of this study was to investigate the experiences of post-operative pain management quality among acutely and electively admitted patients at a Swedish surgical department performing soft-tissue surgery. MethodsA survey study design was used as a method based on a multidimensional instrument to assess post-operative pain management: Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP). Consecutive patients at all wards of a university hospitals surgical department were included. Data collection was performed at hospital discharge. ResultsIn total, 160 patients participated, of whom 40 patients were acutely admitted. A significant difference between acutely and electively admitted patients was observed in the SCQIPP area of environment, whereas acute patients rated the post-operative pain management quality lower compared with those who were electively admitted. ConclusionsThere may be a need for improvement in the areas of post-operative pain management in Sweden, both specifically and generally. There may also be a difference in the experience of post-operative pain quality between acutely and electively admitted patients in this study, specifically in the area of environment. In addition, low levels of the perceived quality of post-operative pain management among the patients were consistent, but satisfaction with analgesic treatment was rated as good.

  • 15.
    Mako, Tünde
    et al.
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Svanäng, Pernilla
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Avdelningen för Kirurgi, Sahlgrenska Akademin, Göteborgs Universitet.
    Patients' perceptions of the meaning of good care in surgical care: a grounded theory study.2016In: BMC nursing, Vol. 15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients in surgical care have reported a fear of being discharged prior to sufficient recovery and a lack of control of their situation. Establishing the patient-nurse relationship is essential in the context of the care. The Swedish National Board of Health and Welfare has established indicators for good care for comparison, evaluation and improvement of the quality of the health care system. These indicators are knowledge-based, appropriate, safe, effective and equal health care, as well as care within a reasonable time and patient-centred care. Current core competence in nursing education include quality improvement, patient-centred care, teamwork and collaboration, using evidence-based practice, safety and informatics. This study investigates patients' perceptions of the meaning of good care in inpatient surgical care.

    METHODS: Grounded theory according to Charmaz was chosen as the study design. Interviews were conducted with 13 patients from six surgical wards in the south of Sweden in 2014-2015.

    RESULTS: The results showed that patients in surgical care perceived good care as being safe, as they were vulnerable and anxious. This could be achieved through accessible care, reliable care, caring attitudes and participating in one's own care. Patient participation was achieved by information and education and the possibility to affect their care.

    CONCLUSION: Patients need safety to experience good care. Caring attitudes and patient participation can be attained through patient-centred care. Bedside handover can improve patients' perceptions of accessible care and reliable care and can increase patient participation. Continuously maintaining competence and using evidence-based practice are needed to achieve reliable care.

  • 16.
    Markström, I
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Avdelningen för Kirurgi, Sahlgrenska Akademin, Göteborgs Universitet.
    Diversities in perceived knowledge and practice of preoperative skin preparation in Swedish orthopaedic surgery.2015In: Journal of perioperative practice, ISSN 1750-4589, Vol. 25, no 5, p. 101-106, article id 26292463Article in journal (Refereed)
    Abstract [en]

    Preoperative skin preparations may reduce the risk of hospital-acquired infections. This cross sectional questionnaire study aimed to identify the practice and knowledge of preoperative skin preparation in Swedish orthopaedic surgery departments. One hundred and six respondents (response rate 68%) from 13 Swedish orthopaedic departments reported a diversity of current recommendations and evidence, and good knowledge of skin preparations. This study found variations in practice and deviations from recommendations, despite high levels of knowledge.

  • 17.
    Olsson, Camilla
    et al.
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Forsberg, Anna
    Lund University, Lund, Sweden; University Hospital, Skåne, Sweden..
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Avdelningen för Kirurgi, Sahlgrenska Akademin, Göteborgs Universitet.
    Safety climate and readiness for implementation of evidence and person centered practice - A national study of registered nurses in general surgical care at Swedish university hospitals.2016In: BMC nursing, ISSN 1472-6955, Vol. 15, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The rationale behind this study is the increasing research on relationships between patient safety, evidence based practice and person centered care, and the growing interest in outcomes of surgical patients. The aim of this study was to explore the safety climate and readiness to implement evidence-based and person centered care as perceived by registered nurses in Swedish surgical care.

    METHODS: The design was an exploratory, cross-sectional survey carried out in a national Swedish context. Data were collected through the Safety Attitudes Questionnaire (SAQ - Short form) and the Context Assessment Index (CAI).

    RESULTS: In total, 1570 questionnaires were distributed, of which 727 were returned, giving a response rate of 46.3 %. The results revealed that in general, the safety climate in Swedish surgical care is positively related to readiness for evidence-based and person centered care, although specific management and cultural factors may be more sensitive and represent targets for improvement.

    CONCLUSION: This study presents new knowledge regarding the safety climate and readiness to implement evidence based practice and person centered care in general surgical wards in university hospitals and indicates important associations between these two areas. While RNs generally reported positive job satisfaction and a good team work culture in their units, there were indications that improvements in organizational management are needed.

  • 18.
    Sposato, Niklas
    et al.
    Scandinavian School of Osteopathy, Gothenburg, Sweden; The Institute of Orthopaedic Medicine, Gothenburg, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Experiences of intervertebral motion palpation in osteopathic practice: – A qualitative interview study among Swedish osteopaths2017In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 21, no 1, p. 101-108Article in journal (Refereed)
    Abstract [en]

    Background

    Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions.

    Method

    The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure.

    Result

    In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP.

    Conclusion

    The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings.

  • 19.
    Vestin, Madelene
    et al.
    Kungälv Hosp, Sweden.
    Carlsson, Jenny M.
    Kungalv Hosp, Sweden.
    Bjerså, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Univ Gothenburg, Sweden.
    Emergency department staffs knowledge, attitude and patient communication about complementary and alternative medicine - A Swedish survey2018In: European Journal of Integrative Medicine, ISSN 1876-3820, E-ISSN 1876-3839, Vol. 19, p. 84-88Article in journal (Refereed)
    Abstract [en]

    Introduction: International studies report high use of complementary and alternative medicine (CAM) by emergency department (ED) patients and low levels of knowledge about CAM among registered nurses (RNs) and physicians. However, the current situation in Swedish EDs is unknown. This study explored knowledge, attitudes, and patient communication about CAM among physicians and RNs working within the Swedish ED context. Method: This research was performed as a cross-sectional questionnaire study at six EDs in the middle of Sweden. Results: Both RNs and physicians (84.7% of all participants) rated their CAM knowledge as low, but wished to gain more knowledge in the area (62.7%). A majority (58.8%) of the participants believed it to be of some importance that they had knowledge about CAM. Of the participants, 68% were interested in taking part in CAM research, and 43.8% had the opinion that more research resources should be reserved for CAM research. 41.2% reported their patient communication about CAM as non-existent or low. Conclusion: Knowledge about CAM and CAM research among Swedish ED staff was indicated as very low, but with a presence of gaining more knowledge. The opinion that more funding should be allocated to CAM research existed. Communication with patients about CAM rarely occurred.

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