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  • 51.
    Raak, Ragnhild
    et al.
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Headache and coping in a female working population2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 325-329Article in journal (Refereed)
    Abstract [en]

    Tension-type headache is a common disorder amongst working people and, because of its very high prevalence, represents one of the most costly ailments in modern society. To study the frequency of tension-type headache in a working female population and to investigate how females who have experienced tension-type headache cope with pain compared with the way healthy pain-free subjects cope with stress. A total of 400 females working at a university hospital in Sweden were asked about their experience of headache in the previous 3 months. Instruments used were a specific Headache Questionnaire, the Jalowiec Stress-coping Questionnaire and Coping Strategy Questionnaire. Before the study, approval from the board of directors and the employees’ council was obtained. About 257 females (64.3%) answered the questionnaire and 78% of them (n = 199) reported that they had experienced headache in the previous 3 months. About 90% of the participants had never had an appointment with a doctor concerning headache and 57% reported a relationship between stress and headache. Regarding pain-coping strategy, increased pain behaviour was the most frequent strategy used. With regard to stress-coping style, a significant difference in the use of emotive style was found between females reporting headache and females not reporting headache. The results indicate that prevention programmes emphasizing stress management and coping may influence the experience of tension-type headache.

  • 52.
    Raak, Ragnhild
    et al.
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Health experiences and employment status in subjects with chronic back pain: a long-term perspective2006In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 7, no 2, p. 64-70Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe health experiences, focused on gender and return to work, in subjects with chronic low back pain in a long-term perspective. The convenient sample consisted of 12 subjects who had attended a pain rehabilitation program 6 years earlier. Typed interviews were transcribed, and a content analysis approach was used. Five categories were found: coping, root causes, control/influence, pain, and sleep. The interviews showed that the subjects expressed well-being, although pain had become part of their daily life. However, both gender and well-being group differences were identified. The women and the group with reduced well-being used the root causes category in a higher degree than the men and the well-being group did. The conclusion is that there are differences according to both gender and return to work within the subjects with chronic pain and that these differences are related to both root causes and coping pattern.

  • 53.
    Raak, Ragnhild
    et al.
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Reply to Dellinger2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 5, p. 698-698p. 698-Article in journal (Refereed)
    Abstract [en]

    No abtract available.

  • 54.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Begreppen integration och problembaserat lärande granskat ur ett vårddidaktiskt perspektiv2004In: Vårdvetenskapens didaktik : caritativ didaktik i vårdandets tjänst / [ed] Dahly Matilainen & Katie Eriksson, Vasa: Åbo Akademi, Institutionen för Vårdvetenskap , 2004, p. 135-147Chapter in book (Other academic)
  • 55.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Arman, M
    Livsförståelseetik2003In: Gryning II: klinisk vårdvetenskap / [ed] Katie Eriksson och Unni Å. Lindström, Vasa: Åbo Akademi: Institutionen för vårdvetenskap , 2003, p. 97-109Chapter in book (Other academic)
  • 56.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Arman Rehnsfeldt, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Livsförståelseetik och vittnesbörd - vårdetiska aspekter2005In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 25, no 3, p. 19-23Article in journal (Refereed)
  • 57.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Eriksson, Katie
    Åbo Akademi.
    The progression of suffering implies alleviated suffering2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, no 3, p. 264-272Article in journal (Refereed)
    Abstract [en]

    There is a lack of research focusing directly on both patients' suffering and alleviated suffering in relation to care. The aim of this paper was to investigate the progression of suffering in relation to the encounter between the suffering person and the caregiver from the perspective of an understanding of life. The progression of suffering is assumed to be an existential 'sign' of the development of understanding of life as an ontological or spiritual entity, which demands a meaning-creating encounter between the patient and caregiver. The concept 'existential caring encounter' was used to describe how the encounter between patient and caregiver can create meaning in communion and thereby alleviate suffering by making it bearable. The study was carried out using an interpretive, hermeneutic approach. The study as a whole comprises three parts, and these include letter-writing and interviews. The findings are described by the following main theses: (a) a darkness in life understanding is existentially experienced as unbearable suffering and requires an encounter involving attentive care and confrontation, (b) the turning point means that the struggle of suffering begins, and (c) the encounter involves being meaningcreating in a communion in the struggle of suffering. An understanding of the patterns of unbearable and bearable suffering can be of help to the caregiver in caring for the patient by serving as a basis for meaning-creation in communion. This may thereby be a way of alleviating the patient's suffering by making it bearable during the progression of suffering.

  • 58.
    Rönnberg, Jerker
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Jedeskog, Bertil
    Linköping University, Department of Welfare and Care (IVV).
    Handikappstudie i Norrköping: En beskrivning av människor med funktionsnedsättning (Handicap study in Norrköping1992Report (Other academic)
  • 59. Sandberg, GE
    et al.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Oral dryness and peripheral neuropathy in subjects with type 2 diabetes2003In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 17, no 4, p. 192-198Article in journal (Refereed)
    Abstract [en]

    Two common complaints related to diabetes mellitus are oral dryness (xerostomia) and peripheral neuropathy (PN) and there is some evidence of a relationship between them. Therefore, we formulated a hypothesis that type 2 diabetic subjects with xerostomia in our study also exhibited PN. The study included 102 randomly sampled type 2 diabetic patients from a healthcare district in mid-Sweden. Besides clinical and X-ray examinations, patients were asked whether they experienced oral dryness. PN was defined through thorough foot examination and the use of a modified neuropathy symptom score (NSS) and neuropathy disability score (NDS). Other diabetes-related variables were extracted from medical records. More than half of the individuals (53.5%) reported oral dryness and 23.8% were diagnosed with PN. None of the variables in a stepwise regression analysis could explain the variance in oral dryness, besides "pain in the legs," which contributed with 5% to the explanation. Our hypothesis that type 2 diabetic subjects with xerostomia also were affected with PN could not be verified in this study, but the results must be interpreted with caution as relatively few subjects were affected with both oral dryness and PN (13.8%). Further and larger controlled studies are needed before the hypothesis can be definitely rejected. Despite our incomplete understanding about the relation between oral dryness and PN, professionals in oral health as well as in primary health have to strive for increased knowledge in this field. ⌐ 2003 Elsevier Inc. All rights reserved.

  • 60. Sandberg, GE
    et al.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning.
    Oral health and health-related quality of life in type 2 diabetic patients and non-diabetic controls2003In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 61, no 3, p. 141-148Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to identify factors in oral health and also diabetes-related and socio-economic components that could be associated with the subject's health-related quality of life (HRQL). One-hundred-and-two randomly sampled type 2 diabetic and 102 age-matched and gender-matched non-diabetic subjects from the same residential area were studied cross-sectionally using the SF-36 questionnaire. Although the HRQL profiles were similar in nature, the control subjects indicated a more favorable health status in their HRQL scores than did type 2 diabetic subjects. Certain oral health factors contributed to deterioration of the patient's HRQL. Multiple regression analyses including both groups were used to determine variables explaining variance in the different HRQL domains. Dissatisfaction with teeth and mouth, feeling of dry mouth and poor financial status contributed to about one-fourth of the explanation of the variance in all health domains. Having diabetes played an important role in the domains Physical Functioning, Role functioning-Physical, General Health, and Social Functioning. Age was important for Physical Functioning and Role functioning-Physical. Our study indicates that different factors may be asociated with impaired HRQL, especially among type 2 diabetic subjects, although only a partial understanding of its relation to oral health could be demonstrated.

  • 61. Sandberg, J
    et al.
    Lundh, Ulla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Nolan, M
    Placing a spouce in a care home for older people: (re)-constructing roles and relationships2003In: Partnership in family care / [ed] Mike Nolan, Ulla Lundh, Gordon Grant, John Keady, Linköping: Linköpings universitet , 2003, p. 199-217Chapter in book (Other academic)
    Abstract [en]

    Considers how family and professional carers can work together more effectively in order to provide the highest quality of care to people who need support in order to remain in their own homes. Adopting a temporal perspective, this book looks at key transitions in caregiving and is useful for health care students and professionals

  • 62. Skovbjerg, H
    et al.
    Hansen, G H
    Niels-Christiansen, L L
    Anthonsen, D
    Ascher, H
    Midhagen, G
    Hallert, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Norén, O
    Sjöström, H
    Intestinal Tissue Transglutaminase in Coeliac Disease of Children and Adults: Ultrastructural Localization and Variation in Expression2004In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 12, p. 1219-1227Article in journal (Refereed)
  • 63. Smide, Bibbi
    et al.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Lukwale, Jane
    Msoka, Agnes
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Smide, B
    Lukwale, J
    Msoka, A
    Self-reported health and glycaemic control in Tanzanian and Swedish diabetic patients2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 37, no 2, p. 182-191Article in journal (Refereed)
    Abstract [en]

    Aims of the study. To investigate self-reported health in adult Tanzanian and Swedish diabetic patients in relation to the general population in the two countries and to investigate whether diabetic patients with poor glycaemic control also rated their self-reported health to be impaired. Design/methods. The study design was cross-sectional and comparative. One hundred and fifty Tanzanian patients were age-and gender-matched with Swedish diabetic patients. Self-reported health was measured using the generic SF-36 health questionnaire, measuring eight different health domains. Glycaemic control was measured by testing glycosylated haemoglobin (HbA1c). Results. The main results were that Tanzanian diabetic patients had poorer health in comparison with general Tanzanian population living in the same geographical area. In contrast, diabetic patients in Sweden did not markedly differ from the Swedish general population. Furthermore, Tanzanian patients had poorer glycaemic control. In both countries poor glycaemic control did not associate with impaired self-reported health, with one exception. Tanzanian patients with unsatisfactory or poor glycaemic control had significantly poorer reported health in the mental health domain. Conclusions. The results indicated that patients' health should be assessed using a specific health measure in addition to general medical measures.

  • 64.
    Steinvall, Ingrid
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Brännskadad2005In: Sjukdomsvärldar: om människors erfarenhet av kroppslig ohälsa / [ed] Bengt Richt och Gunilla Tegern, Lund: Studentlitteratur, 2005, p. 197-230Chapter in book (Other academic)
    Abstract [sv]

    En stor andel av befolkningen i de västerländska samhällena och en växande andel världen över lever med långvarig kroppslig ohälsa. Den utbredda förekomsten har en djupgående påverkan på sättet att leva, både bland de redan sjuka och bland dem som är friska. Kunskap om den kroppsliga ohälsans personliga, sociala och kulturella dimensioner är därför av grundläggande betydelse för förståelsen av tendenser och processer i samtiden. Boken bygger på berättelser från personer som själva lever med olika former av långvarig och ibland svår kroppslig ohälsa. Några kapitel är rättframt rapporterande, medan andra ansluter till sådana förståelseramar som fenomenologi, symbolisk interaktionism och analytisk filosofi. Texten ansluter sig till den internationella vetenskapliga tradition som under senare tid har försökt ge den levda erfarenheten av ohälsa ett språk och en röst, i opposition mot eller som komplement till ett rent biomedicinskt perspektiv. Den är utpräglat tvärvetenskaplig och skriven av personer med olika ämnesbakgrund, alltifrån omvårdnadsvetenskap, filosofi, sociologi och pedagogik till sjukgymnastik och arbetsterapi. Sjukdomsvärldar vänder sig till alla med intresse för vad det kan innebära att leva med kroppslig ohälsa i vardagslivet och för hur de möjliga innebörderna formas av mer övergripande sociala och kulturella omständigheter. Den tvärvetenskapliga inriktningen gör boken väl användbar på såväl olika vårdutbildningar som kurser i både samhällsvetenskap och humaniora.

  • 65.
    Stenhammar, Lars
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Norrköping.
    Fälth-Magnusson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Grodzinsky, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Hallert, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Högberg, Lotta
    Barn och ungdomsmed kliniken Vrinnevisjukhuset, Norrköping.
    Magnusson, Karl-Eric
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Medical Microbiology.
    Från ax till limpa - några svenska bidrag till forskningen om celiaki2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 48, p. 3932-3937Article in journal (Other academic)
  • 66. Strandberg, E L
    et al.
    Wilhelmsson, Susan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV). Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    The meaning of a holistic view in primary health care in Sweden2004In: WONCA,2004, 2004Conference paper (Refereed)
  • 67.
    Sund-Levander, Märtha
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Forsberg, Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Surgery.
    Wahren, Lis Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Normal oral, rectal, tympanic and axillary body temperature in adult men and women: A systematic literature review2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 2, p. 122-128Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate normal body temperature in adult men and women. A systematic review of data was performed. Searches were carried out in MEDLINE, CINAHL, and manually from identified articles reference lists. Studies from 1935 to 1999 were included. Articles were classified as (1) strong, (2) fairly strong and (3) weak evidence. When summarizing studies with strong or fairly strong evidence the range for oral temperature was 33.2-38.2░C, rectal: 34.4-37.8░C, tympanic: 35.4-37.8░C and axillary: 35.5-37.0░C. The range in oral temperature for men and women, respectively, was 35.7-37.7 and 33.2-38.1░C, in rectal 36.7-37.5 and 36.8-37.1░C, and in tympanic 35.5-37.5 and 35.7-37.5░C. The ranges of normal body temperature need to be adjusted, especially for the lower values. When assessing body temperature it is important to take place of measurement and gender into consideration. Studies with random samples are needed to confirm the range of normal body temperature with respect to gender and age.

  • 68.
    Sund-Levander, Märtha
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Normal tympanic and rectal body tempterature in elderly men and women2001Conference paper (Other academic)
  • 69.
    Sund-Levander, Märtha
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Prevention of shivering in patients with severe cerebral injury1999Conference paper (Other academic)
  • 70.
    Sund-Levander, Märtha
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Örtqvist, Åke
    Stockholm County, Norrbacka, Sweden.
    Grodzinsky, Ewa
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Klefsgård, Örjan
    Högland Hospital, Eksjö, Sweden.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Morbiditet, mortalitet och klinisk presentation av pneumoni bland äldre i särskilt boende2002Conference paper (Other academic)
  • 71.
    Söderquist, Johan
    et al.
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Faculty of Health Sciences.
    Thorbert, G.
    Central Hospital of Kalmar, Kalmar, Sweden.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Risk factors in pregnancy for post-traumatic stress and depression after childbirth2009In: BJOG - An international journal of obstetrics and gynaecology, ISSN 1470-0328, Vol. 116, no 5, p. 672-680Article in journal (Refereed)
    Abstract [en]

    Objective  The objective of this study was to find risk factors in pregnancy for post-traumatic stress and depression 1 month after childbirth. Furthermore, the relation between post-traumatic stress and depression was explored.

    Design  A prospective longitudinal study.

    Setting  Pregnant women in Linköping and Kalmar, Sweden.

    Population  A total of 1224 women were assessed in pregnancy, week 12–20 and 32, as well as 1 month postpartum.

    Methods  Post-traumatic stress and depression after delivery were assessed 1 month postpartum. Potential risk factors were assessed in early and late pregnancy. Variables measured during pregnancy were trait anxiety, depression, fear of childbirth, childbirth-related traumatic stress, stress coping capacity, social support, parity, educational level, age, gestation week, parity, educational level, civil status, previous psychological/psychiatric counselling, and previous experience of any traumatic events. Delivery mode was assessed from the medical records.

    Main outcome measures  Prevalence of post-traumatic stress (criteria A, B, C, D, E, and F according to DSM-IV) and depression (Beck’s depression inventory).

    Results  One month postpartum, 12 (1.3%) women had post-traumatic stress (met symptom criteria B, C, and D for post-traumatic stress disorder according to Diagnostic and statistical manual of mental disorders, 4th edition [DSM-IV]). The most important risk factors in pregnancy were depression in early pregnancy (OR = 16.3), severe fear of childbirth (OR = 6.2), and ‘pre’-traumatic stress (in view of the forthcoming delivery) in late pregnancy (OR = 12.5). The prevalence of depression was 5.6%. Post-traumatic stress and depression were positively related 1 month postpartum and were predicted by mainly the same factors.

    Conclusions  Risk factors for post-traumatic stress and depression after childbirth can be assessed in early pregnancy. Post-traumatic stress and depression also seem to share the same underlying vulnerability factors.

  • 72.
    Sörensen Duppils, Gill
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala and The University College in Dalarna, Falun, Sweden.
    Wikblad, Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Delirium: behavioural changes before and during the prodromal phase2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 5, p. 609-616Article in journal (Refereed)
    Abstract [en]

    Background.  Delirium is an important form of psychopathology in older people and is associated with increased morbidity and functional decline. In the prodromal phase of delirium early symptoms occur, before all criteria have been met.

    Aim.  The aim of this study was to delineate behavioural changes before and during the prodromal phase of delirium. That was considered to include the time from the first behavioural change up to the point when all DSM-IV criteria for delirium were met.

    Design.  Prospective and descriptive observation study.

    Methods.  One hundred and three hip surgery patients (hip fracture and hip replacement) aged ≥ 80 years participated in this study. On admission none of them was delirious or had severe cognitive decline, but 32 patients met the DSM-IV criteria for delirium during the hospital stay. Frequent observations were performed up to delirium onset or 48 hours postoperatively. The observations included 37 items on the patient's state of mind, cognition, activity and behaviour. The first observation on admission was used as a reference and behavioural changes were defined as deviations from this first observation.

    Results.  Twenty-one patients out of the 32 who met the DSM-IV criteria (62%, D group) demonstrated behavioural changes before delirium onset, as did 34 (48%, R group) out of the remaining 71 patients. The D group had different and more numerous behavioural changes than the R group. Anxiety was common in both groups. Disorientation and urgent calls for attention were the most frequent changes in the D group. The D group presented a pattern of behavioural changes and early symptoms of the approaching delirium. Six hours immediately before the onset of delirium, the behavioural changes were more numerous and evident.

    Conclusions and relevance to clinical practice.  It is necessary to pay attention to each behavioural change in the patients and to be aware of the prodromal phase of delirium in order to prevent its onset and to maintain the patient's well-being.

  • 73. Thollander, Jan
    et al.
    Gertow, Örjan
    Hansen, Sören
    Carlsson, Birgitta
    Hallert, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Att bedöma inadekvata medicinska akutinläggningar2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, p. 888-892Article in journal (Other academic)
  • 74.
    Törnvall, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Welfare and Care (IVV). 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.
    Impact of primary care management on nursing documentation2007In: Journal of Nursing Management, ISSN 0966-0429, Vol. 15, no 6, p. 634-642Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate whether perceptions of electronic nursing documentation and its performance differed because of primary health care management.

    Background: Success in leading people depends on the manager's personality, the context and the people who are led. Close proximity to clinical work, with manager and personnel sharing the same profession, promotes the authority to carry out changes.

    Methods: This study comprised a postal questionnaire to district nurses and an audit of nursing records from two primary health care organizations, one with a uniprofessional (nursing) organization, and one with multidisciplinary health care centres with general practitioners and/or another profession as managers.

    Results: Uniprofessional nurse management increased district nurses' positive perceptions of nursing documentation but did not affect documentation performance, which was inadequate regardless of management type.

    Conclusions: Positive perceptions of nursing documentation are bases for further development to a nursing documentation including a holistic view of the patient.

  • 75.
    Törnvall, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Linköping University, Department of Welfare and Care (IVV). 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.
    Wahren, Lis Karin
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Electronic nursing documentation in primary health care2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 3, p. 310-317Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe and analyse nursing documentation based on an electronic patient record (EPR) system in primary health care (PHC) with emphasis on the nurses' opinions and what, according to the nursing process and the use of the keywords, the nurses documented. The study was performed in one county council in the south of Sweden and included 42 Primary Health Care Centres (PHCC). It consisted of a survey, an audit of nursing records with the Cat-ch-Ing instrument and calculation of frequencies of keywords used during a 1-year period. For the survey, district nurses received a postal questionnaire. The results from the survey indicated an overall positive tendency concerning the district nurses' opinions on documentation. Lack of in-service training in nursing documentation was noted and requested from the district nurses. All three parts of the study showed that the keywords nursing interventions and status were frequently used while nursing diagnosis and goal were infrequent. From the audit, it was noted that medical status and interventions appeared more often than nursing status. The study demonstrated limitations in the nursing documentation that inhibited the possibility of using it to evaluate the care given. In order to develop the nursing documentation, there is a need for support and education to strengthen the district nurses' professional identity. Involvement from the heads of the PHCC and the manufactures of the EPR system is necessary, in cooperation with the district nurses, to render the nursing documentation suitable for future use in the evaluation and development of care.

  • 76. Wahlberg, AC
    et al.
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Wredling, R
    Telephone nurses' experience of problems with telephone advice in Sweden2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 1, p. 37-45Article in journal (Refereed)
    Abstract [en]

    ò By telephoning a healthcare call centre, individuals in Sweden can consult a nurse to discuss medical problems and health care accessibility, and to receive professional information on how to find their way about the health care system. ò The aim of the study was to identify problems, difficulties and disadvantages that telephone nurses with varying degrees of experience had met during their professional careers. ò The Delphi technique was used with three sets of questionnaires. ò Twenty-five nurses with varying experience of working with telephone advice from six 24-hours call centres participated in the study. The response rate was 100%. ò An open-ended question generated 154 statements. Comments were categorized into 24 different problem categories. ò Ten problem categories were mainly related to the nurse perspective, i.e. the problems experienced were associated with the qualities of the nurse, eight principally to the patient perspective, i.e. problems associated with caller characteristics and six mostly to the organizational perspective, i.e. problems linked to the organization of the national health service. ò 'Lack of health care resources' was rated as the biggest problem, 'second-hand consultations' as the second and 'always making a decision' as the third biggest problem. ò Decision-making seems to be the core of telephone advice nursing and problems related to the nurses, patients and organization seem to influence the telephone nurses' working situation. ò Training should focus on active listening and handling social conflicts.

  • 77.
    Wahlberg, Anna Carin
    et al.
    Institutionen för omvårdnad Karolinska institutet.
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Wredling, Regina
    Institutionen för omvårdnad Karolinska institutet.
    Bases for assessments made by telephone advice nurses2005In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 11, no 8, p. 403-407Article in journal (Refereed)
    Abstract [en]

    Telephone advice nursing includes triage, advice, referral, information and coordination. The aim of the study was to explore what telephone nurses base their assessments on. We conducted 14 interviews with seven telephone nurses at a health-care call centre in Sweden. Two authentic calls per nurse were used in stimulated recall interviews, where the nurses commented on the basis for their assessments. A qualitative manifest content analysis was employed. Three major categories emerged in the analysis: care-seeker, e.g. 'symptomatic sounds', nurse, e.g. 'nurse's own experience', and organization, e.g. 'health-care accessibility'. The findings show that the telephone advice nurses' bases for assessments appear to be very broad. They include both verbally and non-verbally communicated information, and care-seeker-, nurse- and certain organization-related factors influence the assessments. We found that an individualistic view of the care-seeker seems to dominate the assessments in non-urgent calls to a health-care call centre.

  • 78. Wallin, L
    et al.
    Boström, A M
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Ewald, U
    Sustainability in changing clinical practice promotes evidence-based nursing care2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 41, no 5, p. 509-518Article in journal (Refereed)
    Abstract [en]

    Aim. To examine the relationship between sustained work with quality improvement (QI) and factors related to research utilization in a group of nurses. Design. The study was designed as a comparative survey that included 220 nurses from various health care organizations in Sweden. These nurses had participated in uniformly designed 4-day basic training courses to manage a method for QI. Method. A validated questionnaire covering different aspects of research utilization was employed. The response rate was 70% (154 of 220). Nurses in managerial positions at the departmental level were excluded. Therefore, the final sample consisted of 119 respondents. Four years after the training courses, 39% were still involved in audit-related activities, while 61% reported that they had discontinued the QI work (missing = 1). Results. Most nurses (80-90%) had a positive attitude to research. Those who had continued the QI work over a 4-year period reported more activity in searching research literature compared with those who had discontinued the QI work (P = 0.005). The QI-sustainable nurses also reported more frequent participation in research-related activities, particularly in implementing specific research findings in practice (P = 0.001). Some contextual differences were reported: the QI-sustainable nurses were more likely to obtain support from their chief executive (P = 0.001), consultation from a skilled researcher (P = 0.005) and statistical support (P = 0.001). Within the broader health care organization, the existence of a research committee and a research and development strategy, as well as access to research assistant staff, had a tendency to be more common for nurses who had continued the QI work. Conclusion. Sustainability in QI work was significantly related to supportive leadership, facilitative human resources, increased activity in seeking new research and enhanced implementation of research findings in clinical practice. It appears that these factors constitute a necessary prerequisite for professional development and the establishment of evidence-based practice.

  • 79.
    Wallin, Mia
    et al.
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Raak, Ragnhild
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Health related quality of life and catastrophizing in subgroups of individuals with Whiplash Associated Disorders (WAD) based on thermal pain thresholds2007In: International Whiplash Trauma Cenference, IWTC 2007,2007, 2007, p. 31-31Conference paper (Refereed)
    Abstract [en]

      

  • 80.
    Wikblad, Karin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Rudberg, L
    Carlsson, M
    Nilsson, S
    Self-perceived physical, psychologic, and general symptoms in survivors of testicular cancer 3 to 13 years after treatment2002In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 25, no 3, p. 187-195Article in journal (Refereed)
    Abstract [en]

    Due to the large group of patients with advanced testicular cancer now being cured, it is important to identify the men who are at risk of deteriorated health. The purposes of this study were: (1) to delineate and compare frequency of self-perceived physical, psychologic, and general symptoms in men treated for testicular cancer with those of a general population sample and (2) to compare self-perceived physical, psychologic, and general symptoms in relation to secondary Raynaud phenomena, sexual dysfunction, infertility, and self-perceived attractiveness in different treatment modalities. The subjects were 277 survivors of testicular cancer (M = 42.2 years) who had completed a self-reported questionnaire (75.5% response rate). A population survey comprising 392 men was used as a comparison group (M = 45 years). The result demonstrated that although survivors of testicular cancer as a group reported significantly less frequency of backache, leg pain, cough, and eye problems than did the general population sample, they described that they significantly more often felt cold. Men reporting secondary Raynaud phenomena, infertility, and/or feeling less attractive had experienced significantly more self-perceived symptoms. Oncologist nurses could play an important role in psychologic counseling for those men.

  • 81.
    Wikblad, Karin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Smide, B
    Ekman, L
    Diabetes self-care and educational needs in Tanzanian and Swedish diabetic patients: a cross-cultural study.2002In: Tropical doctor, ISSN 0049-4755, E-ISSN 1758-1133, Vol. 32, p. 212-216Article in journal (Refereed)
  • 82.
    Wiklblad, Karin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Wallin, L
    Boström, AM
    Harvey, G
    Ewald, U
    Progress of unit based quality improvement: An evaluation of a support strategy2002Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate a strategy for supporting nurses to work with quality improvement (QI). Design: Post-intervention evaluation. Study participants and intervention: 240 nurses participated in a uniformly designed 4 day basic training course in applying a model for QI. Of these, 156 nurses from over 50 healthcare institutions constituted the generic education (GE) group while 84 nurses from 42 neonatal units took part in a project to develop national guidelines, constituting the targeted intervention (TI) group. Method: Postal questionnaire 4 years after the training courses. Results: The response rate was 80% in the TI group and 64% in the GE group. Nurses in the TI group had a significantly higher rate in completing all phases of the QI cycle (p=O.O002). With no differences between the groups, 39% of ali nurses were still involved in QI work 4 years after the training courses. Three factors were significantly related to nurses continuing their involvement in QI projects: remaining employed on the same unit (OR 11.3), taking courses in nursing science (OR 4.1), and maintenance of the same QI model (OR 3.1). Reported motives for remaining active in QI work were the enhancement of knowledge, influence over clinical practice, and development as a nurse. Reasons for discontinuation were organisational restructuring, a lack of facilitation and knowledge, and change of workplace. Conclusions: Participation in a national guideline project, including a common focus for improvement, facilitation and opportunities for networking, seems to have enhanced the ability to carry out the process of QI, but not to sustain the QI work over a longer period.

  • 83.
    Wilhelmsson, Susan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Foldevi, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Åkerlind, Ingemar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Faresjö, T
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Science in Nursing.
    Unfavourable working conditions for female GPs. A comparison between Swedish general practitiners and district nurses2002In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 20, p. 74-78Article in journal (Refereed)
  • 84.
    Wiman, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Wikblad, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning.
    Caring and uncaring encounters in nursing in an emergency department2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 4, p. 422-429Article in journal (Refereed)
    Abstract [en]

    Background. Caring is a core characteristic of nursing. Nurses' caring behaviour has been explored in several studies. When caring for trauma patients, the most important caring behaviour must be the procedures associated with lifesaving. However, it is important not to forget the patient's psychological needs. Aim. The aim of this study was to highlight encounters between injured patients and nurses in the trauma team and to explore whether the theory of caring and uncaring encounters in nursing and health care is applicable in emergency care. Data collection and analysis. Data were collected by videotaping caring episodes between slightly injured patients and nurses in the trauma team. Five episodes involving 10 nurses were studied. The analysis was carried out in four steps. First the videotapes were studied several times and then transcribed into narratives, which were reduced into courses of events. These were subsequently classified according to aspects of caring and uncaring. Results. The nurses' verbal and non-verbal communication was poor, and they adopted a wait-and-see policy. A new uncaring aspect, instrumental behaviour, emerged from this poor communication. One of the caring aspects, being dedicated and having courage to be appropriately involved, could not be identified. Most encounters included several aspects of caring and uncaring, but the uncaring aspects predominated. The dominance of uncaring aspects indicates a lack of affective caring behaviour. Conclusion. The result showed that the theory is partly applicable in emergency care. A new aspect, instrumental behaviour emerged. The nurses' behaviour in the five episodes was labelled as uncaring. Authentic nurse-patient encounters are essential in nursing. Relevance to clinical practice. The importance of meeting patients' psychological needs and nurses' affective caring behaviour should be emphasized in trauma care, trauma courses and nursing education. It is necessary to measure the caring behaviour of trauma nurses.

  • 85.
    Wiman, Elisabeth
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wikblad, Karin
    Linköping University, Department of Welfare and Care (IVV), Self-Care and Learning. Linköping University, Faculty of Health Sciences.
    Response: Wiman E & Wikblad K (2004) Caring and uncaring encounters in nursing in an emergency department. Journal of Clinical Nursing 13, 422-4292005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 1, p. 124-125p. 124-125Article in journal (Other academic)
  • 86.
    Östlund, Gunnel
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Hensing, G
    Göteborg.
    Alexandersson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Developing a typology of the 'duty to work', as experienced by lay persons with musculoskeletal disorders2002In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 11, no 2, p. 150-158Article in journal (Refereed)
    Abstract [en]

    Musculoskeletal diagnoses account for the majority of cases of reduced work capacity. This article investigates lay persons' strategies in relation to work and musculoskeletal disorders. Twenty interviews were conducted and analysed using grounded theory. A typology of self-presentations was developed. The interviewees' self-presentations revealed a strong sense of a 'duty to work'. This sense of duty took four different forms, leading us to categorise persons expressing particular forms as workaholics, work manics, workhorses or relaxed workers. Relaxed workers seem to have the best prognosis for recovery as they had a confident self-agency and worked to fulfil their own needs rather than those of others. This was in contrast to work manics, with an uncertain self-agency and driven to work by others' needs. In conclusion, awareness of such linguistic forms as self-attributions and idiomatic phrases provides an opportunity to identify and talk about individual's self-agency and driving forces in the recovery process.

  • 87.
    Östlund, Gunnel
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Hensing, Gunnel
    Göteborgs Universitet.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society.
    Domestic strain: A hindrance in rehabilitation?2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, no 1, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Long-term sick leave due to musculoskeletal disorders has increased, especially for women. The aim of this paper was to explore women's and men's descriptions of the private arena in relation to rehabilitation and sickness absence. This study is part of a larger project focusing on consequences of sick leave. Individual interviews were conducted in 1997 and 1998 with 20 women and men who had been long-term sick-listed in 1985 with musculo-skeletal diagnoses. The data were analysed using Grounded theory in combination with gender analysis, which involved separately comparing men's and women's statements in order to find similarities and differences. According to the interviewees, factors in the private arena were closely associated with the rehabilitation process. Women described themselves as being responsible for the domestic work while men more often 'helped out' when asked to do so. Women and men described similar strategies to facilitate domestic work. Three dimensions of domestic life were identified, comprising division of domestic work and division of responsibility for domestic life and the amount of socio-emotional support or isolation at home. Using these dimensions, a 'domestic strain model' was developed. Our study indicates that long-term sicklisted women experiencing domestic strain would rather stay at home than return to work. Domestic strain involves inequities in the division of work and responsibilities and a lack of socio-emotional support at home. However, the model of domestic strain needs further empirical testing.

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