liu.seSök publikationer i DiVA
Ändra sökning
Avgränsa sökresultatet
1234567 51 - 100 av 661
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 51.
    Andreae, Christina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Evangelista, Lorraine
    Sue and Bill Gross School of Nursing, University of California, Irvine, CA.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Sedentary lifestyle is associated with poor appetite in patients with heart failure.2017Konferensbidrag (Refereegranskat)
  • 52.
    Andregård, Anna-Carin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Jangland, Eva
    Uppsala University, Sweden.
    The tortuous journey of introducing the Nurse Practitioner as a new member of the healthcare team: a meta-synthesis2015Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 1Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore the obstacles to and the opportunities for achieving optimal interprofessional team collaboration with the introduction of the nurse practitioner (NP). A team approach can contribute importantly to sustainable and safe patient care, and NPs have been added to the healthcare team in many countries. Following the international trend towards the development of the acute care NP, the role has recently been initiated in surgical care in Sweden. The introduction of an advanced nursing role into existing organisations raises questions about how the role will be developed and what its effects will be on collaboration between the different professions. We conducted a systematic review of qualitative studies using the meta-ethnographic approach developed by Noblit and Hare. Literature in the field of nursing was searched on PubMed and CINAHL, and empirical qualitative studies from outpatient and inpatient care in seven countries were included. The studies were appraised according to national guidelines and templates and were analysed and synthesised according to the meta-ethnographic approach. A total of 26 studies were included in the synthesis. The analysis revealed four themes: (i) a threat to professional boundaries, (ii) a resource for the team, (iii) the quest for autonomy and control, and (iv) necessary properties of a developing interprofessional collaboration. Based on these themes, the synthesis was created and presented as a metaphorical journey. The implementation of a new nursing role in a traditional healthcare team is a complex process influenced by many factors and can be described as a tortuous journey towards a partially unknown destination. The synthesised obstacles and opportunities drawn from international studies may help healthcare organisations and new NPs prepare for, and optimise, the implementation of a new nursing role.

  • 53.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Askenteg, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Wikner, Ulrica
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    "To Cope with Everyday Life, I Need to Sleep" - A Phenomenographic Study Exploring Sleep Loss in Parents of Children with Atopic Dermatitis.2018Ingår i: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 43, s. E59-E65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The whole family is affected when a child has atopic dermatitis (AD), and parents experience sleep disruption related to the child's condition leading to physical and mental exhaustion, mood swings, loss of concentration and lower job performance. This study aimed to explore and describe perceptions of sleep in parents of children <2 years old with AD, consequences of parental sleep loss, and what strategies the parents used to manage sleep loss and to improve sleep.

    DESIGN AND METHODS: This qualitative interview study had an inductive and descriptive design. Twelve parents (eleven mothers and one father) participated in the study. Data analysis was performed using a phenomenographic approach.

    RESULTS: Three categories of description were found: Acceptance and normalization of parental sleep loss; Changed routines and behavior to compensate for sleep loss; and Support is needed to gain sleep and manage daily life.

    CONCLUSIONS: Sleep loss due to the child's AD affected the parents' emotional state, mood, well-being, cognitive function, ability to concentrate and take initiative, and sensitivity to stress and sound negatively. The parents managed their sleep loss mainly by changing their behavior and creating new routines, by taking me-time and through support from partners.

    PRACTICE IMPLICATIONS: Pediatric nurses should acknowledge sleep loss in parents of small children with AD in time to prevent negative consequences, which affect the well-being of the entire family. Advice on how to improve sleep should be given early to increase the parents' understanding, make them feel safer and strengthen them in their parenthood.

  • 54.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Morelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala.
    The cortisol response in parents staying with a sick child at hospital2019Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 2, s. 620-625Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To study the cortisol response in parents staying with their child in paediatric wards, to compare the parents’ cortisol levels between the paediatric ward and at home 4 weeks after discharge and to compare the parents’ cortisol levels with data of an adult reference population, reported by Wust et al., as there are few studies investigating parental cortisol.

    Design

    This study has a descriptive and prospective comparative design.

    Method

    Thirty‐one parents participated. Saliva samples were collected in the paediatric ward and 4 weeks later at home.

    Results

    The parents had lower morning awakening cortisol levels in the paediatric ward than at home after discharge. There were no statistically significant differences in postawakening cortisol or cortisol awakening response (CAR). The child's age, diagnosis or previously diagnosed chronic condition did not affect the parents’ cortisol levels. The morning and postawakening cortisol levels were lower than those of the reference population.

    Conclusion

    The hospital stay with a sick child affects parents’ cortisol levels. Parental stress needs more attention to find interventions to prevent the risk of stress‐related complications that subsequently can affect the care of the child.

  • 55.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Parental mood when staying overnight at hospital with their sick child2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Parental mood when staying overnight at hospital with their sick child

    Objective

    to describe mood in parents, staying with their sick children overnight at the hospital.

    Methodology

    A descriptive design, including 75 parents staying overnight at hospital with their sick child, was used. The parents filled out Mood-scale the morning after staying overnight at the hospital. The Mood-scale is a validated and reliable self-administered instrument measuring six dimensions of mood; control, calmness, social orientation, pleasantness, activation, and extraversion (Sjöberg L, 1979). The study is a part of a larger project, with focus on mood, stress and sleep in parents staying with their sick children overnight at the hospital.

    Results

    The result will describe how parents report their total mood and how they report the different dimensions when they stay with their sick children overnight at the hospital. A comparison will be made between the parent´s mood and gender and the child´s age. Data is under analysis and will be presented as preliminary data.

     

    Conclusion

    According to UNICEF Convention on the Rights of the Child, children in hospital have the right to have their parents with them at all times and parents should be offered accommodation and be encouraged to stay. However, the hospital environment, in combination with having a sick child, might affect the parent´s mood, which in turn might affect the ability to handle the situation and the child´s care. Therefore it is of importance to study parental mood and find ways to help the families during their hospital stay.

  • 56.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Parents' perception of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care services2015Konferensbidrag (Övrigt vetenskapligt)
  • 57. Angelhoff, Charlotte
    et al.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping. Region Östergötland.
    Perceptions of sleep by parents of children in hospital organized home-care2014Konferensbidrag (Refereegranskat)
  • 58. Angelhoff, Charlotte
    et al.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Region Östergötland. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Perceptions of sleep quality and stress by parents of children enrolled in hospital organized home-care2013Konferensbidrag (Refereegranskat)
  • 59.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Filosofiska fakulteten.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Perceptions of sleep quality and stress by parents of children enrolled in hospital organized home-care2013Ingår i: Nordic Advances in Health Care Sciences Research, Lund, 2013: Abstract book / [ed] Gerd Ahlström, Lena von Koch, 2013, s. 56-56Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Introduction

    Caring for a sick child creates much greater demands for parents than those associated with raising a healthy child. Parents of chronically ill children reports higher levels of parental stress as a consequence of the substantial social, emotional and personal demands associated with caring. Sleep quality is an important aspect of wellbeing and is strongly related to stress and quality of life. In some Swedish counties families are offered hospital organized home-care for sick children. Caring for a child at home gives the family the opportunity to be together in an environment they know well and where they can feel comfortable and secure. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation and support their child. No other study is found about how parents sleep when their child is enrolled in hospital organized home-care.

     

    Aim

    To explore parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care.

     

    Material

    Fifteen parents (11 mothers and 4 fathers) with children enrolled in hospital organized home-care from one university hospital and one general hospital in South-eastern Sweden were included. The children ranged in age 0-12 years.

     

    Method

    Parents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both.

     

    Results

    Four descriptive categories in the phenomenon of parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care were identified; Routines helps to manage the situation, Time for oneself and the partner, Feelings of isolation and Need of support

     

    Conclusion

    Sleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.

  • 60.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Edéll-Gustafsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 3-4, s. e544-e550Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives

    To describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.

    Background

    Frequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.

    Methods

    This was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.

    Results

    The parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.

    Conclusion

    Parents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.

    Relevance to Clinical Practice

    The healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.

  • 61.
    Angelhoff, Charlotte
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV).
    Edéll-Gustfsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Mörelius, Evalotte
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.2015Ingår i: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 64, nr 5, s. 372-380Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves.

    Objectives: The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services.

    Method: This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC.

    Results: Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep.

    Discussion: Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

  • 62.
    Apelqvist, Josefin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Dahlin, Jennifer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Postoperativt ileus: En kartläggning av interventioner inom svensk kirurgisk vård2019Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Efter kirurgiska ingrepp förekommer postoperativt ileus (POI) som ett normalfysiologiskt tillstånd. POI definieras som ett avvikande mönster av gastrointestinal motilitet med karakteristiska symtom som illamående och kräkningar, uppspänd buk, samt utebliven gasavgång eller avföring. POI har påvisats påverka den postoperativa återhämtningen negativt.

    Syfte: Syftet med studien var att kartlägga interventioner som används för att minska durationen av postoperativt ileus vid svenska kirurgiska vårdavdelningar.

    Design: Enkätbaserad tvärsnittsstudie.

    Metod: Internetbaserad enkät skickades till vårdenhetschefer vid 86 kirurgiskt inriktade vårdavdelningar på fem universitetssjukhus i södra och mellersta Sverige.

    Resultat: Totalt 21 kirurgiska vårdavdelningar besvarade enkäten. Kunskaper kring innebörden och handläggningen av POI angavs som måttliga till goda. Den mest frekvent föreslagna interventionen inom omvårdnad var mobilisering och laxantia i olika former var den vanligaste farmakologiska interventionen.

    Konklusion: Omvårdnads- och farmakologiska interventioner av varierande evidensgrad används på svenska kirurgiska vårdavdelningar. Det tycks finnas ett behov av utbildning om och implementering av vetenskapliga kunskaper inom området för bedömning och handläggning av POI.

  • 63.
    Appelgren Engstrom, Helene
    et al.
    Malardalen Univ, Sweden.
    Haggstrom-Nordin, Elisabet
    Malardalen Univ, Sweden.
    Borneskog-Sinclair, Catrin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Northumbria Univ, England.
    Almqvist, Anna-Lena
    Malardalen Univ, Sweden.
    Mothers in same-sex relationships-Striving for equal parenthood: A grounded theory study2019Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives To get a deeper understanding of how mothers in same-sex relationships think and reason about their parenthood in terms of gender equality, and how they experience early parental support from child healthcare professionals. Background There is an increasing amount of research on how women in same-sex relationships experience healthcare services when forming a family. Yet there is limited knowledge of what kind of early parental support these women may request. Design Grounded theory. Follows guidelines for qualitative research (COREQ). Method Twenty women ranging from 25 to 42 years of age participated in semi-structured interviews. Data collection and analysis took place in parallel, as recommended in grounded theory methodology. Results The results are described by the core category Same-sex mothers request professional support to achieve equal parenthood, which includes five categories: (a) equality in everyday life, (b) diversity in mother and child attachment, (c) justification of the family structure, (d) ambivalent thoughts about their childs future and (e) a special need for networking and request for professional support. These findings provide a deeper understanding of how same-sex mothers experience their parenthood and the parental support that is offered. Conclusion Child healthcare professionals need to be sensitive and recognise both mothers as equal parents and offer early parenting groups where two-mother families feel included and supported. Relevance to clinical practice Healthcare professionals need to be aware of diverse family formations and meet each parent as a unique individual without heteronormative assumptions. Same-sex mothers must be treated as equal parents and acknowledged as mothers. Healthcare professionals should offer inclusive and supportive parental groups to same-sex families. They should also inform and support nonbirth mothers about the possibility to breastfeed.

  • 64.
    Appelgren Engstrom, Helene
    et al.
    Malardalens Univ, Sweden.
    Häggstrom-Nordin, Elisabet
    Malardalens Univ, Sweden.
    Borneskog-Sinclair, Catrin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Almqvist, Anna-Lena
    Malardalens Univ, Sweden.
    Mothers in Same-Sex Relationships Describe the Process of Forming a Family as a Stressful Journey in a Heteronormative World: A Swedish Grounded Theory Study2018Ingår i: Maternal and Child Health Journal, ISSN 1092-7875, E-ISSN 1573-6628, Vol. 22, nr 10, s. 1444-1450Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives The aim of this study was to gain insight into how women in same-sex relationships experience the process of forming a family through the use of assisted reproduction technique (ART), from planning the pregnancy to parenthood, and their experience of parental support from healthcare professionals. Methods The participants were 20 women in a same-sex relationship who had conceived through ART at a Swedish clinic. Semi-structured interviews including open questions about pregnancy, parenthood and support from healthcare professionals were conducted. The interviews were tape-recorded and transcribed verbatim. The data were analysed according to grounded theory. Results The core category, A stressful journey through a heteronormative world, emerged from the analysis, as did three subcategories: A journey fraught with difficulties and decisions; The nuclear family as the norm; and A need for psychological support. Same-sex parents expressed a need for more information about how to access ART in Sweden. Both the healthcare organization and treatment were perceived as heteronormative. In particular, these women lacked psychological support during the demanding process of utilizing a sperm donor to conceive. Conclusions for Practice Professionals in antenatal care should undergo mandatory cultural competency training to ensure cultural sensitivity and the provision of updated information, tailored brochures and early parental support for families with same-sex parents. All parents need guidance and support from competent, caring personnel throughout the entire process of forming a family.

  • 65.
    Arestedt, Liselott
    et al.
    Linnaeus Univ, Sweden.
    Martinsson, Caroline
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Uhlin, Fredrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Njurmedicinska kliniken US. Tallinn Univ Technol, Estonia.
    Eldh, Ann Catrine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Patient participation in dialysis care-A qualitative study of patients and health professionals perspectivesIngår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and objective End-stage renal disease (ESRD) affects a multitude of aspects in the patients daily life, often entailing their own involvement in various aspects of the treatment. Although patient participation is a core health-care value, what the concept signifies is not yet fully known. The purpose of this paper is to conceptualize patient participation in dialysis care, depicting patients and health-care professionals perspectives. Design This explorative study employed qualitative interviews and content analysis. Setting and participants Seven focus group discussions engaging 42 key informants were performed, including patients, staff and managers with experience of dialysis care. Results In dialysis care, patient participation connotes a sharing of information and knowledge, the learning of and planning of care, including partaking in shared decisions with regards to treatment and management, and being involved in the management of ones own health-care treatment and/or self-care activities. Although these attributes were illustrated by all stakeholders, their significance varied: patients suggested that their preferences regarding primary aspects of participation vary, while staff considered patients performance of dialysis to be the ultimate form of participation. Further, while patients considered multiple ways to execute participation, staff suggested that aspects such as sharing information were a route to, rather than actual, involvement. Conclusions Without a common understanding to denote the idea of patient participation, staff and patients are exposed to a potential deficit in terms of facilitating patient participation in everyday encounters of dialysis treatment. Further studies and means to serve a mutual understanding are needed.

  • 66. Aronsson, M
    et al.
    Janzon, Magnus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Walfridsson, Håkan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Walfridsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Levin, Lars-Åke
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet.
    Cost-effectivesness of catheter ablation as first-line treatment for paroxysmal atrial fibrillation2013Konferensbidrag (Refereegranskat)
  • 67.
    Aronsson, Mattias
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Walfridsson, Håkan
    Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Janzon, Magnus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Walfridsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Nielsen, Jens Cosedis
    Aarhus University Hospital, Denmark.
    Hansen, Peter Steen
    Aarhus University Hospital, Denmark.
    Johannessen, Arne
    Gentofte University Hospital, Denmark.
    Raatikainen, Pekka
    Tampere University Hospital, Finland.
    Hindricks, Gerhard
    Leipzig University Hospital, Germany.
    Kongstad, Ole
    Lund University Hospital, Sweden.
    Pehrson, Steen
    Rigshospitalet, Denmark.
    Englund, Anders
    University Hospital, Örebro, Sweden.
    Hartikainen, Juha
    Kuopio University Hospital, Finland.
    Mortensen, Leif Spange
    Danish Information Technology Centre for Education and Research, Aarhus, Denmark.
    Levin, Lars-Åke
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation: results from a MANTRA-PAF substudy.2015Ingår i: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 17, nr 1, s. 48-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim of this prospective substudy was to estimate the cost-effectiveness of treating paroxysmal atrial fibrillation (AF) with radiofrequency catheter ablation (RFA) compared with antiarrhythmic drugs (AADs) as first-line treatment.

    METHODS AND RESULTS: A decision-analytic Markov model, based on MANTRA-PAF (Medical Antiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation) study data, was developed to study long-term effects and costs of RFA compared with AADs as first-line treatment. Positive clinical effects were found in the overall population, a gain of an average 0.06 quality-adjusted life years (QALYs) to an incremental cost of €3033, resulting in an incremental cost-effectiveness ratio of €50 570/QALY. However, the result of the subgroup analyses showed that RFA was less costly and more effective in younger patients. This implied an incremental cost-effectiveness ratio of €3434/QALY in ≤50-year-old patients respectively €108 937/QALY in >50-year-old patients.

    CONCLUSION: Radiofrequency catheter ablation as first-line treatment is a cost-effective strategy for younger patients with paroxysmal AF. However, the cost-effectiveness of using RFA as first-line therapy in older patients is uncertain, and in most of these AADs should be attempted before RFA (MANTRA-PAF ClinicalTrials.gov number; NCT00133211).

  • 68.
    Arvidsson, Susann
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University, Sweden.
    Tingström, Pia
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study2013Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, nr 7, s. 1500-1514Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

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

    Background

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

    Design

    Randomized controlled trial.

    Methods

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

    Results

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

    Conclusion

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

  • 69.
    Avander, Karin
    et al.
    Sahlgrens University Hospital, Sweden.
    Heikki, Anna
    Sahlgrens University Hospital, Sweden.
    Bjerså, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. University of Gothenburg, Sweden.
    Engstrom, My
    University of Gothenburg, Sweden.
    Trauma Nurses Experience of Workplace Violence and Threats: Short- and Long-Term Consequences in a Swedish Setting2016Ingår i: JOURNAL OF TRAUMA NURSING, ISSN 1078-7496, Vol. 23, nr 2, s. 51-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 70.
    Aviles, Paula
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Ljungberg, Isabella
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Naturbaserad terapi och dess betydelse för personer med psykisk ohälsa: En litteraturstudie om naturen som en resurs inom vård och behandling2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Naturens positiva inverkan på hälsa har belysts sedan antiken. Forskning kring naturbaserad terapi har ökat de senaste decennierna och terapiformen har gett positiva effekter för flertalet patientgrupper. Mer än en tredjedel av EU:s befolkning lider av någon form av psykisk ohälsa och många går utan adekvat behandling. Omvårdnad vid psykisk ohälsa ska enligt riktlinjer innefatta ett personcentrerat förhållningssätt och utformas utifrån kunskap om vårdmiljöns betydelse.

    Syfte: Att beskriva betydelsen av naturbaserad terapi för personer med psykisk ohälsa.

    Metod: En allmän litteraturstudie med systematisk ansats genomfördes. Artikelsökning gjordes i PubMed, Cinahl, AMED, PsykInfo och Scopus. Valda artiklar kvalitetsgranskades och analyserades utifrån kvalitativ innehållsanalys.

    Resultat: Den naturbaserade terapin hade en positiv inverkan på hälsa för personer med psykisk ohälsa. Resultatet baserades på 17 artiklar och speglades i fyra kategorier: naturen som tillflyktsort, betydelsen av social kontext, förändrad syn på livssituation samt symtomförbättring och dess konsekvenser.

    Konklusion: I studien framkom att naturbaserad terapi kan ha stor betydelse för tillfrisknande och daglig funktion för personer med psykisk ohälsa. Studien visar även att omvårdnad som utgår ifrån ett salutogent perspektiv i en terapeutisk naturmiljö bidrar till en förbättrad psykisk hälsa.

  • 71. Back, Christina
    et al.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Interpretativ fenomenologisk analys2015Ingår i: Handbok i kvalitativ analys / [ed] Andreas Fejes och Robert Thornberg, Stockholm: Liber, 2015, 2, s. 148-161Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 72.
    Back, Christina
    et al.
    Universitetssjukhuset i Linköping, Barn- och ungdomspsykiatriska kliniken.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Interpretativ fenomenologisk analys2019Ingår i: Handbok i kvalitativ analys / [ed] Andreas Fejes, Robert Thornberg, Stockholm: Liber, 2019, 3, Vol. Sidorna 165-178, s. 165-178Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 73.
    Back, Christina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Gustafsson, Per A.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Parental opinions of their child's experience in the legal process: an interpretative analysis2014Ingår i: Journal of Child Sexual Abuse, ISSN 1053-8712, E-ISSN 1547-0679, Vol. 23, nr 3, s. 290-303Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study is to demonstrate how parents of children who are victims of sexual assault experience the legal process from the children’s and parents’ perspective. Nine parents, identified in the records of three public prosecution offices in three cities in Sweden, were interviewed. The parents described feelings of shame and guilt over what their children had experienced. They felt stigmatized and had difficulty fulfilling their parental role, perceived a lack of information and support from the professionals involved, and experienced a sense of withdrawal from their role as parents, though they felt the professionals who worked with their children were helpful and influential.

  • 74.
    Backman, Carl G.
    et al.
    Vrinnevi Hosp Norrkoping, Sweden.
    Ahlberg, Mona
    Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Jones, Christina
    Univ Liverpool, England.
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN.
    Group meetings after critical illness-Giving and receiving strength2018Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 46, s. 86-91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: An increasing number of intensive care patients are surviving critical illness, but many develop mental, cognitive and physical impairments after discharge. Adapting to a new life situation, often with major challenges, implies the need of support. Therefore, it is important to develop interventions aimed at promoting recovery. Objective: The aim was to describe former intensive care patients feelings of sharing their experience of critical illness with other former patients. Method: Former intensive care patients (n = 17) participated in group meetings and wrote about their thoughts in a notebook after each group meeting. To deepen the understanding of the former patients experience 11 of the former patients were interviewed. The notes in the notebooks and the interviews were analysed using qualitative content analysis. Findings: Meeting others revealed to the former patients new dimensions of being critically ill, and they both gave and received strength from each other. The meetings were meaningful as they gained insight into other patients lives, and realised what it meant to survive intensive care. Conclusions: The group meetings meant sharing experiences and understanding the process of survival after critical illness. Giving and receiving strength from others helped the participants to go further. (C) 2017 Elsevier Ltd. All rights reserved.

  • 75.
    Baggens, Christina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Sandén, Inger
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Omvårdnad genom kommunikativa handlingar2014Ingår i: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] Febe Friberg, Joakim Öhlén, Lund: Studentlitteratur AB, 2014, 2, s. 507-537Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 76.
    Barmano, Neshro
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Cty Hosp Ryhov, Sweden.
    Charitakis, Emmanouil
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Karlsson, Jan-Erik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Cty Hosp Ryhov, Sweden.
    Nyström, Fredrik H
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken. Primary Hlth Care Ctr Ctr, Sweden.
    Walfridsson, Håkan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Walfridsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Predictors of improvement in arrhythmia-specific symptoms and health-related quality of life after catheter ablation of atrial fibrillation2019Ingår i: Clinical Cardiology, ISSN 0160-9289, E-ISSN 1932-8737, Vol. 42, nr 2, s. 247-255Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The primary goal of radiofrequency ablation (RFA) of atrial fibrillation (AF) is to improve symptoms and health-related quality of life (HRQoL). However, most studies have focused on predictors of AF recurrence rather than on predictors of improvement in symptoms and HRQoL. Hypothesis We sought to explore predictors of improvement in arrhythmia-specific symptoms and HRQoL after RFA of AF, and to evaluate the effects on symptoms, HRQoL, anxiety, and depression. Methods We studied 192 patients undergoing their first RFA of AF. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), arrhythmia-specific questionnaire in tachycardia and arrhythmia (ASTA), and hospital anxiety and depression scale (HADS) questionnaires were filled out at baseline, at 4 months, and at a 1-year follow-up. Results All questionnaire scale scores improved significantly over time. In the ASTA symptom scale score, female gender and amp;gt; 10 AF episodes the month before RFA were significant positive predictors of improvement, while diabetes and AF recurrence within 12 months after RFA were significant negative predictors (R-2 = 0.18; P amp;lt; 0.001). In the ASTA HRQoL scale score, the presence of heart failure and amp;gt; 10 AF episodes the month before RFA were significant positive predictors of improvement, while diabetes, maximum left atrial volume and AF recurrence were significant negative predictors (R-2 = 0.20; P amp;lt; 0.001). Conclusion Left atrial volume, gender, diabetes, heart failure, the frequency of AF attacks prior to RFA, and recurrence of AF after RFA were significant factors affecting improvement in symptoms and HRQoL after RFA of AF. Future studies are warranted to confirm these findings.

  • 77.
    Barmano, Neshro
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden,.
    Charitakis, Emmanouil
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Kronstrand, Robert
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. National Board of Forensic Medicine, Linko¨ping, Sweden.
    Walfridsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Karlsson, Jan-Erik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Walfridsson, Håkan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Nyström, Fredrik H.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken.
    The association between alcohol consumption, cardiac biomarkers, left atrial size and re-ablation in patients with atrial fibrillation referred for catheter ablation2019Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 4, artikel-id e0215121Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Information on alcohol consumption in patients undergoing radiofrequency ablation (RFA) of atrial fibrillation (AF) is often limited by the reliance on self-reports. The aim of this study was to describe the long-term alcohol consumption, measured as ethyl glucuronide in hair (hEtG), in patients undergoing RFA due to AF, and to examine potential associations with cardiac biomarkers, left atrial size and re-ablation within one year after the initial RFA.

    Methods

    The amount of hEtG was measured in patients referred for RFA, and a cut-off of 7 pg/mg was used. N-terminal pro B-type natriuretic peptide (NT-proBNP) and the mid-regional fragment of pro atrial natriuretic peptide (MR-proANP) were examined and maximum left atrium volume index (LAVI) was measured. The number of re-ablations was examined up to one year after the initial RFA. Analyses were stratified by gender, and adjusted for age, systolic blood pressure, body mass index, presence of heart failure and heart rhythm for analyses regarding NT-proBNP, MR-proANP and LAVI and heart rhythm being replaced by type of AF for analyses regarding re-ablation.

    Results

    In total, 192 patients were included in the study. Median (25th– 75th percentile) NT-proBNP in men with hEtG ≥ 7 vs. < 7 pg/mg was 250 (96–695) vs. 130 (49–346) pg/ml (p = 0.010), and in women it was 230 (125–480) vs. 230 (125–910) pg/ml (p = 0.810). Median MR-proANP in men with hEtG ≥ 7 vs. < 7 pg/mg was 142 (100–224) vs. 117 (83–179) pmol/l (p = 0.120) and in women it was 139 (112–206) vs. 153 (93–249) pmol/l (p = 0.965). The median of maximum LAVI was 30.1 (26.7–33.9) vs. 25.8 (21.4–32.0) ml/m2 (p = 0.017) in men, and 25.0 (18.9–29.6) vs. 25.7 (21.7–34.6) ml/m2 (p = 0.438) in women, with hEtG ≥ 7 vs. < 7 pg/ml, respectively. Adjusted analyses showed similar results, except for MR-proANP turning out significant in men with hEtG ≥ 7 vs. < 7 pg/mg (p = 0.047). The odds ratio of having a re-ablation was 3.5 (95% CI 1.3–9.6, p = 0.017) in men with hEtG ≥ 7 vs. < 7 pg/mg, while there was no significant difference in women.

    Conclusions

    In male patients with AF and hEtG ≥ 7 pg/mg, NT-proBNP and MR-proANP were higher, LA volumes larger, and there was a higher rate of re-ablations, as compared to men with hEtG < 7 pg/mg. This implies that men with an alcohol consumption corresponding to an hEtG-value ≥ 7, have a higher risk for LA remodelling that could potentially lead to a deterioration of the AF situation.

  • 78.
    Barmano, Neshro
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Department of Internal Medicine, County hospital Ryhov, Jönköping, Sweden;Jönköping Academy, Jönköping University,Jönköping, Sweden..
    Walfridsson, Ulla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Walfridsson, Håkan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Karlsson, Jan-Erik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Department of Internal Medicine, County hospital Ryhov, Jönköping, Sweden;Jönköping Academy, Jönköping University,Jönköping, Sweden..
    Structured care of patients with atrial fibrillation improves guideline adherence2016Ingår i: Journal of Atrial Fibrillation, ISSN 1941-6911, Vol. 9, nr 4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are many reports of lack of guideline adherence in the treatment of patients with atrial fibrillation (AF), and AF affects health-related quality of life (HRQoL) negatively. The aim of this study was to investigate whether structured care compared to standard care of a general AF population could improve guideline adherence and HRQoL, and reduce symptoms,anxiety and depression.

    Methods

    In total, 176 patients were recruited to the intervention and 146 patients to the control group.The intervention consisted of a structured follow-up program, while patients serving as controls received standard care. The primary outcome was guideline adherence evaluated through: appropriate use of oral anticoagulants (OAC) and antiarrhythmics, whether echocardiogram and thyroid lab tests were performed, and patient-reported outcome measures (PROMs), assessed with the questionnaires SF-36, EQ-5D, HADS and ASTA at baseline and after one year.

    Results

    Guideline adherence was significantly better in the intervention group, 91% vs. 63% (p < 0.01), mainly due to appropriate OAC treatment 94% vs. 74% (p < 0.01). Symptoms assessed with ASTA were less frequent and the negative impact of AF was reduced in the intervention group after one year/ at follow-up. Five scales in SF-36, and the visual analogue scale for current health status in EQ-5D (EQ-VAS), improved significantly in both groups.

    Conclusion

    Structured care of patients with AF significantly improved guideline adherence and patients reported fewer symptoms and a reduced negative impact on disease-specific HRQoL compared to standard care at one year follow-up.

  • 79.
    Bengtsson, Ulrika
    et al.
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien Göteborg, Centrum för personcentrerad vård, Göteborgs universitet.
    Kasperowski, Dick
    Institutionen för filosofi, lingvistik och vetenskapsteori, Göteborgs Universitet.
    Ring, Lena
    Centrum för forsknings- och bioetik, Uppsala Universitet, Läkemedelsverket, Uppsala.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien Göteborg, Centrum för personcentrerad vård, Göteborgs Universitet.
    Developing an interactive mobile phone self-report system for self-management of hypertension. Part 1: Patient and professional perspectives2014Ingår i: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 23, nr 5, s. 288-295Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Low adherence remains a struggle in hypertension management, despite improvement efforts. Presuming that increased patient participation is a possible approach, we collaborated with patients and healthcare professionals to design a self-report system to support self-management. The study aimed to explore and describe relevant aspects of hypertension and hypertension treatment, for use in the development of an interactive mobile phone self-report system. It further aimed to suggest which clinical measures, lifestyle measures, symptoms and side-effects of treatment would be meaningful to include in such a system. Five focus group interviews were performed with 15 patients and 12 healthcare professionals, and data was analysed using thematic analysis. Patients suggested trust, a good relationship with caregivers, and well-being as important aspects of hypertension self-management. Furthermore, they regarded blood pressure, dizziness, stress, headache and tiredness as important outcomes to include. Patients sought to understand interconnections between symptoms and variations in blood pressure, whilst healthcare professionals doubted patients’ ability to do so. Healthcare professionals emphasized accessibility, clear and consistent counselling, complication prevention and educational efforts. The study presents aspects of importance for follow-up to understand the interplay between blood pressure and daily life experiences for patients with hypertension.

  • 80.
    Bengtsson, Ulrika
    et al.
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien Göteborg, Centrum för personcentrerad vård, Göteborgs universitet.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien Göteborg, Centrum för personcentrerad vård, Göteborgs universitet.
    Höfer, Stefan
    Innsbruck Medical University, Department of medical psychology, Innsbruck, Austria.
    Taft, Charles
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien Göteborg.
    Ring, Lena
    Centrum för forsknings- & bioetik, Uppsala Universitet, Läkemedelsverket, Uppsala.
    Developing an interactive mobile phone self-report system for self-management of hypertension. Part 2: Content validity and usability2014Ingår i: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 23, nr 5, s. 296-306Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Self-management support tools using technology may improve adherence to hypertension treatment. There is a need for user-friendly tools facilitating patients’ understanding of the interconnections between blood pressure, wellbeing and lifestyle. This study aimed to examine comprehension, comprehensiveness and relevance of items, and further to evaluate the usability and reliability of an interactive hypertension-specific mobile phone self-report system. Areas important in supporting self-management and candidate items were derived from five focus group interviews with patients and healthcare professionals (n = 27), supplemented by a literature review. Items and response formats were drafted to meet specifications for mobile phone administration and were integrated into a mobile phone data-capture system. Content validity and usability were assessed iteratively in four rounds of cognitive interviews with patients (n = 21) and healthcare professionals (n = 4). Reliability was examined using a test–retest. Focus group analyses yielded six areas covered by 16 items. The cognitive interviews showed satisfactory item comprehension, relevance and coverage; however, one item was added. The mobile phone self-report system was reliable and perceived easy to use. The mobile phone self-report system appears efficiently to capture information relevant in patients’ self-management of hypertension. Future studies need to evaluate the effectiveness of this tool in improving self-management of hypertension in clinical practice.

  • 81.
    Bengtsson, Ulrika
    et al.
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien, Göteborg.
    Kjellgren, Karina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien, Göteborg.
    Hallberg, Inger
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien, Göteborg.
    Lindwall, Magnus
    Institutionen för kost- och idrottsvetenskap, Göteborgs Universitet.
    Taft, Charles
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademien Göteborg.
    Blood pressure decrease with a mobile phone-based system to support self-management2014Konferensbidrag (Övrigt vetenskapligt)
  • 82.
    Benson, Lydia
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Litström, Emma
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad.
    Att förebygga hypotermi hos bukkirurgiska patienter: En systematisk litteraturöversikt och metaanalys2017Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Hypotermi definieras som kärntemperatur under 36,0°C. Vid anestesi störs den fysiologiska regleringen av temperatur vilket är en av orsakerna till att risken för hypotermi under operation är stor. Peroperativt sker 90 % av värmeförlusterna från huden. Patientens riskfaktorer, anestesins längd och operationstid har betydelse i utveckling av hypotermi. Patienter som genomgår öppna bukoperationer som varar länge har hög risk för att utveckla hypotermi, bland annat på grund av stor exponerad kroppsyta.

    Syfte: Att utvärdera olika metoder för att förebygga peroperativ hypotermi hos sövda patienter som genomgår bukkirurgi.

    Metod: Systematisk litteraturstudie med metaanalys. Sökningar har gjorts i databaserna PubMed, CINAHL och SCOPUS.

    Resultat: Totalt 21 studier har inkluderats. Alla studier hade hypoterma patienter någon gång under det peroperativa förloppet, oavsett uppvärmningsmetod. Vid jämförelse av temperatur vid operationsslut uppvisades positivt resultat för både uppvärmd koldioxid och varmluftstäcke.

    Konklusion: Aktiv uppvärmning med varmluftstäcke tycks vara mest effektivt och är gold standard men trots aktiv uppvärmning blir många patienter hypoterma peroperativt. Det finns flera alternativ som visat sig vara lika effektiva som varmluftstäcke, så som värmelampor, eldriven värmemadrass och aktiv värmning med varmvatten. Troligen behövs en kombination av värmande metoder för att undvika hypotermi.

  • 83.
    Berben, Lut
    et al.
    University of Basel, Switzerland.
    Bogert, Laura
    University of Basel, Switzerland.
    Leventhal, Marcia E
    University of Basel, Switzerland.
    Fridlund, Bengt
    Jönköping University, Sweden.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Norekval, Tone M
    Haukeland University Hospital, Norway.
    Smith, Karen
    Ninewells Hospital, UK.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    De Geest, Sabina
    University of Basel, Switzerland .
    Which interventions are used by health care professionals to enhance medication adherence in cardiovascular patients? A survey of current clinical practice2011Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, nr 1, s. 14-21Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice.

    Aim: To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions.

    Method: A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management.

    Results: Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence.

    Conclusion: Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence.

  • 84.
    Berg, Agneta
    et al.
    Kristianstad.
    Suhonen, Riitta
    Finland.
    Idvall, Ewa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    A survey of orthopaedic patients' assessment of care using the Individualised Care Scale2007Ingår i: Journal of Orthopaedic Nursing, ISSN 1361-3111, E-ISSN 1873-4839, Vol. 11, nr 3-4, s. 185-193Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to describe orthopaedic patients' assessments of how individuality in patient care was supported during specific nursing interventions and how that individuality was perceived during hospitalisation. Orthopaedic inpatients (370) from two central county and two county hospitals in Sweden were surveyed using the Individualised Care Scale (ICS) during 2004/2005, (response rate 74% n = 274). The data were analysed using both descriptive and inferential statistics. Eighty-six percent of the respondents stated that it was very important to be treated as an individual or unique person and 59% experienced this type of care. The lowest rated assessments concerned the personal life situation and the highest were concerned with the clinical situation and the decisional control over care. This analysis of patient assessments of individualised nursing care can be used to implement changes to individualise care processes in orthopaedic wards. This will be useful in the evaluation of health care quality improvement, planning and personnel management. © 2007 Elsevier Ltd. All rights reserved.

  • 85.
    Berg, Katarina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Franzén Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Postoperative recovery from the perspective of day surgery patients: A phenomenographic study2013Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, nr 12, s. 1630-1638Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patient’s own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home.

    Objectives: To explore day surgery patients’ perceptions of postoperative recovery.

    Design: A qualitative design with a phenomenographic approach was used.

    Methods and settings: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face-to-face at the patients’ homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital.

    Results: The patients perceived postoperative recovery as comprising internal and external prerequisites and implied changes in ordinary life with varying levels of support. The organization at the day surgery unit, with its advantages and disadvantages, was perceived as having an impact on the subsequent recovery trajectory. The results are demonstrated in three descriptive categories: ‘Conditions for recovery at home’, The rollback to ordinary life’ and ‘Being a cog in a flow of care’.

    Conclusions: Postoperative recovery following day surgery implies, from the patients’ perspective, a migration from being a recipient of care at the day surgery unit to playing an active role, with extensive responsibility at home. To manage self-care confidently, postdischarge patients require knowledge and understanding of what constitutes the normal range in recovery following their specific surgical procedure.

  • 86.
    Berg, Katarina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Idvall, Ewa
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Ulrica
    Örebro University Hospital.
    Franzén Årestedt, Kristofer
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Unosson, Mitra
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Psychometric evaluation of the post-discharge surgical recovery scale2010Ingår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 16, nr 4, s. 794-801Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale, aim and objectives Day surgery patients are discharged after a short period of postoperative surveillance, and reliable and valid instruments for assessment at home are needed. The aim of this study was to evaluate the psychometric properties of a Swedish version of the post-discharge surgical recovery (PSR) scale, an instrument to monitor the patients recovery after day surgery, in terms of data quality, internal consistency, dimensionality and responsiveness. Methods Data were collected on postoperative days 1 and 14 and included 525 patients. Data quality and internal consistency were evaluated using descriptive statistics, correlation analyses and Cronbachs alpha. The dimensionality of the scale was determined through an exploratory factor analysis. Responsiveness was evaluated using the standardized response mean and the area under the receiver operating characteristics curve (AUC). The correlation between change score in PSR and change score in self-rated health was assessed using Pearsons correlation coefficient. Patients ability to work and their self-rated health on postoperative day 14 were used as external indicators of change. Results Six items showed floor or ceiling effects. Cronbachs coefficient alpha was 0.90 and the average inter-item correlation coefficient was 0.44 after the deletion of two items. The items were closely related to each other, and a one-factor solution was decided on. A robust ability to detect changes in recovery (standardized response mean = 1.14) was shown. The AUC for the entire scale was 0.60. When initial PSR scores were categorized into three intervals, the ability to detect improved and non-improved patients varied (AUC 0.58-0.81). There was a strong correlation between change scores in PSR and health (0.63). Conclusions The Swedish version of the PSR scale demonstrates acceptable psychometric properties of data quality, internal consistency, dimensionality and responsiveness. In addition to previous findings, these results strengthen the PSR scale as a potential instrument of recovery at home.

  • 87.
    Berg, Katarina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Kaspersen, Rikard
    Sykehuset Osffold HF, Norway .
    Unby, Christina
    Sirius Humanum AB, Sweden .
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Endokrinmedicinska enheten.
    The Interaction Between the Patient and Nurse Anesthetist Immediately Before Elective Coronary Artery Bypass Surgery2013Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 28, nr 5, s. 283-290Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Establishing a purposive interaction with a patient who is in a vulnerable situation before coronary artery bypass graft (CABG) surgery poses a challenge for the nurse anesthetist. The aim of this study was to identify and describe the interaction between the patient and the nurse anesthetist immediately before elective CABG surgery. less thanbrgreater than less thanbrgreater thanDesign: An observational study using a grounded theory design was used. less thanbrgreater than less thanbrgreater thanMethods: A theoretical selection of patients and nurse anesthetists was made. A total of 11 situations of patient/nurse anesthetist interaction were observed. The data were analyzed using the constant comparative method. Findings:A core category of reassurance emerged from other categories of continuity, confirmation, and control. Continuity was characterized by expedient anesthesia nursing of high quality, confirmation was related to communication in a trusting atmosphere, and control was associated with skilled nursing interventions in the thoracic operating theatre. less thanbrgreater than less thanbrgreater thanConclusions: Reassurance can be achieved through a well-structured anesthesia nursing performance in the thoracic operating theatre, and by focusing on the patient and continuously giving him/her information during the preoperative preparation phase.

  • 88.
    Bergdahl, Elisabeth
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. FOU nu, Sweden .
    Benzein, Eva
    Ersta Skondal University of Coll, Sweden .
    Ternestedt, Britt-Marie
    Ersta Skondal University of Coll, Sweden .
    Elmberger, Eva
    Ersta Skondal University of Coll, Sweden .
    Andershed, Birgitta
    Ersta Skondal University of Coll, Sweden .
    Co-creating possibilities for patients in palliative care to reach vital goals - a multiple case study of home-care nursing encounters2013Ingår i: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 20, nr 4, s. 341-351Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The patients home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patients relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.

  • 89.
    Bergdahl, Elisabeth
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. FOU, Stockholm; Sykepleievitenskap Universitetet i Nordland, Bodö, Norge.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    The myth of induction in qualitative nursing research2015Ingår i: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 16, nr 2, s. 110-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In nursing today, it remains unclear what constitutes a good foundation for qualitative scientific inquiry. There is a tendency to define qualitative research as a form of inductive inquiry; deductive practice is seldom discussed, and when it is, this usually occurs in the context of data analysis. We will look at how the terms ‘induction’ and ‘deduction’ are used in qualitative nursing science and by qualitative research theorists, and relate these uses to the traditional definitions of these terms by Popper and other philosophers of science. We will also question the assertion that qualitative research is or should be inductive. The position we defend here is that qualitative research should use deductive methods. We also see a need to understand the difference between the creative process needed to create theory and the justification of a theory. Our position is that misunderstandings regarding the philosophy of science and the role of inductive and deductive logic and science are still harming the development of nursing theory and science. The purpose of this article is to discuss and reflect upon inductive and deductive views of science as well as inductive and deductive analyses in qualitative research. We start by describing inductive and deductive methods andlogic from a philosophy of science perspective, and we examine how the concepts of induction and deduction are often described and used in qualitative methods and nursing research. Finally, we attempt to provide a theoretical perspective that reconciles the misunderstandings regarding induction and deduction. Our conclusion is that openness towards deductive thinking and testing hypotheses is needed in qualitative nursing research. We must also realize that strict induction will not create theory; to generate theory, a creative leap is needed.

  • 90.
    Bergdahl, Elisabeth
    et al.
    Research and Development Unit, FOU nu, SLSO, Stockholm, Sweden / Faculty of Professional Studies, Nursing Science, Nord University, Bodö, Norway.
    Berterö, Carina M
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Concept analysis and the building blocks of theory: misconceptions regarding theory development.2016Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, nr 10, s. 2558-2566Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

    DESIGN: Discussion paper.

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

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

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

  • 91.
    Bergdahl, Elisabeth
    et al.
    Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Ternestedt, Britt-Marie
    Department of Health Care Science/ Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Andershed, Birgitta
    Department of Health Care Science/ Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden; Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjøvik, Norway .
    The theory of a co-creative process in advanced palliative home care nursing encounters: A qualitative deductive approach over time2019Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 1, s. 175-188Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives

    The aim of this study was to test the theoretical conceptualization of the co‐creative process in home care nursing encounters over time.

    Method and design

    This was a multiple case study with a deductive analysis of qualitative data over time, using interviews and observations collected from three cases.

    Results

    The co‐creative process was complex and contained main, sub‐ and micro‐processes. Time was important and valuable, giving the patient and relatives space to adjust the process to their own pace. Some processes were worked on more intensively in accordance with the patients’ and relatives’ needs, and these are considered the main‐process. The further developed theory of the co‐creative process and its main, sub‐ and microprocesses can be understood as a concretization of how good nursing care can be performed within caring relationships in the context of advanced palliative home care.

  • 92.
    Berglund, Helene
    et al.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Vårdalinstitutet, The Swedish Institute for Health Sciences, Lund, Sweden.
    Blomberg, Staffan
    Department of Social Work, Lund University, Lund, Sweden; Vårdalinstitutet, The Swedish Institute for Health Sciences, Lund, Sweden.
    Dunér, Anna
    Department of Social Work, University of Gothenburg, Gothenburg, Sweden; Vårdalinstitutet, The Swedish Institute for Health Sciences, Lund, Sweden.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Organizing integrated care for older persons: strategies in Sweden during the past decade2015Ingår i: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 29, nr 1, s. 128-151Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose - The purpose of this paper is to describe and analyse ways of organizing integrated care for older persons in Sweden during the past decade. Design/methodology/approach - The data consist of 62 cases of development work, described in official reports. A meta-analysis of cases was performed, including content analysis of each case. A theoretical framework comprising different forms of integration (co-ordination, contracting, co-operation and collaboration) was applied. Findings - Co-operation was common and collaboration, including multiprofessional teamwork, was rare in the cases. Contracting can be questioned as being a form of integration, and the introduction of consumer choice models appeared problematic in inter-organization integration. Goals stated in the cases concerned steering and designing care, rather than outcome specifications for older persons. Explicit goals to improve integration in itself could imply that the organizations adapt to strong normative expectations in society. Trends over the decade comprised development of local health care systems, introduction of consumer choice models and contracting out. Research limitations/implications - Most cases were projects, but others comprised evaluations of regular organization of integrated care. These evaluations were often written normatively, but constituted the conditions for practice and were important study contributions. Practical implications - Guiding clinical practice to be aware of importance of setting follow-up goals. Social implications - Awareness of the risk that special funds may impede sustainable strategies development. Originality/value - A theoretical framework of forms of integration was applied to several different strategies, which had been carried out mostly in practice. The study contributes to understanding of how different strategies have been developed and applied to organize integrated care, and highlights some relationships between integration theory and practice.

  • 93.
    Berglund, Helene
    et al.
    Sahlgrenska Academy at the University of Gothenburg, Sweden; Vårdalinstitutet, Swedish Institute for Health Sciences, Lund, Sweden.
    Dunér, Anna
    University of Gothenburg, Sweden; Vårdalinstitutet, Swedish Institute for Health Sciences, Lund, Sweden.
    Blomberg, Staffan
    Lund University, Sweden; Vårdalinstitutet, Swedish Institute for Health Sciences, Lund, Sweden.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Institutionen för vårdvetenskap och hälsa & Centrum för personcentrerad vård (GPCC), Göteborgs Universitet.
    Care planning at home: a way to increase the influence of older people?2014Konferensbidrag (Refereegranskat)
  • 94.
    Berglund, Helene
    et al.
    University of Gothenburg, Sweden; Swedish Institute Health Science, Sweden.
    Hasson, Henna
    Swedish Institute Health Science, Sweden; Karolinska Institute, Sweden.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. University of Gothenburg, Sweden.
    Wilhelmson, Katarina
    Swedish Institute Health Science, Sweden; University of Gothenburg, Sweden.
    Effects of a continuum of care intervention on frail older persons life satisfaction: a randomized controlled study2015Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 7-8, s. 1079-1090Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: The aim of this study was to analyse effects of a comprehensive continuum of care (intervention group) on frail older persons life satisfaction, as compared to those receiving usual care (control group). The intervention included geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care-planning meetings in older persons own homes. Background: Improvements in older persons subjective well-being have been shown in studies including care planning and coordination by a case manager. However, effects of more complex continuum of care interventions on frail older persons life satisfaction are not well explored. DesignRandomised controlled study. Methods: The validated LiSat-11 scale was used in face-to-face interviews to assess older persons life satisfaction at baseline and at three, six and 12 months after the baseline. The odds ratio for improving or maintaining satisfaction was compared for intervention and control groups from baseline to three-month, three- to six-month as well as six- to 12-month follow-ups. Results: Older persons who received the intervention were more likely to improve or maintain satisfaction than those who received usual care, between 6 and 12 month follow-ups, for satisfaction regarding functional capacity, psychological health and financial situation. Conclusions: A comprehensive continuum of care intervention comprising several components had a positive effect on frail older persons satisfaction with functional capacity, psychological health and financial situation. Relevance to clinical practice: Frail older persons represent a great proportion of the persons in need of support from the health care system. Health care professionals need to consider continuum of care interventions impact on life satisfaction. As life satisfaction is an essential part of older persons well-being, we propose that policy makers and managers promote comprehensive continuum of care solutions.

  • 95.
    Berglund, Helene
    et al.
    Sahlgrenska Academy at the University of Gothenburg, Sweden; Vårdalinstitutet, Swedish Institute for Health Sciences, Lund, Sweden.
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Institutionen för vårdvetenskap och hälsa & Centrum för personcentrerad vård (GPCC), Göteborgs Universitet.
    Dunér, Anna
    (University of Gothenburg, Sweden; Vårdalinstitutet, Swedish Institute for Health Sciences, Lund, Sweden.
    Organizing integrated care for older persons: strategies in Sweden2014Konferensbidrag (Övrigt vetenskapligt)
  • 96.
    Berglund, Helene
    et al.
    University of Gothenburg, Sweden .
    Wilhelmson, Katarina
    Swedish Institute Health Science, Sweden .
    Blomberg, Staffan
    Swedish Institute Health Science, Sweden .
    Duner, Anna
    Swedish Institute Health Science, Sweden .
    Kjellgren, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. University of Gothenburg, Sweden .
    Hasson, Henna
    Swedish Institute Health Science, Sweden .
    Older people's views of quality of care: a randomised controlled study of continuum of care2013Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 19-20, s. 2934-2944Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives To analyse frail older peoples views of quality of care when receiving a comprehensive continuum of care intervention, compared with those of people receiving the usual care (control group). The intervention included early geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care-planning meetings in older peoples own homes. less thanbrgreater than less thanbrgreater thanBackground Prior studies indicate that tailored/individualised care planning conducted by a case manager/coordinator often led to greater satisfaction with care planning among older people. However, there is no obvious evidence of any effects of continuum of care interventions on older peoples views of quality of care. less thanbrgreater than less thanbrgreater thanDesign Randomised controlled study. less thanbrgreater than less thanbrgreater thanMethods Items based on a validated questionnaire were used in face-to-face interviews to assess older peoples views of quality of care at three, six and 12months after baseline. less thanbrgreater than less thanbrgreater thanResults Older people receiving a comprehensive continuum of care intervention perceived higher quality of care on items about care planning (p0005), compared with those receiving the usual care. In addition, they had increased knowledge of whom to contact about care/service, after three and 12months (pandlt;003). less thanbrgreater than less thanbrgreater thanConclusions The study gives evidence of the advantages of a combination of components such as organising care-planning meetings in older peoples own homes, case management and interprofessional teamwork. less thanbrgreater than less thanbrgreater thanRelevance to clinical practice The results have implications for policymakers, managers and professionals in the area of health and social care for older people to meet individual needs of frail older people.

  • 97.
    Bergstrand, Sara
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Preventing pressure ulcers by assessment of the microcirculation in tissue exposed to pressure2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of this thesis was to combine optical methods into a system with the ability to simultaneously measure blood flow changes at different tissue depths. The goal of such a system was to reveal vascular mechanisms relevant to pressure ulcer etiology under clinically relevant conditions and in relation to the evaluation of pressure-redistribution support surfaces.

    This thesis consists of four quantitative, cross-sectional studies measuring blood flow responses before, during, and after pressure exposure of the sacral tissue. Two optical methods – photoplethysmography and laser Doppler flowmetry – were combined in a newly developed system that has the ability to discriminate blood flows at different tissue depths. Studies I and II explored blood flow responses at different depths in 17 individuals. In Study I the blood flow was related to tissue thickness and tissue compression during pressure exposure of ≥ 220 mmHg. In Study II, the sacral tissue was loaded with 37.5 mmHg and 50.0 mmHg, and the variation in blood flow was measured. Studies III and IV included 42 healthy individuals < 65 years, 38 healthy individuals ≥ 65 years, and 35 patients ≥ 65 years. Study III included between-subject comparisons of blood flow and pressure between individuals in the three study groups lying in supine positions on a standard hospital mattress. Study IV added within-subject comparisons while the individual was lying on four different types of mattress. The studies explored the vascular phenomena pressure-induced vasodilation (PIV) and reactive hyperemia (RH).

    The most common blood flow response to tissue exposure in this thesis was PIV, although a decrease in blood flow (a lack of PIV) was observed in some individuals. The patients tended to have higher interface pressure during pressure exposure than the healthy groups but no differences in blood flow responses were seen. Our results showed that pressure levels that are normally considered to be harmless could have a significant effect on the microcirculation in different tissue structures. Differences in individual blood flow responses in terms of PIV and RH were seen, and a larger proportion of individuals lacked these responses in the deeper tissue structures compared to more superficial tissue structures.

    This thesis identified PIV and RH that are important vascular mechanisms for pressure ulcer development and revealed for the first time that PIV and RH are present at different depths under clinically relevant conditions. The thesis also identified a population of individuals not previously identified who lack both PIV and RH and seem to be particularly vulnerable to pressure exposure. Further, this thesis has added a new perspective to the microcirculation in pressure ulcer etiology in terms of blood flow regulation and endothelial function that are anchored in clinically relevant studies. Finally, the evaluation of pressureredistribution support surfaces in terms of mean blood flow during and after tissue exposure was shown to be unfeasible, but the assessment of PIV and RH could provide a new possibility for measuring individual physiological responses that are known to be related to pressure ulcer development.

    Delarbeten
    1. Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
    Öppna denna publikation i ny flik eller fönster >>Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
    2010 (Engelska)Ingår i: MICROCIRCULATION, ISSN 1073-9688, Vol. 17, nr 4, s. 311-319Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Pandgt;Objective: The aim was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure and compression in elderly individuals using a newly developed optical probe prototype. Methods: The tissue blood flow and tissue thickness in the sacral area were measured during load in 17 individuals using laser Doppler flowmetry and photoplethysmography in a combined probe, and digital ultrasound. Results: The mean age was 68.6 +/- 7.0 years. While loading, the mean compression was 60.3 +/- 11.9%. The number of participants with existing blood flow while loading increased with increased measurement depth. None had enclosed blood flow deep in the tissue and at the same time an existing more superficial blood flow. Correlation between tissue thickness and BMI in unloaded and loaded sacral tissue was shown: r = 0.68 (P = 0.003) and r = 0.68 (P = 0.003). Conclusions: Sacral tissue is highly compressed by external load. There seems to be a difference in responses to load in the different tissue layers, as occluded blood flow in deeper tissue layers do not occur unless the blood flow in the superficial tissue layers is occluded.

    Ort, förlag, år, upplaga, sidor
    Taylor and Francis, 2010
    Nyckelord
    pressure ulcer, photoplethysmography, laser Doppler flowmetry, non-invasive, tissue blood flow
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-56449 (URN)10.1111/j.1549-8719.2010.00027.x (DOI)000277123800008 ()
    Anmärkning
    This is an electronic version of an article published in: Sara Bergstrand, Toste Länne, Maria Linden and Margareta Lindgren, Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype, 2010, MICROCIRCULATION, (17), 4, 311-319. MICROCIRCULATION is available online at informaworldTM: http://dx.doi.org/10.1111/j.1549-8719.2010.00027.x Copyright: Taylor and Francis http://www.tandf.co.uk/journals/default.asp Tillgänglig från: 2010-05-17 Skapad: 2010-05-17 Senast uppdaterad: 2017-03-27
    2. Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
    Öppna denna publikation i ny flik eller fönster >>Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
    Visa övriga...
    2009 (Engelska)Ingår i: Skin research and technology, ISSN 0909-752X, E-ISSN 1600-0846, Vol. 15, nr 2, s. 139-147Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background/purpose: This study has evaluated a multi-parametric system combining laser Doppler flowmetry and photoplethysmography in a single probe for the simultaneous measurement of blood flow at different depths in the tissue. This system will be used to facilitate the understanding of pressure ulcer formation and in the evaluation of pressure ulcer mattresses.

    Methods: The blood flow in the tissue over the sacrum was measured before, during and after loading with 37.5 mmHg, respectively, 50.0 mmHg. The evaluation of the system consisted of one clinical part, and the other part focusing on the technicalities of the probe prototype.

    Results: An increase in blood flow while loading was the most common response, but when the blood flow decreased during loading it was most affected at the skin surface and the blood flow responses may be different due to depths of measurement. Reactive hyperaemia may occur more frequently in the superficial layers of the tissue.

    Conclusion: The study showed that the new system is satisfactory for measuring tissue blood flow at different depths. The laser Doppler complements the photoplethysmography, and further development of the system into a thin flexible probe with the ability to measure a larger area is required.

    Ort, förlag, år, upplaga, sidor
    Wiley-Blackwell, 2009
    Nyckelord
    pressure ulcers, blood flow, photoplethysmography, laser Doppler flowmetry, non-invasive
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-18018 (URN)10.1111/j.1600-0846.2008.00337.x (DOI)
    Anmärkning

    This is the authors’ version of the following article: Sara Bergstrand, Lars-Göran Lindberg, Anna-Christina Ek and Margareta Lindgren, Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques, 2009, SKIN RESEARCH AND TECHNOLOGY, (15), 2, 139-147. which has been published in final form at: http://dx.doi.org/10.1111/j.1600-0846.2008.00337.x Copyright: Blackwell Publishing Ltd http://www.blackwellpublishing.com/

    Tillgänglig från: 2009-05-26 Skapad: 2009-05-04 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    3. Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
    Öppna denna publikation i ny flik eller fönster >>Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
    Visa övriga...
    2014 (Engelska)Ingår i: Microcirculation, ISSN 1073-9688, E-ISSN 1549-8719, Vol. 21, nr 8, s. 761-771Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.

    METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.

    RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.

    CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.

    Ort, förlag, år, upplaga, sidor
    John Wiley & Sons, 2014
    Nyckelord
    Pressure ulcer, photoplethysmography, laser Doppler flowmetry, non-invasive, tissue blood flow
    Nationell ämneskategori
    Omvårdnad Klinisk medicin
    Identifikatorer
    urn:nbn:se:liu:diva-109950 (URN)10.1111/micc.12160 (DOI)000344789400010 ()25100630 (PubMedID)
    Tillgänglig från: 2014-08-29 Skapad: 2014-08-29 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
    4. Microcirculatory responses of sacral tissue in healthy individuals and in patients on different pressure-redistribution mattresses
    Öppna denna publikation i ny flik eller fönster >>Microcirculatory responses of sacral tissue in healthy individuals and in patients on different pressure-redistribution mattresses
    Visa övriga...
    2015 (Engelska)Ingår i: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 24, nr 8, s. 346-358Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The aim of this study was to explore the interaction between interface pressure and pressure-induced vasodilation and reactive hyperemia with different pressureredistribution mattresses.

    Method: A cross-sectional study was performed with a convenience sample of 42 healthy individuals between 18 and 64 years of age, 38 healthy individuals 65 years or older, and 35 inpatients 65 years or older at a university hospital in Sweden. Blood flow was measured at depths of 1 mm, 2 mm, and 10 mm using a combined system of laser Doppler flowmetry and photoplethysmography. The blood flow, interface pressure and skin temperature were measured in the sacral tissue before, during, and after load while lying on one standard hospital mattress and three different pressure-redistribution mattresses.

    Results: There were significant differences between the three foam mattresses with regard to average sacral pressure, peak sacral pressure, and local probe pressure with the lowest values at the visco-elastic foam/air mattress (23.5 ± 2.5 mmHg, 49.3 ± 11.1 mmHg, 29.2 ± 14.0 mmHg respectively). A greater proportion of subjects had affected blood flow in terms of lack of pressure-induced vasodilation on the visco-elastic foam/air mattress compared to the alternating pressure mattress at tissue depths of 2 mm (39.0% vs. 20.0%, respectively) and 10 mm (56.9 % vs. 35.1%, respectively). Eleven individuals, including subjects in all three subject groups were identified with no pressure-induced vasodilation or reactive hyperemia in any mattress, and this was considered a high-risk blood flow response.

    Conclusion: Interface pressure magnitudes considered not harmful during pressure-exposure lying on different pressure-redistribution mattresses can affect the microcirculation in different tissue structures. Despite having the lowest pressure values compared to the other mattresses, the visco-elastic foam/air mattress had the highest proportion of subjects with decreased blood flow indicating a more affected blood flow. Three young healthy individuals were identified with the high-risk blood flow response, indicating an innate vulnerability to pressure exposure and may not benefit from pressure-redistribution mattresses. Finally it was shown that the evaluation of pressure-redistribution support surfaces in terms of mean blood flow during and after tissue exposure is not feasible but assessment of pressure-induced vasodilation and reactive hyperemia could be a new possibility to assess individualized physiological measurements of mechanisms known to be related to pressure ulcer development.

    Nyckelord
    interface pressure, pressure-induced vasodilation, pressure ulcer, reactive hyperemia, tissue blood flow
    Nationell ämneskategori
    Omvårdnad Klinisk medicin
    Identifikatorer
    urn:nbn:se:liu:diva-109951 (URN)10.12968/jowc.2015.24.8.346 (DOI)000359210200004 ()
    Anmärkning

    Vid tiden för disputationen var publikationen ett manuskript ("Exploring pressure-induced microcirculatory responses in sacral tissue in healthy individuals and inpatients on different pressure-redistribution mattresses")

    Funding text: None declared. The study was funded by the Swedish Research Council, the Faculty of Health Sciences at Linkoping University, Region of Ostergotland., King GustafV and Queen Victoria's Freemason Foundation, NovaMedTech, and the European Union Regional Development Fund.

    Tillgänglig från: 2014-08-29 Skapad: 2014-08-29 Senast uppdaterad: 2019-11-11Bibliografiskt granskad
  • 98.
    Bergstrand, Sara
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Källman, Ulrika
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Department of Dermatology, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Ek, Anna-Christina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Akutkliniken.
    Engström, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Lindgren, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Microcirculatory responses of sacral tissue in healthy individuals and in patients on different pressure-redistribution mattresses2015Ingår i: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 24, nr 8, s. 346-358Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this study was to explore the interaction between interface pressure and pressure-induced vasodilation and reactive hyperemia with different pressureredistribution mattresses.

    Method: A cross-sectional study was performed with a convenience sample of 42 healthy individuals between 18 and 64 years of age, 38 healthy individuals 65 years or older, and 35 inpatients 65 years or older at a university hospital in Sweden. Blood flow was measured at depths of 1 mm, 2 mm, and 10 mm using a combined system of laser Doppler flowmetry and photoplethysmography. The blood flow, interface pressure and skin temperature were measured in the sacral tissue before, during, and after load while lying on one standard hospital mattress and three different pressure-redistribution mattresses.

    Results: There were significant differences between the three foam mattresses with regard to average sacral pressure, peak sacral pressure, and local probe pressure with the lowest values at the visco-elastic foam/air mattress (23.5 ± 2.5 mmHg, 49.3 ± 11.1 mmHg, 29.2 ± 14.0 mmHg respectively). A greater proportion of subjects had affected blood flow in terms of lack of pressure-induced vasodilation on the visco-elastic foam/air mattress compared to the alternating pressure mattress at tissue depths of 2 mm (39.0% vs. 20.0%, respectively) and 10 mm (56.9 % vs. 35.1%, respectively). Eleven individuals, including subjects in all three subject groups were identified with no pressure-induced vasodilation or reactive hyperemia in any mattress, and this was considered a high-risk blood flow response.

    Conclusion: Interface pressure magnitudes considered not harmful during pressure-exposure lying on different pressure-redistribution mattresses can affect the microcirculation in different tissue structures. Despite having the lowest pressure values compared to the other mattresses, the visco-elastic foam/air mattress had the highest proportion of subjects with decreased blood flow indicating a more affected blood flow. Three young healthy individuals were identified with the high-risk blood flow response, indicating an innate vulnerability to pressure exposure and may not benefit from pressure-redistribution mattresses. Finally it was shown that the evaluation of pressure-redistribution support surfaces in terms of mean blood flow during and after tissue exposure is not feasible but assessment of pressure-induced vasodilation and reactive hyperemia could be a new possibility to assess individualized physiological measurements of mechanisms known to be related to pressure ulcer development.

  • 99.
    Bergstrand, Sara
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Källman, Ulrika
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Department of Dermatology, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Ek, Anna-Christina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Akutkliniken.
    Lindberg, Lars-Göran
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik.
    Engström, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Lindgren, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions2014Ingår i: Microcirculation, ISSN 1073-9688, E-ISSN 1549-8719, Vol. 21, nr 8, s. 761-771Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.

    METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.

    RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.

    CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.

  • 100.
    Bergstrand, Sara
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Morales, Maria-Aurora
    CNR Inst Clin Physiol, Italy.
    Coppini, Giuseppe
    CNR Inst Clin Physiol, Italy.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    The relationship between forearm skin speed-resolved perfusion and oxygen saturation, and finger arterial pulsation amplitudes, as indirect measures of endothelial function2018Ingår i: Microcirculation, ISSN 1073-9688, E-ISSN 1549-8719, Vol. 25, nr 2, artikel-id e12422Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Endothelial function is important for regulating peripheral blood flow to meet varying metabolic demands and can be measured indirectly during vascular provocations. In this study, we compared the PAT finger response (EndoPAT) after a 5-minutes arterial occlusion to that from forearm skin comprehensive microcirculation analysis (EPOS). Methods: Measurements in 16 subjects with varying cardiovascular risk factors were carried out concurrently with both methods during arterial occlusion, while forearm skin was also evaluated during local heating. Results: Peak values for EPOS skin Perf(conv) and speed-resolved total perfusion after the release of the occlusion were significantly correlated to the EndoPAT RHI (rho =.68, P = .007 and rho =.60, P = .025, respectively), mainly due to high-speed blood flow. During local heating, EPOS skin oxygen saturation, SO2, was significantly correlated to RHI (rho = .62, P =.043). This indicates that SO2 may have diagnostic value regarding endothelial function. Conclusions: We have demonstrated for the first time a significant relationship between forearm skin microcirculatory perfusion and oxygen saturation and finger PAT. Both local heating and reactive hyperemia are useful skin provocations. Further studies are needed to understand the precise regulation mechanisms of blood flow and oxygenation during these tests.

1234567 51 - 100 av 661
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf