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  • 1.
    Andersson, Caroline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Bondesson, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    En kvalitativ intervjustudie om implementeringsprocessen av ett projekt för att stärka stöd och rehabilitering efter förvärvad hjärnskada.2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Knowledge about implementation is important for new methods to be integrated with regular working methods and reach those who can benefit from them. In order to improve the long-term support for people with acquired brain injury, a collaboration project has been carried out in Stockholm for three years.

    Objective: With focus on Normalization Process Theory (NPT) describe managers’ and employees’ experiences of an implementation process in the project Hjärna Tillsammans.

    Method: A descriptive study with qualitative approach where interviews were used for data collection, and various workplaces in the project were represented. The analysis was done with a qualitative content analysis with a deductive approach where NPT constituted the theoretical framework.

    Result: The analysis resulted in twelve subcategories under the four main categories on which NPT is structured. The respondents described the project in different ways, but the majority described the project and the collaboration between different workplaces as valuable for the target group to get a better support in their illness. One difficulty in implementing the work was to reach the target group. For example, to involve employees, the project has been distributed at various meetings, but it was rarely done with a plan for the work.

    Conclusion: When implementing complex interventions, a coherence of those who are to implement the project is required. It may also be of value to have a plan for implementation and use methods that promote the implementation process.

  • 2.
    Berggren, Malin
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Strömberg, Camilla
    Dalarna University, School of Health and Social Studies, Caring Science.
    Granskning av riktlinjer vid Sveriges förlossningskliniker gällande sfinkterskada i samband med förlossning: Innehållsanalys med en kombination av en deduktiv och induktiv ansats2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sphincter injury is serious complication in connection to vaginal childbirth. Desire to avoid vaginal birth again is seen in women who previously suffered from a sphincter injury.

    Objective: To identify and evaluate obstetric guidelines in Sweden regarding sphincter injury in relation to childbirth

    Method: Content analysis with a combination of a deductive and inductive approach.

    Results: The most frequently occurring risk factors and prevention with help of perineal protection were described in the guidelines. The physician made diagnosis and repaired the sphincter injury at the theatre.  Complications such as coital pain and anal incontinence were described in the guidelines. Paracetamol and diclofenac was most common analgesic regimen given for pain. Prophylaxis such as antibiotic treatment and laxative were common. Information given to women was described. Follow-up by physician, midwife and physiotherapist was recommended after four weeks to six months. For future birth a cesarean section was recommended.

    Conclusion: The guidelines were constructed in the same way and had to a large extent similar content. The authors of the present work recommend a national guideline.

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  • 3.
    Bergling, Hanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Landin, Terese
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Upplevelsen av gångträning med Hybrid Assistive Limb (HAL) hos personer med stroke: En intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One of the most common goals people post stroke express is to improve gait. Gait training with the Hybrid Assistive Limb (HAL) enables intense and repetitive training and has been proved safe to use during rehabilitation post stroke. Qualitative research is needed to describe how people post stroke experience gait training with HAL.

    Aim: To describe how people post stroke experience gait training with HAL.

    Method: An interview study was carried out with people post stroke (n = 18) who participated in a gait study with HAL and had good communicative ability. A semi-structured interview guide was used, and the interviews were analysed with an inductive approach, using qualitative content analysis.

    Results: Gait training with HAL was perceived as challenging physically and mentally which was described as a positive thing. However, some participants experienced that gait training with HAL took all their energy and affected the ability to participate in other activities. Most of the participants experienced improvements in strength, fitness and balance. Several experienced improved gait and a positive impact on their self-confidence. Wearing HAL was described as heavy and clumsy. Gait training with HAL was experienced as amusing and meaningful.

    Conclusion: The participants described that gait training with HAL was challenging and improved their gait and various body functions. Benefits from gait training with HAL were that participants perceived it as amusing and meaningful. More qualitative studies are needed to explore the experience of gait training with HAL.

  • 4.
    Berglund, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Nilsson, Frida
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Parent’s experiences of feeding their preterm infant in Neonatal Units in Sweden.: Ethnographic design2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Studies have shown that having a preterm infant may cause stress and powerlessness for parents. It is important to support parents around the feeding situation, and that the Neonatal Intensive Care Unit (NICU) has appropriate space and place to help the family to bond to each other. For the healthcare professionals it is important to promote skin-to-skin contact and breastfeeding; particularly for preterm infants. There are many studies on parent’s experiences of NICUs and a few studies on parent’s experiences of feeding their infant in the NICU.

    Objective: The objective of this study was to explore parents experiences of feeding their infant in the NICU.

    Design: The study was conducted using an ethnographic design.

    Results: A global theme of ‘The journey in feeding’ was developed from four organising themes: ‘Ways of infant feeding’; ‘Environmental influences’; ‘Relationships’ and ‘Emotional factors’. These themes illustrate the challenges mothers reported with different methods of feeding. The environment had a big impact on parent’s experiences of infant feeding. Some mothers felt that breastfeeding seemed unnatural because their infant was so tiny but breastfeeding and skin-to-skin contact helped them to bond to their infant. The mothers thought it was difficult to keep up with the milk production by only pumping. Routines were not inviting parents to find their own rhythm. They also felt stressed about the weighing. Healthcare professionals had positive and negative influences on the parents.

    Conclusions: This study demonstrates that while all parents expressed the wish to breastfeed, their ‘journey in feeding’ was highly influenced by method of feeding, environmental, relational and emotional factors. The general focus upon routines and assessing milk intake generated anxiety and reduced relationality. Midwives and neonatal nurses need to ensure that they emphasise and support the relational aspects of parenting and avoid over-emphasising milk intake and associated progress of the infant

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  • 5.
    Björnhager, Erika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Heij Rose´n, Märet
    Närståendes upplevelser och behov av sjuksköterskans stöd och bemötande vid anhörigs psykossjukdom: En kvalitativ intervjustudie med närstående2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim was to illustrate relatives experiences and needs of support and professional approach from nurses associated with family members psychotic disorder.

    Method: This study was conducted as an empirical study with qualitative approach, based on semi-structured interviews. Relatives were asked to describe their previous experiences of support and professional approach from the nurse, when a family member suffers from a psychotic disorder. They also described which needs of support and professional approach they claimed to have.

    Results: The results showed that relatives of people with psychosis have no support from nurses and other health professionals. Experience of the nurse´s approach revealed deficiencies. The relatives felt extradited, rejected and without influence.

    . Relatives described their needs for support from the nurse to be relieved, valued and freed from guilt. They described a desire to be treated with care. It also emerged need to be more involved in the care of the family member, and to get advice and support. Mainly in the form of a contact person to turn to.

    Conclusion: Existing health care programs and guidelines need to be followed so relatives could receive the support they are entitled to. If the nurse involved relatives in health care, should relatives conditions for good health improve. It also contributes to relatives possibilities to support their sick family member to a better life.

  • 6.
    Boltenstern, Rebecca
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Granath, Ingrid
    Dalarna University, School of Health and Social Studies, Caring Science.
    Mammors upplevelser i samband med beskedet att det väntade barnet dött i livmodern2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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  • 7.
    Breivik, Mia
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Midwives’ perceptions of HIV-positive women’s sexual and reproductive health and rights in urban Namibia: An interview study with ten midwives2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Namibia has challenges in the area of sexual and reproductive health and rights. Working with sexual and reproductive health care, midwives are an important facilitating factor for a better sexual and reproductive health in Namibia.

    Aim:

    To explore midwives’ perceptions of HIV-positive women's sexual and reproductive health and rights in urban Namibia.

    Method:

    A qualitative study with ten midwives at a hospital in Windhoek. Individual interviews were done using an interview guide. The method used for analysis was phenomenography. The phenomenon being studied was the sexual and reproductive health and rights of HIV-positive women and the phenomenon was studied through the perceptions of midwives.

    Findings:

    The midwives perceived that improvements of HIV-positive women’s reproductive health were obstructed. The midwives perceived that the HIV-positive women’s reproductive possibilities and decisions were related to HIV. According to the midwives’ perceptions, sexual relations could be complicated by HIV and it was difficult for HIV-positive women to use condoms.

    Conclusion:

    The findings of this study can be used to reflect on the current situation for HIV-positive women in Namibia. The midwives' perceptions highlight the need to reduce the remaining stigma related to HIV and to work towards the empowerment of HIV-positive women.

  • 8.
    Carlsson, Maria
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Sofri, Fatima
    Dalarna University, School of Health and Social Studies, Caring Science.
    Behandlingsmetoder och amningsförekomst vid bröstböld2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Amningens fördelar för mor, barn och samhälle är välkända. En komplikation vid amning är bröstböld. Medvetenhet om fördelar och nackdelar med olika behandlingsmetoder vid bröstböld och deras inverkan på fortsatt amning är viktig.

    Syftet: Att studera behandlingsmetoder och amningsförekomst vid bröstböld.

    Metod: Retrospektiv design från en journalgranskning genomförd på Södersjukhuset mellan januari 2006 och september 2008. Statistiska analyser genomfördes med Chi-två test, Independent samples T-test samt Fishers exakta test.

    Resultat: Totalt 139 kvinnor med bröstböld behandlades med nålpunktions-, pigtail- eller dränagebehandling, eller en kombination av dessa. Sextiotre procent pigtailbehandlades enbart och dessa behövde i mindre omfattning sjukhusinläggning jämfört med ej enbart pigtailbehandlade, samt resulterade i större andel av ett till tre sjukhusbesök. Enbart dränagebehandling och flera metoder resulterade i större andel sjukhusinläggningar än ej enbart dränagebehandling och en metod. Amningsförekomsten sjönk från 96 procent före behandling till 69 procent en månad efteråt.

    Konklusion: Enbart pigtailbehandling var den vanligaste metoden och resulterade i färre sjukhusinläggningar och sjukhusbesök. Förekomsten av amning hade sjunkit efter behandling av bröstböld

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  • 9.
    Dahlkvist, Sara Erica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Molinder, Rosa-Lill Eleonor
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Nepali men’s perceptions of the role of the man in family planning, during pregnancy and childbirth: A qualitative interview study2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Nepal has a rich culture and tradition in which family life and marriage are generally controlled by patriarchal norms, sanctions, values and gender differences. Despite global efforts to initiate midwifery education beneficial to women’s reproductive health in Nepal, the initiation is still pending.

    Objective: To describe Nepali men´s perceptions of the role of the man in family planning, during pregnancy and childbirth.

    Methods: A qualitative interview study with open questions was conducted with 15 Nepalese men in urban and rural areas. The material was analyzed by inductive content analysis.

    Results: The main category was, `He leads – She follows´. Six subcategories were presented under the category `supporting women in family planning, during pregnancy and childbirth´. Six subcategories formed the category `withdraw from supporting women in family planning, during pregnancy and childbirth´.

    Conclusion: The role of the man in Nepal was supportive and yet support was withdrawn in maybe the woman’s most vulnerable time of life.

    Clinical implications: With men playing such an important role in family planning, during pregnancy and childbirth, inviting him to knowledge sessions might improve women’s and girls’ sexual and reproductive health and rights.

    Further research: Proposal for further research that could capture the whole picture should be implemented with a more extensive quantitative research in Nepal.

  • 10.
    Danielsson, Madeleine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Lind, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors strategier för att främja fysisk aktivitet under graviditeten: En Kvalitativ Intervjustudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Physical activity should be recommended to all women during pregnancy. Midwives have an important role in the health promotion practice. There are recommendations about physical activity during pregnancy, although studies show that few pregnant women actually follow them. The midwife experience difficulties in counselling and there is a need to find strategies that can be used to promote physical activity. The aim of this study was to describe the midwives strategies to promote physical activity during pregnancy. The study was conducted by qualitative method and semistructured interviews were used to collect data. The data was analysed by thematic analysis. Several strategies emerged that the midwives used to promote physical activity during pregnancy; To advice, To motivate, To seek support in the surroundings, To individualize, To take care of the relationship and To elaborate. Another finding in the study was that promotion of physical activity was perceived as important but difficult by the midwives. These strategies can be used by midwives and other healthcare providers to promote physical activity during pregnancy.

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  • 11.
    Dragsten, Mirjam
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Salmonsson, Ingela
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Vårdpersonalens kunskapsläge i hjärtlungräddning samt följsamhet till det svenska hjärtlungräddningsregistret på ett länssjukhus i Mellansverige: En kvantitativ tvärsnittsstudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: To identify the healthcare professional´s knowledge and training frequency of cardiopulmony resuscitation in a county hospital in central Sweden, and compliance of the Swedish Register of cardiopulmony resuscitation.

    Method: Survey with quantitative approach consisting of 177 respondents, as well as a retrospective observational study.

    Main results: Individuals answered correctly to all knowledge questions, but as a group, there were deficiencies in the knowledge of cardiopulmonary resuscitation. When comparing healthcare professional´s knowledge it was demonstrated that in four of the seven knowledge questions it was a significant difference in knowledge between the health professionals who have more regular training than those with fewer. Those who had more regular education had more right answers. A significant difference was also detected depending on when they had their latest CPR training, where those who have had their education more recently also had more right answers. Compliance of healthcare professional´s to register patients treated for cardiac arrest in hospital at the Swedish CPR registry, can be summarized by the deficiencies in reporting. Conclusion: It is important to create conditions for frequent training to health professionals to increase the knowledge and preparedness in CPR, which can also be seen as a quality assurance work. An improvement is necessary in order to improve compliance to registration.

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  • 12.
    Ehrling, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Kvinnans individuella upplevelse av förlossningssmärta: En begreppsanalys2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Labor pain is a term used in education and healthcare, where women are cared for during pregnancy and in maternity wards. How the concept is defined is described in literature and how and what is covered by the concept is wide. Labor pain has great location within maternity care but as a concept it is relatively undefined. Aim: The aim was to describe the concept of labor pain through a concept analysis. Methods: A concept analysis with qualitative design. Five midwives were selected trough a convenience sampling and were interviewed; earlier a literature review was conducted. The result from the field study phase was brought together with the result from the theoretical phase. Results: After the analysis of the concept of labor pain the main results is that it is truly one unique experience of labour pain. Defined three dimensions sensory, affective and cognitive. The sensory dimension stands for physiology, the affective dimension for earlier experiences and the cognitive dimension for how a person thinks about pain and the experience of it. Pain in labour is a unique experience. Only the woman in labour knows how it feels like. Pain during labour is an individual experience and just like all other experience it has its unique and individual interpretation for the person involved. Conclusion: Labor pain can be identified as a complex concept adapted to each pregnancy based on the defined dimensions. Clinical applicability: Clarification of the concept is important in education of midwifery students.

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  • 13.
    Ekborn, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Att föda barn i vatten: Kvinnors upplevelse av utdrivningsskedet när det sker i vatten. En kvalitativ intervjustudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To give birth in water is still and has for a long time been questioned regarding the benefits and safety in many countries. In Sweden there is no longer any a restriction or recommendations about water births. The aim of this study was to investigate women´s experience of the second stage of labour in water.

    Method: Interviews were conducted with six women three to four months after the water birth. The interviews were analyzed qualitative.

    Result: Four categories were identified; Handle the pain, kept integrity, feeling secure and natural childbirth.

    None of the women had planned for a water birth but all had a wish to avoid medical pain relief and have a natural birth if possible. Their experience was that the bath made it easier to support natural child birth and the women were positive to stay in the bath as long as the midwife told them everything was fine. The primiparas expressed the pain in the second stage of labour as mainly positive. The multiparas thought the pain was equal as previous experience. The most psychological benefit was the experience of kept integrity in the bath. The women felt less exposed in the water compared with previous experiences or ideas. Women´s opinion of the midwife as skilled and calm had importance for the choice of a water birth.

    Conclusions: The women experienced the water as protective and a way to support natural birth. The primiparas expressed the pain in the second stage of labour as mainly positive. The multiparas thought the pain was equal as previous experience. The women expressed the kept integrity as most beneficial about water birth. High confidence with the midwife had importance for feeling safe in with the water birth.

  • 14.
    Ekenberg, Linda
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Löwegren, Linda
    Dalarna University, School of Health and Social Studies, Caring Science.
    Tidig föräldrastress hos mammor med för tidigt födda barn2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When an infant is born preterm (<37 gestational weeks) unexpected stresses affect the whole family. Significant improvements in the perinatal care has been made in the recent decades and now the chance of survival is high. To become a mother in a Neonatal Intensive Care Unit (NICU) entail consequences for the mother emotionally and in her care for her infant. Aim: To investigate parental stress and describe factors associated to early parenting stress in mothers of preterm infants at two months of corrected age. Method: The study was conducted in four NICUs in Sweden. The inclusion criteria were that the infant was born prematurely and had a hospital stay for at least 72 hours. To measure perceived parental stress, the mothers (n=276) answered the Swedish Parental Stress Questionnaire (SPSQ) at two months of corrected age. Results: Mothers whose infants were not cared for in a NICU with co-care, whose infants were cared for in an incubator, who were multiparous, older, who smoked and/or who were breastfeeding exclusively, experienced more stress than their counterparts in various dimensions explored. Conclusion: The study shows that factors relating to the environment and the mother are associated to parental stress among mothers’ of preterm infants. These findings show the need for improved support, both during the NICU stay and after discharge. These findings also highlight the need for improvements in the physical environment of the NICUs to reduce the risk for parental stress. 

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  • 15.
    Ekendahl, Sigrid
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Johansson, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors erfarenheter av att stödja kvinnor i deras sexualitet första året efter förlossning: Intervjustudie med kliniskt verksamma barnmorskor i mödrahälsovården2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To apply knowledge on sexuality and relationships and providing support by dialogue is part of sexual and reproductive health, and part of the midwives’ competence.

    Research shows that women experience transition in their sexuality up to one year post partum, and that women express the need for support on the subject from health professionals.

    Aim: The aim of this study was to describe midwives’ experiences of giving support to women in their sexuality in the first year post partum.

    Method: The study was conducted through a qualitative method with an inductive approach.

    Data was collected from semi-structured individual interviews with eight midwives. The data was processed by qualitative inductive content analysis.

    Results: The result of the study showed that the midwives provided support in sexuality the first year post partum to women by dialogue, where the midwives approach was important. The dialogue support was provided by information and normalisation, investigation and consulting. The informants felt that further education in sexology was needed to give support to women in their sexuality the first year post partum.

    Clinical application: Through the experiences of the midwives in supporting women in their sexuality the first year post partum, this study might be used as inspiration for other midwives active in the field.

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  • 16.
    Elfstrand, Rebecka
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Karlsson, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Sexual and reproductive knowledge and perceptions in a school going population of youth in Kathmandu, Nepal: A questionnaire sample study2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The sexual and reproductive health of youths is a topic that has been neglected around the world for a long time. The level of sexual and reproductive knowledge needs to increase and the achievements from the healthcare units has to be more accessible in order to prevent the transmission of sexual transmitted diseases, HIV included, prevent unwanted pregnancies, unsafe abortions and teen births. Like many other countries in Asia Nepal just resent introduced sexual education in school. As well as youth friendly preventive healthcare services. The reason for this is that sex among youths is taboo in this culture.

    Aim: This study aimed to examine sexual and reproductive knowledge and perceptions of a school going population youth in Kathmandu, Nepal.

    Method: A quantitative questionnaire sample study with 160 pupils in 10th to 12th grade was conducted in four schools in Kathmandu, the Capital city of Nepal. The youth answered a self-administrated questionnaire.

    Result: 1/3 of the youths did not know that it is possible to get pregnant at first intercourse. 2/3 of the girls and nearly 3/5 of the boys did know that it is possible to get infected with a sexual transmitted disease at first intercourse. More than half of the students did know at what period of the menstrual cycle it is easiest get pregnant. The boys have a subordinate amount of awareness in all of the sexual and reproductive knowledge questions except in methods to prevent pregnancy. Both boys and girls preferred primarily to receive their sexual and reproductive knowledge from friends and secondarily from the internet.

    Conclusion and clinical implication: For youths in this study it was more important to prevent unwanted pregnancies than to protect oneself from sexual transmitted diseases. Reliable internet and school information and education could be beneficial to youth regarding their sexual knowledge in Nepal.

  • 17.
    Enström, Peter
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Sjuksköterskors upplevelse av centrala venösa infarter inom prehospital vård – en kvalitativ intervjustudie2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Today, numerous elderly people are cared for at home with advanced home health care. An increase in the number of elderly people in society is likely to lead to a rice in the number of patients with central venous access in prehospital care.Purpose: The purpose of the study was to investigate nurses' experiences of existing central intravenous inline in prehospital care. The research questions were how the nurses experienced the use of central venous access and their experience of what influenced the choice of venous access.Method: The method was based on descriptive qualitative semi-structured interviews with twenty nurses working in Ambulance Care in Region Dalarna. All nurses had more than five years work experience in ambulance care. The answers of the interviews have been compiled through a content analysis.Results: The result presented that almost all the nurses interviewed perceived their own insecurity or uncertainty with their colleagues when it comes to managing central intravenous catheters. There were differences in knowledge among the nurses to manage central intravenous catheters.Conclusion: The conclusion of the study showed that the Nurses wanted more knowledge and the results showed that the interviewed nurses experienced uncertainty, shortage of experience and of support. This was crucial for their experience of central venous entrances. There were differences in the nurses' knowledge regarding the management of central venous entrances. Another factor was a distinct and strong will of the interviewees not do mistakes and not to hurt knowledge support in the form of treatment guidelines and opportunities to practice.

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  • 18.
    Eriksson, Paula
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Söderström, Sofia
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    En kartläggning av användandet av postoperativa restriktioner efter en total höftprotesoperation på svenska ortopedkliniker2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Joint movement- and load precautions are common after a total hip arthroplasty and aims to prevent dislocation of the hip and to prevent the loss of sutured muscles while the soft tissue heal, usually 6-8 weeks. Prosthesis and surgical technics have changed over the years, which had led to a reduced number of postoperative hip dislocations and hence have some orthopedic clinics in Sweden begun abandon postoperative joint movementand load precautions.

    Aim: A mapping of the use of joint movement- and load precautions in Swedish orthopedic clinics and if there has been any changes in precautions during the last five years.

    Method: The study was conducted as a quantitative cross-sectional study with the help of a selfdeveloped validated online survey.

    Result: 81 % of the 16 respondent clinics stated they had some form of precautions (joint movement- or load precautions) for their hip replaced patients. The most common precaution was joint movement where 62% of respondents answered yes to the question "Does your unit/Clinic recommend patients undergoing surgery with total hip replacement any joint movement precautions". The corresponding figure for load precautions was 50%. A total absence of restrictions occurred in 19 % of the respondent clinics. 63 % responded that modifications of load precautions took place for more than 10 years ago while 50 % responded that the modifications of joint movement precaution took place over the past 5 years. The result in our study indicated that the use of precautions had decreased. The most common change was a decrease in jointmovementprecautions that occurred with 60 % of the respondents.

    Conclusion: In our study we found that 4 out of 5 Swedish orthopaedic clinics who participated in our survey recommended joint movement- or load precautions after a hip replacement and it also showed that 1 out of 5 didn´t recommend precautions. Half of the clinics had changed the movement precautions during the past five years, and less than 40 % had changed the load precautions.

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  • 19.
    Falk Johansson, Marcus
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Jacobsen, Amanda
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Fridberg, Helena
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Vill vi tillbaka till långvårdens tidevarv?2020In: Socialpolitik, ISSN 1104-6376, article id 2020-06-05Article in journal (Other (popular science, discussion, etc.))
  • 20.
    Falk Johansson, Marcus
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Nationella Forskarskolan om Äldre och Hälsa (SWEAH).
    Marmstål Hammar, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens Högskola.
    Summer Meranius, Martina
    Mälardalens högskola.
    Vem tar över anhörigas insatser för äldre?2020In: Socialpolitik, ISSN 1104-6376, article id 2020-05-05Article in journal (Other (popular science, discussion, etc.))
  • 21.
    Falk Johansson, Marcus
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Nationella Forskarskolan om Åldrande och Hälsa (SWEAH).
    Marmstål Hammar, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Summer Meranius, Martina
    Mälardalens Högskola .
    Viktigt att anhörigvårdarna får stöd efter unika behov2019In: Dagens Samhälle, ISSN ISSN 1652-6511Article in journal (Other (popular science, discussion, etc.))
  • 22.
    Falkenström, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Hein, Terese
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Kvinnors upplevelser av fosterrörelser och upplevd anknytning med mindfetalness2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The movement pattern is unique to each individual child, and so even the woman's experiences of fetal movements. The patterns intensity and duration, provides important information about the unborn child's well-being. Different methods to document the child´s movement pattern, are used by pregnant women. The self-assessment method mindfetalness, means that you are paying attention to the fetal movement's strength, type and frequency.

     

    Aim: To examine women's experiences of fetal movements and perceived attachment with mindfetalness as self-assessment method.

     

    Method: Crossover trial with a qualitative and abductive approach. Systematic text condensation was used as analyzed method.

     

    Result: Three main categories and six subcategories could be identified in the results. Security was a major factor why the women wanted to feel fetal movements. Lightweight, stretchy and strong movements, was most abundant in the descriptions. Mindfetalness helped the women feel attachment with their child and create an expectation.

     

    Conclusion: Mindfetalness can be a good method to help women strengthen their connection to the unborn baby and her self-confidence. Living in the moment and take the time to get to know their child and its movements can be very helpful in the related process. Fetal movements are unique and the midwife can use mindfetalness, to get information about the movement pattern and the treatment of the woman.

     

    Clinical applicability: There is limited research on the topic mindfetalness and the authors believe that further research on the topic for it to be used in clinical practice.

  • 23.
    Fallqvist, Carolina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Persson N., Jennifer
    Dalarna University, School of Health and Social Studies, Caring Science.
    Att vårda patienter i rättspsykiatrisk vård som uppvisar självskadebeteende: sjuksköterskors erfarenheter och upplevelser2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Deliberate self harm as defined pathologically as well as socially is becoming an increasing phenomenon within forensic psychiatry. Nurses working with patients who have self harm behaviour and are confined to forensic psychiatry face different challenges which affect their feelings and attitudes in different ways, in their nursing practice.

    Purpose: To explore nurses’ experiences of caring for patients who suffer from deliberate self harm behaviour and are confined to forensic psychiatry.

    Method: Qualitative semi- structured interview s from eight nurses working within the forensic psychiatric clinic. Interviews were analysed by using a qualitative content analysis.

    Results: They worked strategically and emphasized the importance of teamwork, good communication and urged for the need to get necessary education, staff focused tutoring and patient focused therapy.

    Conclusion: Need for necessary education, patient focused therapy and staff focused tutor is needed to empower staff working with patients who are confined within forensic psychiatry and suffer from deliberate self harm behaviour.

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  • 24.
    Fredborg, Elisabeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Raninen Jansson, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Sjuksköterskestudenters skattade upplevelser av lärandemiljön före och efter inrättandet av Kompetenscentrum2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In recent years, an increasing number of clinical training centers for skill

    training is available to allow for a safe and secure learning environment with simulation

    opportunities for students and staff. Clinical skill training is an important part of nursing at

    University College of Dalarna (HDa) where learning environment at the center of excellence

    (KC) can contribute to an improvement in this part of the training.

    Aim: The aim of this study was to investigate the nursing students ' experiences through the

    estimation of learning environment of clinical skill training before and after the establishment

    of center of excellence.

    Method: The study was conducted as a survey with quasiexperimental design.

    The questionnaire was based on Saarikoski and Leino-Kilpis gauges CLES where questions

    were modified with the help of Delphi method based on the three different dimensions:

    educational environment, relationship and the teacher's role. The measurement before the

    establishment was carried out during autumn 2010 and the measurement after establishment

    occurred in autumn of 2011. A total of 266 students were included in the study, of which 198

    (74%) responded to the questionnaire.

    Result: Nursing students estimated the experience of learning environment more favorable

    after the establishment of center of excellence where the results show a significantly higher

    estimate in 8 of the 16 questions. Nursing students´ believe that the training environment is

    more realistic, they are more satisfied with skill training and that inspires them to work as a

    nurse. The relationship between them and the teacher is based on respect and that opens up to

    a more positive atmosphere during skill training. On the other hand, no significant difference

    in the student’s experience of the clinical teacher's role was noticed.

    Conclusion: It is clear that the learning environment is important for nurse student's

    integration of theoretical as well as practical knowledge and skills improvement and provides

    a good basis for work as a nurse. Strategies should be taken to maintain and develop the

    learning environment at KC and focus more on the integration of theory and practice.

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  • 25.
    Fridberg, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Gustavsson, Catharina
    Dalarna University, School of Education, Health and Social Studies, Medical Science. b Center for Clinical Research Dalarna, Uppsala University.
    Self-efficacy in activities of daily living and symptom management in people with dizziness: a focus group study2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 6, p. 705-713Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-efficacy is associated with health status, health behaviour and health behaviour change in various chronic health conditions.

    PURPOSE: To describe self-efficacy in relation to Activities of daily living and symptom management in people with dizziness.

    MATERIAL AND METHODS: Thirteen women and three men, aged 45-82 years, with persistent dizziness (duration 4 months to 30 years) were recruited from an outpatient physiotherapy unit. A qualitative study was conducted using four focus groups and one individual interview and was then analysed with qualitative content analysis.

    RESULTS: The participants conveyed, in-depth information concerning two predefined main categories. Self-efficacy in Activities of daily living was related to challenging body positions and motions, environments, social activities, work tasks, and complex cognitive behaviours. Self-efficacy in symptom management was related to distress and aggravated symptoms, unfamiliar environment, and unknown people.

    CONCLUSIONS: People with dizziness describe how self-efficacy for specific activities varies according to the perceived difficulty of the task, the context of the activity, and day-to-day variations in general wellbeing. The results underscore the importance of targeting self-efficacy in the rehabilitation of people with dizziness. Our findings can guide the rehabilitation process by providing a deeper understanding of self-efficacy judgements in relation to Activities of daily living and symptom management in people with dizziness. Implication for rehabilitation This study adds important in-depth knowledge to the rehabilitation area on self-efficacy beliefs in relation to Activities of daily living and symptom management in people with dizziness. Self-efficacy for specific activities varies according to the perceived difficulty of the task, the context in which the activity takes place and day-to-day variations in perceived general well-being. The results can be used as a topic list to guide rehabilitation efforts in exploring and intervening aspects of people's everyday activities that are affected by low self-efficacy judgements. Activities perceived to be crucial to everyday life and important for well-being should be targeted in rehabilitation to increase self-efficacy and thereby activity performance and participation in people with dizziness.

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  • 26.
    Fridberg, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Sahlgrenska Academy at the University of Gothenburg.
    Wallengren, C.
    Kottorp, A.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Tistad, Malin
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet.
    Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care2020In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, no 1, article id 960Article in journal (Refereed)
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  • 27.
    Gillenstrand, Sara
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Hedblom, Fia
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors erfarenheter och upplevelser kring postpartumsamtal2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research shows postpartum counselling beneficial, women value to talk about their childbirth experiences. Still, not all women are offered the option of postpartum counselling. Midwives find it beneficial for women to have a postpartum counselling. Midwives find they have a lack of knowledge to perform fulfilling postpartum counselling.

    Aim: The aim was to describe midwives’ experiences of postpartum counselling.

    Method: Three focus group interviews were conducted with midwives employed at the maternity ward. The interviews were semi-structured, based on a questionnaire. Qualitative content analysis was used as the analyze method.

    Results: One theme, four categories and 15 subcategories were identified. The theme was: Postpartum counselling today: To meet the need and challenges for the future. The categories were: The meaning of postpartum counselling for the woman, Postpartum counselling, not for everyone, To perform postpartum counselling, Conditions to perform postpartum counselling.

    Conclusion: The midwives’ experiences were that postpartum counselling was of importance to women, their partners but also for the midwive. The organization is in need for adjustment to be able to offer postpartum counselling based on the parents’ needs. Knowledge could be drawn from postpartum counselling for both professional development and care development. This could be one step closer to women centered care.

    Clinical application: The results of the study could lead to development of routines surrounding postpartum counselling. Yet there is a need for more research in the development of a postpartum counselling model. The model could clarify the content and how to perform postpartum counselling.

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  • 28.
    Grim, Katarina
    Dalarna University, School of Education, Health and Social Studies, Social Work. Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Legitimizing the knowledge of mental health service users in shared decision making: Promoting participation through a web-based decision support tool2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The overall aim of this thesis was to explore the manner in which user knowledge and user perspectives can be included and supported in shared decision making (SDM) in mental health services.

    The thesis consists of four studies. Study I explored what needs service users identify to participate in deliberative processes and decision making in their care. Study II examined how a decision support tool (DST) for SDM can be designed to enhance service users’ ability to have active and meaningful roles in SDM. Study III investigated barriers and facilitators associated with the implementation of a web-based DST designed to provide a concrete structure to support SDM. In study IV, a theoretical analysis was performed to elucidate the barriers associated with user knowledge being expressed and legitimized in decision-making processes.

    Methods: A key feature of the project involved a process of exploring decisional and informational needs and of developing, testing and implementing a DST for SDM. Qualitative data have been collected through focus group and individual interviews with service users and service providers, usability testing with service users and checklists.

    Findings: The findings show a number of characteristics specific to the mental health service context that need to be considered when developing support for SDM. Decisions were often complex and found to encompass a number of life domains. Issues related to social context and individual recovery highlighted the necessity to include the knowledge perspectives of service users throughout decision processes. In response, phases for preparation and follow-up was emphasized in the DST. The results indicate that supportive structures are required for service users to express their knowledge perspectives and for providers to include them in their decision-making. Moreover, existing barriers related to organizational structures and to power differentials need to be addressed.       

    Conclusions and implications: A DST specifically designed for the mental health context, that methodically invites service users to participate in each phase of the decision-making process might function as a guiding structure to validate service users as knowledgeable agents.

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  • 29.
    Grim, Katarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Karlstads universitet.
    Rosenberg, David
    Svedberg, Petra
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Development and usability testing of a web-based decision support for users and health professionals in psychiatric services2017In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, no 3, p. 293-302Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported.

    METHOD: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers.

    RESULTS: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool.

    CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. (PsycINFO Database Record

  • 30.
    Grim, Katarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Rosenberg, David
    Svedberg, Petra
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Shared decision-making in mental health care: a user perspective on decisional needs in community-based services2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30563Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

    OBJECTIVE: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

    METHODS: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.'s model of SDM.

    RESULTS: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

    CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

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  • 31.
    Grim, Katarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Karlstads universitet.
    Tistad, Malin
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work. Stockholms universitet.
    Rosenberg, David
    Umeå universitet.
    The legitimacy of user knowledge in decision-making processes in mental health care: An analysis of epistemic injustice2019In: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, Vol. 6, no 2, p. 157-173Article in journal (Refereed)
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  • 32.
    Halldin, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Helinder, Lina
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors erfarenheter av preventivmedelsrådgivning på ungdomsmottagning: - En intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The midwife’s field of work today includes sexual,- reproductive,- and

    perinatal health and the core of the profession is to promote health. The midwife should have

    the knowledge, to provide information and teach about sexuality and relationships from a

    gender and lifecycle approach. The mission of the youth center is to work with sexuality and

    health and the prevention of unwanted pregnancies and STI’s.

    Aim: The aim was to describe midwives' experiences of contraceptive counseling at youth

    clinics.

    Method: Interviews were conducted with nine midwives in youth clinics. In time of the

    interview a questionnaire was used and semistructured questions were asked. Qualitative

    content analysis was used as analyze method.

    Results: Four categories and 15 subcategories were identified. The categories were as

    follows: Importance of experience and knowledge, the Clinical approach, Moderating factors

    and Challenges.

    Conclusion: Midwives feel they have good knowledge and experience of young people and

    contraceptive counseling at the youth clinic and has experience that it is a dynamic work that

    contributes to constant development. When they meet contraception seeking young people

    they wish to meet them at an individual level. The midwives had experiences in that there are

    moderating factors and challenges for the contraception counselling and compliance in

    contraceptive use, this means that contraceptive counselling for young people is complex.

    Clinical application: The result of the study could mean greater understanding for the work

    in youth clinics and create a basis for meeting the challenges that midwives face in their daily

    work.

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  • 33.
    Hellman, Daniela
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Söderström, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskans uppfattning om indikationer och effekter av förlossning med elektiva kejsarsnitt på humanitär indikation utifrån arbetslivserfarenhet: En intervjustudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Statistics show an increased number of elective caesarean section internationally and nationally. A caesarean section can save the life of mother and child if complications arise, elective caesarean section in common with other major surgeries involve risk of complications. The number of elective caesarean sections on humanitarian indication has increased in Sweden and about 17% of all deliveries via caesarean section. To care and support women before, during and after a cesarean is an essential part of midwifery work. Objective: The aim of the study is to describe midwives' perception of indications and effects of childbirth by elective caesarean section on humanitarian indication illuminated on the basis of work experience. Method: A qualitative approach: semi structural interviews with nine midwives, phenomenographic analysis in seven steps was used for analysis of data. Results: Four descriptive categories emerged, elective Caesarean section on humanitarian indication is an ethical dilemma, elective Caesarean section on humanitarian indication is major surgery, elective Caesarean section on humanitarian indication affect the organization and midwives working environment and elective Caesarean section on humanitarian indication affect the woman's birth experience. Further nine categories that describe midwive´s perceptions emerged. Conclusion: Midwives perceived elective ceaserean section as something complex, that with their professional skills they support the natural part in caesarean sections on humanitarian indication and they lacked mandate to support and strengthen women's informed choice regarding elective Caesarean section on humanitarian indication. Clinical applicability: The result can be used in education regarding midwives supportive and caring role in deliveries with caesarean section. In addition the result can be used in discussions at delivery wards and antenatal care units regarding improving midwives mandate for their supportive and informative tasks.

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  • 34.
    Hermansson, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Östman, Gabriella
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Psykiatrisjuksköterskans personcentrerade vård av vuxna med föräldrar som har alkoholmissbruk – En kvalitativ intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Mental illness that may be due to having grown up with alcohol addicted parents is problematic. The psychiatric nurse should be aware of how a promoted mental health for this target group can be achieved in psychiatric careIt is therefore important to describe how psychiatric nurses work person-centered with this patient group in care situations. Aim: To describe how nurses within adult psychiatric care throw Person-Centered care can promote continuous development of psychiatric health regarding adults with parents who have an alcohol abuse. Method:Data was collected from six semi-structured interviews and analyzed with qualitative content analysis. Result: The result material presented the following categories; Create Confidence and trust, Identify need for efforts, Work in team around patient, Get patient to take responsibility for their own choices, and Let the patient affect planned efforts. Conclusion: The nurses who participated in the study argued that the motivation and strengthening of the patient to take responsibility were central aspects.

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  • 35.
    Hirvonen, Helena
    Dalarna University, School of Health and Social Studies, Caring Science.
    Kvinnors upplevelser av prehospital förlossning: En intervjustudie2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Several hundred women have an unplanned birth outside hospital in Sweden each year but limited knowledge exists about their experience. The purpose of this study is to describe eight women's emotional experiences of prehospital birth and semi-structured in-depth interviews were chosen as method. The data were analyzed qualitatively using a phenomenological analysis.The essential meaning of the phenomenon of unplanned birth outside hospitals can be understood as a dual experience; at one hand the strength and pride to cope with the situation, on the other hand disappointment. The women were taken by surprise by their bodies, but found in the moment of birth power and focus that, despite the circumstances, guided them through childbirth and in taking care of their newborns. Relief and pride arose afterwards when they knew that everything went well. The phenomenon was also imbued with disappointment that the expectations upon the health care system were not met. The event leaved a trace in the form of enhanced self-esteem, but also concern about giving birth in the future. These findings may provide a basis for further research in the area but also provide the opportunity for a customized treatment and follow-up in the health care system.

  • 36.
    Hjorth, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Sylvén, Katarina
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Test av patientenkät riktad till personer med levercirros i uppföljning vid leversjuksköterskemottagning:: En pilotstudie med mixad metod2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To test the patient questionnaire used in the evaluation of an intervention with nurse-led clinic for patients with decompensated liver cirrhosis to examine the experience of answering the questions as well as their relevance to the patient's situation.

    Method: The pilot study was conducted with a mixed method.

    Results: The variation of the participants' experience of anxiety/discomfort of the questionnaire was large (VAS 6-100 millimeters). Individuals with few disease symptoms had concerns about future development of the disease, in the case of long disease experience all the symptoms was familiar. Following alcohol induced disease thoughts of past behavior occurred. A smaller variation (VAS 66-92 millimeters) was seen regarding the experience of how important/essential the questions felt. Questions about treatment were considered important and affected the perception of care. Questions about individualized information was requested as well as the experience of participation in the exchange of information. The participants showed a high appreciation (VAS 73-95 millimeters) that the disease/situation was highlighted by the survey. The visits to the nurse differed from appointments to physicians. The nurse focused on self-care and more time was available for information. For one informant the intervention increased the total number of hospital visits, coordination meant advantages and disadvantages. Symptoms of fatigue and impaired concentration made the questionnaire experienced as too long, a two-parted questionnaire was requested, the size was not strain in mild disease. The language was easy to understand and the content perceived relevant. The open issues brought nothing for the three informants.

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  • 37. Hägglund, Patricia
    et al.
    Koistinen, Susanne
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Ståhlnacke, Katri
    Wester, Per
    Levring Jäghagen, Eva
    Older people with swallowing dysfunction and poor oral health are at greater risk of early death2019In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 47, no 6, p. 494-501Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden.

    METHODS: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI).

    RESULTS: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02-2.75; P = .041 and aHR: 1.98, 95% CI 1.07-3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15-5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%).

    CONCLUSIONS: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.

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  • 38. Hägglund, Patricia
    et al.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Ståhlnacke, Katri
    Persenius, Mona
    Hägg, Mary
    Andersson, Maria
    Koistinen, Susanne
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Örebro universitet.
    Carlsson, Eva
    Study protocol for the SOFIA project: Swallowing function, oral health, and food intake in old age2017In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, no 1, article id 78Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia).

    METHODS/DESIGN: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT <10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups.

    DISCUSSION: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.

    TRIAL REGISTRATION: This trial was retrospectively registered at ClinicalTrials.gov, on July 4, 2016, identifier: NCT02825927 .

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  • 39.
    Hällsten, Lisa
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Svensson, Ida
    Dalarna University, School of Health and Social Studies, Caring Science.
    Gravida kvinnors tankar om amning2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Internationally, the frequency of breastfeeding in today`s Sweden is high, but has declined somewhat in recent years. Studies showed that attitudes to breastfeeding were positive, but the difficulties associated with breastfeeding and lack of information and support also emerged. The aim of this master essay was to examine pregnant women`s thoughts about breastfeeding, breastfeeding information and support. The study was conducted with a qualitative approach and, data was collected through focus group interviews with 18 pregnant women in autumn 2012. Data was analysed with a qualitative content analysis. The analysis yielded an overall theme; Balance between individual expectations and difficulties. Five categories emerged; Being aware of breastfeeding benefits, Being aware of the difficulties of breastfeeding, To plan for their next lactation, To be influenced by their surroundings and To have expectations of support for the next lactation. The result showed that pregnant women were aware of breastfeeding benefits and difficulties, that environment affected their thoughts, and that the women often felt that breastfeeding “dissolves naturally”, The results revealed most clearly women`s perceived lack of knowledge about breastfeeding problems and a desire to get breastfeeding information late in the pregnancy. Breastfeeding information given during pregnancy should be varied and, extensive and prepare parents that breastfeeding can be stressful. It is important to involve the partner in information and preparation for breastfeeding.

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  • 40.
    Jonasson Lindegren, Carolina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Karlsson, Sara
    Dalarna University, School of Health and Social Studies, Caring Science.
    Internet- den nya barnmorskan?: En enkätstudie om hur gravida kvinnor söker information om graviditet och förlossning via Internet2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Internet is used globally in many areas and current research shows that pregnant women use the Internet to search for information about pregnancy and childbirth.  A pregnancy holds many questions and women seek information to get a sense of security and assurance that everything is “normal” with their health and the baby.

    Purpose: To investigate pregnant women´s use of the Internet to receive information about pregnancy and childbirth.

    Method: Descriptive cross-sectional study. Data was collected through a survey and were analyzed using descriptive and comparative approach.

    Results: Almost all women used the Internet for information about pregnancy and childbirth. Pregnant women seek information about child-development, diet/nutrition and gestational age to a great extent. Highly educated women have different criteria for credibility on websites than women with less education.

    Conclusion: Midwifes should be conscious to pregnant women`s usage of Internet and self-create an perception about the information the pregnant women read on the Internet. Our study shows that the midwives recommendation about websites on Internet has great significance to the pregnant women.

     

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  • 41.
    Karlsson, Annica
    Dalarna University, School of Health and Social Studies, Caring Science.
    Sjuksköterskors upplevelse av läkemedelshantering till äldre i kommunal hälso– och sjukvård: En kvalitativ studie2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att beskriva hur sjuksköterskor inom den kommunala hälso – och sjukvården upplevde läkemedelshantering till äldre. Metod: Studien hade en kvalitativ design och data samlades in med enskilda intervjuer av fem sjuksköterskor och analyserades med hjälp av innehållsanalys enligt Graneheim och Lundman. Resultat: Dataanalysen resulterade i fyra teman med underliggande kategorier. De teman som framkom var: Sjuksköterskan har en betydelsefull roll, att ha insikt och kompetens om äldres läkemedelsanvändning, att anpassa behandlingen till patientens förutsättning och att ha en fungerande verksamhet.  Resultatet visade att det fanns en ökad medvetenhet kring läkemedelsbehandling till äldre men det behövdes mer utbildning inom området. Att ha en fungerande verksamhet ansågs viktigt och det var betydelsefullt att ha ett bra samarbete med andra. Det upplevdes positivt med läkemedelsgenomgångar och i resultatet framkom att sjuksköterskorna tog ett stort ansvar för kvaliteten, var uppmärksamma och följde upp läkemedelsbehandlingar. Att anpassa läkemedelsbehandlingen till patientens förutsättningar ansågs viktigt för att undvika läkemedelsrelaterade problem. Det framgick av resultatet att läkarkontinuitet underlättade arbetet för sjuksköterskorna och höjde kvaliteten på äldres läkemedelsanvändning. Det fanns ett önskemål om en geriatriker inom verksamheten då en del sjuksköterskor upplevde att allmänläkarna saknade kunskap om läkemedelsbehandling till äldre.  Slutsats: Sjuksköterskan har en viktig roll och tar ett stort ansvar för läkemedelbehandlings kvalitet. Att anpassa läkemedelsbehandlingen till patientens förutsättningar är viktigt för att undvika läkemedelsrelaterade problem. Det finns ett behov av ökad kompetens inom området bland alla yrkesgrupper. Det är angeläget med ökad bemanning och god läkarkontinuitet i verksamheten för att höja kvaliteten på läkemedelsbehandlingen.

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  • 42.
    Kilde, Therése
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Kling, Madeleine
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Förutsättningar för att ge god och säker omvårdnad vid sekundärtransport av kritiskt sjuka patienter.: - En kvalitativ studie ur anestesisjuksköterskans perspektiv2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The area of responsibility of nurse anesthetist include transporting critically ill

    patients to another hospital for care, inter-hospital transports, which is perceived as a difficult

    task. Research suggests that inter-hospital transport of critically ill patients can be risky and

    cause patient injury. Aim: To describe prerequisites to provide good and safe nursing for

    inter-hospital transports of critically ill patients from the nurse anesthetist perspective.

    Method: A descriptive exploratory design with qualitative focus group interviews and an

    inductive approach was used. Nineteen nurse anesthetist at a Regional Swedish hospital were

    interviewed in three focus groups. The interviews were transcribed and analyzed by content

    analysis. Codes close to the data, which briefly describes the content, were identified and

    later grouped in subcategories and categories. Results: The analysis revealed three

    categories that were considered to meet the needs at inter- hospital transports. The informants

    requested training, teamwork and structure to give them good pre-conditions to safely

    transport critically ill patients. Conclusion: By examining how the anesthesia nurses viewed

    the prerequisites to provide good and safe nursing for inter-hospital transports of critically ill

    patients knowledge was revealed, which in an extension can provide a basis for procedures

    including checklist, team training, continuous training and skills development through

    practical exercises to assure the quality of care for inter-hospital transports.

    Keywords:

  • 43.
    Kilde, Therése
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Kling, Madeleine
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Förutsättningar för att ge god och säker omvårdnad vid sekundärtransport av kritiskt sjuka patienter: En kvalitativ studie ur anestesisjuksköterskans perspektiv2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The area of responsibility of nurse anesthetist include transporting critically ill patients to another hospital for care, inter-hospital transports, which is perceived as a difficult task. Research suggests that inter-hospital transport of critically ill patients can be risky and cause patient injury. Aim: To describe prerequisites to provide good and safe nursing for inter-hospital transports of critically ill patients from the nurse anesthetist perspective. Method: A descriptive exploratory design with qualitative focus group interviews and an inductive approach was used. Nineteen nurse anesthetist at a Regional Swedish hospital were interviewed in three focus groups. The interviews were transcribed and analyzed by content analysis. Codes close to the data, which briefly describes the content, were identified and later grouped in subcategories and categories. Results: The analysis revealed three categories that were considered to meet the needs at inter- hospital transports. The informants requested training, teamwork and structure to give them good pre-conditions to safely transport critically ill patients. Conclusion: By examining how the anesthesia nurses viewed the prerequisites to provide good and safe nursing for inter-hospital transports of critically ill patients knowledge was revealed, which in an extension can provide a basis for procedures including checklist, team training, continuous training and skills development through practical exercises to assure the quality of care for inter-hospital transports.

  • 44.
    Koistinen, Susanne
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oral health, experiences of oral care, associated factors, and mortality among older people in short-term care2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objective: The overall aim of this thesis was to describe oral health and oral health-related quality of life (OHRQoL), to compare self-perceived oral health with professional assessment, and to examine associated factors of importance for oral health, experiences, and mortality among older people in short-term care. Paper I describes oral health, daily oral care, and related factors among older people in short-term care and compares the older people’s self-perceived oral health with professional assessment of oral health. Paper II describes OHRQoL among older people in short- term care, and identifies associated factors. Paper III investigates the association between poor oral health, swallowing dysfunction, and mortality in older people. Paper IV describes how older people in short-term care experience their oral health and daily oral care.

    Methods: The thesis is part of a Swedish research study: Swallowing Function, Oral Health, and Food Intake in Old Age (SOFIA). In total, 391 older people from 36 short-term care units from 19 Swedish municipalities in 5 regions were included. Papers I–II are based on descriptive cross-sectional studies, Paper III is a prospective cohort study, and Paper IV is a descriptive qualitative study. Oral health was assessed professionally by clinical oral assessment (Papers I– II) and the Revised Oral Assessment Guide (ROAG) (Papers I–III). The older people’s perceived oral and general health was measured via self-reported questions (Papers I–II). Self- care ability was assessed with the Katz Index of Activities of Daily Living (Katz-ADL) (Papers I–III), OHRQoL was measured using the Oral Health Impact Profile (OHIP-14) (Paper II), and swallowing function was assessed with the Timed Water Swallow Test (TWST) (Paper III). Qualitative data were collected through fourteen individual interviews using a semi-structured interview guide (Paper IV). Data were analysed with descriptive statistics, Cohen-s kappa coefficient, logistic regression models, survival analysis, and inductive content analysis.

    Results: Papers I–III: The median age of the 391 participants was 84 years, and 209 (53%) were women; 167 (43%) had at least 20 remaining teeth and 74 (19%) were completely edentulous. A need for dental treatment was identified among 148 (41%) of the older people. A total of 74 (19%) participants received some or entire help with oral self-care, and 190 (54%) had less good to poor oral hygiene (Papers I–II). Oral problems according to ROAG were identified in 297 (77%) participants, with the most frequent problems being related to teeth and dentures (Papers I–III). There was a low level of agreement between the clinical assessment based on ROAG and the older people’s self-perceived oral health (Paper I). Poor OHRQoL was reported by 125 (34%) and associated factors were swallowing problems according to ROAG; quite poor/ poor self-perceived physical, psychological, and oral health; and being a woman (Paper II). Poor oral health and swallowing dysfunction were both independently associated with 1-year mortality, and in combination they predicted the highest mortality rate (Paper III). The older people’s experiences of oral health and daily oral care could be expressed as one main category: Adapting to a changed oral condition while striving to retain independence (Paper IV).

    Conclusion: Oral problems were identified among most older people in short-term care, although the participants claimed that they were satisfied with their oral health. There was an association between OHRQoL and self-perceived health and oral problems. Poor oral health and swallowing dysfunction were risk factors for 1-year mortality. These results show the importance of both asking older persons about how they perceive their oral health and making systematic assessment of oral health status and swallowing function. The ability to perform daily oral care and need for assistance with oral care should be included in the individual care planning. A close collaboration among different health professionals is important to support older people’s oral health and quality of life.

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  • 45.
    Koistinen, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences. Örebro universitet.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Ståhlnacke, Katri
    Folktandvårdens Folkhälsoenhet, Region Örebro län.
    Anna, Fält
    Klinisk epidemiologi och biostatistik, Institutionen för medicinska vetenskaper, Örebro universitet.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oral health and oral care in short-term care: prevalence, related factors, and coherence between older peoples and professionals assessments2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 3, p. 712-722Article in journal (Refereed)
    Abstract [en]

    Background: Oral health is important for well-being and overall health. Older peoples oral health is well described in the residential care context, but remains understudied in short-term care.

    Objective: The aim of this study was to describe oral health, daily oral care and related factors among older people in short-term care and to compare self-perceived oral health with professional assessment.

    Materials and methods: This cross-sectional study included 391 older people in 36 short-term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self-perceived oral health. Self-care ability was assessed with Katz Index of Activities of Daily Living (Katz-ADL).

    Results: Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self-care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self-perceived oral health.

    Conclusion: Professionals’ assessments of oral health differed considerably from the older peoples own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self-care (ADL). This study indicates that in order to improve older peoples oral health and oral care we need to provide person-centred oral care and to develop a close collaboration between nursing and dental staff.

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    Koistinen et al 2019
  • 46.
    Koistinen, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ståhlnacke, Katri
    Fält, Anna
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Munhälsa hos äldre personer inom korttidsvård bedömd ur två perspektiv, självupplevd och professionell2018Conference paper (Refereed)
  • 47.
    Koistinen, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ståhlnacke, Katri
    Fält, Anna
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Munhälsa hos äldre personer inom korttidsvård, bedömd ur två perspektiv, självupplevd och professionell2018Conference paper (Refereed)
  • 48.
    Koistinen, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ståhlnacke, Katri
    Fält, Anna
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Munhälsorelaterad livskvalitet hos äldre personer inom korttidsvård2018Conference paper (Refereed)
  • 49.
    Koistinen, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ståhlnacke, Katri
    Fält, Anna
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oral health among elderly people assessed from two perspectives: self-perceived and professional2018Conference paper (Refereed)
  • 50.
    Koistinen, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Care Sciences.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ståhlnacke, Katri
    Fält, Anna
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oral health and related quality of life among older people in short-term care2019Conference paper (Refereed)
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