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  • 151.
    Friedrichsen, Maria
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatrics and Hospital based homecare VHN.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping.
    Concerns about losing control when breaking bad news to terminally ill patients with cancer: Physicians' perspective2006In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 9, no 3, p. 673-682Article in journal (Refereed)
    Abstract [en]

    Objective: To study and explore problems perceived by physicians when breaking bad news to advanced cancer patients about discontinuing or not offering tumor-specific treatment due to incurable cancer. Design: A qualitative phenomenographic interview study. Setting: The county of Östergötland in Sweden. Participants: Thirty physicians with different demographic characteristics. Results: According to the physicians' answers breaking bad news was perceived as involving a risk of losing control in different ways, regarding emotions, oneself, confidence, professionalism and patient trust. Four different main categories described as problems were identified, perceptions focusing on existential thoughts, relationships, knowledge, and perceptions related to time and environmental disturbances. Conclusion: Physicians perceived that breaking bad news to dying patients with cancer involved a risk of losing control. Existential thoughts and a lack of knowledge contribute to this risk. Theoretical education in existentiality/spirituality and clinical practice in a palliative context may help maintaining control. © Mary Ann Liebert, Inc.

  • 152.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.
    Strang, Peter
    Karolinska Institutet, Stockholm.
    Doctors' strategies when breaking bad news to terminally ill cancer patients2003In: Journal of Palliative Medicine, ISSN 1096-6218, Vol. 6, no 4, p. 565-574Article in journal (Refereed)
    Abstract [en]

    Breaking bad news to patients with a terminal disease is a difficult task for physicians. The aim of this study was to study how doctors perceive their strategies when giving information to cancer patients about discontinuing active tumour treatment. Thirty doctors with different demographic characteristics working with patients with cancer in Sweden participated. Semistructured interviews were conducted and analyzed using a qualitative phenomenographic method. The goal when giving this information was described as making the patient understands while being as considerate as possible. However, the strategies for reaching this goal were different: (1) explaining and convincing information, (i.e., giving a long explanation about why treatment has to be discontinued); (2) softening the impact of the information, with the doctor recommending discontinuation of treatment; (3) and preparing either the patient or the physician himself/herself for the information; (4) adapting or tailoring the information to the patient, with the doctor actively seeking knowledge about the patient in order to be able to adapt the information to the patient's level, or with the doctor briefly describing the situation and then remaining silent, allowing room for the patient's reactions and questions (i.e., letting the patient take an active part). When giving information, the doctors' goal was to make patients understand, but the strategies differed depending on the context.

  • 153.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatric Medicine in Norrköping.
    Strang, Peter
    Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
    Carlsson, Maria
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Breaking bad news in the transition from curative to palliative cancer care-patient's view of the doctor giving the information2000In: Supportive Care in Cancer, ISSN 0941-4355, Vol. 8, no 6, p. 472-478Article in journal (Refereed)
    Abstract [en]

    In the transition from curative to palliative cancer care, communication is of special importance. The aim of this study was to explore how patients with a disseminated cancer disease experienced the information about their incurable state, focusing on the physician. The persons taking part were 30 patients admitted to a hospital-based home care unit in Sweden. Semi-structured interviews were conducted and analysed using a qualitative method. All patients described their doctors as experts, despite different qualities. Six subcategories were identified: (1) the inexperienced messenger, (2) the emotionally burdened, (3) the rough and ready expert (4) the benevolent but tactless expert, (5) the "distanced" doctor and (6), the empathic professional. The relationship was described as very important to the patients' capacity to handle the information and was felt to have been built up during earlier meetings. The relationship was described in four subcategories: personal between well-acquainted individuals, impersonal between unacquainted individuals, personal between unacquainted individuals and impersonal between well-acquainted individuals. Both the character of the physician and his or her ability to create personal relationships influence patients' capacity to cope with this specific situation. Education and guidance are needed both in clinical practice and in medical schools.

  • 154.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Strang, Peter
    Karolinska Institutet, FOUU, Stockholms Sjukhem, Stockholm .
    Carlsson, Maria
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Cancer patients' interpretations of verbal expressions when given information about ending cancer treatment2002In: Palliative Medicine, ISSN 0269-2163, Vol. 16, no 4, p. 323-330Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cancer patients' interpretations of the meaning of words used when given bad news are not well studied in medical settings. The aim of this study was to ascertain what significance verbal expressions had for cancer patients when they were given information about ending active tumour treatment, and what message they felt they received.

    METHODS: Tape-recorded semi-structured interviews were performed and analysed using a qualitative phenomenographical approach.

    RESULTS: Thirty patients with incurable cancer admitted to hospital-based home care unit in Sweden participated. Three main categories about the significance of words emerged: 1) words could indicate indirect warnings as being forewarnings, evasive or ambiguous; 2) words could also be perceived as emotionally trying, as threats or abandoning; 3) other words were fortifying and strengthened the patient in this situation. The overall message given during the information could be interpreted differently: either focused on treatment, on quality of life, or on threat and death.

    CONCLUSION: The understanding of the significance of words to tailor the information to patients helps the physician to use forewarnings and fortifying words and to identify and avoid the use of threatening words.

  • 155.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Strang, Peter
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Carlsson, Maria
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden.
    Cancer patients' perceptions of their own participation and own resources after receiving information about discontinuation of active tumour treatment2000In: Acta Oncologica, ISSN 0001-6381, Vol. 39, no 8, p. 919-925Article in journal (Refereed)
    Abstract [en]

    The focus of most studies on informational needs has been on primary cancer diagnosis. The aim of this study was to explore how cancer patients in a palliative care setting perceived their own participation and resources after receiving information about the discontinuation of active tumour treatment. Thirty cancer patients admitted to a hospital-based home-care unit participated in the study. Semi-structured interviews were conducted and analysed using a phenomenographic method. The patients described their own participation as being either verbally passive or active, in order to receive more information or to avoid information. Furthermore, previous knowledge, at different levels, was described as important: 1) Unsuspecting naive, 2) apprehensive suspicious, 3) well prepared. Patients' own resources included a sense of wellbeing, a sense of security and individual strength. In conclusion, patients' previous knowledge and own resources are important components for their capacity to take part in the dialogue when receiving information.

  • 156.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatric Medicine in Norrköping.
    Strang, Peter
    Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
    Carlsson, Maria
    Uppsala University, Uppsala, Sweden.
    Receiving bad news- experiences of family members2001In: Journal of Palliative Care, ISSN 0825-8597, Vol. 17, no 4, p. 241-247Article in journal (Refereed)
    Abstract [en]

    Little is known about how next-of-kin experience receiving bad news. The aim of this study was to explore the experiences of family members when receiving information about ending tumour treatment, with a focus on their role in this context.

    METHODS: Semi-structured interviews were performed and analyzed using a qualitative phenomenographic method.

    RESULTS: Twenty family members of patients with incurable progressive cancer admitted to hospital-based home care were included in the study. Data showed that family members want to protect, represent, or act on behalf of the patient. Some described themselves as assuming prominent roles: the demander-of-truth role, the secret-keeper role, and the controller role. Others assumed more passive roles: the surrendering role, the considerate listener role, and the excluded outsider role.

    CONCLUSION: This study has revealed possible-explanations as to why family members are dissatisfied with information. The results of this study may help doctors in clinical practice recognize the different types of behaviour family members exhibit when receiving bad news.

  • 157.
    Gallagher, R
    et al.
    University Technology Sydney.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Luttik, M L
    University Medical Centre Groningen.
    Social support and self care in heart failure in EUROPEAN HEART JOURNAL, vol 31, issue , pp 946-9462010In: EUROPEAN HEART JOURNAL, Oxford University Press , 2010, Vol. 31, p. 946-946Conference paper (Refereed)
    Abstract [en]

    n/a

  • 158.
    Gallagher, Robyn
    et al.
    University of Technology, Sydney.
    Luttik, Marie-Louise
    University of Groningen.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Social Support and Self-care in Heart Failure2011In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 26, no 6, p. 439-445Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVE:: Self-care by heart failure (HF) patients is essential for optimal disease management of their condition. However, as the nature of HF is unrelenting and burdensome, self-care is usually achieved with the support of partners. It is not clear what role the level of social support by partners plays in HF self-care; therefore, this study sets out to determine the types of social support provided to HF patients and the impact of differing levels of social support on HF patients' self-care. SUBJECTS AND METHOD:: This is secondary analysis of a subgroup of patients experiencing their second hospital admission for HF at baseline in the COACH study, a multisite trial conducted in the Netherlands. Measures included the European Heart Failure Self-care Behaviour Scale and a multiple component assessment of social support, which categorized patients into low, moderate, and high levels of social support according to the presence of a partner and their perception of support they received from their partner. RESULTS AND CONCLUSIONS:: Patients (n = 333) had an average age of 72 (SD, 11) years, and 92% belonged to New York Heart Association class III or greater. Of the patients with partners (56%), only 49% had a high level of support from their partner. No demographic or clinical characteristic was associated with self-care behavior. Patients with a high level of support reported significantly better self-care (P = .002) than patients with low or moderate levels of social support. Patients with a high level of social support reported being significantly more likely to consult with a health professional for weight gain (P = .011), to limit the amount of fluids they have (P = .02), take their medication (P = .017), to get a flu shot (P = .001), and to exercise on a regular basis (P < .001) than those with medium or low levels of social support. The presence of social support by a partner is not sufficient to influence HF patients' self-care. Social support provided by partners needs to be of a quality and content that matches HF patients' perception of need to influence self-care. Caregivers, especially partners, should be considered as integral in the treatment and care of HF patients.

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  • 159.
    Gantschning, Brigitte E.
    et al.
    Zurich University of Applied Sciences, Winterthur, Switzerland.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    La Cour, Karen
    University of Southern Denmark, Odense.
    Feeling and Being Involved?: Participation Experienced by Children with Disabilities at Regular Schools in Austria2011In: Journal of Occupational Therapy, Schools & Early Intervention, ISSN 1941-1251, Vol. 4, no 3-3, p. 260-275Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain an in-depth knowledge about children with disabilities’ lived experiences of participation in regular schools in Austria. Qualitative interviews were conducted with 5 children. Data were analyzed according to the descriptive phenomenological method. Children with disabilities appreciated attending regular schools. Being a part of school life was identified to include experiences of participation and nonparticipation. Different aspects of the environment influence experiences of participation and awareness of differences are facilitated through interaction with peers. Together, the findings complement empirical insights to the understanding of experienced and performed involvement combined with subjective dimensions of environmental features that influence participation.

  • 160.
    Garvin, Peter
    et al.
    Linköping University, Department of Medical and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsson, Evalill
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Ernerudh, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    The joint subclinical elevation of CRP and IL-6 is associated with lower health-related quality of life in comparison with no elevation or elevation of only one of the biomarkers2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no 1, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Measures of health-related quality of life (HRQoL), like the Short Form (SF)-36, have been suggested to correlate with inflammatory biomarkers. It is, however, unclear whether a joint measure of two inflammatory biomarkers would bring additional information in comparison with evaluation of one inflammatory biomarker. To evaluate associations between SF-36 and low-grade inflammation in a Swedish population, with emphasis on a combined measure of C-reactive protein (CRP) and interleukin-6 (IL-6) as a proxy for low-grade inflammation. In a randomly selected sample of a middle-aged Swedish general population (n = 905; aged 45-69 years, 50 % women), relations between SF-36 parameters and the biomarkers were tested. Regression and correlation analyses were adjusted for sex, age, presence of disease, lifestyle, and psychological factors. After adjustment for sex and age, HRQoL was significantly lower in the group with a joint elevation of CRP and IL-6 in comparison with either the group with no elevation or the groups showing elevation of one of the two biomarkers. Also after full adjustments, the combined measure of elevated CRP and IL-6, with few exceptions, was associated with significantly lower HRQoL in comparison with elevations in one of them, difference ranging from 4 (Mental Health scale) to 18 scale steps (Role-Physical scale). This study confirms that there is a relationship between HRQoL and low-grade inflammation. In particular, SF-36 scores are significantly lower in a group with joint elevation of IL-6 and CRP, in comparison with elevation of either one of them.

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  • 161. Gheorghiade, Mihai
    et al.
    Follath, Ferenc
    Ponikowski, Piotr
    Barsuk, Jeffrey H
    Blair, John E A
    Cleland, John G
    Dickstein, Kenneth
    Drazner, Mark H
    Fonarow, Gregg C
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Jondeau, Guillaume
    Sendon, Jose Lopez
    Mebazaa, Alexander
    Metra, Marco
    Nieminen, Markku
    Pang, Peter S
    Seferovic, Petar
    Stevenson, Lynne W
    van Veldhuisen, Dirk J
    Zannad, Faiez
    Anker, Stefan D
    Rhodes, Andrew
    McMurray, John J V
    Filippatos, Gerasimos
    Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine.2010In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 12, no 5, p. 423-33Article in journal (Refereed)
    Abstract [en]

    Patients with acute heart failure (AHF) require urgent in-hospital treatment for relief of symptoms. The main reason for hospitalization is congestion, rather than low cardiac output. Although congestion is associated with a poor prognosis, many patients are discharged with persistent signs and symptoms of congestion and/or a high left ventricular filling pressure. Available data suggest that a pre-discharge clinical assessment of congestion is often not performed, and even when it is performed, it is not done systematically because no method to assess congestion prior to discharge has been validated. Grading congestion would be helpful for initiating and following response to therapy. We have reviewed a variety of strategies to assess congestion which should be considered in the care of patients admitted with HF. We propose a combination of available measurements of congestion. Key elements in the measurement of congestion include bedside assessment, laboratory analysis, and dynamic manoeuvres. These strategies expand by suggesting a routine assessment of congestion and a pre-discharge scoring system. A point system is used to quantify the degree of congestion. This score offers a new instrument to direct both current and investigational therapies designed to optimize volume status during and after hospitalization. In conclusion, this document reviews the available methods of evaluating congestion, provides suggestions on how to properly perform these measurements, and proposes a method to quantify the amount of congestion present.

  • 162.
    Goossens, E
    et al.
    Katholieke University Leuven.
    Norekval, T M
    Haukeland Hospital.
    Faerch, J
    Copenhagen University Hospital.
    Hody, L
    Clin University St Luc, Brussels.
    Olsen, S S
    Haukeland Hospital.
    Darmer, M R
    Copenhagen University Hospital.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Moons, P
    Katholieke University Leuven.
    Sexual counselling of cardiac patients in Europe: culture matters2011In: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 65, no 10, p. 1092-1099Article in journal (Refereed)
    Abstract [en]

    Background: Sexual problems are common amongst cardiac patients, and concerns may arise when resuming sexual activities after a cardiac event. Sexual counselling is therefore indispensible. Culture is an identified barrier to talking about sex, but research is lacking on whether and how culture influences nurses in providing sexual counselling. Design: This cross-sectional descriptive study assessed four areas related to sexual counselling provided by cardiovascular nurses. We investigated the impact of culture on these areas by surveying cardiovascular nurses living in Denmark, Norway and two regions of Belgium - Flanders, Dutch-speaking region and Wallonia, French-speaking region. Methods: Overall, 819 participants were recruited as they attended cardiovascular nursing congresses in Denmark, Norway and Belgium. Subjects completed the Undertaking Nursing Interventions Throughout Europe (UNITE) sexual counselling questionnaire, measuring practice, responsibility, confidence and perceived comfort of patients. Controlling for demographic, educational and professional covariates, we performed multiple linear regression analysis to determine the impact of culture on sexual counselling. Results: All four subscale scores were independently associated with culture. Danish nurses counselled patients significantly more often, reported feeling more responsibility and confidence and estimated more comfort in patients than Norwegian, Flemish and Walloon nurses. Conclusions: This study showed that culture matters with respect to sexual counselling for cardiac patients. Interventions should be developed improving sexual counselling of cardiac patients. Educational courses and training of healthcare professionals on sexual counselling should be more sensitive to sociocultural differences. Cross-cultural perspectives may bias attitudes of professionals as they deal with concerns of cardiac patients about resuming sexual activity.

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  • 163.
    Grodzinsky, Ewa
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Bergfors, Elisabet
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Olsen Faresjö, Åshild
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Could gastrointestinal disorders differ in two close but divergent social environments?2012In: International Journal of Health Geographics, ISSN 1476-072X, E-ISSN 1476-072X, Vol. 11, no 5Article in journal (Refereed)
    Abstract [en]

    Background: Many public health problems in modern society affect the gastrointestinal area. Knowledge of the disease occurrence in populations is better understood if viewed in a psychosocial context including indicators of the social environment where people spend their lives. The general aim of this study was to estimate the occurrence in the population and between sexes of common gastrointestinal conditions in two neighborhood cities representing two different social environments defined as a "white-collar" and a "blue-collar" city. less thanbrgreater than less thanbrgreater thanMethods: We conducted a retrospective register study using data of diagnosed gastrointestinal disorders (cumulative incidence rates) derived from an administrative health care register based on medical records assigned by the physicians at hospitals and primary care. less thanbrgreater than less thanbrgreater thanResults: Functional gastrointestinal diseases and peptic ulcers were more frequent in the white-collar city, while diagnoses in the gallbladder area were significantly more frequent in the blue-collar city. Functional dyspepsia, irritable bowel syndrome, and unspecified functional bowel diseases, and celiac disease, were more frequent among women while esophageal reflux, peptic ulcers, gastric and rectal cancers were more frequent among men regardless of social environment. less thanbrgreater than less thanbrgreater thanConclusions: Knowledge of the occurrence of gastrointestinal problems in populations is better understood if viewed in a context were the social environment is included. Indicators of the social environment should therefore also be considered in future studies of the occurrence of gastrointestinal problems.

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  • 164.
    Grönlund, V.
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in Finspång, Primary Health Care in Finspång. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland.
    Carlsson, A.
    Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Primary Health Care in Motala.
    Tingström, Pia
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Nilsson, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Kärner, Anita
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    The desire for a good life - patients beliefs of self-care after a coronary event2013Conference paper (Other academic)
    Abstract [en]

         

    Introduction: After a first coronary event there is an increased risk for a recurrent event. Despite that risk, 1/5 of the patients continue to smoke, 1/3 is obese and more than half of the patients have elevated blood pressure and total cholesterol. Secondary preventive self-care activities are needed to improve outcomes and the belief of patients plays a vital role in changing behavior.                         

    Aim: To examine patients’ beliefs of self-care 6-12 months after a coronary event.                         

    Method: The study design was qualitative. Twenty-five patients, including 10 women, mean age 65 years with stable coronary artery disease participated in four focus group interviews. Data were taped, transcribed and analyzed according to the conventional content analysis.                         

    Findings: Patients’ belief of self-care is influenced by their desire of a good life even though life seems fragile. Patients try to live up to the standard of health care prescription and advices. However, these achievements require behavior change and conscious boundaries, which are challenged by various obstacles such as fear of, overstrain and stress. Physical activity is considered as both a source to well-being and a necessity, but patients are uncertain and afraid for overstraining. A healthy diet is seen as important but the advices given are sometimes contradictory and create confusion. Medication is found important but not at the cost of all the side-effects. Patients also report that in order to believe in their ability and to be responsible for self-care, support from health care providers is expected. But at the same time the invaluable support and information is often not provided, creating uncertainty.                         

    Discussion: The study highlights the patients’ perspective of self-care and what they view as important in self-care after an event of coronary artery disease. The patients’ expectations on health services comprise information, support and continuous follow-up. This is necessary to facilitate the patient’s responsibility for their own care.                         

    Conclusion: Patients’ beliefs about the concept of self-care after an event of coronary artery disease are multifaceted and voluminous compared to the health care definition. The findings of the study challenge health care policies approach to self-care. There is a need to reconsider and assess what and how secondary preventive patient education should be performed after an event of coronary artery disease.  

                        

  • 165.
    Grönlund, V.
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in Finspång, Primary Health Care in Finspång. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland.
    Rudenas, A.
    Östergötlands Läns Landsting, Local Health Care Services in Finspång, Primary Health Care in Finspång. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland.
    Appel, M.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland.
    Ednarsson, T.
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Primary Health Care in Norrköping.
    Nilsson, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland.
    Tingström, Pia
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Kärner Köhler, Anita
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Problem-based learning after Coronary artery disease - how do patients experience it?2014Conference paper (Other academic)
  • 166.
    Gunnarsson, Nina
    et al.
    Jönköping University, Sweden.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Hydén, Lars-Christer
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Mothers’ accounts of healthcare encounters: Negotiating culpability and fulfilling the active mother role2013In: Discourse & Society, ISSN 0957-9265, E-ISSN 1460-3624, Vol. 24, no 4, p. 1-15Article in journal (Refereed)
    Abstract [en]

    This article explores mothers’ accounts of initial interactions and encounters with healthcare professionals and the outcomes where questions about their children’s problems are concerned. A case-based storyline was reconstructed as part of the analysis, focusing on

    when and how mothers claimed to be responsible parents. The outcomes of these encounters were presented by the mothers in this study as a drawn-out process, with disagreement between mothers and healthcare providers, resulting in different performances of moral agency. Some mothers portrayed themselves as dependent on healthcare expertise and made moral claims by attributing and deflecting blame, negotiating back and forth about their own and the healthcare professionals’ culpability, restoring moral agency. Other mothers did not generally defend or justify their actions or place blame, but appealed instead to fulfilment of the active mother role where they controlled the interaction and claimed full responsibility for their child’s care, hence presenting their moral agency as indisputable.

  • 167.
    Gustavsson, Martha
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden.
    Liedberg, Gunilla
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Larsson Ranada, Åsa
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Everyday doings in a nursing home - described by residents and staff2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 6, p. 435-441Article in journal (Refereed)
    Abstract [en]

    Objective: For many groups of elderly people it is important to be active, which can be hindered by disabilities that come with age. Research has progressed in this area but mostly concerns the elderly living at home. The aim of this study was to examine how residents and staff at a nursing home described the residents everyday doings. Methods: A nursing home was selected in which 15 of the residents and six of the staff were interviewed about the residents activities during an ordinary day and week. Results: The material was analysed using qualitative content analysis in which two categories emerged: shared doings and individual doings. The shared doings were important for supporting the residents in their social and physical activities, but participation in these was often hampered by reduced functions. The individual doings, where the residents own interests can be promoted, were also hampered by their disabilities. Being able to be active and having something to do were emphasized, either continuing with previous activities or participating in shared activities at the nursing home. Conclusions: Receiving care and being forced to adjust to the context at the nursing home had a significant impact on the residents daily doings. Most of the residents needed help to be able to continue performing their activities or to find new ones. The social environment consisting of other residents and staff also influenced the residents activities.

  • 168.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Arabic-speaking migrants' attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare: a postal cross-sectional survey2014In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 7, no 71Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Good communication is an important prerequisite for equal treatment in a healthcare encounter. One way to overcome language barriers when patients and healthcare staff do not share the same language is to use a professional interpreter. Few previous studies have been found investigating the use of interpreters, and just one previous study from the perspective of European migrants, which showed that they perceived interpreters as a communication aid and a guide in the healthcare system as regards information and practical matters. No previous study has gathered quantitative information to focus on non-European migrants' attitudes to the use of interpreters in healthcare encounters. Thus, the aim of this study was to investigate Arabic-speaking individuals' attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare in order to: (i) understand how persons' expectations and concerns regarding interpreters may vary, both within and across cultural/linguistic populations; (ii) understand the consequences of diverse opinions/expectations for planning responsive services; and (iii) confirm findings from previous qualitative studies.

    METHOD: A postal cross-sectional study using a structured self-administered 51-item questionnaire was used to describe and document aspects of Arabic-speaking individuals' attitudes to the use of interpreters in healthcare. The sample of 53 Arabic-speaking migrants was recruited from three different places. Participants were mostly born in Iraq and had a high level of education and were almost equally divided between genders. Data were analysed with descriptive statistics.

    RESULTS: The main findings were that most of the participants perceived the interpreter's role as being a communication aid and a practical aid, interpreting literally and objectively. Trust in the professional interpreter was related to qualification as an interpreter and personal contact with face-to-face interaction. The qualities of the desired professional interpreter were: a good knowledge of languages and medical terminology, translation ability, and sharing the same origin, dialect and gender as the patient.

    CONCLUSION: This study confirmed previous qualitative findings from European migrant groups with a different cultural and linguistic background. The study supports the importance of planning a good interpretation situation in accordance with individuals' desire, irrespective of the migrant's linguistic and cultural background, and using interpreters who interpret literally and objectively, who are highly trained with language skills in medical terminology, and with a professional attitude to promote communication, thus increasing cost-effective, high-quality individualized healthcare.

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  • 169.
    Hadziabdic, Emina
    et al.
    Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden .
    Arabic-speaking migrants' experiences of the use of interpreters in healthcare: a qualitative explorative study2014In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 13, no 49Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Arabic-speaking migrants have constituted a growing population in recent years. This entails major challenges to ensure good communication in the healthcare encounter in order to provide individual and holistic healthcare. One of the solutions to ensure good communication between patient and healthcare staff who do not share the same language is to use a professional interpreter. To our knowledge, no previous qualitative studies have been found concerning Arabic-speaking migrants and the use of interpreters. This study aims to ascertain their individual experiences which can help extend our understanding of the studied area.

    METHOD: A purposive sample of 13 Arabic-speaking persons with experience of using interpreters in healthcare encounters. Data were collected between November 2012 and March 2013 by four focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.

    RESULTS: Four categories appeared from the analysis: 1) The professional interpreter as spokesperson; 2) Different types of interpreters and modes of interpretation adapting to the healthcare encounter; 3) The professional interpreter's task and personal properties affected the use of professional interpreters in a healthcare encounter; 4) Future planning of the use of professional interpreters in a healthcare encounter. The main findings were that the use of interpreters was experienced both as a possibility and as a problem. The preferred type of interpreters depended on the interpreter's dialect and ability to interpret correctly. Besides the professional interpreter's qualities of good skill in language and medical terminology, translation ability, neutrality and objectivity, Arabic-speaking participants stated that professional interpreters need to share the same origin, religion, dialect, gender and political views as the patient in order to facilitate the interpreter use and avoid inappropriate treatment.

    CONCLUSION: The study showed that the personal qualities of a good interpreter not only cover language ability but also origin, religion, dialect, gender and political views. Thus, there is need to develop strategies for personalized healthcare in order to avoid inappropriate communication, to satisfy the preferences of the person in need of interpreters and improve the impact of interpretation on the quality of healthcare.

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  • 170.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Working with interpreters: practical advice for use of an interpreter in healthcare2013In: International Journal of Evidence-Based Healthcare, ISSN 1744-1595, E-ISSN 1744-1609, Vol. 11, no 1, p. 69-76Article in journal (Refereed)
    Abstract [en]

    The aim is to improve communication in healthcare when an interpreter is used by providing practical advice to healthcare professionals when considering using interpreters. This descriptive commentary considered the issues of planning, preparation and implementation of interpretation sessions to reveal the complexities and dilemmas of an effective healthcare encounter when using interpreters. Using the design of a discursive paper, this work seeks to explore and position of what is published in the literature on the topic and based on previous studies to provide practical advice on the use of interpreters. The results  showed that the interpreter should be used not only as a communication aid but also as a practical and informative guide through the healthcare system. In planning and preparing the interpretation session, it is important to consider the type (trained professional interpreter, family member or bilingual healthcare staff as interpreters) and mode (face to face and telephone) of interpreting. Furthermore, it is important to consider the interpreter's ethnic and religious background, gender, language or dialect, social group, appearance, clothes and attitude. During the healthcare encounter, the interpreter should follow the recommendations given in guidelines for interpreters. Healthcare professionals should choose an appropriate room and be aware of their own attitude, behaviour and appearance during the healthcare encounter. Good planning is needed, with careful consideration of choices regarding the right kind of interpreter, mode of interpretation and individual preferences for the interpretation in order to deliver high-quality and cost-effective healthcare. Depending on the nature of the healthcare encounter, healthcare professionals need to plan interpretation carefully and in accordance with the individuals' wishes and choose the type of interpreter and mode of interpreting that best suits the present need in the healthcare situation in order to deliver healthcare high in quality.

  • 171.
    Hadziabdic, Emina
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Lundin, Christina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Boundaries and conditions of interpretation in multilingual and multicultural elderly healthcare2015In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, no 458Article in journal (Refereed)
    Abstract [en]

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

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  • 172.
    Hagberg, Jan-Erik
    et al.
    Linköping University, Department of Social and Welfare Studies, Society, Diversity, Identity. Linköping University, Faculty of Arts and Sciences.
    Larsson, Åsa
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Gamla människors teknikrum2009In: Åldrande, åldersordning, ålderism / [ed] Håkan Jönson, Linköping: Linköping University Electronic Press , 2009, 1:1, p. 157-175Chapter in book (Other academic)
    Abstract [sv]

    I denna artikel tar vi fasta på ålderns och livshistorians betydelse för individens förhållande till vardagstekniken. Den som har levt länge har byggt upp sitt teknikrum under lång tid och förvärvat vanor, erfarenheter och intressen som ger en "teknikstil". En "gammal" person gör matchningen mellan det befintliga och det nya med andra förtecken än en ung eller medelålders.28 Just den matchningen intresserar oss särskilt här. Vi koncentrerar oss därför på hur äldre förändrar sitt teknikrum genom att släppa in nya tekniska objekt och omvänt utsorterar sådant som man inte längre tycker att man behöver.

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    Gamla människors teknikrum
  • 173.
    Haglund, Lena
    Linköping University. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Arbetsterapeutisk bedömning inom psykiatrisk vård1999Report (Other (popular science, discussion, etc.))
  • 174.
    Haglund, lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Occupational therapists´ agreement in screening patients in general psychiatric care for occupational therapy1996In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, no 3, p. 61-67Article in journal (Refereed)
  • 175.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Path guide: a way to include clients in Occupational Therapy educaction2010Conference paper (Refereed)
  • 176.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Slutrapport. Betydelse av aktivitet som behandlingsform för ökad psykisk hälsa. FORSS2008Report (Other (popular science, discussion, etc.))
  • 177.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    The value of Specialist Training for Occupational Therapists2010Conference paper (Refereed)
  • 178.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Behrbohm Fallsberg, Margareta
    Consultant, Stensudden, SE-585 96 Linköping Sweden.
    Eeg-Olofsson, Anne-Marie
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    A Follow-up of an Occupational Therapy Programme based on Problem-Based Learning (PBL)2009Report (Other academic)
    Abstract [en]

    A follow-up study explored how graduate occupational therapists valued quality aspects of their undergraduate education on a Problem-Based Learning (PBL) occupational therapy programme. One hundred and fifty of 195 graduates completed a questionnaire. The survey focused on factors such as: specific occupational therapy content combined with practical skills and preparation for future work; problem-solving and critical thinking; ability to communicate and collaborate; personal and professional development; and life-long learning. The respondents rated items after considering them from two aspects: acquired skills and objective importance. The main results show that the respondents rated their skills as above average in the quality aspects of the programme. A discrepancy was evident between the rated acquired skills and the rated importance of key qualities of the curriculum.

    Student –centred learning with PBL is evaluated as having value but is rejected.

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    A Follow-up of an Occupational Therapy Programme based on Problem-Based Learning (PBL)
  • 179.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences.
    Rahm Hallberg, Ingalill
    Practice models in Swedish psychiatric occupational therapy2000In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, Vol. 7, no 3, p. 107-113Article in journal (Refereed)
    Abstract [en]

    In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown which theoretical approaches and practice models influence Swedish occupational therapists' daily work. In this study a questionnaire (n=334) was used to investigate approaches and models used in Swedish psychiatric care service and in psychiatric occupational therapy service. The results showed that the psychosocial approach influenced both psychiatric care and psychiatric occupational therapy most. The most frequently used practice model was the Model of Human Occupation. However, 75% of the respondents did not identify theoretical thinking based on models from their own field behind their actions. Many practitioners seemed to use knowledge developed by other disciplines more often. Years of clinical experience in the profession or education did not seem to have any impact on the ability to identify the practice models that were used. The results indicate that education in occupational therapy must emphasize knowledge in its own field more than has been done up to now.

  • 180.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Forsyth, Kirsty
    Queen Margaret University, Edinburgh, Scottland, UK.
    The measurement properties of the Occupational Circumstances Interview and Rating Scale - Sweden (OCAIRS-S V2)2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 412-419Article in journal (Refereed)
    Abstract [en]

    AIM:

    This paper reports the measurement properties of the Occupational Circumstances Assessment Interview and Rating Scale - Sweden (OCAIRS-S V2). The OCAIRS is a semi-structured interview and rating scale designed to capture, in detail, a person's occupational participation. The English version 4.0 has been translated into Swedish. The psychometric properties of the Swedish version are unknown.

    METHODS:

    Eleven Swedish occupational therapists working in mental health completed 38 OCAIRS-S (V2) assessments in addition to linking videotapes. A total of 60 clients were, therefore, entered into the analysis. Many-faceted Rasch analysis was used to analyse the data.

    RESULTS AND CONCLUSIONS:

    Results supported internal, construct, and person response validity of the OCAIRS-S (V2). Inter-rater reliability was established. The scale was shown to discriminate between people who were living in the community. In addition, the results indicate a need to explore the skill items.

  • 181.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Fältman, Susanne
    Psykiatri Skåne, Lund, Sweden .
    Activity and Participation - self-assessment according to the International Classification of Functioning: a study in mental health2012In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 75, no 9, p. 412-418Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim of this exploratory study was to discover if a fifth qualifier in the domain of Activity and Participation in the International Classification of Functioning, Disability and Health (ICE) could highlight the experience of satisfaction and enjoyment in the everyday life of people with severe mental illness. It also investigated the correlation between the assessment made by an occupational therapist and nursing staff based on performance, and the assessment made by the clients themselves. less thanbrgreater than less thanbrgreater thanMethod: Twenty-nine clients with schizophrenia or other forms of psychosis participated, using a self-assessment. The performance was investigated by using the first qualifier in the ICF, domain Activity and Participation. less thanbrgreater than less thanbrgreater thanFindings: The Major life area was rated with the most dissatisfaction and displeasure by the clients. Communication and General task and demands also had low ratings. Self-care was rated with the most satisfaction and enjoyment. There was a correlation between the assessments made by the occupational therapist and the nursing staff, but their assessments differed from those made by the clients. less thanbrgreater than less thanbrgreater thanConclusion: The study indicates the importance of using self-assessment when understanding everyday life as presented in the ICE, and the importance of using different assessment methods to gain a broad picture of clients.

  • 182.
    Haglund, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Henriksson, Chris
    Linköping University, Faculty of Health Sciences.
    Activity - From action to activity1995In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, no 9, p. 227-34Article in journal (Refereed)
  • 183.
    Haglund, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Henriksson, Chris
    Linköping University, Faculty of Health Sciences.
    Testing a Swedish version of OCAIRS on two different patient groups1994In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, p. 223-30Article in journal (Refereed)
  • 184.
    Haglund, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Karlsson, Gunilla
    Kielhofner, Gary
    Shea Lai, J
    Validity of the Swedish version of the worker role interview.1997In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, no 4, p. 23-29Article in journal (Refereed)
  • 185.
    Haglund, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Kjellberg, Anette
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    A critical analysis of the Model of Human Occupation.1999In: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie, ISSN 0008-4174, no 2, p. 102-1089Article in journal (Refereed)
    Abstract [en]

    Examination of the applicability of the Model of Human Occupation in Swedish occupational therapy concludes that the environment is a central factor in understanding occupational behavior, but the model does not accurately or adequately depict the relationship between individuals and the environment. Volition is also an important factor in occupational-therapy intervention

  • 186.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Linking MOHO-based assessments to ICF2012Conference paper (Other academic)
  • 187.
    Haglund, Lena
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Lundgren Pierre, Birgitta
    Sahlgrenska Universitetssjukhuset, Psykiatri Mölndal.
    Arbetsterapi för personer med depressionssjukdom och/eller ångestsyndrom. Forskning i Praxis2009In: Arbetsterapeuten, no 8Article in journal (Other (popular science, discussion, etc.))
  • 188.
    Haglund, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Thorell, Lars-Håkan
    Wålindeer, Jan
    Assessment of occupational functioning for screening of patients to occupational therapy in general psychiatric care.1998In: The Occupational therapy journal of research, ISSN 0276-1599, no 4, p. 193-206Article in journal (Refereed)
  • 189.
    Haglund, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care.
    Thorell, Lars-Håkan
    Wålinder, Jan
    Occupational functioning in relation to psychiatric diagnoses: schizophrenia and mood disorders.1998In: Nordic Journal of Psychiatry, ISSN 0803-9488, Vol. 52, no 3, p. 223-29Article in journal (Refereed)
    Abstract [en]

    The purposeof the study was to investigate whether a patient's adaptive occupational functioning is related to diagnoses of schizophrenia or mood disorders. The Occupational Case Analysis Interview and Rating Scale (OCAIRS) was used to examine the patient's adaptation in everyday occupation. Three groups of patients were studied: patients with schizophrenia (n=18), major depression (n=20), and bipolar disorders (n=22). The adaptive occupational functioning of patients with schizophrenia and those with bipolar disorders was significantly reduced, to the same levels as that of patients with major depression. Thus, a patient's adaptive occupational functioning seems to be related to the studied psychiatric diagnoses. This observation may be used as a first step when screen patients for occupational therapy.

  • 190.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Swedish oats is superior to usual diet in maintaining ulcerative colitis patients in remission2010In: J Crohn’s & Colitis, 2010Conference paper (Refereed)
  • 191.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Women with coeliac disease living on a gluten-free diet for years continue to seek more health-care2009In: Gut 2009;58 (suppl II) A262., 2009Conference paper (Refereed)
  • 192.
    Hallert, Claes
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Roos, Susanne
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    On treatment outcomes in coeliac disease diagnosed in adulthood2012In: Celiac Disease - From Pathophysiology to Advanced Therapies / [ed] Peter Kruzliak and Govind Bhagat, InTech, 2012, p. 159-184Chapter in book (Other academic)
    Abstract [en]

    Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten-containing grains (including wheat, rye and barley) in genetically susceptible individuals. CD can manifest itself with a previously unappreciated range of clinical presentations, including the typical malabsorption syndrome and a spectrum of symptoms potentially affecting any organ system. Since CD often presents in an atypical or even silent manner, many cases remain undiagnosed and carry the risk of long-term complications, including anemia and other hematological complications, osteoporosis, neurological complications or cancer. The high prevalence of the disease and its variety of clinical outcomes raise several interesting questions. This book covers most of the aforementioned controversial and yet unresolved topics by including the contributions of experts in CD.What the reader will surely find stimulating about this book is not only its exhaustive coverage of our current knowledge of CD, but also provocative new concepts in disease pathogenesis and  treatment.

  • 193.
    Hallert, Claes
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Svensson, M.
    Värnamo Hospital.
    Tholstrup, J.
    Eksjö Hospital .
    Hultberg, B.
    Lund University Hospital.
    B vitamins improve health in patients with coeliac disease living on a gluten-free diet2009In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 29, no 8, p. 811-816Article in journal (Refereed)
    Abstract [en]

    Background Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status.

    Aim To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease.

    Methods In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45–64 years on a strict gluten-free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status.

    Results Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 μmol/L (7.4–23.0), significantly higher than in matched population controls [10.2 μmol/L (6.7–22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well-being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well-being.

    Conclusions Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet.

  • 194.
    Hallert, Claes
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Sverker, Annette M.
    Nordiska folkhälsohögskolan, Göteborg, Sverige.
    Fridell, Karin
    Må bra med glutenintolerans: fakta, råd, recept2009 (ed. 1)Book (Other academic)
    Abstract [sv]

    Må bra med glutenintolerans är för dig som inte tål gluten, oavsett om du varit glutenintolerant under en lång tid eller om du nyligen fått diagnosen celiaki. Skriften är författad av docent Claes Hallert som är en av Sveriges mest namnkunniga läkare inom området. Claes ger en pedagogisk förklaring av sjukdomen, orsak, symtom och behandling samt aktuell forskning.Aukt socionom Annette Sverker, verksam på Nordiska folkhälsohögskolan i Göteborg, ger tips och råd hur du kan hantera vardagen som glutenintolerant, när du ska handla glutenfritt, äta på restaurang, fika på arbetet, äta middag hos vänner eller åka på utlandssemester.Dietisten Karin Fridell berättar vad man kan äta och vad man måste undvika som glutenintolerant. Karin redogör även för de nya EU-reglerna kring livsmedelsmärkning, ger baktips och en rad nya glutenfria recept.Skriften är rikligt illustrerad med inspirerande foton. Den är faktagranskad av leg. dietist Carina Lunneryd, Lunds universitetssjukhus, Iréne Jonson, Svenska celiakiförbundet och leg. läkare Ann Österman som själv är

  • 195.
    Hallgren Elfgren, Ing-Marie
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Törnvall, Eva
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Grodzinsky, Ewa
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    The process of implementation of the diabetes register in Primary Health Care2012In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 24, no 4, p. 419-424Article in journal (Refereed)
    Abstract [en]

    Quality problem or issue According to Swedish law, all health care units must have a system for quality improvement. The aim of this study was to follow an implementation process of a uniform routine for quality control of diabetes care in Primary Health Care in one county.                    

    Initial assessment Primary Health Care had a decentralized organization and patients with type 2 diabetes were served at 42 different Primary Health Care Centres.                    

    Choice of solution As the Swedish Diabetes Register (National Diabetes Register, NDR) holds the most important quality indicators, implementation of the NDR registration at all centres was chosen to be the best way to follow up quality in diabetes care.                    

    Implementation The process of implementing the NDR went through different phases and the main way to encourage commitment to the process was to reward performance in a progressively more differentiated way.                    

    Evaluation During the implementation process (2001–05) there was an increasing rate of registration. When the programme ceased, the registration rate had reached a level of 75%, which has remained stable and was still in 2010 one of the highest rates in                        Sweden.                    

    Lessons learned Important factors for success were the initiative taken by the profession itself and strong support from the leaders of the county council. It was also important to let the process develop gradually in order to get all staff involved. Among the outcomes was an increase in computer use in clinical practice among the diabetes nurse specialists and a structured way of encouraging the patients' participation in self-care.                    

                   

  • 196.
    Hallgren, Ing-Marie
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Grodzinsky, Ewa
    Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Törnvall, Eva
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    “Measuring makes aware” Implementation of the Diabetes Registry for Quality Improvement in Primary Health 2013In: Abstracts, Linköping, 2013, p. 26-27Conference paper (Refereed)
    Download full text (pdf)
    Measure makes aware
  • 197.
    Hare, David L.
    et al.
    University of Melbourne, Heidelberg, Australia; Austin Heatlh, Heidelberg, Australia .
    Toukhsati, Samia R.
    Austin Heatlh, Heidelberg, Australia .
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Social and Welfare Studies, Division of Nursing Science.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Depression and cardiovascular disease: a clinical review2014In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, no 21, p. 1365-1372Article in journal (Refereed)
    Abstract [en]

    Cardiovascular disease (CVD) and depression are common. Patients with CVD have more depression than the general population. Persons with depression are more likely to eventually develop CVD and also have a higher mortality rate than the general population. Patients with CVD, who are also depressed, have a worse outcome than those patients who are not depressed. There is a graded relationship: the more severe the depression, the higher the subsequent risk of mortality and other cardiovascular events. It is possible that depression is only a marker for more severe CVD which so far cannot be detected using our currently available investigations. However, given the increased prevalence of depression in patients with CVD, a causal relationship with either CVD causing more depression or depression causing more CVD and a worse prognosis for CVD is probable. There are many possible pathogenetic mechanisms that have been described, which are plausible and that might well be important. However, whether or not there is a causal relationship, depression is the main driver of quality of life and requires prevention, detection, and management in its own right. Depression after an acute cardiac event is commonly an adjustment disorder than can improve spontaneously with comprehensive cardiac management. Additional management strategies for depressed cardiac patients include cardiac rehabilitation and exercise programmes, general support, cognitive behavioural therapy, antidepressant medication, combined approaches, and probably disease management programmes.

    Download full text (pdf)
    fulltext
  • 198.
    Hedman, Ragnhild
    et al.
    Ersta Sköndal University College, Sweden; Karolinska Institutet, Sweden.
    Hansebo, Görel
    Ersta Sköndal University College, Sweden; Karolinska Institutet, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Sweden; Karolinska Institutet, Sweden.
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Sweden; Umeå University, Sweden.
    How people with Alzheimer's disease express their sense of self: analysis using Rom Harré's theory of selfhood2013In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 12, no 6, p. 713-733Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to use Harré's social constructionist theory of selfhood to describe how people with mild and moderate Alzheimer's disease (AD) express their sense of self. The findings show that Self 1, the embodied sense of being a person, was expressed fluently by participants through the use of first-person indexicals. Self 2, the experienced personal attributes and life narrative, had undergone changes. Those changes were not entirely for the worse; participants had also developed new skills in managing life with AD. In a lifetime perspective, those changes were minor and participants perceived themselves to be basically the same people that they were before having AD. When constructing Self 3, the social personae, participants usually described being supported by others, but sometimes described being exposed to malignant positioning. They also feared that they might become more exposed to negative attitudes as their AD progressed. However, participants were understanding towards the offensive behaviours of others.

  • 199.
    Hedman, Ragnhild
    et al.
    Karolinska Institute, Sweden Ersta Skondal University of Coll, Sweden Ersta Skondal University of Coll, Sweden .
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Ternestedt, Britt-Marie
    Karolinska Institute, Sweden Ersta Skondal University of Coll, Sweden .
    Hansebo, Gorel
    Karolinska Institute, Sweden Ersta Skondal University of Coll, Sweden .
    Norberg, Astrid
    Ersta Skondal University of Coll, Sweden Umeå University, Sweden .
    Social positioning by people with Alzheimers disease in a support group2014In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 28, p. 11-21Article in journal (Refereed)
    Abstract [en]

    People with Alzheimers disease (AD) are often negatively positioned by others, resulting in difficulties upholding a positive sense of self. This might cause them to withdraw socially and apparently lose their minds. Conversely, the sense of self can be strengthened with the support from others. This study aimed to describe, in accordance with positioning theory, how people with moderate AD positioned themselves and each other in a support group for people with AD. We describe five first-order positions; the project manager, the storyteller, the moral agent, the person burdened with AD, and the coping person. In the interactions that followed among the support group participants, those positions were mainly affirmed. This enabled participants to construct strong and agentic personae, and to have the severity of their illness acknowledged. Despite their language impairment participants managed to position and reposition themselves and others by assistance of the trained facilitator.

  • 200.
    Hellberg, Kristina
    et al.
    Linköping University. Linköping University, Department of Behavioural Sciences and Learning.
    Kjellberg, Anette
    Linköping University. Linköping University, Department of Social and Welfare Studies. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Övergång till högre studier eller arbetsliv för ung vuxna med neuropsykiatrisk problematikConference paper (Refereed)
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