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  • 251.
    Hambre, David
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Vergara, Marta
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Lood, Yvonne
    Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Sweden.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    Nyström, Fredrik H
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    A randomized trial of protein supplementation compared with extra fast food on the effects of resistance training to increase metabolism2012In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 72, no 6, p. 471-478Article in journal (Refereed)
    Abstract [en]

    Objective. To prospectively evaluate the effects of resistance training combined with increased energy intake or protein-supplementation on lean body-mass, resting metabolic-rate (RMR) and cardiovascular risk factors. Methods. Twenty-four healthy males (aged 19-32 years) performed resistance exercise for 12 weeks aiming for at least 1 hour training-sessions 3 times a week. The participants were randomized to consume extra protein (33 g whey protein/day) or a meal of fast-food/day (1350 kcal, 41 g protein). Body-composition was measured with Dual-Energy X-ray Absorptiometry (DEXA) and RMR by indirect calorimetry. Fasting blood samples were drawn before and after the 3-month training period and after 12 months. Results. The body weight increased from 75.1 +/- 6.9 kg to 78.7 +/- 7.2 kg (p andlt; 0.0001), without differences between the groups. RMR increased from 1787 +/- 143 kcal/24 h to 1954 +/- 187 kcal/24 h (p andlt; 0.0001, N = 24), which was more than expected from the increase in lean body-mass (increase from 59.7 +/- 4.3 kg to 61.8 +/- 4.1 kg p = 0.004). Fasting serum-insulin levels increased in the fast-food group compared with the extra-protein group (p = 0.03). ApoB increased from 0.691 +/- 0.14 g/L to 0.768 +/- 0.17 g/L, p = 0.004, in the fast-food group only. Long-term follow up after 12 months showed that RMR, body weight, total fat and lean body-masses did not differ from baseline (n = 19). Conclusions. Resistance training for 12 weeks increased RMR and lean body-mass similarly when based on either an increased energy-intake or protein supplement. However, the increase in RMR was higher than expected from the increase in lean body-mass. Thus resistance training could potentially decrease the risk of obesity by induction of increased RMR.

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  • 252.
    Hanberger, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics.
    Samuelsson, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    The influence of process, structure and policy on Haemoglobin A1c levels in treatment of children and adolescents with type 1 diabetes2012In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 96, no 3, p. 331-338Article in journal (Refereed)
    Abstract [en]

    Objective: We aimed to identify factors for improvements of mean A1C at centres treating children and adolescents with diabetes.

    research Design and methods: Through data from the Swedish paediatric diabetes quality registry, SWEDIABKIDS, five centres with the lowest mean A1C (Low group), five with the highest (High group), and five with the largest decrease in centre mean A1C (Decrease group) were identified. The diabetes team members completed a questionnaire, response rate 85%, (109/128) and reported team structure and process. Open-ended questions regarding messages to patients about important diabetes matters were analysed with summative content analysis.

    Results: Compared to the High group, the Low and Decrease groups showed shorter professional experience and lower proportion of special diabetes-educated team members, and higher compliance with guidelines. Trends for higher mean insulin dose, larger centre size and larger team size were found. The content analysis indicated that the Low and Decrease groups gave a clear message and had lower A1C target value. The team members in these groups were engaged, had a positive attitude and a perception of a well-functioning team. The High group gave a vague message, needed more frames and had a perception of lack of cooperation in the team.

    Conclusions: The team members' approach seems to affect metabolic control in children and adolescents. The team members need to be aware of their approach and how it affects patients and parents, and also of the importance of the possibility of using resources and competence within the team.

  • 253.
    Hemlin, Claes
    et al.
    Aleris Sabbatsberg Hospital, Stockholm.
    Sunnergren, Ola
    County Hospital Ryhov, Jönköping.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Hessén Söderman, Anne- Charlotte
    Karolinska University Hospital.
    Roos, Kristian
    Capio Lundby Hospital, Göteborg.
    Passmark, H
    Stalfors, Joacim
    Sahlgrenska University Hospital, Göteborg.
    A Patient questionnaire can give valid information on the prescence of morbidity after tonaillar surgery - results of a validation study2012Conference paper (Other academic)
  • 254.
    Henriksson, Anette
    et al.
    University of Örebro, Sweden .
    Arestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Linnaeus University, Sweden .
    Benzein, Eva
    Linnaeus University, Sweden .
    Ternestedt, Britt-Marie
    Ersta Skondal University of Coll, Sweden .
    Andershed, Birgitta
    Ersta Skondal University of Coll, Sweden .
    Effects of a support group programme for patients with life-threatening illness during ongoing palliative care2013In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 27, no 3, p. 257-264Article in journal (Refereed)
    Abstract [en]

    Background: Health care systems in many countries are moving towards outpatient care in which family members are central in providing care for patients with life-threatening illness. Several studies show that family members report a lack of preparation, knowledge and the ability to handle the caregiver role, and a need for information and psychosocial support. less thanbrgreater than less thanbrgreater thanAim: The aim was to investigate the effects of a support group programme for family members of patients with life-threatening illness during ongoing palliative care. less thanbrgreater than less thanbrgreater thanDesign: A prospective quasi-experimental design, including an intervention group and a comparison group, was used. less thanbrgreater than less thanbrgreater thanSettings/participants: A support group programme was offered to family members during ongoing palliative care at three intervention settings: two specialist palliative care units and one haematology unit. A fourth setting, a specialist palliative care unit, was used for comparisons. less thanbrgreater than less thanbrgreater thanResults: Family members taking part in the support group programme significantly increased their perceptions of preparedness for caregiving, competence for caregiving, and rewards of caregiving. Hope, anxiety, depression symptoms and health showed no significant changes. less thanbrgreater than less thanbrgreater thanConclusions: The intervention, including a support group programme delivered to family members of patients with life-threatening illness during ongoing palliative care, proved to be effective in certain domains of caregiving. No negative outcomes were detected. The results indicate that this intervention could be implemented and delivered to family members during ongoing palliative care.

  • 255.
    Henriksson, Annette
    et al.
    University of Örebro, Sweden .
    Andershed, Birgitta
    Ersta Skondal University of Coll, Sweden Gjovik University, Norway .
    Benzein, Eva
    Ersta Skondal University of Coll, Sweden Linneaus University, Sweden .
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Adaptation and psychometric evaluation of the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale in a sample of Swedish family members of patients with life-threatening illness2012In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 26, no 7, p. 930-938Article in journal (Refereed)
    Abstract [en]

    Background: Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. less thanbrgreater than less thanbrgreater thanAim: This study aimed to translate, adapt and psychometrically evaluate the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale in Swedish family members of patients with life threatening illness. less thanbrgreater than less thanbrgreater thanDesign: Correlational. less thanbrgreater than less thanbrgreater thanSetting/participants: The study took place in four settings including advanced palliative care. The scales were tested in a sample of 125 family members of persons with life-threatening illness. All three scales were tested in relation to distribution of item and scale scores, missing data patterns, dimensionality, convergent validity and reliability. less thanbrgreater than less thanbrgreater thanResults: The results in this study indicate that the Swedish versions of The Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale are valid, reliable and user-friendly scales. Confirmatory factor analysis showed that the scales were unidimensional and all demonstrated Cronbachs alpha values of andgt;= 0.9. less thanbrgreater than less thanbrgreater thanConclusions: As a result of this study it is anticipated that the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale could provide a basis for collaborative research between different countries and make international studies more comparable and generalizable despite differences in language and culture.

  • 256.
    Hessén Söderman, Anne- Charlotte
    et al.
    Karolinska University Hospital.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Hemlin, Claes
    Aleris Sabbatsberg Hospital, Stockholm.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Roos, Kristian
    Capio Lundby Hospital, Göteborg.
    Sunnergren, Ola
    County Hospital Ryhov, Jönköping.
    Stalfors, Joacim
    Sahlgrenska University Hospital, Göteborg.
    Posttonsillectomy haemorrhage rates related to surgical technique.2012Conference paper (Other academic)
  • 257.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Dahl, A
    n/a.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Mårtensson, J
    n/a.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Profile of cognitive impairment in chronic heart failure among octogenerians in Sweden.2009In: 9th Annual Spring Meeting on Cardiovascular Nursing, CCNAP., 2009Conference paper (Refereed)
  • 258.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Dahl, Anna
    Jönköping University, Sweden.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jönköping University, Sweden.
    Mårtensson, Jan
    Jönköping University, Sweden.
    Johansson, Boo
    University of Gothenburg, Sweden.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 7-8, p. 994-1003Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim of this study was to examine the relationship between heart failure and specific cognitive abilities in octogenarians with regard to level and change over time.

    Background.  Cognitive impairment is influenced by many factors, and the impact of heart failure is debated. Intact cognitive ability is crucial for successful self-care in patients with heart failure. Middle-aged patients with heart failure seem to have an increased risk of cognitive impairment. No studies have examined the association between heart failure and longitudinal cognitive changes in octogenarians (individuals 80 years and older).

    Design.  A prospective longitudinal design.

    Methods.  Cognitive tests were carried out five times (1991–2002) in 702 octogenarians from the Swedish Twin Registry, including same-sex twin pairs. The test battery included the measurement of processing speed, visuospatial ability, short-term, episodic and semantic memory. Latent growth curve modelling was employed to measure change and performance over time and compares the group diagnosed with heart failure to individuals without a heart failure diagnosis.

    Results.  At baseline, the participants’ mean age was 83·5 years, 67% were women and 13% suffered from heart failure. Individuals diagnosed with heart failure scored significantly lower in spatial abilities and episodic memory than participants not diagnosed with heart failure. Moreover, measures of episodic memory declined more over time in individuals diagnosed with heart failure. There were no significant differences between the groups in other cognitive tests.

    Conclusion.  Spatial problems and episodic memory have implications for everyday life. This might contribute to decreased adherence to prescribed therapy and self-care management and lead to socio-behavioural problems because of an impaired capacity to drive, read and write.

    Relevance to clinical practice.  Nurses should take into account in their assessment that cognitive impairment may restrain elderly heart failure patient’s ability to make decisions and perform self-care actions. Patient education strategies should also be adapted to cognitive ability.

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  • 259.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Arestedt, K
    University of Kalmar.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sleep-disordered breathing and cognitive impairment among patients with heart failure in JOURNAL OF SLEEP RESEARCH, vol 21, issue SI, pp 256-2572012In: JOURNAL OF SLEEP RESEARCH, Wiley-Blackwell , 2012, Vol. 21, no SI, p. 256-257Conference paper (Refereed)
    Abstract [en]

    n/a

  • 260.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Jönköping University .
    Association between sleep-disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure2013In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 15, no 5, p. 496-504Article in journal (Refereed)
    Abstract [en]

    Aims Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction.

    Methods and results In this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoea–hypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition.

    Conclusion The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.

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  • 261.
    Hjelm, Carina
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Franzén Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Broström, Anders
    Hälsohögskolan i Jönköping.
    Effects of sleep disordered breathing, insomnia and excessive daytime sleepiness on cognitive function among patients with heart failure2012Conference paper (Other academic)
  • 262.
    Hjelm, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Nursing Science.
    Hartwig, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Department of Welfare and Care (IVV). Linköping University, The Institute of Technology.
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Nursing Science.
    An inevitable journey by train: Nurses' narratives about palliative care2007In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 9, no 4, p. 206-211Article in journal (Refereed)
    Abstract [en]

    The purpose of this article is to explore the meaning of palliative care in the context of the caring relationship described by nurses providing such care in the home. Eleven nurses were interviewed, and the transcripts were analyzed using the hermeneutic narrativism method. The study found that the nurses'' narrative account of a caring relationship can be represented by a metaphor: an inevitable journey by train, characterized by the three themes of transit points, time, and guidance. Each journey passes through the same four points in chronological order. Time always moves forward, but the duration of the journey can be either long or short. Having more time creates better conditions for developing a caring relationship. The nurse provides guidance through a journey that she has made before, although each journey is unique. A caring relationship signifies commitment and involvement. © 2007 Lippincott Williams & Wilkins, Inc.

  • 263.
    Hjelm, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Social support as described by Swedish people diagnosed with type 2 diabetes mellitus2009In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 10, p. 26-37Article in journal (Refereed)
  • 264.
    Hollman Frisman, G
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Evidence based nursing2009Conference paper (Other (popular science, discussion, etc.))
  • 265.
    Hollman Frisman, G
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Leadership aiming to develop nursing care2008Conference paper (Other (popular science, discussion, etc.))
  • 266.
    Hollman Frisman, Gunilla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Having knowledge of metabolic syndrome: Does the meaning and consequences of the risk factors influence the life situation of Swedish adults?2008In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 10, no 4, p. 300-305Article in journal (Refereed)
    Abstract [en]

    The underlying causes of metabolic syndrome (MS) are uncertain. Knowledge from those who have experience of this syndrome should provide new insight. The aim was to explore the meaning and consequences of MS. Thirteen Swedish adults with MS, aged between 33 and 82 years, were interviewed. The interviews were analyzed using constant comparative analysis, which is the basis of grounded theory. The core category for the meaning and consequences of having the risk factors of MS consisted of the recurrence of behavior. The participants attempted to balance their insight into the causes and consequences by referring to their normal life, lifestyle, and fatalistic approach to life. Attention needs to be paid to the attitudes of the individuals with MS, as well as the known risk factors and their consequences, in order to facilitate a long-term lifestyle change in these individuals.

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  • 267.
    Hollman Frisman, Gunilla
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Knowing about the metabolic syndrome, does it influence life?2008In: 8th Annual Spring Meeting on Cardiovascular Nursing, 2008Conference paper (Refereed)
  • 268.
    Hollman Frisman, Gunilla
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Knowing about the metabolic syndrome, does it influence life?2007In: A elebration event Med dr hc professor Afaf Meleis and Twenty years of Nursing Science., 2007Conference paper (Refereed)
  • 269.
    Hollman Frisman, Gunilla
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Eriksson, Carrie
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Pernehed, Sara
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Norrköping.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    The experience of becoming a grandmother to a premature infant - A balancing act, influenced by ambivalent feeling2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 21-22, p. 3297-3305Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  To explore and describe the experience of becoming a grandmother to a premature infant.

    Background.  Becoming a grandmother involves a new perspective of life. Grandmothers of sick infants find themselves in a new situation with an adult child undergoing serious stress. Few studies have approached the grandmothers’ own experience of becoming a grandmother to a premature infant.

    Design.  A qualitative content analysis was used.

    Methods.  Eleven women, 52–66 years of age, who were grandmothers to premature infants born at a gestational age of 25–34 weeks, were interviewed during 2010. The infants were less than three years old at the time of the interview. The interviews were analysed with qualitative content analysis.

    Results.  The overall theme was a balancing act. Two categories of experience were identified: emotional experiences and a new role. ‘Emotional experiences’ was related to the first meeting, ambivalent feelings and confidence in care. ‘A new role’ was related to the subcategories supportive, a balance of involvement and limitations.

    Conclusions.  To become a grandmother to a premature infant was experienced as a balancing act influenced by ambivalent feelings of joy, fear and worry. The grandmothers sensed the seriousness of the situation at the same time as they wanted to be happy about the newborn infant. They worried about their adult child’s as well as the premature infant’s health but put their own needs aside. The grandmothers’ new role was a balance between being involved and supportive without disturbing.

    Relevance to clinical practice.  Neonatal intensive care unit staff should be open to grandmothers’ needs and acknowledge them as an obvious support for the immediate family of a premature infant. The grandmothers need guidance and information about what to expect concerning the infants health, the parents situation and their own role.

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  • 270.
    Hollman Frisman, Gunilla
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    Jacobsson, Catrine
    PrioriteringsCentrum.
    Hela teamets kompetens: sjuksköterskors, sjukgymnasters och arbetsterapeuters erfarenheter av att delta i prioriteringsarbete2011Report (Other academic)
    Abstract [en]

     

    When health services cannot meet all care needs we must set priorities. This has always been done, but seldom in a systematic way. In Sweden, the Health Services Act places the responsibility for healthcare priority setting on local governing bodies (mainly the county councils and regions). The task of priority setting is grounded in the ethical platform and must apply across all health services.

    In 2003, the Östergötland County Council initially decided that specific limitations must be established regarding the supply of health services. However, follow-up of the county-council-wide effort to set priorities reveals that this work has not reached far enough down into the organisation.

    Earlier reports from the National Centre for Priority Setting in Health Care describe the initial political decision-making process, the extent to which the policy decisions have been implemented in health care, and the progress of the county council’s prioritisation initiative from 2003 to 2006. With this report we aim to increase knowledge regarding how staff groups other than management- level physicians participated in establishing vertical ranking lists during this period and how these lists were used in Östergötland County Council.

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    Hela teamets kompetens: sjuksköterskors, sjukgymnasters och arbetsterapeuters erfarenheter av att delta i prioriteringsarbete
  • 271.
    Hollman Frisman, Gunilla
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Kristenson, Margareta
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Psychosocial status and health related quality of life in relation to the metabolic syndrome in a Swedish middle-aged population2009In: EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, ISSN 1474-5151, Vol. 8, no 3, p. 207-215Article in journal (Refereed)
    Abstract [en]

    Background: The Metabolic Syndrome (MS) is a combination of risk factors related to increased risk of cardiovascular disease. Psychosocial factors and stress have been suggested to be important determinants. Aim: To analyse how psychosocial factors, perceived stress and health related quality of life are related to MS, and assess if observed associations are dependent of life-style. Methods: A cross-sectional study of a random sample of 502 men and 505 women aged 45-69, front southeast Sweden, including fasting blood samples, blood pressure, anthropometrics, self-reported data of life-style, psychosocial status and health related quality of life (SF-36). Linear regression models were adjusted for age and, in a second step, also for life-style. Results: Men and women with MS reported lower levels of physical activity, lower scores on physical and social dimensions of SF-36, and women with MS reported stronger effect of social change compared to those without MS (p andlt; 0.05), but we found no differences for mental health or perceived stress. The major part of observed associations was lost after adjustment for effects of life-style. Conclusion: Our data speak against a direct effect of social stress on MS via psychological strain but suggest an indirect pathway via a sedentary life-style.

  • 272.
    Hollman, G
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Att leva med ökad risk för hjärtinfarkt2003Conference paper (Other (popular science, discussion, etc.))
  • 273.
    Hollman, G
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Familjär hyperkolesterolemi. Optimal behandlingsstrategi och livskvalitet.1999Conference paper (Other academic)
  • 274.
    Hollman, G
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Quality of life in family members in families with familial hypercholesterolemia2003Conference paper (Other academic)
  • 275.
    Hollman, G
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, C
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, A-C
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Livskvalitet vid genetiskt ökad sjukdomsrisk2003Conference paper (Other academic)
  • 276.
    Hollman, G
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, A-C
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Olsson, AG
    Achievment of treatment goals2004Conference paper (Other academic)
  • 277.
    Hollman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Att leva med ärftligt höga kolesterolvärden och ökad risk för hjärt-kärlsjukdom2003In: Dagens Medicin, ISSN 1104-7488Article in journal (Other (popular science, discussion, etc.))
  • 278.
    Hollman, Gunilla
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Living with the metabolic syndrome2006In: The 2006 WENR Scientific Symposium, Obesity as a threat to health. How can nursing research contribute to prevention and care?, 2006Conference paper (Refereed)
  • 279.
    Hollman, Gunilla
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Kristenson, Margareta
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    The prevalence of the metabolic syndrome and its risk factors in a middle-aged Swedish population - mainly a function of overweight?2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 1, p. 21-26Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of obesity, one risk factor for developing the metabolic syndrome (MS), has increased during the last decades. It has therefore been assumed that the prevalence of MS would also increase.

    Aims: The aim was to analyse the prevalence of MS and its risk factors in a middle-aged Swedish population.

    Methods: Data were obtained between 2003 and 2004 from a random population based sample of 502 men and 505 women, 45-69 years old. Measures of plasma glucose, serum lipids, blood pressure, weight, height, waist circumference and self-reported data concerning presence of disease, medication and lifestyle were obtained.

    Results: The prevalence of MS was 14.8 % among men and 15.3 % among women, with an increase by age among women only, 10 % to 25 % (p=0.029). Among individuals with MS the most frequent risk factor was large waist circumference, present in 85 % of men and 99 % of women, followed by high blood pressure, high triglycerides, high glucose and HDL cholesterol (38 % and 47 % respectively).

    Conclusion: The prevalence of MS was 15 %, increasing with age only among women.

    Overweight was a dominant characteristic, and only half of the individuals with MS had glucose/HDL cholesterol levels beyond defined cut points of the syndrome.

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  • 280.
    Holmberg, T
    et al.
    Linköping University, Department of Medicine and 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. Linköping University, Faculty of Health Sciences.
    Börelius, L
    n/a.
    Ledström, B
    n/a.
    Andersson, I
    n/a.
    Foldemo, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Utvärdering av de psykosociala teamen i Borensberg, Motala och Vadstena2009Report (Other academic)
  • 281.
    Holmberg, Tommy
    et al.
    Linköping University, Department of Medicine and Health Sciences. 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.
    Börelius, L
    Andersson, I
    Foldemo, Anniqa
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. 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.
    Utvärdering av det psykosociala teamet inom primärvården i Norrköping.2009Report (Other academic)
  • 282.
    Holst, M.
    et al.
    Hospital, Aalborg.
    Rasmussen, H.H.
    Hospital, Aalborg.
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Well-established nutritional structure in Scandinavian hospitals is accompanied by increased quality of nutritional care2009In: e-SPEN, ISSN 1751-4991, Vol. 4, no 1Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate Scandinavian nurses self-reported attitudes, practice and barriers towards nutrition practice, and to explore whether nurses working in departments with a well defined structure (w-DS) for nutritional aspects, have better nutritional practise. Preventing and treating undernutrition is shown to be complicated. Investigations are needed to priority efforts. The design is a questionnaire-based investigation of Scandinavian hospital nurses attitudes and practise to clinical nutrition. A questionnaire regarding nutritional care process sent to 6000 nurses in Scandinavia. A definition of w-DS and p-DS (less defined structure) was made according to ESPEN Guidelines. Nurses were classified as working at w-DS or p-DS departments, if three or more of five organisational structure markers were met. Overall 2759 responded. Discrepancy was found between attitudes and practise (p less than 0.0001). W-DS was found in 49%. Nurses who worked at departments with w-DS had higher frequency for nutrition actions (p less than 0.0001). Knowledge and time past graduation, were amongst independent factors for good nutritional structure (p less than 0.0001). Differences were seen between countries and specialities (p less than 0.0005). Organisation structure recommended by ESPEN seems important. Knowledge and experience were independent factors for good nutrition structure. The content of nutrition education needs consideration.

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  • 283. Holst, M
    et al.
    Strömberg, A
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Willenheimer, R
    Fluid restriction in heart failure patients: Is it useful?2003Conference paper (Other academic)
  • 284.
    Holst, Marie
    et al.
    Malmö Universitet.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Lindholm, Maud
    Malmö universitet.
    Willenheimer, Ronnie
    Lunds universitet.
    Description of self-reported fluid intake and its effects on body weight, symptoms, quality of life and physical capacity in patients with stable chronic heart failure2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 17, p. 2318-2326Article in journal (Refereed)
    Abstract [en]

    Aim. To describe the self-reported fluid intake and its effects on body weight, signs and symptoms of heart failure, quality of life, physical capacity and thirst, in patients with stabilised chronic heart failure. Background. Patients with chronic heart failure are often recommended a fluid restriction of 1.5 l/day but there is no evidence in the literature for this recommendation and little is known about the fluid intake consequences. Design. Crossover study. Methods. Chronic heart failure patients, clinically stabilised after an unstable state, were randomised to a 32-week cross-over study assessing the clinical importance of fluid prescription. In a secondary analysis of 63 patients, efficacy variables were analysed in relation to the self-reported median fluid intake of 19 ml/kg body weight/day. Results. The mean fluid intake was 16 ml/kg/day in the below-median group and 24 ml/kg/day in the above-median group. No between-group differences were found in change in body weight, signs and symptoms, diuretic use, quality of life or physical capacity. However, the above-median group significantly decreased sense of thirst and difficulties to adhere to the fluid prescription compared with the below-median group. Conclusion. In clinically stabilised chronic heart failure patients on optimal pharmacological treatment, a larger fluid intake was associated with decreasing thirst without any measurable negative effects on signs and symptoms of heart failure, diuretic use or physical capacity. Thus, a more liberal fluid intake may be advisable in chronic heart failure patients who have been stabilised after an initial unstable clinical state. Relevance to clinical practice. Nurses involved in the care for patients with heart failure known how troublesome thirst can be and how difficult it can be to follow a restricted fluid intake. This study indicates that it is possible to reassess and recommend a less strict fluid intake in stabilised patients with chronic heart failure. © 2008 The Authors.

  • 285.
    Holst, Marie
    et al.
    Malmö universitet.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Lindholm, Maud
    Malmö Universitet.
    Willenheimer, Ronnie
    Lunds universitet.
    Liberal versus restricted fluid prescription in stabilised patients with chronic heart failure: Result of a randomised cross-over study of the effects on health-related quality of life, physical capacity, thirst and morbidity2008In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 42, no 5, p. 316-322Article in journal (Refereed)
    Abstract [en]

    Objective. To compare the effects of a restrictive versus a liberal fluid prescription, on quality of life, physical capacity, thirst and hospital admissions, in patients who had improved from NYHA class (III-)IV CHF to a stable condition without clinical signs of significant fluid overload. Design. The present study is a randomised cross-over study. Seventy-four patients (mean age 70±10 years, 16% women) - with mild-moderate CHF - were randomised 1:1 to either of two 16-week interventions. Intervention 1 prescribed a maximum fluid intake of 1.5 L/day. Intervention 2 prescribed a maximum fluid intake of 30-35 ml/kg body weight/day. Sixty-five patients completed the study. Results. There were no significant between-intervention differences in end-of-intervention quality of life, physical capacity or hospitalisation. However, there was a significant favourable effect on thirst and less difficulties to adhere to the fluid prescription during the liberal fluid prescription intervention. Conclusion. The results from this study indicate that it may be beneficial and safe to recommend a liberal fluid prescription, based on body weight, in stabilised CHF patients. These results warrant further investigation of the effects of fluid advice in CHF. © 2008 Informa UK Ltd.

  • 286.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Hemlin, Claes
    Aleris Sabbatsberg Hospital, Stockholm.
    National Guidelines for Tonsillotomy in children in Sweden.2012Conference paper (Other academic)
  • 287.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
    Hemlin, Claes
    Aleris specialistvård Sabbatsberg, Stockholm.
    Eggertsen, Robert
    Avd. för Samhällsmedicin och folkhälsa/allmänmedicin, Göteborgs Universitet.
    Lundeborg-Hammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Marcusson, Agneta
    Östergötlands Läns Landsting, Sinnescentrum, Department of Oral Surgery UHL.
    Proczkowska-Björklund, Marie
    Barn- och ungdomspsykiatri, Psykiatriska kliniken, Höglandet Eksjö/Nässjö.
    Stjernquist-Desatnik, Anna
    Öron-näsa-hals-kliniken, Universitetssjukhuset Lund.
    Zettergren-Wijk, Lena
    Avdelningen för tandreglering, Folktandvården Gävleborg AB, Gävle.
    Moa, Gunnar
    Projektledare Nationella medicinska indikationer.
    Törnqvist, Helene
    Projektledare Nationella medicinska indikationer.
    Indikation för tonsillotomi på barn och ungdomar2011Report (Other academic)
  • 288.
    Hultsjo, Sally
    et al.
    Department of Psychiatry, Ryhov County Hospital, Jönköping.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Arvidsson, Hans
    Department of Psychology, The University of Gothenburg, Gothenburg, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö.
    Core components in the care of immigrants with psychoses: A Delphi survey of patients, families, and health-care staff2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, no 3, p. 174-184Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to identify core components in the care of immigrants with psychosis in Sweden. Experts (n = 43) from different perspectives (immigrants, families, and health-care staff) were assembled and used to score the importance of statements regarding components in the care for a person with psychosis in three questionnaire rounds. After each round, the opinions were consolidated and compared to identify whether consensus was reached. Consensus was reached about the importance of being treated on equal terms, regardless of country of birth. Staff interest and respect, shown in different ways of understanding, was valued. Consensus could not be reached on approximately half of the statements, of which four tended to be ranked towards unimportant. Those included that staff should have specific cultural knowledge or that the patient should be allowed to decide whether to be cared for by male or female staff. Nor was it regarded as important to identify a persons religious or ethnic background. The results illustrate the importance of fundamental psychiatric nursing, which should enable nurses to identify and meet the basic needs of all patients, regardless of country of origin. Areas for which consensus was not reached illustrate a future challenge for health-care staff to identify situations when cultural clashes could appear. Staff should have strategies to accomplish cultural negotiations to build an effective treatment alliance with the patient, as well as the family, to meet individual needs.

  • 289. Order onlineBuy this publication >>
    Hultsjö, Sally
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Caring for foreign‐born persons with psychosis and their families: Perceptions of psychosis care2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to describe and analyse perceptions of psychosis care among those involved in care, foreign-born persons with psychoses, their families and health care staff, and further to reach agreement about core components in psychosis care. This was in order to find out whether current psychosis care in Sweden is suitable for foreign-born persons and their families. The study design was explorative and descriptive. Health care staff (n=35), persons with psychosis (n=22) and families (n=26) of persons with psychosis were chosen from different regions in Southern Sweden. To capture health care staff’s experiences and to explore whether specific needs occurred within psychiatric care, nine focus group interviews were held. The perspectives of psychosis care among persons with psychoses and their families were captured through individual interviews. Finally, a study was accomplished all over Sweden in which staff, foreign-born persons with psychosis and foreign-born families of persons with psychoses answered a questionnaire to identify core components in psychosis care of foreign-born persons and their families. There was agreement that the core components in psychosis care concern general psychiatric caring, even though varying perceptions were identified. Asking about foreign-born persons’ religious and ethnic background or having the possibility to decide whether care should be provided by male or female staff were agreed to be less important. No agreement could be reached concerning the importance of considering different perceptions of psychosis care, treatments and different ways of managing the psychosis. Nor could agreement be reached as to whether staff should have specific cultural knowledge and whether interpreters should be unknown to the family but speak the right dialect. Perceptions among staff in somatic and psychiatric care as well as perceptions among foreign- and Swedish-born persons with psychosis and their families were more similar than different. General psychiatric care is important for Swedish-born as well as foreign-born persons with psychosis and their families, indicating the importance of not letting culturally determined perceptions dictate the care and take away energy from health care staff and make them lose their focus on the basic elements in general psychiatric care. However, within the general care there were individual perceptions on whose importance those involved in care did not agree. Further development suggested is to illuminate the importance of identifying individual perceptions which may differ between different persons and could be related to cultural background. Staff need to acquire strategies so they can easily manage to encounter and offer general care to foreign-born persons. Development must be achieved on both an organizational level and an individual level.

    List of papers
    1. Immigrants in emergency care: Swedish health care staff's experiences
    Open this publication in new window or tab >>Immigrants in emergency care: Swedish health care staff's experiences
    2005 (English)In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 52, no 4, p. 276-285Article in journal (Refereed) Published
    Abstract [en]

    Background: During the past few decades Sweden has developed into a multicultural society. The proportion of patients with different cultural backgrounds increases, which naturally makes new demands on health care staff.

    Aim: To identify whether staff in somatic and psychiatric emergency care experienced problems in the care of migrants, and if so to compare these.

    Method: The study design was explorative. Focus group interviews of 22 women and 13 men working as nurses and assistant nurses at an emergency ward, an ambulance service and a psychiatric intensive care unit were held.

    Findings: The results showed that the main problems experienced in all wards were difficulties related to caring for asylum-seeking refugees. Some dissimilarities were revealed: unexpected behaviours in migrants related to cultural differences described by staff working in the emergency ward; migrants' refusal to eat and drink and their inactive behaviour in the psychiatric ward; and a lot of non-emergency runs by the ambulance staff because of language barriers between the emergency services centre and migrants.

    Conclusion: The main problems experienced by the health care staff were situations in which they were confronted with the need to care for asylum-seeking refugees. Practice implications: These emphasize the importance of support from organizational structures and national policies to develop models for caring for asylum-seeking refugees. Simple routines and facilities to communicate with foreign-language-speaking migrants need to be developed. Health care staff need a deeper understanding of individual needs in the light of migrational and cultural background.

    Place, publisher, year, edition, pages
    Wiley InterScience, 2005
    Keywords
    Ambulance, Asylum-seeking Refugees, Emergency, Health Care Staff, Migrants, Psychiatry
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18083 (URN)10.1111/j.1466-7657.2005.00418.x (DOI)
    Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2017-12-13Bibliographically approved
    2. Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders
    Open this publication in new window or tab >>Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders
    2007 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 3, p. 279-288Article in journal (Refereed) Published
    Abstract [en]

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

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

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

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

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

    Keywords
    Interviews, migrants, nursing, patients’ perceptions, phenomenography, psychiatric nursing, psychotic disorder
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18084 (URN)10.1111/j.1365-2648.2007.04391.x (DOI)17822426 (PubMedID)
    Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2017-12-13Bibliographically approved
    3. Foreign-born and Swedish-born families perceptions of psychosis care
    Open this publication in new window or tab >>Foreign-born and Swedish-born families perceptions of psychosis care
    2009 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 1, p. 62-71Article in journal (Refereed) Published
    Abstract [en]

    The aim of the study was to describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Eleven foreign-born and 15 Swedish-born family members were interviewed and the data were analyzed using a phenomenographic approach. The findings showed three main descriptive categories: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.

    Keywords
    Family, phenomenography, psychosis, psychosis care, quality of care
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-17154 (URN)10.1111/j.1447-0349.2008.00587.x (DOI)
    Available from: 2009-03-07 Created: 2009-03-07 Last updated: 2017-12-13Bibliographically approved
    4. Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi technique
    Open this publication in new window or tab >>Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi technique
    (English)Manuscript (Other academic)
    Abstract [en]

    The purpose of this study was to let persons involved in psychosis care (foreign-born persons, families and health care staff) identify the core components in care of foreign-born persons with psychosis and their families in Sweden. The results from three previous qualitative studies consisting of perceptions of psychosis care were reformulated and structured into statements in a questionnaire which was delivered to 43 persons involved in psychosis care. The statements were scored in terms of perceived importance in two rounds using the Delphi technique. The results revealed agreement about the importance of general psychiatric care. Individual perceptions on which importance there was no agreement, suggested that staff must seek to understand a person’s individual perceptions to gain insight about ways to build an effective care alliance with foreign born persons with psychosis and their families.

    Keywords
    Delphi technique, foreign-born persons, psychosis care, nursing
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18085 (URN)
    Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2013-09-12Bibliographically approved
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    Caring for foreign-born persons with psychosis and their families
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  • 290.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Arvidsson, Hans
    School of Health Sciences and Social Work, Växjö University, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi techniqueManuscript (Other academic)
    Abstract [en]

    The purpose of this study was to let persons involved in psychosis care (foreign-born persons, families and health care staff) identify the core components in care of foreign-born persons with psychosis and their families in Sweden. The results from three previous qualitative studies consisting of perceptions of psychosis care were reformulated and structured into statements in a questionnaire which was delivered to 43 persons involved in psychosis care. The statements were scored in terms of perceived importance in two rounds using the Delphi technique. The results revealed agreement about the importance of general psychiatric care. Individual perceptions on which importance there was no agreement, suggested that staff must seek to understand a person’s individual perceptions to gain insight about ways to build an effective care alliance with foreign born persons with psychosis and their families.

  • 291.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hjelm , Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Foreign-born and Swedish-born families perceptions of psychosis care2009In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 1, p. 62-71Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Eleven foreign-born and 15 Swedish-born family members were interviewed and the data were analyzed using a phenomenographic approach. The findings showed three main descriptive categories: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.

  • 292.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hjelm, Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 3, p. 279-288Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 293.
    Höglund, Johan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Tödt, Tim
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Johansson, Ingela
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    The effect of early mobilisation for patient undergoing coronary angiography; A pilot study with focus on vascular complications and back pain2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 2, p. 130-136Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The optimal length of bed rest after femoral coronary angiography is still unknown. Short immobilisation could cause puncture site complications due to the modern antiplatelet therapy used, while long immobilisation time increases the risk of back pain for the patient. PURPOSE: To assess the safety, as well as perceived comfort, of early mobilisation after coronary angiography with femoral approach. METHODS: A randomised, single centre pilot trial with 104 coronary angiography patients (including 58 patients with non ST-elevation acute coronary syndrome) assigned to a post-procedural bed rest time for either 1.5 or 5h. The primary endpoint was any incidence of vascular complication. Patients' discomfort was measured as self-perceived grade of pain in the back. RESULTS: The presence of haematomas >/=5cm was 5.8% in the short immobilisation group vs. 3.8% in the control group (ns). There was a significantly lower rate of perceived back pain in the short immobilisation group, compared to the controls, at the time of mobilisation, which remained significant also after 2h of mobilisation. CONCLUSION: Early ambulation after coronary angiography is safe, without affecting the incidence of vascular complications, and decreases the patients' pain, both during and after the bed rest.

  • 294. Order onlineBuy this publication >>
    Idvall, Ewa
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Development of Strategic and Clinical Quality: Indicators in Postoperative Pain Management2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to identify important aspects of surgical nursing care, designing strategic and clinical quality indicators in postoperative pain management, investigate content validity, develop and evaluate psychometric properties of an instrument to measure the indicators, test the applicability of the instrument and investigate patient and nurse assessment.

    To identify the important aspects of nursing care which might impact on quality of care in surgical wards, it was conducted 4 focus group interviews with clinical nurses (n=20). A tentative model with 15 categories in 2 dimensions, elements of performance and prerequisites, emerged from the data analysis. The categories were, e.g. detecting and acting on signs and symptoms, informing and educating, promoting relationships, responsibility and attitudes. The model was used as a foundation for developing indicators in postoperative pain management, one in each category, each supported by a literature review. To assess the content validity of the indicators, a questionnaire was compiled and sent to registered nurses with a special interest in pain (n=210) and to a random sample of clinical nurses working in surgical wards (n=321). The groups assessed the indicators as essential for achieving high quality, realistic to carry out and possible for nurses to influence management. The first group validated 14 of the 15 indicators and the second group validated 12 as “major” factors in terms of being essential to achieve high quality of care. The remaining factors were classified as “supportive”. No indicator was discarded.

    To measure the indicators, an instrument was developed and psychometric properties were evaluated. The indicators were converted to statements suitable for a patient questionnaire and were scored on a 5-point scale with higher values indicating higher quality of care. Patients (n=198) answered the questionnaire on their second postoperative day. The inter-item and item-total correlation coefficients were in a satisfactory range, and Cronbach’s coefficient alpha (0.84) supported internal consistency reliability. Four sub-scales, entitled communication, action, trust and environment emerged from the factor analysis with a total variance of 61.4%. The total scale correlated (rs=0.53) with the single item pain-relief-satisfaction question. The patients who reported more pain than expected scored lower on the total scale and the patients who received epidural analgesia reported higher scores on the total scale. A nurse questionnaire, similar to the patient questionnaire, was compiled. The responsible nurse at the time (n=63) answered 196 questionnaires paired with the individual patient. The new instrument appeared to be useful in identifying important areas for improvement both from the patients’ and nurses’ perspectives, based on the number of disagreements (1 and 2). Differences were found among departments. The patients’ assessments on the environment sub-scale and the overall satisfaction question were higher than the nurses’ assessments. The findings suggest initial support for the instrument as a means to measure the quality of nursing care in postoperative pain management. Key words: quality indicators; health care, pain; postoperative, focus groups, psychometrics, questionnaires, nursing care.

    List of papers
    1. Important aspects of nursing care in surgical wards as expressed by nurses
    Open this publication in new window or tab >>Important aspects of nursing care in surgical wards as expressed by nurses
    1998 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 7, no 6, p. 512-520Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to find out clinical nurses' perceptions of important aspects of nursing care that might have an impact on quality of care in surgical wards. A qualitative approach using focus group interviews was used. The data analysis revealed 15 categories of important aspects of care which could be condensed into two dimensions, here called 'prerequisites' (i.e., staffing, routines and attitudes) and 'elements of performance' (i.e., detecting and acting on signs and symptoms and acting on behalf of the patients). These aspects could be a starting point for developing quality indicators. Carper's four fundamental patterns of knowing were used to make a theoretical interpretation, and three of them were identified.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13613 (URN)
    Available from: 2001-05-29 Created: 2001-05-29
    2. A tentative model for developing strategic and clinical nursing quality indicators: postoperative pain management
    Open this publication in new window or tab >>A tentative model for developing strategic and clinical nursing quality indicators: postoperative pain management
    1999 (English)In: International journal of nursing practice, ISSN 1322-7114, Vol. 5, no 4, p. 216-226Article in journal (Refereed) Published
    Abstract [en]

    The purpose of the study was to evaluate the usefulness of a tentative model, based on important aspects of surgical nursing care, for designing strategic and clinical quality indicators. Objective postoperative pain management was chosen for the model because it is a priority area in surgical nursing care. Items within a questionnaire were designed by using the tentative model as a base and by means of a literature review. The questionnaire, directed to clinical nurses (n = 233), was compiled to establish the validity and the usefulness of the indicators. Fourteen items were assessed as essential for achieving high quality outcomes in postoperative pain management (11 as realistic to carry out, and 13 as possible for nurses to influence) with mean scores > or = 4 (on a 5-point scale). The conclusion reached was that the tentative model combined with a literature search was found to be effective for designing items that might be useful as strategic and clinical indicators of quality in postoperative pain management.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13614 (URN)
    Available from: 2001-05-29 Created: 2001-05-29 Last updated: 2009-05-19
    3. Quality indicators in postoperative pain management: a validation study
    Open this publication in new window or tab >>Quality indicators in postoperative pain management: a validation study
    2001 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 15, no 4, p. 331-338Article in journal (Refereed) Published
    Abstract [en]

    In a previous study, strategic and clinical quality indicators were developed from a tentative model to assess high quality in postoperative pain management. The aim of the present study was to investigate the content validity of these 15 indicators. The indicators were compiled in a questionnaire, and two groups of nurses (n=210, n=321) scored each indicator on a 5-point scale (strongly disagree to strongly agree) from three different standpoints: whether it was essential for achieving high quality, whether it was realistic to carry out, and whether it was possible for nurses to influence management. The respondents were also asked to choose the most crucial indicators for the quality of care. The results showed that both groups of nurses judged the 15 indicators to have content validity from all three standpoints. Both groups also found the same six indicators to be the most crucial. These indicators concerned detecting and acting on signs and symptoms, performing prescriptions, informing and educating, acting on behalf of patients, competence/knowledge, and attitudes. The validated indicators should be useful to consider when implementing a strategy for postoperative pain management and when planning to evaluate the quality of care.

    Keywords
    pain, postoperative, quality indicators, validitym, clinical nursing research
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13615 (URN)10.1046/j.1471-6712.2001.00037.x (DOI)
    Available from: 2001-05-29 Created: 2001-05-29 Last updated: 2009-05-19
    4. Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management
    Open this publication in new window or tab >>Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management
    2002 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 37, no 6, p. 532-540Article in journal (Refereed) Published
    Abstract [en]

    AIM OF THE STUDY: To develop and evaluate psychometric properties, that is reliability and validity, of an instrument to measure strategic and clinical quality indicators in postoperative pain management.

    BACKGROUND: Strategic and clinical quality indicators in postoperative pain management were previously developed from a tentative model of important aspects of surgical nursing care and assessed to have content validity, that is to be essential for the quality of care, realistic to carry out and possible for nurses to use to influence management.

    METHODS: The quality indicators were converted to items suitable for a patient questionnaire and were scored on a 5-point scale, with higher scores indicating higher quality of care. Inpatients from five surgical wards took part in this study on their second postoperative day. The response rate was 96% and the average ages of the female (n=120) and the male (n=78) respondents were 62 and 63 years, respectively.

    RESULTS: Items in the total scale had an average inter-item correlation >0.20 and an item-total correlation >0.30. Cronbach's coefficient alpha was 0.84 for the total scale. Four factors entitled 'communication', 'action', 'trust' and 'environment' emerged from an orthogonal factor analysis, with a cumulative variance of 61.4%. Patients who received epidural analgesia had higher scores on the total scale compared with those who did not receive epidural analgesia. Patients who reported more pain than expected had lower scores on the total scale compared with those who did not report more pain than expected. Correlation between the total scale and an overall pain relief satisfaction question was 0.53.

    CONCLUSION: The results suggest initial support for the new instrument as a measure of strategic and clinical quality indicators in postoperative pain management, but it must be further refined, tested and evaluated.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13616 (URN)10.1046/j.1365-2648.2002.02130.x (DOI)
    Available from: 2001-05-29 Created: 2001-05-29 Last updated: 2009-05-19
    5. Patient and nurse assessment of quality of care in postoperative pain management
    Open this publication in new window or tab >>Patient and nurse assessment of quality of care in postoperative pain management
    2002 (English)In: Quality & Safety in Health Care, ISSN 1475-3898, Vol. 11, no 4, p. 327-334Article in journal (Refereed) Published
    Abstract [en]

    Objective: To describe and compare patient and nurse assessments of the quality of care in postoperative pain management, to investigate differences between subgroups of patients, and to compare patient assessments in different departments.

    Design: Patient and nurse questionnaires.

    Setting: Five surgical wards in general surgery, orthopaedics, and gynaecology in a central county hospital in Sweden.

    Sample: Two hundred and nine inpatients and 64 registered nurses. The response rates were 96% for the patients and 99% for the nurses; there were 196 paired patient-nurse assessments.

    Method: The Strategic and Clinical Quality Indicators in Postoperative Pain Management patient questionnaire was used which comprises14 items in four subscales (communication, action, trust, and environment). The items were scored on a 5 point scale with higher values indicating a higher quality of care. Five complementary questions on levels of pain intensity and overall satisfaction with pain relief were scored on an 11 point scale. Twelve of the 14 items in the patient questionnaire and two of the complementary questions were adjusted for use in the nurse questionnaire.

    Results: The patients’ mean (SD) score on the total scale (scale range 14–70) was 58.6 (8.9) and the nurses’ mean (SD) score (scale range 12–60) was 48.1 (6.2). The percentage of patients who scored 1 or 2 for an individual item (disagreement) ranged from 0.5% to 52.0%, while for nurses the percentage ranged from 0.0% to 34.8%. Forty two patients (24%) reported more pain than they expected; these patients assessed the quality of care lower. There were differences between patient and nurse assessments concerning the environment subscale, the question on overall satisfaction, and patients’ experience of worst possible pain intensity.

    Conclusion: The results provided valuable baseline data and identified important areas for quality improvement in postoperative pain management.

    Keywords
    postoperative pain, quality improvement, patient assessment, nurse assessment
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13617 (URN)
    Available from: 2001-05-29 Created: 2001-05-29 Last updated: 2009-05-19
    Download full text (pdf)
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  • 295.
    Idvall, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Patient assessment of postoperative pain management - Orthopaedic patients compared to other surgical patients2008In: Journal of Orthopaedic Nursing, ISSN 1361-3111, E-ISSN 1873-4839, Vol. 12, no 1, p. 35-40Article in journal (Refereed)
    Abstract [en]

    We used a 14-item patient questionnaire, Strategic and Clinical Quality Indicators in Postoperative Pain Management, to describe how orthopaedic patients assessed the quality of care they received. The patients highest and lowest assessments were compared to assessments by other groups of surgical patients as reported in studies being published. Our study included 300 inpatients from four different orthopaedic wards in two county councils in Sweden. Patients answered a questionnaire on the day of discharge. The response rate was 74%, and 44% of the respondents were male. Elective surgery was the main reason for admission, and the mean length of stay was 7.3 days. One of the items rated highest was that pain relief was given quickly when requested. A literature review showed that this item also received a high rating in other studies using the same patient questionnaire. The item rated lowest concerned the regular use of a pain assessment instrument, which also received a low rating from patient groups other than the orthopaedics in this study. In conclusion, we found that orthopaedic patients and other groups of surgical patients gave similar assessments concerning the highest and lowest assessments of postoperative pain management. Nevertheless, further improvement is needed. © 2007 Elsevier Ltd. All rights reserved.

  • 296.
    Idvall, Ewa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berg, Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Brudin, Lars
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
    Nilsson , U
    Örebro University Hospital.
    Assessment of recovery after day surgery using a modified version of quality of recovery-402009In: ACTA ANAESTHESIOLOGICA SCANDINAVICA, ISSN 0001-5172 , Vol. 53, no 5, p. 673-677Article in journal (Refereed)
  • 297.
    Idvall, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Bergqvist, Anna
    Vrinnevisjukhuset Norrköping.
    Silverhjelm, Jenny
    Länssjukhuset Ryhov Jönköping.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Perspectives of Swedish patients on postoperative pain management2008In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 10, no 2, p. 131-136Article in journal (Refereed)
    Abstract [en]

    This study aimed to describe the perspectives of surgical patients towards postoperative pain management during their hospital stay. Thirty strategically chosen postoperative inpatients from different surgical wards in a university hospital in Sweden participated. A qualitative, descriptive approach using individual interviews was chosen. These were tape-recorded, transcribed verbatim, and analyzed according to a qualitative content analysis. The patients' descriptions of postoperative pain management indicated that pain was a symptom that was always in focus, either because it was constantly present or because pain could appear abruptly during different activities and movements. Although the focus was on pain and an awareness that it should be relieved or avoided, the solutions were often routine, short-term, and involved the regular intake of drugs, plus additional medication if needed for an acute pain episode. From the patients' descriptions of their experience with postoperative pain management, we distinguished three categories: "patients' pain knowledge", "patients' pain management approaches", and "patients' views of health-care professionals". The findings from this study highlight important aspects of nursing care that should receive greater attention in postoperative pain management. The patients' narratives could be a valuable asset in the quality improvement of postoperative pain management as these narratives highlight episodes difficult to elicit in other ways. © 2008 The Authors Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.

  • 298.
    Idvall, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Ehrenberg, A.
    Health and Caring Sciences, Dalarna University, Falun Campus, Falun, Sweden.
    Nursing documentation of postoperative pain management2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 6, p. 734-742Article in journal (Refereed)
    Abstract [en]

    • Previous studies have shown that nursing documentation is often deficient in its recording of pain assessment and treatment. In Sweden, documentation of the care process, including assessment, is a legal obligation. • The aim of this study was to describe nursing documentation of postoperative pain management and nurses' perceptions of the records in relation to current regulations and guidelines. • The sample included nursing records of postoperative care on the second postoperative day from 172 patients and 63 Registered Nurses from surgical wards in a central county hospital in Sweden. • The records were reviewed for content and comprehensiveness based on regulations and guidelines for postoperative pain management. Three different auditing instruments were used. The nurses were asked if the documentation concurred with current regulations and guidelines. • The result showed that pain assessment was based mainly on patients' self-report, but less than 10% of the records contained notes on systematic assessment with a pain assessment instrument. Pain location was documented in 50% of the records and pain character in 12%. About 73% of the nurses reported that the documentation concurred with current regulations and guidelines. • The findings indicate that significant flaws existed in nurses' recording of postoperative pain management, of which the nurses were not aware. © 2002 Blackwell Science Ltd.

  • 299.
    Idvall, Ewa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hamrin, Elisabeth
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology . Linköping University, Faculty of Health Sciences.
    Rooke, L.
    Sjöström, Björn
    Department of Health Care Pedagogics, Göteborg University and Department of Health Sciences, University of Skövde, Skövde, Sweden.
    A tentative model for developing strategic and clinical nursing quality indicators: postoperative pain management1999In: International journal of nursing practice, ISSN 1322-7114, Vol. 5, no 4, p. 216-226Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to evaluate the usefulness of a tentative model, based on important aspects of surgical nursing care, for designing strategic and clinical quality indicators. Objective postoperative pain management was chosen for the model because it is a priority area in surgical nursing care. Items within a questionnaire were designed by using the tentative model as a base and by means of a literature review. The questionnaire, directed to clinical nurses (n = 233), was compiled to establish the validity and the usefulness of the indicators. Fourteen items were assessed as essential for achieving high quality outcomes in postoperative pain management (11 as realistic to carry out, and 13 as possible for nurses to influence) with mean scores > or = 4 (on a 5-point scale). The conclusion reached was that the tentative model combined with a literature search was found to be effective for designing items that might be useful as strategic and clinical indicators of quality in postoperative pain management.

  • 300.
    Idvall, Ewa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hamrin, Elisabeth
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology . Linköping University, Faculty of Health Sciences.
    Sjöström, Björn
    Department of Health Care Pedagogics, Göteborg University and Department of Health Sciences, University of Skövde, Skövde, Sweden .
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Patient and nurse assessment of quality of care in postoperative pain management2002In: Quality & Safety in Health Care, ISSN 1475-3898, Vol. 11, no 4, p. 327-334Article in journal (Refereed)
    Abstract [en]

    Objective: To describe and compare patient and nurse assessments of the quality of care in postoperative pain management, to investigate differences between subgroups of patients, and to compare patient assessments in different departments.

    Design: Patient and nurse questionnaires.

    Setting: Five surgical wards in general surgery, orthopaedics, and gynaecology in a central county hospital in Sweden.

    Sample: Two hundred and nine inpatients and 64 registered nurses. The response rates were 96% for the patients and 99% for the nurses; there were 196 paired patient-nurse assessments.

    Method: The Strategic and Clinical Quality Indicators in Postoperative Pain Management patient questionnaire was used which comprises14 items in four subscales (communication, action, trust, and environment). The items were scored on a 5 point scale with higher values indicating a higher quality of care. Five complementary questions on levels of pain intensity and overall satisfaction with pain relief were scored on an 11 point scale. Twelve of the 14 items in the patient questionnaire and two of the complementary questions were adjusted for use in the nurse questionnaire.

    Results: The patients’ mean (SD) score on the total scale (scale range 14–70) was 58.6 (8.9) and the nurses’ mean (SD) score (scale range 12–60) was 48.1 (6.2). The percentage of patients who scored 1 or 2 for an individual item (disagreement) ranged from 0.5% to 52.0%, while for nurses the percentage ranged from 0.0% to 34.8%. Forty two patients (24%) reported more pain than they expected; these patients assessed the quality of care lower. There were differences between patient and nurse assessments concerning the environment subscale, the question on overall satisfaction, and patients’ experience of worst possible pain intensity.

    Conclusion: The results provided valuable baseline data and identified important areas for quality improvement in postoperative pain management.

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